OB Chapt 1Perspectives on Maternal, Newborn & Women's Health Care

A nurse informs a 19-year-old client that she is pregnant. The client immediately states that she plans to have an abortion. What would be the most appropriate response from the nurse to this client? a) "I'll put together the information that you will need." b) "Have you notified the father?" c) "Are you sure you want to do that?" d) "I don't know of any doctors who will perform them."

"I'll put together the information that you will need." Correct Explanation: The nurse should not respond to this client with any judgment or biased information. The client does not have to notify the father, and the other responses show the nurse's personal bias. If a nurse has an ethical issue with this procedure, she should address it with her managers, not the clients. p27

Which of the following people is at highest risk for death? a) 6 month old b) 18 month old c) 5 year old d) 15 year old

6 month old Correct Explanation: The risk of death in the first year of life is higher than that in any other year before age 55.

Which of the following is essential to the contribution of the health of a woman and fetus? a) Social support b) Prenatal care c) Emotional support d) All of the above

All of the above Correct Explanation: The outcomes of pregnancy and for the maternity patient are multifactorial and require support, both financial and emotional, as well as health care.

A nurse is caring for a woman who has just given birth to a child with Down syndrome. The nurse is focussing on how to help this patient adapt to the changes associated with becoming a mother of a child with special needs. Which nursing theory would be most helpful to this nurse? a) Dorthea Orem's theory b) Patricia Benner's theory c) Calistra Roy's theory d) 2020 National Health Goals

Calistra Roy's theory Correct Explanation: Nursing theories are designed to offer helpful ways to view clients so nursing activities can be created to best meet client needs—for example, Calistra Roy's theory stresses an important role of the nurse is to help patients adapt to change caused by illness or other stressors; Dorthea Orem's theory concentrates on examining patients' ability to perform self-care; Patricia Benner's theory describes the way nurses move from novice to expert as they become more experienced and prepared to give interprofessional care (Roy, 2011, Orem & Taylor, 2011, Benner, 2011). The 2020 National Health Goals are not a nursing theory but are goals intended to help citizens more easily understand the importance of health promotion and disease prevention and to encourage wide participation in improving health in the next decade.

A nurse is spending his summer volunteering his services as a maternal and child health care professional in a clinic in a developing nation stricken by famine. He notes that the low percentage of men in the population due to war as well as poor nutrition make conception more rare among the women he encounters. Which measure of maternal and child health would best confirm his observations? a) Maternal mortality rate b) Birth rate c) Fetal death rate d) Fertility rate

Fertility rate Correct Explanation: The fertility rate tends to be low in countries where there is famine because poor nutrition makes conceiving difficult, as well as in countries where the proportion of young adult men is low because of war or disease. The other measures listed do not pertain to conception.

Cost containment in the health care field has become a sought-after necessity because of rising costs and the influence of managed care. Which of the following is a cost-containment strategy implemented by nurses? a) Alternative Delivery Systems b) Quality Improvement c) Health Promotion d) Patient teaching

Health Promotion Correct Explanation: Specific cost-containment strategies that nurses have been instrumental in implementing include health promotion, case management, and critical care paths. p 24

The primary focus of health care education by nurses to clients is: a) Health promotion b) Disease prevention c) Rehabilitation to pre-disease state d) Acute disease treatment

Health promotion Correct Explanation: The current movement in health care is to focus on health promotion and thereby prevent future illness and diseases. Prevention, treatment, and rehabilitation are all processes of care. In health care today, the treatments are based on prevention in order to save time, money, and improve the quality of life.

