Chapter 1: Perspectives on Maternal and Child Health Care PREP U
A 15-year-old client has just given birth and states that she does not want her infant to receive any newborn vaccines. What is the appropriate action for the nurse to take? Withhold the vaccines. Call the primary care provider. Administer the newborn vaccines. Ask the grandparents for permission.
Withhold the vaccines.
What aspects of care play an essential role in the health of a woman and fetus during pregnancy? Select all that apply. A. financial support B. emotional support C. prenatal care D. maternal nutrition E. high level of income
A. financial support B. emotional support C. prenatal care D. maternal nutrition
The nurse is reviewing the medical records of several infants. Which infant is at highest risk for death according to the infant mortality rate in the United States? An infant born to adolescent parents An infant born at a low birth weight An infant born at 38 weeks' gestation An infant born to a 43-year-old mother
An infant born at a low birth weight
A young mother with an ill child tells the visiting nurse that she belongs to the Christian Scientist religious group and will not seek medical attention for the child. Which statement best reflects the mother's religion's beliefs about health? A. Illness is an opportunity to develop the soul with no treatment sought. B. Healing will come through prayer and spiritual regeneration only. C. Illness comes from violating dietary restrictions, and no treatment will be sought. D. Fasting will establish health back to normal.
B. Healing will come through prayer and spiritual regeneration only.
A nursing instructor is teaching a session investigating infant mortality as a standard measurement of the quality of health care in the country. The instructor determines the session is successful when the students correctly choose which factors as contributing to the high numbers of deaths in the United States? Select all that apply. A. Male gender of infant B. Maternal complications C. Preterm births D. Congenital deformities and chromosomal abnormalities E. Maternal age 30 to 34 years
B. Maternal complications C. Preterm births D. Congenital deformities and chromosomal abnormalities
The nurse is presenting to a shelter for women and children who experienced intimate partner violence and is asked by a participant, "What does the No Child Left Behind Act mean?" How should the nurse best respond? A. "It has led to increased research and treatment of major health issues concerning children." B. "Nutritional supplementation and education to low-income families and pregnant women will be provided." C. "It is a federal program that will ensure all children in classrooms receive up-to-date, research-based curriculum." D. "This act provides increased funding for newborn screening grants and neonatal education."
C. "It is a federal program that will ensure all children in classrooms receive up-to-date, research-based curriculum."
To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? A. Help integrate exercise practices and programs into the lifestyles of individuals and communities. B. Provide guidance regarding proper nutrition. 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.
A healthy client without a primary care provider is exploring the options available for a health care provider to assist with her pregnancy. Which health care provider can the nurse point out as a best option? Certified nurse midwife Clinical nurse specialist (CNS) Women's health nurse practitioner (NP) Lay midwife
Certified nurse midwife
A nurse is determining whether or not informed consent has been obtained from the family of a child who is going to have abdominal surgery. Which statement by the family would lead the nurse to suspect that informed consent is lacking? A. "Although there are risks involved, our son needs the surgery to cure the problem." B. "We are amazed that he'll be up and walking around the day after surgery." C. "He might miss some school afterwards, but he'll be feeling much better." D. "We had to sign the form right away so the surgery could get scheduled."
D. "We had to sign the form right away so the surgery could get scheduled."
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? A. "I plan to give birth in a hospital setting with my family at my side." B. "My sister-in-law is due to have her baby the same month as our baby is due." C. "In my culture, we have family help us care for the baby in our home for several months." D. "We just moved here from another state and I am still getting used to the new town."
D. "We just moved here from another state and I am still getting used to the new town."
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: A. increases are noted because of the growing number of pregnancies to teen mothers. B. expectant mothers are seeking prenatal care later, resulting in decreases in the number. C. increases are noted due the increasing number of older mothers becoming pregnant. D. improved prenatal care has reduced the numbers of fetal deaths.
D. improved prenatal care has reduced the numbers of fetal deaths.
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? Transportation to the clinic Language barrier Health care workers' attitudes Family finances
Family finances
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 Quality improvement Client teaching
Health promotion
A nursing student is preparing a presentation illustrating the Human Genome Project. Which function will the student point out as being the primary focus? Detection of genetic mutations in children Genetic testing in adults Treatment of gene mutations Identification of human genes and functions
Identification of human genes and functions
The nurse is updating the records of a 10-year-old girl who had her appendix removed. Which action could jeopardize the privacy of the child's medical records? Letting another nurse use the nurse's log-in session. Changing identification and passwords monthly. Printing out confidential information for transmittal. Closing files before stepping away from computer.
