Changing Maternal-Child Health Care Enviroment
A nurse is working in a community designated as having low fertility rates. Which would be an appropriate first-level investigation by the nurse? immunization records local dietary habits male to female ratio incidence of disease
local dietary habits Explanation: Fertility rates are effected by poor nutrition, which can make conceiving difficult. The nurse should assess the local dietary habits of the community to understand if there is a lack of nutritional resources available to the community.
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 maternal nutrition during pregnancy -Spending more money on health care for infants and mothers -Improving accessibility to postnatal health care for infants -Mothering classes for all primiparous mothers
-Improving accessibility to postnatal health care for infants Explanation: Infant deaths are due to many factors, including congenital malformations, deformations, and chromosomal abnormalities; disorders related to short gestation and low birth weight; and newborns affected by maternal complications of pregnancy. The mother's nutritional status would affect a limited number of infants. Making postnatal health care available and affordable would have the greatest impact on improving infant health and reducing the number of infant deaths. Spending more money on health care has proven to not improve infant survival rates postnatally. Although providing for mothering classes and improving maternal nutrition would be a good idea, these measures will not positively impact infant survival rates.
Which actions should the nurse perform when supporting the goals of maternal and child health care? Select all that apply. -Advocates protecting the rights of the mother and fetus -Teaches family members interventions to improve health -Adheres to principles that focus on the needs of the mother -Encourages maternal hospitalization to regain strength and stamina -Assesses family members for strengths and specific needs or challenges
Advocates protecting the rights of the mother and fetus Teaches family members interventions to improve health Assesses family members for strengths and specific needs or challenges Explanation: Actions that the nurse should perform when supporting the goals of maternal and child health care include advocating the rights for the mother and fetus, teaching health promotion interventions, and assessing the family for strengths and specific needs or challenges. Adhering to principles that focus on the needs of the mother and encouraging maternal hospitalization to regain strength and stamina are not actions that support the goals of maternal and child health care.
A nurse compares the average length of stay of postpartum women of today with the past and notes the stay is shorter. Which factor has most influenced this trend of shorter hospital stays? -A shift toward a wellness focus in health care -More cooperative efforts between caregivers and families -Access to quality community follow-up care -Efforts to contain health care costs
Efforts to contain health care costs Explanation: Providing comprehensive prenatal care can help reduce potential problems, which helps reduce the high cost of specialized care in situations which can be avoided. There has been a factor of wellness focus within the health care system but that is not the main factor in this case.
A nurse is trying to reduce a mother's anxiety about her child being in the hospital. What would be the best way to accomplish this? -Tell the mother about the tests being performed. -Let the mother know you will relay any messages she has for the doctor. -Include the mother in the medical decision-making. -Address all the mother's concerns promptly.
Include the mother in the medical decision-making Explanation: The family-centered care approach is a researched-based philosophy that promotes family coping with a child needing medical attention. The nurse should collaborate with the family to address the family's needs, as well as the medical care of the child. Including the mother in the medical decision-making is an example of how to accomplish this.
A nurse is trying to reduce a mother's anxiety about her child being in the hospital. What would be the best way to accomplish this? -Tell the mother about the tests being performed. -Let the mother know you will relay any messages she has for the doctor. -Include the mother in the medical decision-making. -Address all the mother's concerns promptly.
Include the mother in the medical decision-making. Explanation: The family-centered care approach is a researched-based philosophy that promotes family coping with a child needing medical attention. The nurse should collaborate with the family to address the family's needs, as well as the medical care of the child. Including the mother in the medical decision-making is an example of how to accomplish this.
For which reasons would a nurse review infant mortality statistics in the United States? Select all that apply. -Measures the quality of pregnancy care -Reviews information on overall nutrition -Compares health with those of other states -Determines infant health and available care -Provides an index of the country's general health
Measures the quality of pregnancy care Reviews information on overall nutrition Determines infant health and available care Provides an index of the country's general health Explanation: Infant mortality statistics provide an index of a country's general health, measures the quality of pregnancy care, provides information on overall nutrition, and determines infant health and available care. Infant mortality statistics compares the health with those of other countries and not with those of other states.
