Maternity and Peds
What term is used to represent the number of deaths in the first 28 days of life? a) Infant death rate b) Neonatal death rate c) Couplet death rate d) Fetal death rate
b) Neonatal death rate Explanation: The neonatal death rate is the number of deaths of an infant in the first 28 days of life.
When communicating with a client who speaks a different language, the best practice for the nurse is to: a) Arrange for an interpreter when communicating with the client. b) Speak loudly and slowly. c) Stand close to the client and talk loudly. d) Speak with a family member about the client's condition.
a) Arrange for an interpreter when communicating with the client. Explanation: The nurse should arrange for an interpreter when communicating with a client who speaks another language. Speaking loudly or talking with a member of the client's family does not ensure that the client will receive the information he or she needs.
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? a) Assist in the treatment and recovery of a woman with ovarian cancer b) Discuss methods of alleviating morning sickness with a patient in her first trimester c) Read a recent journal article on breastfeeding and its benefits for new mothers d) Provide preconceptual health care to a patient
a) Assist in the treatment and recovery of a woman with ovarian cancer Explanation: The primary goal of both maternal and child health nursing can be stated simply as the promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing. Assisting in the treatment and recovery of a woman with ovarian cancer is the least likely function of a nurse specializing in this type of nursing. Preconceptual care, care of a woman during her first trimester, and reading journal articles regarding breastfeeding are all within the scope of practice of maternal and child health nursing.
What two major developments greatly influenced the way maternity care is practiced in the United States? a) Development of anesthesia and acceptance of the germ theory b) Advent of birthing centers and the development of maternity care c) Technologic advances and the use of forceps by physicians d) Development of pediatrics as a specialty and replacement of midwives as the primary attendants at births
a) Development of anesthesia and acceptance of the germ theory Explanation: The development of anesthesia allowed women a choice for pain management in childbirth; the germ theory advanced the progress of general health care and decreased infections in laboring women. Pediatrics did not replace midwives, maternity care continues to evolve, and birthing centers are still under development. Forceps are not considered an advance in maternity care.
Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because: a) Increasing numbers of children live with chronic disabilities due to advances in healthcare that allow children with formerly fatal diseases to survive. b) There are fewer positions for nurses in institutions providing acute care. c) More disabilities are occurring in children because many women are delaying pregnancy and giving birth to babies later in life. d) Uninsured families can access these services. e) Disability and chronic illness have increased with the appearance of more genetic abnormalities.
a) Increasing numbers of children live with chronic disabilities due to advances in healthcare that allow children with formerly fatal diseases to survive. Explanation: Advances in healthcare leading to more children living with chronic illness or disability is true. The statements about genetic disease and older women may contain some truth but account for few numbers added to the chronic illness total. Acute care pediatric nursing positions are decreasing in community hospitals but are more available in medical centers. Uninsured families may or may not be able to access nonhospital care.
A program designed to decrease the infant mortality rate in the United States would probably make the greatest impact if it focused on which of the following? a) Increasing the number of women receiving prenatal care b) Changing genetic traits c) Increasing the education level of parents d) Reducing the number of home births
a) Increasing the number of women receiving prenatal care Explanation: Attending prenatal care has proven to be a major strategy for reducing infant mortality.
The nurse seeking aid for an impoverished family knows that Medicaid is a form of health insurance for low-income and disabled individuals. a) True b) False
a) True Explanation: Established in 1965 as Title XIX of the Social Security Act, Medicaid is a federal entitlement program (an open-ended program serving all eligible individuals entitled to the service, with no budgetary cap)
A nurse is caring for a woman who has just given birth to a child with Down syndrome. The nurse is focussing on how to help this patient adapt to the changes associated with becoming a mother of a child with special needs. Which nursing theory would be most helpful to this nurse? a) Patricia Benner's theory b) Calistra Roy's theory c) Dorthea Orem's theory d) 2020 National Health Goals
b) Calistra Roy's theory Explanation: Nursing theories are designed to offer helpful ways to view clients so nursing activities can be created to best meet client needs—for example, Calistra Roy's theory stresses an important role of the nurse is to help patients adapt to change caused by illness or other stressors; Dorthea Orem's theory concentrates on examining patients' ability to perform self-care; Patricia Benner's theory describes the way nurses move from novice to expert as they become more experienced and prepared to give interprofessional care (Roy, 2011, Orem & Taylor, 2011, Benner, 2011). The 2020 National Health Goals are not a nursing theory but are goals intended to help citizens more easily understand the importance of health promotion and disease prevention and to encourage wide participation in improving health in the next decade.
