ob chapter 1 prep u

A new single mother is sharing her concerns about the cost of daycare with her nurse. She is new to the area. The nurse recognizes that which trend is contributing to this client's concerns? Select all that apply.

-Fewer extended family members to help care for a child• -Ninety percent of women working outside the home• -The increase in the number of single parent families• -The increased tendency for families to move from one part of the country to another

A nurse is providing care to several clients. Which client would the nurse identify as being unable to provide consent for health care? 14-year-old male 17-year-old married female 20-year-old male 24-year-old pregnant female

14-year-old male Explanation: Generally, only people over the age of majority (18 years of age) can legally provide consent for health care, except in the case of an emancipated minor (a person who is no longer subject to parental control, e.g., one who marries).

A nurse is working in an ambulatory health care clinic located in a poor neighborhood. Which nursing intervention would provide the greatest benefit for the women and their children seen at this clinic? Educating the parents about preventive care Cautioning the parents about home safety issues Screening for diabetes and malnutrition Promoting healthy sleep and rest habits

Cautioning the parents about home safety issues Explanation: Preventative care is consistent with a health promotion approach that aims to prevent illnesses and health disorders before they develop. Home safety is one example of health promotion and preventative care but there are many others. Screening for disease and promoting sleep are likely to be beneficial, but a general focus on preventative care is likely to have the greatest benefit.

Which statement best describes the pattern of maternal mortality since World War II? After decreasing until the 1960s, it has increased steadily. It has steadily increased. It has steadily decreased. It has remained constant.

It has steadily decreased. Explanation: Improved prenatal care and early ambulation after birth are factors that have decreased maternal death rates following birth over the past 70 years.

A nurse has just started working at a clinic that has a large refugee client population. When providing care to this population group, which aspect would be most important for the nurse to recognize? ethnic background cultural differences language lack of understanding of American ways

cultural differences Explanation: Although an understanding of the groups ethinicity, language, and understanding of American ways may be helpful, it is important for nurses to recognize the various cultural differences among the clients. It is important for nurses to recognize the various cultural differences among the clients. It is important to recognize these traditions and practices as a point of congruence rather than a potential source of conflict. With today's changing demographic patterns, nurses must be able to assimilate cultural knowledge into their interventions so they can care for culturally diverse women, children, and families. Nurses must be aware of the wide range of cultural traditions, values, and ethics. Cultural competence is the ability to apply knowledge about a client's culture so that the health care provided can be adapted to meet his or her needs.

The nursing faculty is teaching students about maternal mortality and morbidity rates for African American women, noting that they are often three to four times higher than for white women. This fact can most accurately be contributed to which reason?

lack of access to adequate prenatal care The maternal mortality and morbidity rates for African American women have been three to four times higher than for non-Hispanic white women. Researchers do not entirely understand what accounts for this disparity but recognize that there are a number of factors that increase the incidence such as lack of prenatal care, obesity, and hypertension during pregnancyChapter 1: Perspectives on Maternal, Newborn, and Women's Health Care: p. 11.

The nurse is updating the records of a woman who recently gave birth to a healthy 7-lb (3,175-g) newborn. Which action could jeopardize the privacy of the woman's medical records? You Selected:

letting another nurse use the nurse's login session It is important to log off whenever leaving the computer. The person who shares the nurse's login session may get called away from the computer, leaving the nurse responsible for any breach in security. Keeping IDs and passwords confidential is basic computer security. Page 32

A nurse is conducting research in preparation for developing programs to improve maternal and newborn health. The nurse is reviewing statistics revealing the number of infant deaths occurring in the first 28 days of life. The nurse is researching which rate?

neonatal mortality rate Explanation: The neonatal mortality rate is the number of infant deaths occurring in the first 28 days of life per 1,000 live births. Fetal mortality rate refers to the spontaneous intrauterine death of a fetus at any time during pregnancy per 1000 live births. Infant mortality rate is the number of deaths occurring in the first 12 months of life. The perinatal mortality rate is the total of the fetal and neonatal mortality rates.