Which statement correctly defines the term "perinatal death rate"? -Number of deaths in utero of a fetus 500 g or more per 1000 live births -Number of deaths per 1000 live births occurring in the first 28 days of life -Number of deaths per 1000 live births occurring at birth or in the first 12 months of life -Number of deaths per 1000 live births beginning when the fetus reaches 500 g and ending 28 days after birth
Number of deaths per 1000 live births beginning when the fetus reaches 500 g and ending 28 days after birth Explanation: The term "perinatal" refers to the time of birth and that closely following it or the time "around birth."
The maternal child health nurse is providing care to the following clients. Which client would the nurse assess as being in the health restoration phase? -A 29-year-old G1P1L1 is assessed for ongoing complications from eclampsia, one week postpartum. Blood pressure is 128/92 mm Hg, heart rate 78 bpm, respiratory rate 22 breaths/min, temperature 98.8° F (37° C). Client states no headaches, no vision changes, and no seizure activity. -Several 14- to 18-year-old females are present in health education class at the local high school. Nurse provided teaching related to safer sex practices, teen pregnancy, and sexually transmitted infections. -Nurse is providing home visiting to 26-year-old G2P1L1; nurse is assessing for need for additional safeguards in the home. Client will be moving in the next few weeks and is unsure on how to add additional childproofing. devices to the home. -A 32-year-old G1P1L1 is recovering from recent bilateral mastectomy. Client reports diagnosis was upgraded to stage 4.
A 29-year-old G1P1L1 is assessed for ongoing complications from eclampsia, one week postpartum. Blood pressure is 128/92 mm Hg, heart rate 78 bpm, respiratory rate 22 breaths/min, temperature 98.8° F (37° C). Client states no headaches, no vision changes, and no seizure activity. Explanation: The client who is 1 week postpartum recovering from eclampsia is working to return to a state of wellness and therefore is the individual who is in the restoration phase of health
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? White Asian Black Hispanic Indian
Black Explanation: Racial disparity in the United States occurs predominately among black women with regard to mortality rate and pregnancy complications. While there may be racial disparity with access to health care for other ethnic groups, the maternal morality rate is higher among black women
During an initial assessment, a mother reports several problems she has been having coming to the local clinic. Which reported problem should the nurse give highest priority to in assisting this client? -Language barrier -Health care workers' attitudes -Transportation to the clinic -Family finances
Family finances Explanation: Financial barriers are one of the most important factors that limit care, with a substantial number of children and families either not having any insurance, not having enough insurance to cover services obtained, or not being able to pay for services. Language, health care workers' attitudes, and transportation are also barriers to health care but are not as fundamentally important as finances.
The nurse notes that statistics on maternal mortality had improved but are again becoming elevated. What does the nurse realize as a reason for this change in maternal mortality rates? Earlier prenatal care Gestational hypertension Increased vaginal deliveries Treatment for chronic diseases
Gestational hypertension Explanation: This increasing rate in maternal mortality is associated with more cesarean births, more gestational hypertension related to preexisting hypertensive disorders, and lack of health insurance for many Americans. This increase is not because of earlier prenatal care, increased vaginal deliveries, or treatment for chronic diseases.
For which reasons would a nurse review infant mortality statistics in the United States? Select all that apply. Measures the quality of pregnancy care Reviews information on overall nutrition Compares health with those of other states Determines infant health and available care Provides an index of the country's general health
Measures the quality of pregnancy care Reviews information on overall nutrition Determines infant health and available care Provides an index of the country's general health Explanation: Infant mortality statistics provide an index of a country's general health, measures the quality of pregnancy care, provides information on overall nutrition, and determines infant health and available care. Infant mortality statistics compares the health with those of other countries and not with those of other states.
A client with a history of type 1 diabetes mellitus is questioning the nurse concerning the best option for the health care provider to assist with her pregnancy and delivery of her newborn. The nurse determines the client needs additional information to make a wise decision when she suggests seeking the care of which specialist? Obstetrician Certified Nurse Midwife Neonatologist Perinatologist
Neonatologist Explanation: An obstetrician, certified nurse midwife, or perinatologist may be involved in the pregnancy and delivery of a newborn. The neonatologist may be present at the time of birth; however, the neonatologist's focus is to provide specialized care to at-risk newborns
The nurse has been hired to provide care to patients on a maternal and child unit. What will the nurse use as a guide to legally provide care to this patient population? Code of ethics Nursing research Standards of practice Evidence-based guidelines
Standards of practice Explanation: Understanding standards of care can help nurses practice within appropriate legal parameters. The Code of Ethics will help with ethical situations. Nursing research and evidence-based guidelines will help with providing care that is based upon best practices.