A program designed to decrease the infant mortality rate in the United States would probably make the greatest impact if it focused on which of the following? a) Increasing the education level of parents b) Increasing the number of women receiving prenatal care c) Reducing the number of home births d) Changing genetic traits

Increasing the number of women receiving prenatal care Correct Explanation: Attending prenatal care has proven to be a major strategy for reducing infant mortality. p12

A nurse working in a pediatrician's office has requested that a generic brand of cotton swabs be ordered in place of a more expensive brand name. Which trend in today's health care environment is most related to this nurse's action? a) Increasing health insurance coverage cost b) Initiating cost containment c) Increasing use of technology d) Increasing reliance on home care

Initiating cost containment Correct Explanation: Cost containment refers to reducing the cost of health care by closely monitoring the costs of personnel, use and brands of supplies, length of hospital stays, number of procedures carried out, and number of referrals requested yet maintaining quality care. The other trends listed are not as directly related or are unrelated to this nurse's action.

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

It has steadily decreased. Correct Explanation: Improved prenatal care and early ambulation following childbirth are factors that have decreased death in childbirth. p 11

The nursing student correctly identifies which of the following to be the contributing factor to making hospitals more attractive for deliveries in the early 1900's? a) They had childbirth classes. b) It showed affluence and they provided pain management. c) They had nurse midwives. d) It allowed for the father to be involved.

It showed affluence and they provided pain management. Correct Explanation: In the early 1900's many women were attracted to hospitals because this showed affluence and hospitals provided pain management. Nurse midwives were not located in hospitals at this time and childbirth classes did not evolve until the late 1950's when "natural childbirth" became popular again. The father was prohibited in the delivery room until much later. p6

A new mother is nervous about sudden infant death syndrome (SIDS) and asks the nurse how to prevent it when the newborn is ready to sleep. The nurse tells the mother to: a) Let the newborn sleep in the same bed as the parents. b) Lay the newborn on her stomach, with her face turned. c) Lay the newborn on her side. d) Lay the newborn on her back, rather than on her stomach.

Lay the newborn on her back, rather than on her stomach. Correct Explanation: The newborn or infant should be placed on her back to sleep. Sleeping on the stomach (prone) may limit the newborn's ability to move her head, which increases the chance of suffocation. p 13

An important change in maternal and child health care that nurses must often explain is the new emphasis on ambulatory care. This change in emphasis is meant to achieve which of the following? a) Reduce the number of hospitals needed b) Decrease responsibility for parents c) Reduce the number of drug interactions d) Prevent the separation of children from parents

Prevent the separation of children from parents Correct Explanation: Separation from parents can be traumatic for young children; ambulatory care increases responsibility for parents. p24

In an attempt to control Medicare costs, the government developed a system that predetermines rates to be paid to the health care provider. The rates are paid regardless of the costs that the health care provider actually incurs. What is this system called? a) Prospective payment system b) Ambulatory payment classifications c) DRGs d) Cost sharing

Prospective payment system Explanation: A prospective payment system predetermines rates to be paid to the health care provider for patients with diseases in certain classifications. These rates are paid regardless of the costs that the health care provider actually incurs. Ambulatory payment classifications and DRGs are forms of prospective payments. Cost sharing refers to the costs that the patient incurs when using his or her health insurance plan.

A nurse is working in an ambulatory health care clinic located in a poor neighborhood. Which nursing intervention would most likely provide the greatest benefit for the women and their children seen at this clinic? a) Providing them with drug samples for therapy b) Cautioning them about home safety issues c) Educating the parents about preventive care d) Promoting healthy sleep and rest habits

Providing them with drug samples for therapy Explanation: Preventive care is not as important as ensuring that women and children get the medicine needed. Home safety is not as important as ensuring that women and children get the medicine needed. People who live in poverty and many who live on very low incomes do not have enough money to afford the medications needed for therapy. Providing them with drug samples is a common intervention. Proper sleep and rest are not as important as ensuring that the child gets the medicine needed. p18

The nursing instructor is teaching about evidence-based practice and tells the students that studies have shown that women who receive continuous support during labor have which of the following results? a) an increase in the length of labor b) greater chance of a cesarean section c) greater chance of a spontaneous vaginal birth d) a decrease in satisfaction with their labor experience

greater chance of a spontaneous vaginal birth Correct Explanation: Evidence-based practice studies show that women receiving continuous intrapartum support had a greater chance of a spontaneous vaginal delivery. They also had a slight decrease in the length of labor and required less analgesia during this time. They also reported increased satisfaction with their labor and childbirth experience.