A group of students are reviewing the historical aspects of birth. The students demonstrate understanding of the information when they identify the use of twilight sleep as a key event during which time frame?

1900s Twilight sleep, or the use of a heavy dose of narcotics and amnesiacs, was used on women during birth in the United States during the 1900s. Female midwives attended the majority of births during the 1700s. Care shifted to doctors among middle-class women during the 1800s. Certified nurse midwives and birth classes characterize the 2000s.

After teaching a group of students about pregnancy-related mortality, the nurse determines that additional teaching is needed when the students identify which condition as a leading cause? Unsafe abortion Intra-amniotic infection Anesthesia complications Postpartum hemorrhage

Anesthesia complications Explanation: Most pregnancy-related related to the physiologic changes associated with pregnancy. The leading causes of pregnancy-related mortality are hemorrhage, infection, preeclampsia-eclampsia, obstructed labor, and unsafe abortion. Anesthesia complications is not a leading cause.

A nurse who specializes in maternal and child health care performs many varied functions in diverse settings over the course of a year. Which action would be outside the nurse's scope of practice? Read a recent journal article on breastfeeding and its benefits for new mothers. Provide preconceptual health care to a client. Discuss methods of alleviating morning sickness with a client in her first trimester. Assist in the treatment and recovery of a woman with ovarian cancer.

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.

A nurse is preparing a breast cancer presentation for a health forum. Which fact would the nurse expect to address in this presentation? Breast cancer is more advanced in Black women when found. Black women have the BRCA1 and BRCA2 gene. More Hispanic women smoke, which increases their risk. White women respond better to breast cancer treatment.

Breast cancer is more advanced in Black women when found. Explanation: White women get breast cancer at a higher rate than Black women; however, Black women are more likely to die becuase they get breast cancer before 40 years of age, cancer is more advanced when found, and survival at every cancer stage is worse among Black women. Black women are not at greater risk due to the BRCA1 or BRCA2 genes that cause breast cancer. There is no evidence that Hispanic women smoke more, placing them at risk. White women do not respond better to cancer treatment.

When describing birth during the 18th century, which description would be most accurate regarding maternal care during pregnancy and birth? You Selected: The majority of births occurred in the home with female midwives in attendance.

During the 18th century (1700s), female midwives attended the majority of 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 also became readily available during the 20th century.

A new single mother is sharing her concerns about the cost of daycare with her nurse. She is new to the area. The nurse recognizes that which trend is contributing to this client's concerns? Select all that apply. You Selected: the increase in the number of single parent families fewer extended family members to help care for a child the increased tendency for families to move from one part of the country to another ninety percent of women working outside the home

In this client's case, moving to a new a new area, lack of extended family members to help care for the child, having to work outside the home, and being a single parent all contribute to her concern over the cost of child care. Increased use of the Internet to monitor health or ask health questions would not contribute to her concern. There is no evidence that child or partner violence is occurring in this case.

A nurse is conducting an assessment of a pregnant woman on a routine follow-up prenatal visit. Assessment findings suggest that the client may have a substance use disorder. Which action by the nurse would be most appropriate to ensure proper care of the client and the unborn fetus?

Initiate a referral to available community services. Explanation: Nurses should employ a flexible approach to the care of women who have substance use disorders, and they should encourage the use of all available community resources. Women should be counseled about the risks of preconception, antepartum, and postpartum substance use in a calm, nonjudgmental manner by nurses (AWHONN, 2015). Pregnant women who have a substance use disorder should be afforded access to preventive, supportive, and recovery services that meet their special needs. The nurse can be instrumental in facilitation referral to community programs for both pregnant and postpartum women that can help ensure their full recovery and better lives for them and their children.Many state laws require evidence of prenatal drug exposure to be reported, which may lead to charges of negligence and child endangerment against the pregnant woman. It has been found that incarceration or threat of it has no effect in reducing cases of alcohol or drug use disorders. Laws that criminalize drug use during pregnancy usually deter women from seeking prenatal care that can provide them access to appropriate counseling, referral, and monitoring (AWHONN, 2015). This punitive approach to fetal injury raises ethical and legal questions about the degree of government control that is appropriate in the interests of child safety.

