Peds PrepU Chapter 1:The Nurse's Role in a Changing Maternal-Child Health Care Environment

A nurse is speaking with a patient who has just learned that she is pregnant with her first child. The nurse reads in the patient's chart that she does not drink alcohol on a regular basis. However, the nurse decides to go ahead and warn the patient about the dangers of drinking alcohol while pregnant. Which phase of health care would this action be classified as?

Health promotion

Which of the following is a trend in child health care today?

Health promotion rather than health restoration is stressed.

Which of the following is NOT a trend in child health care today?

Health restoration is stressed over health promotion.

A national campaign to improve the health of the people in the United States has as one of its goals to "eliminate health disparities". What is the name of this national campaign?

Healthy People 2020

The student nurse is teaching breastfeeding to a group of clients on the postpartum unit. The student recognizes that this action represents which component of the nursing process?

Implementation

Infants in the U.S. are at highest risk for death statistically in comparison to other modernized countries.Which initiative, if implemented, would have the greatest impact on improving these numbers?

Improved accessibility to postnatal health care for infants

When educating nursing students about the major health concerns in the 21st century, which statement would indicate that the students need further clarification regarding the Healthy People 2020 Report?

"Immunizations may be the cause of some illnesses being seen currently."

A mother of a child being cared for in a home setting makes the following statements. Which statement best illustrates one of the positive aspects of home health care?

"I can do my child's care since you taught the procedure to me."

In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the:

Family

What physician is known as the "Father of Pediatrics"?

Abraham Jacobi

The nursing instructor is explaining the utilization of regionalized care to a group of maternal infant students. The instructor recognizes that which of the following is an example of regionalized care?

An at-risk mother is sent to a specialized facility to deliver.

A terminally ill 15-year-old tells the nurse that she wants to stop all treatments and go home despite her parents' directives to provide extraordinary means to keep their child alive. What is the best resource available to this nurse to help solve this dilemma?

An institutional ethics committee

Which aspect of patient wellness has not been a focus on health during the 21st century ?

Analysis of morbidity and mortality

Asian American women have the lowest risk of infant mortality of all cultural groups. Which statement best explains this phenomena?

Asian American women have better access to prenatal care.

A nurse who specializes in maternal and child health care performs many varied functions in diverse settings over the course of a year. Which of the following would she be least likely to do, as it would be outside her scope of practice?

Assist in the treatment and recovery of a woman with ovarian cancer

A group of nurses are discussing the reasons for the United States' low rankings for infant and maternal mortality (27% and 21% respectively) and what impact they could make on them in their practice. Which action could nurses implement to reduce these rates?

Assuring early and adequate prenatal care

Pediatric nurses are important members of the staff of ambulatory care centers. What is a major factor in treating children in an ambulatory care center?

Avoidance of separating children from their families when providing care.

In an effort to improve the health status of women and their children several national campaigns have been implemented. The campaign that reduced the incidence of Sudden Infant Death (SIDS) by 50% was called what?

Back to Sleep Campaign

A nurse counsels a 14-year-old girl on the risks of teenage birth and on methods of contraception. The nurse recognizes that provision of sex education to adolescents have had a positive influence on which measurememt in the past 10 years in the United States?

Birth rate

The community health nurse is working with a group of clients receiving prenatal care. The nurse recognizes that there is racial disparity in the maternal mortality rate for which of the following racial groups?

Black

What makes the area of maternal-child health nursing a more extensive area for consideration of legal issues than other areas of nursing?

Caring for a fetus, an unseen patient

When integrating the principles of family-centered care into the birthing process, the nurse would base her care upon which belief?

Childbirth results in changes in relationships.

The nurse is providing care to an ill child and his family. Which activity reflects the use of the assessment step of the nursing process when providing care for children?

Collecting data about the child and family

The LVN providing care for Mrs. Jones and her newborn son is in the process of passing out morning medications to Mrs. Jones and her other patients. While in Mrs. Jones's room the nurse makes suggestions on different positions to hold the newborn while breastfeeding. What is the most important part of these nursing interventions?

Documenting the care given

The nurse is reviewing the length of stay of postpartum women on her unit and notes that they generally experience shorter hospital stays than were common for women in the past. Which factor has most influenced this trend of shorter hospital stays?

Efforts to contain healthcare costs.

The United States has one of the highest gross national products in the world and is known for its technological capabilities, but its infant mortality rate among developed nations in 2004 was ranked 29th. Which factor has the greatest impact on decreasing these rates?