The neonatal death rate is defined as which of the following? a) Death in the first year of life b) Death in the first 28 days of life c) Death in utero in the last 28 days of pregnancy d) Death in the first 6 months of life
b) Death in the first 28 days of life Explanation: The neonatal death rate is the number of deaths of an infant in the first 28 days of life.
The primary focus of health care education by nurses to clients is: a) Rehabilitation to pre-disease state b) Health promotion c) Acute disease treatment d) Disease prevention
b) Health promotion Explanation: The current movement in health care is to focus on health promotion and thereby prevent future illness and diseases. Prevention, treatment, and rehabilitation are all processes of care. In health care today, the treatments are based on prevention in order to save time, money, and improve the quality of life.
Which of the following best describes the pattern of maternal mortality since World War II? a) After decreasing until the 1960s, it has increased steadily. b) It has steadily decreased. c) It has remained constant. d) It has steadily increased
b) It has steadily decreased. Explanation: Improved prenatal care and early ambulation following childbirth are factors that have decreased death in childbirth.
Mary Ann said that she learned in her Family Living course that more African-American infants than white infants die before they are 1 year old. In response to her questions about the reasons for this, the nurse accurately answers that the major reason for the high infant mortality rate is: a) Being unmarried b) Lack of prenatal care c) Income d) Having formal education
b) Lack of prenatal care Explanation: A black woman is 3.5 times more likely to have complications or die during childbirth, a maternal mortality rate directly related to lack of prenatal care secondary to lack of access to services or insurance. Income as well as educational level may play a role in the availability of health care, but they are not directly responsible. Being unmarried has no bearing on infant mortality.
A new mother is nervous about sudden infant death syndrome (SIDS) and asks the nurse how to prevent it when the newborn is ready to sleep. The nurse tells the mother to: a) Lay the newborn on her stomach, with her face turned. b) Lay the newborn on her back, rather than on her stomach. c) Let the newborn sleep in the same bed as the parents. d) Lay the newborn on her side.
b) Lay the newborn on her back, rather than on her stomach. Explanation: The newborn or infant should be placed on her back to sleep. Sleeping on the stomach (prone) may limit the newborn's ability to move her head, which increases the chance of suffocation.
A nurse has just assisted in the delivery of a premature neonate. She recognizes that which of the following factors, when associated with prematurity, is a leading cause of death in neonates? a) Famine b) Low birth weight c) Maternal hemorrhage d) Low proportion of young adult men
b) Low birth weight Explanation: The leading causes of death during the neonatal period are prematurity with associated low birth weight or congenital malformations. Famine and a low proportion of young adult men are associated with low fertility rates, and maternal hemorrhage is associated with high maternal mortality rates.
An older couple approaches the nurse's station seeking information about their hospitalized grandchild. What should be the nurse's response? a) Ask to see identification from the two individuals. b) Tell the couple to seek information directly from the child's parents. c) Answer the grandparents' questions in a less public place. d) Assume "busy-looking" behaviors and move away.
b) Tell the couple to seek information directly from the child's parents. Explanation: To protect the child's privacy, information can be shared only with legal guardians, parents, or those identified in writing. "Looking busy" only temporarily avoids confronting the privacy rights.
A single18-year-old woman in her second trimester presents at the clinic with vaginal bleeding. She confides to the nurse in confidence that she has been using cocaine to "calm her nerves" and hopes it didn't harm her baby. What would be the nurse's best response to this situation? a) Explain the effects of cocaine on the fetus and tell the mother that she must quit for her baby's sake. b) Consult with the healthcare facility's institutional ethics committee for an appropriate response. c) Refer the mother to a drug and alcohol rehabilitation program and follow up with her recovery. d) Tell the doctor about the mother's drug use and ask him to intervene in the situation.
b)Consult with the healthcare facility's institutional ethics committee for an appropriate response. Explanation: Ethical issues of fetal well-being and treatments arise with debate about the appropriate balance between the maternal and fetal interests. Issues related to problematic behaviors generally revolve around use of illicit drugs and alcohol and their harmful effect on the fetus. These cases are very difficult to resolve successfully, whether the course of action is inside or outside the legal system and may require consultation with the IEC.