The nursing instructor stresses that preventing complications of pregnancy is a goal for all patients. She informs the students that the best way to do this is which of the following? a) weight gain of less than 10 pounds b) prenatal care c) taking multivitamins after learning of pregnancy d) staying overhydrated

prenatal care Correct Explanation: Prenatal care is well known to prevent complications of pregnancy and to support the birth of healthy infants. Lack of care during pregnancy is a major factor contributing to poor outcomes. Gaining less than 10 pounds is not recommended and the patient should take vitamins prior to getting pregnant. Although staying hydrated is good, being overhydrated could lead to problems such as edema and fluid overload.

The nurse instructs the new mother that some health promotion strategies can significantly improve an infant's health and chance of survival. These include which of the following? (Check all that apply.) a) mothers joining support groups b) placing infant on back to sleep c) breastfeeding d) formula feeding e) placing infant on stomach to sleep

• breastfeeding • placing infant on back to sleep • mothers joining support groups Explanation: Certain health promotion strategies after birth can significantly improve an infant's health and chances of survival. Breastfeeding has been shown to reduce rates of infection in infants and to improve their long-term health. Placing an infant on his or her back when sleeping will reduce the incidence of sudden-infant death syndrome. Encouraging mothers to join support groups to prevent postpartum depression and learn sound childrearing practices will improve the health of both the mothers and their infants. p13

When describing childbirth during the 18th century, which of the following would the nurse include? a) The majority of births occurred in the home with female midwives. b) Books on childbirth education became readily available. c) Streptococci were identified as the major cause of puerperal fever. d) Heavy doses of narcotics were used during labor.

The majority of births occurred in the home with female midwives. Correct Explanation: During the 18th century (1700s), female midwives attended the majority of all births and these births occurred in the home setting. Louis Pasteur demonstrated that streptococci were the major cause of puerperal fever during the 19th century (1800s). The use of twilight sleep, in which heavy doses of narcotics were used during labor, occurred during the early 20th century (1900s). Books on childbirth education became readily available during the 20th century (1900s).

The nursing instructor states, "the maternal mortality and morbidity rates for African-American women have been three to four times higher than for white women." This statement is which of the following? a) True b) False

True Correct Explanation: The maternal mortality and morbidity rates for African-American women have been 3-4 times higher than for white women. Researchers do not entirely understand what accounts for this disparity.

Which of the following groups has the lowest risk of infant mortality? a) Hispanic American women b) African American women c) Native American women d) Asian American women

Asian American women Correct 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.

The nursing instructor informs students that different cultures have different beliefs and practices that affect maternal and children's health. Which of the following group fosters little involvement of the father during labor and a stoic, quiet appearance of the woman during labor? a) Native Americans b) Arab Americans c) Asian Americans d) African Americans

Asian Americans Explanation: Asian Americans have little involvement of the father during labor and the woman has a quiet and stoic appearance during labor.

What term is used to represent the number of deaths in the first 28 days of life? a) Neonatal death rate b) Couplet death rate c) Fetal death rate d) Infant death rate

Neonatal death rate Correct Explanation: The neonatal death rate is the number of deaths of an infant in the first 28 days of life.

The nursing instructor is teaching students about the types of anesthesia used during labor and delivery. She informs the students that in the 1900's a heavy dose of narcotics and amnesiacs was used on women during childbirth in the United States. This is referred to as which of the following? a) light sedation b) twilight sleep c) hypnosis d) sundown syndrome

twilight sleep Correct Explanation: Twilight sleep (a heavy dose of narcotics and amnesiacs) was used on women during childbirth in the United States in the 1900's. Sundown syndrome refers to a multitude of behavioral problems that begin to occur in the evening or while the sun is setting. Hypnosis is a mental state or imaginative role while light sedation involves the administration of small amounts of medication in order to deal with anxiety or agitation. p7