Asian American women have the lowest risk of infant mortality of all cultural groups. Which statement best explains this phenomena? -Asian American women have fewer incidences of hypertension. -Asian American women have better access to prenatal care. -Asian American women rarely have preterm infants born to them. -Asian American women have the lowest incidence of chromosomal anomalies of any cultural group.
Asian American women have better access to prenatal care. Explanation: African, Hispanic, and Native Americans have the highest risk of infant mortality because more than 40% of these populations do not receive any prenatal care. Asian American women are not less likely to have preterm infants, have fewer chromosomal anomalies or develop hypertension during pregnancy.
Which of the 2020 National Health Goals should a maternal child health nurse working in a developed nation focus on for the betterment of clients? Select all that apply. reduction of child mortality improvement of primary education increase in foreign aid dependency environmental sustainability gender equality
Goals that focus on disease, poverty, and gender equality impact the health of women and children in all countries. A nurse working in a developed country will encounter individuals from various socioeconomic, ethnic, and cultural backgrounds. Therefore, it is important to understand how to help in meeting these goals of reducing child mortality, improving primary or elementary education, increasing environmental sustainability, and promoting gender equality and empowering women.
The nurse works at the local public health office. Which is a major but often overlooked problem in this setting? fetal mortality infant mortality neonatal mortality maternal mortality
fetal mortality Explanation: Fetal mortality is a major, but often overlooked, public health problem. This refers to the spontaneous intrauterine death at any time during pregnancy, commonly referred to as a miscarriage. The fetal mortality rate in the United States is 6.2 per 1,000 live births. The impact of fetal mortality on families is considerable and provides a picture of the quality of maternal health and prenatal care.
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 Explanation: Knowing the laws in the state where care is being given is the most important consideration because laws vary from state to state. Emancipation is a legal consideration that is viewed differently by laws of different states. Establishment of parental competency is a legal consideration that may be judged differently by laws of different states. Contacting the parents prior to giving emergency care is a legal consideration that may be judged differently by laws of different states.
The nurse is planning an educational session for community members to address the issue of school-age child mortality. Which topic should the nurse identify as the highest priority for this population? Cancer Assault Suicide Accidents
Accidents Explanation: For the school-age child between the ages of 5 and 14 years, the number one cause of mortality is from unintentional injuries or accidents. Other top five causes for child mortality include cancer, assault, and suicide.
The nursing instructor is explaining the utilization of regionalized or centralized care to a group of maternal infant students. Which example should the instructor point out best demonstrates regionalized or centralized care? All deliveries occur at one central facility. An at-risk mother is sent to a specialized facility to deliver. Mothers deliver in the communities in which they live. Sick infants are sent to a facility close to the clients home to receive care.
An at-risk mother is sent to a specialized facility to deliver. Explanation: Regionalized or centralized care was designed to prevent duplication of services in communities. To accomplish this goal, a regional or central facility may be created that contains the most highly specialized care in one central location even though it may not be the closest facility to the client's home. Regionalized or centralized care may require that a sick infant go to a facility that is actually farther away from the community in order to receive specialized care.
The nursing instructor is explaining the utilization of regionalized or centralized care to a group of maternal infant students. Which example should the instructor point out best demonstrates regionalized or centralized care? -All deliveries occur at one central facility. -An at-risk mother is sent to a specialized facility to deliver. -Mothers deliver in the communities in which they live. -Sick infants are sent to a facility close to the clients home to receive care.
An at-risk mother is sent to a specialized facility to deliver. Explanation: Regionalized or centralized care was designed to prevent duplication of services in communities. To accomplish this goal, a regional or central facility may be created that contains the most highly specialized care in one central location even though it may not be the closest facility to the client's home. Regionalized or centralized care may require that a sick infant go to a facility that is actually farther away from the community in order to receive specialized care.
During an initial assessment, a mother reports several problems she has been having coming to the local clinic. Which reported problem should the nurse give highest priority to in assisting this client? Language barrier Health care workers' attitudes Transportation to the clinic Family finances
Family finances Explanation: Financial barriers are one of the most important factors that limit care, with a substantial number of children and families either not having any insurance, not having enough insurance to cover services obtained, or not being able to pay for services. Language, health care workers' attitudes, and transportation are also barriers to health care but are not as fundamentally important as finances.