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? a) Regionalizing intensive care b) Meeting the work needs of pregnant and breastfeeding women c) Increasing use of alternative treatment modalities d) Initiating cost containment
c) Increasing use of alternative treatment modalities Explanation: There is a growing tendency for families to use alternative forms of therapy, such as acupuncture or therapeutic touch, in addition to or instead of traditional health care measures. Nurses have an increasing obligation to be aware of complementary or alternative therapies such as these as they have the potential to either enhance or detract from the effectiveness of traditional therapy. The other answers do not pertain to the arrangement the patient has made to have her massage therapist present at her labor.
To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? a) Provide guidance regarding proper nutrition. b) Help integrate exercise practices and programs into the lifestyles of individuals and communities. c) Teach injury prevention and proper safety practices. d) Advocate for more research into control of environmental toxins.
c) Teach injury prevention and proper safety practices. Explanation: The leading cause of death throughout childhood is unintentional injury
When describing childbirth during the 18th century, which of the following would the nurse include? a) Books on childbirth education became readily available. b) Streptococci were identified as the major cause of puerperal fever. c) The majority of births occurred in the home with female midwives. d) Heavy doses of narcotics were used during labor.
c) The majority of births occurred in the home with female midwives. Explanation:During the 18th century (1700s), female midwives attended the majority of all births and these births occurred in the home setting. Louis Pasteur demonstrated that streptococci were the major cause of puerperal fever during the 19th century (1800s). The use of twilight sleep, in which heavy doses of narcotics were used during labor, occurred during the early 20th century (1900s). Books on childbirth education became readily available during the 20th century (1900s).
You are discussing health care provider options with a patient. She indicates she felt her doctor was too busy for her during her last pregnancy and wants to know what her options are for receiving care during her pregnancy and for labor and delivery. Which of the following is the best option? a) Women's health nurse practitioner b) Lay midwife c) Clinical nurse specialist d) Certified nurse midwife
d) Certified nurse midwife Explanation: A certified nurse midwife is a nurse with advanced practice training in the care of women, specific to pregnancy and delivery. A women's health NP would not be able to deliver the infant. A CNS is not able to be a health care provider, and the lay midwife is not an option for health care.
What makes the area of family nursing a difficult arena to provide care at times? a) Nurses having different values from families b) Family-centered care plans and use of community areas in acute care settings c) The presence of family in the hospital rooms d) Family members who might not agree on treatments and a plan of care
d) Family members who might not agree on treatments and a plan of care Explanation: The family may not agree of the plan of care or treatment plans with each other or for their children. This is a difficult situation as the children do not have their rights to make their own decisions and the family needs to agree.
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? a) Home deliveries b) Early pre-natal care c) Low adolescent delivery rates d) Low birth weight
d) Low birth weight Explanation:Many factors may be associated with high infant mortality rates and poor health. Low birth weight and late or nonexistent prenatal care are main factors in the poor rankings in infant mortality.
The physician most likely to provide care to a pregnant woman during her prenatal period and her labor/delivery is what type of physician? a) Neonatologist b) Perinatologist c) Family practitioner d) Obstetrician
d) Obstetrician The obstetrician is the physician of choice for prenatal care through labor and delivery. Perinatologists may care for women who are high-risk pregnancy, and neonatologists provide care to infants. Family practitioner physicians may provide care but are less likely to attend in labor and delivery.
After hearing of a lawsuit being filed by a patient against another nurse, a nurse becomes concerned about her own potential liability in working with premature infants at high risk for morbidity and mortality. Which of the following actions is most essential for the nurse to take to protect herself in the event of litigation? a) Having the parents of each infant she works with sign a liability waiver form b) Staying up to date on the research in her field c) Having an attending physician confirm each intervention she makes before she makes it d) Carefully documenting every intervention she makes with a patient
d)Carefully documenting every intervention she makes with a patient Explanation: Documentation is essential for justifying actions and for providing evidence of proper care in the event of a lawsuit. Although staying current in the research of one's field is advisable, it does not protect a nurse in the event of a lawsuit. Having parents sign waiver forms and having a physician confirm the nurse's every decision are not feasible.