The development of what medical treatment was most influential in moving birth from the home into the hospital? a) Planned cesarean birth b) Anesthesia and analgesic therapy c) Instruments to assist in delivery of infants d) Infection control and germ theory

Anesthesia and analgesic therapy Correct Explanation: Movement from the home to the hospital for delivery 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 is anesthesia. Infection control could be maintained at home so it was not a driving force. The use of instruments developed along with cesarean technology. p7

When communicating with a client who speaks a different language, the best practice for the nurse is to: a) Arrange for an interpreter when communicating with the client. b) Stand close to the client and talk loudly. c) Speak with a family member about the client's condition. d) Speak loudly and slowly.

Arrange for an interpreter when communicating with the client. Correct Explanation: The nurse should arrange for an interpreter when communicating with a client who speaks another language. Speaking loudly or talking with a member of the client's family does not ensure that the client will receive the information he or she needs.

A nurse who specializes in maternal and child health care performs many varied functions in diverse settings over the course of a year. Which of the following would she be least likely to do, as it would be outside her scope of practice? a) Assist in the treatment and recovery of a woman with ovarian cancer b) Read a recent journal article on breastfeeding and its benefits for new mothers c) Provide preconceptual health care to a patient d) Discuss methods of alleviating morning sickness with a patient in her first trimester

Assist in the treatment and recovery of a woman with ovarian cancer Correct 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 counsels a 14-year-old girl on the risks of teenage birth and on methods of contraception. The nurse knows that such interventions have helped reduce which of the following measures in the past 10 years in the United States? a) Infant mortality rate b) Birth rate c) Child mortality rate d) Childhood morbidity rate

Birth rate Correct Explanation: The birth rate in the United States has decreased gradually over the past 10 years due to additional counseling and publicity of the risks of teenage birth. Such counsel is not pertinent to the other measures listed.

After hearing of a lawsuit being filed by a patient against another nurse, a nurse becomes concerned about her own potential liability in working with premature infants at high risk for morbidity and mortality. Which of the following actions is most essential for the nurse to take to protect herself in the event of litigation? a) Carefully documenting every intervention she makes with a patient b) Staying up to date on the research in her field c) Having an attending physician confirm each intervention she makes before she makes it d) Having the parents of each infant she works with sign a liability waiver form

Carefully documenting every intervention she makes with a patient Correct Explanation: Documentation is essential for justifying actions and for providing evidence of proper care in the event of a lawsuit. Although staying current in the research of one's field is advisable, it does not protect a nurse in the event of a lawsuit. Having parents sign waiver forms and having a physician confirm the nurse's every decision are not feasible.

What makes the area of maternal-child health nursing a more extensive area for consideration of legal issues than other areas of nursing? a) Caring for a fetus, an unseen patient b) Age of the patients c) Lack of evidence-based information d) Risk of labor and delivery

Caring for a fetus, an unseen patient Correct Explanation: When providing care for the pregnant patient, the fetus is unseen and unable to speak. This makes providing care for the maternal-child couplet at an increased risk for legal and ethical issues as the fetus is not "born" nor of age to give consent for procedures.

You are discussing health care provider options with a patient. She indicates she felt her doctor was too busy for her during her last pregnancy and wants to know what her options are for receiving care during her pregnancy and for labor and delivery. Which of the following is the best option? a) Certified nurse midwife b) Clinical nurse specialist c) Women's health nurse practitioner d) Lay midwife

Certified nurse midwife Correct Explanation: A certified nurse midwife is a nurse with advanced practice training in the care of women, specific to pregnancy and delivery. A women's health NP would not be able to deliver the infant. A CNS is not able to be a health care provider, and the lay midwife is not an option for health care. p6

What is the leading cause of infant mortality in the United States? a) Prematurity b) Low birth weight c) Respiratory distress syndrome d) Congenital abnormalities

Congenital abnormalities Correct Explanation: Congenital abnormalities remain the leading cause of infant mortality in the US. Low birth weight and prematurity are significant predictors of infant mortality. Respiratory distress syndrome is not the leading cause of infant mortality.