Letting another nurse use the nurse's log-in session.
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? Home deliveries Early prenatal care Low adolescent delivery rates Low birth weight
Low birth weight
An infant at 33 weeks' gestation 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 preterm gestational death postneonatal death infant death under one month
Neonatal death
A nurse is caring for a child. Which individual would the nurse identify as being primarily responsible for initiating and coordinating health care? case manager social worker community parents
Parents
The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group? Exercise and good nutrition Prevention of infection and communicable disease The importance of crossing streets safely The importance of immunizations
The importance of crossing streets safely
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. health care facility. government. community.
family.
A nursing student is preparing a presentation illustrating the Human Genome Project. Which function will the student point out as being the primary focus? Detection of genetic mutations in children Identification of human genes and functions Treatment of gene mutations Genetic testing in adults
identification of human genes and functions
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? obtaining food stamps for the family assessing the child's cognitive level discussing family health history observing the mother/child interaction
observing the mother/child interaction
What nursing intervention by the maternity nurse is the most important in providing family-centered care? promoting uninterrupted infant bonding allowing siblings in the delivery room providing early discharge allowing doulas to attend the woman in labor
promoting uninterrupted infant bonding
The line at the well-child walk-in clinic is long, with closing time near. Which child does the nurse assess based on knowledge of morbidity data? the foreign-born adopted child the infant at the 25th percentile on the growth chart the teen needing a sports assessment the toddler with a "poor appetite"
the foreign-born adopted child
The nurse is providing care to a woman who has just given birth to a healthy term neonate. The woman's partner arrives and asks about the neonate's status. Which action by the nurse would be appropriate? A. Ask the partner for identification first before sharing any information. B. Tell the partner that no information can be shared with him or her at this time. C. Answer the partner's questions honestly and without hesitation. D. Check the medical record for written client approval with whom to share information.
D. Check the medical record for written client approval with whom to share information.
A nurse is reviewing a labor plan with a client who has been admitted to the labor and birth unit. The client states that she has been drinking a significant amount of herbal teas lately to help with uterine contractions. Which is the priority action by the nurse? Prepare the client for a fetal nonstress test. Ask the client when she last ate or drank anything. Determine the type of herbal teas recently consumed. Ask about other complementary and alternative therapies.
Determine the type of herbal teas recently consumed.
A 15-year-old client has just given birth and states that she does not want her infant to receive any newborn vaccines. What is the appropriate action for the nurse to take? Call the primary care provider. Withhold the vaccines. Administer the newborn vaccines. Ask the grandparents for permission.
Withhold the vaccines
The nurse is providing care to a woman who has just given birth to a healthy term neonate. The woman's partner arrives and asks about the neonate's status. Which action by the nurse would be appropriate? A. Answer the partner's questions honestly and without hesitation. B. Ask the partner for identification first before sharing any information. C. Tell the partner that no information can be shared with him or her at this time. D. Check the medical record for written client approval with whom to share information.
D. Check the medical record for written client approval with whom to share information.
A nurse is speaking with a client who has just learned that she is pregnant with her first child. The nurse reads in the client's chart that she does not drink alcohol on a regular basis. However, the nurse decides to go ahead and warn the client about the dangers of drinking alcohol while pregnant. Which phase of health care would this action be classified as? health maintenance health rehabilitation health restoration health promotion
health promotion
A client learns she is 6 weeks' pregnant and asks the nurse for the name of the local abortion clinic. What is the most appropriate response by the nurse? A. Call the hospital chaplain to talk to the client. B. Ask the health care provider to discuss the issue with the client. C. Provide the client with the requested information. D. Tell the client that abortion (elective termination of pregnancy) results in death of the fetus.
C. Provide the client with the requested information.
Which physician is known as the "Father of Pediatrics"? Joseph Brennaman Ren Spitz John Bowlby Abraham Jacobi
Abraham Jacobi
A nurse is caring for a 31-year-old pregnant client who is subjected to intimate partner violence. The client has developed a feeling of hopelessness and does not feel confident in dealing with the situation at home, which makes her feel suicidal. Which nursing intervention should the nurse offer to help the client deal with her situation? A. Introduce the client to a women's rights group. B. Counsel the client's partner to refrain from subjecting his partner to violence. C. Provide emotional support to empower the client to help herself. D. Help the client understand the legal impact of her situation to help protect her.