A nurse is conducting a class about breast cancer for a group of young adult women. Which statements by the class indicates to the nurse that the teaching was successful? Select all that apply. "My risk is increased if I had an irregular menstrual cycle starting at an early age." "Being underweight is a major risk factor for developing breast cancer." "Using condoms and spermicides increase a woman's risk for breast cancer." "A diet high in fat can be a risk factor for developing breast cancer." "If someone in the family has breast cancer, my risk would be increased."

My risk is increased if I had an irregular menstrual cycle starting at an early age." "A diet high in fat can be a risk factor for developing breast cancer." "If someone in the family has breast cancer, my risk would be increased." A positive family history of breast cancer, aging, and irregularities in the menstrual cycle at an early age are major risk factors. Other risk factors include excess weight, not having children, oral contraceptive use, excessive alcohol consumption, a high-fat diet, and long-term use of hormone replacement therapy. page 15

The nursing instructor is introducing students to Healthy People 2020, which highlights the major health indicators of the 21st century that need to be addressed. The nurse informs the students that this includes national health goals for maternal, infant, and child health. Which goals would be included? Select all that apply

Reduce fetal and infant death rates.Reduce maternal deaths.Increase infant birth weights.Reduce preterm births. Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care: p. 11.

The nursing instructor is introducing students to Healthy People 2020, which highlights the major health indicators of the 21st century that need to be addressed. The nurse informs the students that this includes national health goals for maternal, infant, and child health. Which goals would be included? Select all that apply. You Selected: Increase infant birth weights. Reduce fetal and infant death rates. Reduce preterm births. Reduce maternal deaths.

The National Health Goals identified by Healthy People 2020 for maternal, infant, and child health are numerous. Some of these include reducing the fetal and infant deaths, reducing low birth weights, reducing maternal deaths, reducing preterm labor, and decreasing the number of cesareans.

When assessing the postpartum client 2 hours after giving birth, which finding indicates the need for further action?

The fundus is firm and deviated sharply to the right side of the abdomen. Explanation: In the immediate postpartum period, the fundus is regularly assessed. The fundus must be firm. A boggy fundus indicates uterine atony and will result in blood loss. The fundus is to be midline in the abdomen. A deviation to the side may indicate a full bladder. In the immediate hours after birth, the fundus may be found at one fingerbreadth above or below the umbilicus.

When assessing the postpartum client 2 hours after giving birth, which finding indicates the need for further action? The fundus is firm and located at the level of the umbilicus. The fundus is firm and located one fingerbreadth below the level of the umbilicus. The fundus is firm and deviated sharply to the right side of the abdomen. The fundus is firm and located 1 fingerbreadth above the level of the umbilicus.

The fundus is firm and deviated sharply to the right side of the abdomen. Explanation: In the immediate postpartum period, the fundus is regularly assessed. The fundus must be firm. A boggy fundus indicates uterine atony and will result in blood loss. The fundus is to be midline in the abdomen. A deviation to the side may indicate a full bladder. In the immediate hours after birth, the fundus may be found at one fingerbreadth above or below the umbilicus. Reference:

The nursing faculty is teaching students about maternal mortality and morbidity rates for black women in the United States, noting that they are often three to four times higher than for white women. This fact can most accurately be contributed to which reason? You Selected: lack of access to adequate prenatal care

The maternal mortality and morbidity rates for black women in the United States have been three to four times higher than for non-Hispanic white women. Researchers do not entirely understand what accounts for this disparity but recognize that there are a number of factors that increase the incidence such as lack of prenatal care, obesity, and hypertension during pregnancy.

