OB Exam 1 Review

What behaviors might the nurse expect to see in a 3-year-old child whose parents have been recently divorced? acting out in a negative way because of their loss of status of being "in charge" clinginess, bedwetting, and thumb sucking acting "angelic" and acting "good" to get the parents to come together Fighting with siblings, tantrums, and imagining that he or she caused the breakup

clinginess, bedwetting, and thumb sucking

A couple had decided not to circumcise their newborn for nonreligious reasons. What is the appropriate response from the nurse? "What arrangements have you made outside the hospital?" "It's much better for the health of your newborn if you circumcise him." "That's very unusual; tell me what has led you to this decision." "OK, great. I will let the physician know."

"OK, great. I will let the physician know."

After teaching a group of students about the concept of maternal mortality, the instructor determines that additional teaching is needed when a student makes which statement? "The time frame is typically for a specified year." "The rate includes accidental causes for deaths." "The duration of the pregnancy is a concern." "It addresses pregnancy-related causes."

"The rate includes accidental causes for deaths." The maternal mortality ratio is the annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births, for a specified year.

The nurse is caring for several families enrolled in Medicaid in the prenatal setting. 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." "In my culture, we have family help us care for the baby in our home for several months." "We just moved here from another state and I am still getting used to the new town." "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."

When a pregnant client explains to the nurse that strawberries cause birthmarks, what is the nurse's best response? "You should eat at least 3 to 5 servings of fruit a day. Strawberries are a great way to get a serving in." "Strawberries are high in folic acid and are great food for you and your baby." "Wow, that's very interesting. Where did you learn that?" "That is ridiculous. Strawberries do not cause birthmarks."

"Wow, that's very interesting. Where did you learn that?"

A nurse is conducting a monthly chart audit in the newborn nursery. Which finding could indicate an ethical consideration of practice? Overall 2% decrease in length of stay 200% increase in IV cath attempts Change in bottle feeding protocol 7% increase in the number of clients

200% increase in IV cath attempts

Which is not true regarding culture and the perception of pain? A nurse's personal values and beliefs may influence how he or she responds to a person in pain. The perception of pain can differ between cultures. The meaning of pain can differ between cultures. Although many cultures communicate their pain differently, most people physically express pain in a universal manner.

Although many cultures communicate their pain differently, most people physically express pain in a universal manner.

A group of nursing students are comparing the various changes in maternity care over the course of history and discover that the development of what medical treatment was most influential in moving birth from the home into the hospital setting? Anesthesia and analgesic therapy Planned cesarean birth Instruments to assist in birth of infants Infection control and germ theory

Anesthesia and analgesic therapy Movement from the home to the hospital for the birth of infants began with the use of medications to control pain during labor. This trend started with the wealthy and followed to include more of society. Cesarean births are a more recent development than the advent of anesthesia. Infection control could be maintained at home, so it was not a driving force. The use of instruments developed along with cesarean technology.

A nurse is providing care to a group of childbearing families from a different culture at the local family health clinic. Which action should the nurse prioritize? Assess personal feelings about that culture. Determine similarities between both cultures. Ask the family to explain their culture. Adapt to the practices of the family's culture.

Assess personal feelings about that culture.

Today, families come in a variety of structures. Which statement best describes a blended family? All the adult relatives living in the household participate in raising the children and grandchildren. Both adults are custodial parents and bring their children to the family structure. Custodial parents live together and raise one parent's children as one family. The parents choose to legally take into their family structure a child who is not a biological child to either parent.

Both adults are custodial parents and bring their children to the family structure.

A nurse is working with a culturally diverse patient population. Which strategy would the nurse most likely use to assist in recognizing cultural influences on pain perception? Select all that apply. Develop an awareness of personal values and beliefs. Recognize that communication of pain may not even be acceptable within a culture. Appreciate that the meaning of pain varies among cultures. Assume that everyone who is in pain will behave like they are in pain. Remember that if someone is in enough pain, he or she will inform others. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. Appreciate that not all people communicate or express their level of pain in the same way.

Develop an awareness of personal values and beliefs. Recognize that communication of pain may not even be acceptable within a culture. Appreciate that the meaning of pain varies among cultures. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. Appreciate that not all people communicate or express their level of pain in the same way.

A nurse is providing cardiopulmonary resuscitation (CPR) to an infant with chronic health problems when the mother of the child tells the nurse to discontinue CPR. Which is the most appropriate action by the nurse? Continue CPR until help arrives. Stop and call 911. Discontinue all resuscitation efforts. Continue chest compression only.

Discontinue all resuscitation efforts.