C. Provide emotional support to empower the client to help herself.
The nurse is updating the records of a 10-year-old girl who had her appendix removed. Which action could jeopardize the privacy of the child's medical records? Printing out confidential information for transmittal. Closing files before stepping away from computer. Letting another nurse use the nurse's log-in session. Changing identification and passwords monthly.
Letting another nurse use the nurse's log-in session.
Which statement best describes the pattern of maternal mortality since World War II? It has steadily decreased. It has steadily increased. After decreasing until the 1960s, it has increased steadily. It has remained constant.
It has steadily decreased.
A nurse is conducting a teaching session on sudden infant death syndrome (SIDS) for expectant parents. Which information should the nurse include? Select all that apply. A. Maintain neutral temperatures and avoid overheating. B. Co-bedding or sharing a bed creates parental bonding. C. Sharing a room allows for monitoring of the infant. D. Place the infant on his or her back to sleep. E. Allow the infant to sleep with a bottle.
A. Maintain neutral temperatures and avoid overheating. C. Sharing a room allows for monitoring of the infant. D. Place the infant on his or her back to sleep.
A nurse is caring for a 31-year-old pregnant client who is subjected to intimate partner violence. The client has developed a feeling of hopelessness and does not feel confident in dealing with the situation at home, which makes her feel suicidal. Which nursing intervention should the nurse offer to help the client deal with her situation? A. Provide emotional support to empower the client to help herself. B. Help the client understand the legal impact of her situation to help protect her. C. Counsel the client's partner to refrain from subjecting his partner to violence. D. Introduce the client to a women's rights group.
A. Provide emotional support to empower the client to help herself.
A nurse is conducting a teaching session on sudden infant death syndrome (SIDS) for expectant parents. Which information should the nurse include? Select all that apply. A. Sharing a room allows for monitoring of the infant. B. Allow the infant to sleep with a bottle. C. Co-bedding or sharing a bed creates parental bonding. D. Maintain neutral temperatures and avoid overheating. E. Place the infant on his or her back to sleep.
A. Sharing a room allows for monitoring of the infant. D. Maintain neutral temperatures and avoid overheating. E. Place the infant on his or her back to sleep.
Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent? A. Telephone consent with two witnesses listening simultaneously. B. Treating the minor and obtaining written informed consent when the parent arrives. C. Explaining the needed treatment to the minor and documenting this action. D. Contacting the institution's attorney to provide and document consent.
A. Telephone consent with two witnesses listening simultaneously.
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: A. increases are noted because of the growing number of pregnancies to teen mothers. B. improved prenatal care has reduced the numbers of fetal deaths. C. expectant mothers are seeking prenatal care later, resulting in decreases in the number. D. increases are noted due the increasing number of older mothers becoming pregnant.
B. improved prenatal care has reduced the numbers of fetal deaths.
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. Which action would be most appropriate to implement that would have the greatest impact on reducing these numbers? A. Administering oxytocic medications for increased postpartum bleeding. B. Referring to a cardiologist for any arrhythmias. C. Practicing high standards of infection control. D. Monitoring maternal glucose levels in mothers with type 1 diabetes. E. Beginning antibiotics prior to birth for a febrile mother.
C. Practicing high standards of infection control.
The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation? A. Tell the parents to state in writing that they will not participate in the treatment and give the letter to their physician. B. Tell the doctor that the procedure is not in the best interests of this girl and ask him to respect the rights of the family. C. Reassure the family that the doctor is acting in their best interests and they should reconsider the treatment. D. Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.
D. Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.
What makes the area of family nursing a difficult arena in which to provide care at times? A. family-centered care plans and use of community areas in acute care settings B. the presence of family in the hospital rooms C. nurses having different values from families 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
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: A. increases are noted due the increasing number of older mothers becoming pregnant. B. increases are noted because of the growing number of pregnancies to teen mothers. C. expectant mothers are seeking prenatal care later, resulting in decreases in the number. D. improved prenatal care has reduced the numbers of fetal deaths.