The nursing instructor is teaching a class about the use of critical pathways by the health care team. The instructor determines the class is successful when the students correctly choose which goal as the primary focus for utilizing a critical pathway? -It decreases cost for the client and hospital. -It helps to establish a trusting relationship with clients. -It is followed by all members of the health team. -It is requested by insurance companies.
It decreases cost for the client and hospital. Explanation: Specific cost-containment strategies that nurses have been instrumental in implementing include health promotion, case management, and critical care paths. The result helps establish trusting relationships with clients and provides guidelines for all members of the health care team to follow, keeping the goal of providing care for the client firmly in mind. Insurance companies are not a consideration for following critical pathways
The nursing instructor is teaching a class about the use of critical pathways by the health care team. The instructor determines the class is successful when the students correctly choose which goal as the primary focus for utilizing a critical pathway? -It decreases cost for the client and hospital. -It helps to establish a trusting relationship with clients. -It is followed by all members of the health team. -It is requested by insurance companies.
It decreases cost for the client and hospital. Explanation: Specific cost-containment strategies that nurses have been instrumental in implementing include health promotion, case management, and critical care paths. The result helps establish trusting relationships with clients and provides guidelines for all members of the health care team to follow, keeping the goal of providing care for the client firmly in mind. Insurance companies are not a consideration for following critical pathways.
A nurse is explaining to a young couple the advantages of seeking maternal and child health care in an ambulatory setting versus the emergency department in nonemergent situations. Which goal should the nurse emphasize the most? -Minimize the separation of children from their parents. -Decrease the number of hospital visits. -Increase the number of urgent care clinics. -Encourage treatment of illness in a calmer setting.
Minimize the separation of children from their parents. Explanation: Separation from parents can be traumatic for young children; ambulatory settings minimize this to some degree. Ambulatory care increases responsibility for parents, has no real bearing on the number of needed hospitals (since they treat different types of clients) and the calm environment does not play a role in change in emphasis. Decreasing the number of hospital visits or increasing the number of urgent care centers could possibly result from more emphasis on ambulatory care; however, the main focus would be reducing the trauma a young child may experience receiving medical care.
A nurse is explaining to a young couple the advantages of seeking maternal and child health care in an ambulatory setting versus the emergency department in nonemergent situations. Which goal should the nurse emphasize the most? -Minimize the separation of children from their parents. -Decrease the number of hospital visits. -Increase the number of urgent care clinics. -Encourage treatment of illness in a calmer setting.
Minimize the separation of children from their parents. Explanation: Separation from parents can be traumatic for young children; ambulatory settings minimize this to some degree. Ambulatory care increases responsibility for parents, has no real bearing on the number of needed hospitals (since they treat different types of clients) and the calm environment does not play a role in change in emphasis. Decreasing the number of hospital visits or increasing the number of urgent care centers could possibly result from more emphasis on ambulatory care; however, the main focus would be reducing the trauma a young child may experience receiving medical care.
A new mother asks the nurse if all of the new baby's injections can be given in one visit because the mother is losing income from missing work because of the office visits. What does this new mother's issue indicate to the nurse? -The mother needs to find an alternative employer. -The mother's income is more important that the baby's health. -Missing work does not support the baby's health maintenance visits. -The federal government needs to do more to support well-baby visits.
Missing work does not support the baby's health maintenance visits. Explanation: An area that needs additional research is finding effective stimuli to encourage women to bring children for health maintenance visits. The mother losing income because of missing work for well-baby visits will deter health maintenance visits for the baby going forward. This mother's issue does not indicate that the mother needs to find another job, that the mother's income is more important that the baby's health, or that the federal government needs to do more to support well-baby visits.
Which statement correctly defines the term "perinatal death rate"? -Number of deaths in utero of a fetus 500 g or more per 1000 live births -Number of deaths per 1000 live births occurring in the first 28 days of life -Number of deaths per 1000 live births occurring at birth or in the first 12 months of life -Number of deaths per 1000 live births beginning when the fetus reaches 500 g and ending 28 days after birth
Number of deaths per 1000 live births beginning when the fetus reaches 500 g and ending 28 days after birth Explanation: The term "perinatal" refers to the time of birth and that closely following it or the time "around birth."