The nurse is providing tertiary care to a young, uninsured family who has a child with frequent seizures. Which action by the nurse would demonstrate tertiary care? Educating the parents regarding appropriate play activities for the child Finding a company to provide a helmet for the child to wear daily. Performing a well-child checkup, noting weight gain Nutritional guidance for healthy meals for the family.

Finding a company to provide a helmet for the child to wear daily.

A 4-year-old adopted child has begun to ask questions about when she was born. Which suggestions by the clinic nurse would be considered the most appropriate answer for this child related to her birth? Select all that apply. Tell the child that her biological mom could not care for her after birth because she was HIV positive. Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Explain that her biological mom could not care for her so she was given away. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. Inform the child that her biological mom was in prison and would not be able to care for her for a long time.

Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them.

Cost containment in the health care field has become a sought-after necessity because of rising costs and the influence of managed care. Nurses are instrumental in assisting with cost containment of health care by prioritizing which strategy? Alternative birth systems Health promotion Client teaching Quality improvement

Health promotion

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of his condition and care. Which is the most effective way of advocating for this child and family? Teaching the parents how to perform chest physiotherapy Locating the best price on a high-frequency chest compression vest Helping parents access the area's multidisciplinary cystic fibrosis clinic Assisting the parents in getting the child on a lung transplant list

Helping parents access the area's multidisciplinary cystic fibrosis clinic Accessing the cystic fibrosis clinic where specialists collaborate with the child and family to provide information, direct care, and services empowers the family with tools to meet their needs. Chest physiotherapy will be a known skill since it is nearly certain the child has been diagnosed with this genetic disease for a number of years. Lung transplant may be a future treatment option but is probably not under present consideration. Helping save money on a treatment device is considerate but not the most effective advocacy method.

The nursing instructor is discussing the infant mortality rate with a group of students. The instructor determines the discussion is successful when the students correctly choose which action as a priority to help decrease infant mortality in the United States? Improving accessibility to postnatal health care for infants Mothering classes for all primiparous mothers Improving maternal nutrition during pregnancy Spending more money on health care for infants and mothers

Improving accessibility to postnatal health care for infants

A community health nurse is preparing to teach childbirth classes at the local high school. This nurse is actively involved in which type of community health care? Secondary prevention Primary prevention Couplet care Tertiary prevention

Primary prevention Primary prevention involves teaching and promotes health and prevention of injury. Childbirth classes are primary prevention. Secondary prevention focuses on health-screening activities that aid in early diagnosis and encourage prompt treatment before long-term negative effects. Tertiary prevention includes health-promoting activities that focus on rehabilitation and providing information to prevent further injury or illness. Couplet care is allowing the newborn and mother to stay in the same room after delivery.

Which policy recommendation would be more politically correct and culturally sensitive for health care organizations to adopt in terms of caring for lesbian, gay, bisexual, transgender, queer (LGBTQ) clients? Include the term LGBTQ whenever the strategic plan discusses the population served. Rewrite policies incorporating the LGBTQ population as new language into existing policies. Incorporate LGBTQ partners into visitation rights if the couple is legally married. List the LGBTQ partner on official birth certificates if the couple has been legally wed.

Rewrite policies incorporating the LGBTQ population as new language into existing policies.

Which intervention best demonstrates the L & D nurse is respectful of a client who is deaf and in early labor? Write down information on a piece of paper that the client can keep. Seek assistance from another health care professional who can converse in sign language. Utilize hand signals like in charades to try to communicate important pieces of information. Utilize the labor coach so he or she can interpret and relay information to the client.

Seek assistance from another health care professional who can converse in sign language.

A nurse is reviewing information about how an increase in family mobility affects the overall health status of the family. The nurse demonstrates an understanding of the information by identifying which aspect as playing a role? Migrant workers know they will always be able to find services. Immunization services are available at every publicly funded health center. Families have consistent access to health care services. Services can be inconsistent across local and regional areas.

Services can be inconsistent across local and regional areas.

The nurse is caring for a 5-year-old girl with meningitis. What action by the nurse may be considered ethical behavior? Starting intravenous fluids even though the child protests Referring to the child as "her" when she is present Telling her an intramuscular injection won't hurt Scheduling a laboratory procedure at lunchtime

Starting intravenous fluids even though the child protests Ignoring the child's dissent regarding proposed therapy is ethically sound. The treatment will benefit the child, and at 5 years of age the decision maker is nearly always the parent or legal guardian. However, the nurse must use developmentally appropriate techniques to inform the child about the therapy and to carry it out. Telling her an intramuscular injection won't hurt lacks veracity. Referring to the girl as "her" when she is present shows disrespect. Scheduling a laboratory procedure at lunchtime is unfair to the child and lacks justice.