D. improved prenatal care has reduced the numbers of fetal deaths.
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? Stop and call 911. Discontinue all resuscitation efforts. Continue CPR until help arrives. Continue chest compression only.
Discontinue all resuscitation efforts.
Which nursing intervention would best demonstrate evidence-based practice in maternal-child health care? Decentralizing care to allow clients to be closer to home Family-centered pediatric care Placing adults and children with similar diseases on the same unit Minimizing parental interaction with preterm infants
Family-centered pediatric care
A nursing student is preparing a presentation illustrating the Human Genome Project. Which function will the student point out as being the primary focus? Treatment of gene mutations Identification of human genes and functions Genetic testing in adults Detection of genetic mutations in children
Identification of human genes and functions
A group of nurses are discussing the most recent statistics on death due to prematurity in the United States. Which action, if implemented, would have the greatest impact on improving outcomes? Examine health disparities between ethnic groups. Improve women's access to receiving prenatal care. Identify specific national health goals related to maternal and infant health. Track the incidence of violent crime against pregnant women.
Improve women's access to receiving prenatal care.
A nurse is conducting a presentation for a group of pregnant women about appropriate health promotion strategies to address issues related to infant mortality. Which strategy would the nurse encourage to reduce the infant's risk for infection after birth? folic acid supplementation breastfeeding newborn development support groups sleeping on the back
breastfeeding
A nurse witnesses a peer tell a client, "You are a mother now and you have to do what is best for you baby. You have to breastfeed her!" Which is the best action by the nurse? Pull the nurse aside and inquire as to the content of the conversation. Approach the client later and provide correct information. Fill out an incident report to go in the nurse's personnel file. Immediately interrupt the conversation and reprimand the nurse.
Pull the nurse aside and inquire as to the content of the conversation.
A nurse witnesses a peer tell a client, "You are a mother now and you have to do what is best for you baby. You have to breastfeed her!" Which is the best action by the nurse? Pull the nurse aside and inquire as to the content of the conversation. Fill out an incident report to go in the nurse's personnel file. Approach the client later and provide correct information. Immediately interrupt the conversation and reprimand the nurse.
Pull the nurse aside and inquire as to the content of the conversation.
Before World War II women moved from home to hospital births. What was the primary reason for that shift in maternity care? They had no other options as many could not afford midwives. They were convinced that setting would improve birth outcomes. They were convinced that setting would lessen the pain of labor. They were convinced that setting would provide them with natural birth.
They were convinced that setting would improve birth outcomes.
A young couple are very excited to learn they are expecting their first child and question the nurse about which test they need to discover its gender. Which procedure will best provide this information to the couple? Ultrasound Amniocentesis HGP Chorionic villus sampling
Ultrasound
When preparing a teaching plan for a group of women during their first pregnancy, the nurse reviews how maternity care has changed over the years. Which information would the nurse include when discussing events occurring in the 20th century? epidemics of puerperal fever x-ray developed to assess pelvic size performance of the first cesarean birth development of birthing centers
development of birthing centers
When preparing a teaching plan for a group of women during their first pregnancy, the nurse reviews how maternity care has changed over the years. Which information would the nurse include when discussing events occurring in the 20th century? x-ray developed to assess pelvic size performance of the first cesarean birth development of birthing centers epidemics of puerperal fever
development of birthing centers
A nurse is working as part of a larger community group to develop programs to address current barriers to health care being experienced by women. The community is in the city with a large population of low-income families. On which factor should the group focus their efforts to address a main barrier to access to care? low health literacy health insurance language transportation
health insurance
A nurse is working as part of a larger community group to develop programs to address current barriers to health care being experienced by women. The community is in the city with a large population of low-income families. On which factor should the group focus their efforts to address a main barrier to access to care? transportation low health literacy health insurance language
health insurance
A nurse is speaking with a client who has just learned that she is pregnant with her first child. The nurse reads in the client's chart that she does not drink alcohol on a regular basis. However, the nurse decides to go ahead and warn the client about the dangers of drinking alcohol while pregnant. Which phase of health care would this action be classified as? health maintenance health promotion health restoration health rehabilitation
health promotion
A nurse has just assisted in the birth of a premature neonate. The nurse recognizes that which factor, when associated with prematurity, is a leading cause of death in neonates? low birth weight gestational diabetes season of the year maternal hemorrhage
low birth weight