The nurse is caring for a 5-year-old Hispanic boy and his family. Which action best demonstrates cultural competence? a) Asking about complementary modalities used b) Coordinating care through the mother c) Checking with the father to approve care d) Promoting good medicine over prayers

Coordinating care through the mother Correct Explanation: Promoting good medicine over the power of prayer is inappropriate to this culture. Checking with the father to approve care is inappropriate to this culture. Asking about complementary modalities used is inappropriate to this culture. In Hispanic families, the mother makes the decisions about health, so all care should be coordinated through her.

The neonatal death rate is defined as which of the following? a) Death in utero in the last 28 days of pregnancy b) Death in the first 6 months of life c) Death in the first 28 days of life d) Death in the first year of life

Death in the first 28 days of life Correct Explanation: The neonatal death rate is the number of deaths of an infant in the first 28 days of life.

What two major developments greatly influenced the way maternity care is practiced in the United States? a) Development of anesthesia and acceptance of the germ theory b) Advent of birthing centers and the development of maternity care c) Development of pediatrics as a specialty and replacement of midwives as the primary attendants at births d) Technologic advances and the use of forceps by physicians

Development of anesthesia and acceptance of the germ theory Correct Explanation: The development of anesthesia allowed women a choice for pain management in childbirth; the germ theory advanced the progress of general health care and decreased infections in laboring women. Pediatrics did not replace midwives, maternity care continues to evolve, and birthing centers are still under development. Forceps are not considered an advance in maternity care. p7

The nurse is reviewing the discharge needs of postpartum women, who generally experience shorter hospital stays than were common for women in the past. Which of the following factors has most influenced this trend of shorter hospital stays? a) More cooperative efforts between caregivers and families. b) Efforts to contain healthcare costs. c) Access to quality community care. d) A shift toward a wellness focus in healthcare.

Efforts to contain healthcare costs. Correct Explanation: Average length of hospital stays for postpartum women have been decreasing since the early 1990s in an effort to contain healthcare costs. This cost-containment effort is the primary reason women are discharged quickly after deliveries. p12

Which of the following is the basic unit of society? a) Race b) Government c) Family d) Nation

Family Correct Explanation: The family is the basic unit of society.

A nurse is speaking with a patient who has just learned that she is pregnant with her first child. The nurse reads in the patient's chart that she does not drink alcohol on a regular basis. However, the nurse decides to go ahead and warn the patient about the dangers of drinking alcohol while pregnant. Which phase of health care would this action be classified as? a) Health maintenance b) Health promotion c) Health restoration d) Health rehabilitation

Health promotion Correct Explanation: This action is an example of health promotion, which may be defined as educating parents and children to follow sound health practices through teaching and role modeling. Health maintenance is intervening to maintain health when risk of illness is present. Health restoration is using conscientious assessment to be certain symptoms of illness are identified and interventions are begun to return client to wellness most rapidly. Health rehabilitation is helping prevent complications from illness, helping a client with residual effects achieve an optimal state of wellness and independence, and helping a client to accept inevitable death.

A patient in her third trimester has just learned that she has developed gestational diabetes. The nurse gives her an injection of insulin to help return her blood glucose levels to normal. Which phase of health care would this action be classified as? a) Health restoration b) Health rehabilitation c) Health maintenance d) Health promotion

Health restoration Explanation: This action is an example of health restoration, which is using conscientious assessment to be certain symptoms of illness are identified and interventions are begun to return client to wellness most rapidly. Health promotion is educating parents and children to follow sound health practices through teaching and role modeling. Health maintenance is intervening to maintain health when risk of illness is present. Health rehabilitation is helping prevent complications from illness, helping a client with residual effects achieve an optimal state of wellness and independence, and helping a client to accept inevitable death.