A nurse is conducting an in-service program for a group of maternal-neonatal nurses about factors affecting maternal and newborn health. As part of the presentation the nurse describes how the family has changed over the years. The nurse determines that the teaching was successful when the group identifies which family structure as having been considered the traditional structure? You Selected: nuclear

The way that families are defined has changed. In years past, the nuclear family was once considered the traditional family structure. However, now, this structure is less common due to increased divorce rates and child rearing by unmarried persons.

Before World War II women moved from home to hospital births. What was the primary reason for that shift in maternity care? They were convinced that setting would improve birth outcomes. They were convinced that setting would provide them with natural birth. They had no other options as many could not afford midwives. They were convinced that setting would lessen the pain of labor.

They were convinced that setting would improve birth outcomes. Explanation: Prior to World War II, American women moved from home to the hospital for birth in part because they were convinced that setting would improve birth outcomes. Women who labored and gave birth at home were traditionally attended to by relatives and midwives. Many women were attracted to hospitals because this showed affluence and hospitals provided pain management, which was not available in home births.

The nurse is caring for several families enrolled in Medicaid in the prenatal settinng. Which statement by an expectant mother would alert the nurse to assess the family further? "My sister-in-law is due to have her baby the same month as our baby is due." "We just moved here from another state and I am still getting used to the new town." "In my culture, we have family help us care for the baby in our home for several months." "I plan to give birth in a hospital setting with my family at my side."

We just moved here from another state and I am still getting used to the new town." Explanation: Medicaid is a financial assistance program for low income families and varies from state to state in terms of elgibility and application process. When a family has moved from one state to another, there may be delays in getting Medicaid established in the new state. Hospital births are typically covered by Medicaid. Family helping with the newborn is a benefit, and would not affect Medicaid resources. The mother's sister-in-law giving birth in the same month would not be a situation the nurse would need to assess further, especially regarding Medicaid resources.

The nurse is organizing health information to teach a client basic principles that will help maintain wellness in the family. Which actions should the nurse prioritize in this teaching? encouraging yearly checkups for all clients. teaching insulin injection techniques medication administration assisting in understanding a treatment

encouraging yearly checkups for all clients. Explanation: The current movement in health care is to focus on health promotion and thereby prevent future illness and diseases. Encouraging yearly checkups would assist with finding problems before they become serious. Prevention, treatment, and rehabilitation are all processes of care. Teaching a client how to give injections, administer medication, or understand a treatment would occur after a specific health issue but not prevent these issues from occurring.

A nurse is reviewing the statistical outcomes related to fetal deaths nationwide and notes that the numbers have changed over the last several decades. The best explanation would be: increases are noted because of the growing number of pregnancies to teen mothers. increases are noted due the increasing number of older mothers becoming pregnant. expectant mothers are seeking prenatal care later, resulting in decreases in the number. improved prenatal care has reduced the numbers of fetal deaths.

improved prenatal care has reduced the numbers of fetal deaths. Explanation: The number of fetal deaths in the United States has fallen. This has been attributed to the improvement in the delivery of prenatal care.

The nurse working in a free health clinic is providing care to a 1-year-old girl and her single teenage mother. Which action would be most important initially? discussing family health history assessing the child's cognitive level obtaining food stamps for the family observing the mother/child interaction

observing the mother/child interaction Explanation: The nurse's initial interactions with the parent and child can provide valuable insights into maternal-child attachment. This information can be used to inform other aspects of the health assessment. This observation is likely to precede formal assessments, such as cognitive assessment and family health history. At this point, it is not known if food stamps are needed. Assessment is the priority.

The World Health Organization's definition of health was approved in 1948 and included a definition of health as "a state of complete physical, mental, and social well-being." What data was not a part of this definition?

the new understanding of disease at cellular, individual, and societal levels Explanation: The World Health Organization defines health as "a state of complete physical, mental, and social well-being." It is a complex definition, and it is not merely the absence of disease. The other ideas were part of the initial definition—environmental influences and mental health being seen as a state of well-being. The introduction of new cellular, individual, and societal levels of diseases has changed this era of health care