A gay couple asks their health care provider about how they can begin a family. Which method(s) will be discussed to accomplish their goal of a family? Select all that apply. The couple can find a female surrogate and then donate sperm to allow for artificial insemination. One or both partners can donate sperm to a surrogate gestational carrier. Both partners can donate sperm and take the sperm to a fertility clinic for insemination. The nurse can give the couple a list of area adoption agencies that might be helpful to use to grow their family. The couple can buy an "egg" and mix it with their sperm and then take it to a fertility clinic for preservation until a surrogate can be chosen.

The couple can find a female surrogate and then donate sperm to allow for artificial insemination. One or both partners can donate sperm to a surrogate gestational carrier. The nurse can give the couple a list of area adoption agencies that might be helpful to use to grow their family.

The nurse is scheduled to work in a clinic in a neighborhood with many diverse cultures. Which action(s) by the nurse demonstrate cultural competence? Select all that apply.

The nurse asks the child or family about the use of folk remedies. The nurse learns about the demographic of the neighborhood. The nurse researches folk healers in the area

A gay couple is considering adopting a newborn and they want to know the long-term outcomes for children in gay families. What is the best response by the nurse? Their social relationships are usually more strained. There is lack of evidence on how this will impact the children. This type of adoption is not recommended for a newborn. Their psychological health is similar to children of heterosexual parents.

Their psychological health is similar to children of heterosexual parents.

The nurse is assessing a family and identifies that the members of this family include a man, a woman, and the woman's child from a previous relationship. Which family type(s) does this description match? Select all that apply. extended communal nuclear dyad blended

blended

As part of the nurse's prenatal checklist when working with an expectant mother, the nurse mentions the potentially harmful effects of the mother drinking alcohol during pregnancy. Both the mother-to-be and her spouse look offended and say, "We are Sikhs! Alcohol is prohibited in our religion." The nurse responds, "I apologize—I am afraid I do not know much about your religion, although I would like to learn more. Are there any resources you could refer me to?" Which behavior is the nurse exhibiting? ethnocentrism prejudice cultural humility cultural awareness

cultural humility

A nurse is reviewing a journal article that describes a view of the world and a set of traditions that a specific social group uses and transmits to the next generation. The nurse is reading an article about which concept? ethnicity ancestry group cultural values culture

culture

A Native American who has just delivered her first child asks the nurse if she might have the placenta to take home. The nurse tells a co-worker that she thought it was the most bizarre request she has ever heard. This is an example of which type of behavior by the nurse? ethnocentrism assimilation discrimination acculturation

ethnocentrism Ethnocentrism is the belief that one's own culture is superior to all others. Assimilation means that people have adopted the values of the dominant culture. Acculturation refers to the loss of ethnic traditions when a person gives up his or her native country's traditions for another's. Discrimination is the act of treating people differently based on their physical or cultural traits.

A nurse is reviewing statistics about maternal and child health. Which rate would the nurse identify as reflecting the proportion of women who could have babies that are having them? implantation rate fertility rate morbidity rate birth rate

fertility rate

A client is recovering from a hysterectomy, and the nurse is teaching postoperative measures for care after being discharged from the hospital. What measure is the nurse performing? health maintenance health restoration health rehabilitation health promotion

health rehabilitation

A family that regularly takes in foster children is visiting the junior high school nurse to inform the staff that there will be a new 8th grade foster child beginning school the following week. The school nurse should monitor this new student for which psychosocial response to being moved to the foster care system? aggressive behavior as the child acts out feelings high level of insecurity refusal to complete required immunizations eating disorders like anorexia nervosa

high level of insecurity

A nurse working in a busy urban family clinic has noted a high percentage of single mothers. What should the nurses in this clinic be prepared to offer these single mothers? contraceptive advice to prevent future pregnancies support when a problem related to childrearing occurs financial planning for college accounts for each child organizational and time management skills

support when a problem related to childrearing occurs

A nurse needs to ensure an informed consent has been obtained to provide care to a young client. Which aspect would be the most important for the nurse to consider related to the informed consent? knowing the laws in the state where care is being provided determining if the child is emancipated establishing if the parents are competent contacting the parents prior to giving emergency care

knowing the laws in the state where care is being provided

The nurse is caring for a young pregnant couple who are members of an extended family. The nurse anticipates the greatest challenge for this family will involve which factor? a child developing a chronic illness lack of support people in a crisis limited amount of available resources a parent wishing he or she had more education

limited amount of available resources

A nurse writes the following on a child's electronic medical record: "The child will state the signs and symptoms that indicate an exacerbation of asthma." The nurse is involved in which component of the nursing process? assessment evaluation outcome identification implementation

outcome identification