Ensuring early and adequate prenatal care

What is the effect of low birth weights in babies born in the United States?

Increased infant mortality rates

An expectant mother has arranged for her massage therapist to provide gentle hand, arm, and neck massage for the patient while she is in labor in the hospital. Which trend in today's health care environment is most related to this arrangement?

Increasing use of alternative treatment modalities

A nurse working in a pediatrician's office has requested that a generic brand of cotton swabs be ordered in place of a more expensive brand name. Which trend in today's health care environment is most related to this nurse's action?

Initiating cost containment

Which statement best describes the pattern of maternal mortality since World War II?

It has steadily decreased.

When describing the State Children's Health Insurance Program (SCHIP) to a group of families, which of the following would the nurse include?

It provides health insurance to children whose families are not eligible for Medicaid but cannot afford to purchase health insurance.

When describing childbirth during the 18th century, which description would be most accurate regarding maternal care during pregnancy and delivery?

The majority of births occurred in the home with female midwives in attendance.

A nurse has just assisted in the delivery of a premature neonate. She recognizes that which factor, when associated with prematurity, is a leading cause of death in neonates?

Low birth weight

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries?

Low birth weight

The nurse is assessing a 9-year-old boy with pneumonia. Which finding is a factor for this child's morbidity?

Medical records reveal a history of asthma

An important change in maternal and child health care that nurses must often explain is the new emphasis on ambulatory care. The goal of this change in emphasis is meant to achieve which outcome?

Minimize the separation of children from their parents

A 33-week gestation infant dies after 1 week of life in the Neonatal Intensive Care Unit. This infant's death rate would be classified under which statistical category?

Neonatal death

The nurse is reviewing a copy of the U.S. Surgeon General's Report, Healthy People. Which nursing action best reflects the nurse fostering this health care agenda?

The nurse volunteers at a local health care clinic providing free vaccinations for low-income populations

The nurse is providing family-centered care for a 6-year-old boy with cancer. Which of the following actions is most likely to be an asset related to the case management process?

Parents may initiate actions to solve problems independently.

When integrating the principles of family-centered care, the nurse would include which concept?

People have taken increased responsibility for their own health.

When integrating the principles of family-centered care, the nurse would NOT include which of the following?

People have taken less responsibility for their own health.

The nursing process is a scientific method and proven form of problem solving. It consists of what component?

Planning

A nurse is doing a literature search on maternal mortality and finds that direct causes comprise the majority of maternal deaths. Direct causes are noted to be unpredictable reasons. What could nurses do to have the greatest impact on reducing these numbers?

Practice high standards of infection control.

A Scottish physician named Alexander Gordon first realized that many women were becoming sick and even dying because of an infection transmitted from patient to patient by the attending physicians and nurses. What is this infection called?

Puerperal fever

The nurse is caring for a 14-year-old boy with a growth hormone deficiency. Which action best reflects using the nursing process to provide quality care to children and their families?

Reviewing the effectiveness of interventions

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?

Teach injury prevention and proper safety practices.

Infant mortality rates are a good index of general health. Which of the following statements is true regarding a comparison of infant mortality rates of the United States to those of 30 countries with the lowest infant mortality rates?

The United States has a higher rate of infant mortality.

A group of students are reviewing information about Medicaid. The students demonstrate a need for additional study when they identify which of the following?

The federal government is responsible for administering it.

You are going to provide an education program to early grade-school children. Which of the following topics would address the number one cause of death for this age group?

The importance of crossing streets safely

In 1965 Medicaid, a federally funded program, was initiated. It supplied block grants to states to provide health care to those who have low income and who meet other state-determined eligibility criteria. What federal mandate was Medicaid created under?

Title XIX of the Social Security Act

The nurse is educating a group of parents about child safety practices in a health promotion class. The nurse chooses to focus on this topic because the leading cause of death in children is:

Unintentional injuries.

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because:

increasing numbers of children live with chronic disabilities due to advances in healthcare that allow children with formerly fatal diseases to survive.

The nursing instructor is discussing maternal mortality with a group of students. Included within the discussion would be that the leading causes of maternal mortality rate in the United States are related to: (Select all that apply.)

• Hemorrhage • Embolism • Pregnancy-related hypertension

A nursing group is examining their hospital's maternal outcomes for the previous 5 years. Which identified factors have contributed to the decline in the maternal mortality rate? Select all that apply.

• Use of ultrasound to detect disorders • Closer monitoring for complications associated with hypertension of pregnancy • Better management of hemorrhage and infection • Increased participation of women in prenatal care