A national campaign to improve the health of the people in the United States has as one of its goals to "eliminate health disparities". What is the name of this national campaign? a) National Health and Nutrition Examination Survey (NHANES) b) National Maternal and Child Health Bureau (MCHB) Center for Child Death Review c) Healthy People 2010 d) Pregnancy Risk Assessment Monitoring System (PRAMS)

Healthy People 2010 Correct Explanation: Healthy People 2010 outlines two basic goals for health promotion and disease prevention (Healthy People 2010, 2001): 1. Increase quality and years of healthy life 2. Eliminate health disparities p10

An expectant mother has arranged for her massage therapist to provide gentle hand, arm, and neck massage for the patient while she is in labor in the hospital. Which trend in today's health care environment is most related to this arrangement? a) Increasing use of alternative treatment modalities b) Initiating cost containment c) Regionalizing intensive care d) Meeting the work needs of pregnant and breastfeeding women

Increasing use of alternative treatment modalities Correct Explanation: There is a growing tendency for families to use alternative forms of therapy, such as acupuncture or therapeutic touch, in addition to or instead of traditional health care measures. Nurses have an increasing obligation to be aware of complementary or alternative therapies such as these as they have the potential to either enhance or detract from the effectiveness of traditional therapy. The other answers do not pertain to the arrangement the patient has made to have her massage therapist present at her labor.

When providing care to a child, which aspect would be most important for the nurse to consider related to informed consent? a) Establishing if the parents are competent b) Determining if the child is emancipated c) Knowing the laws in the state where care is being provided d) Contacting the parents prior to giving emergency care

Knowing the laws in the state where care is being provided Correct Explanation: Knowing the laws in the state where the 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. p29

Mary Ann said that she learned in her Family Living course that more African-American infants than white infants die before they are 1 year old. In response to her questions about the reasons for this, the nurse accurately answers that the major reason for the high infant mortality rate is: a) Having formal education b) Being unmarried c) Lack of prenatal care d) Income

Lack of prenatal care Correct Explanation: A black woman is 3.5 times more likely to have complications or die during childbirth, a maternal mortality rate directly related to lack of prenatal care secondary to lack of access to services or insurance. Income as well as educational level may play a role in the availability of health care, but they are not directly responsible. Being unmarried has no bearing on infant mortality. p12

A nurse has just assisted in the delivery of a premature neonate. She recognizes that which of the following factors, when associated with prematurity, is a leading cause of death in neonates? a) Maternal hemorrhage b) Low birth weight c) Famine d) Low proportion of young adult men

Low birth weight Correct Explanation: The leading causes of death during the neonatal period are prematurity with associated low birth weight or congenital malformations. Famine and a low proportion of young adult men are associated with low fertility rates, and maternal hemorrhage is associated with high maternal mortality rates.

Which of the following is the best statistical indicator of the adequacy of prenatal care? a) Infant mortality rate b) Maternal mortality rate c) Abortion rate d) Fertility rate

Maternal mortality rate Explanation: Maternal mortality rate is the best indicator of a country's level of prenatal care. Increases in prenatal care result in a decrease in maternal mortality. Fertility rate refers to the ratio of live births in an area to the population of that area, and abortion rate is unrelated to prenatal care. Infant mortality is a reflection of postnatal care.

The nursing instructor informs the students that the main reason that nurseries were started in the 1900's was due to which of the following? a) Mothers could not care for their babies due to chloroform gas. b) Mothers could not care for their babies after receiving an epidural. c) Mothers wanted a rest after 9 months of pregnancy. d) Nurses wanted to be the sole caregiver of the babies.

Mothers could not care for their babies due to chloroform gas. Correct Explanation: Nurseries were started in the 1900's because mothers could not care for their babies for several days after receiving chloroform gas. Epidurals were not being used at that time and would not prevent the mother from caring for her baby. Wanting a rest would not prevent the mother from caring for her baby and nurses asking to be the sole caregiver did not play a role in developing nurseries. p7

When describing childbirth during the 18th century, which of the following would the nurse include? a) The majority of births occurred in the home with female midwives. b) Books on childbirth education became readily available. c) Heavy doses of narcotics were used during labor. d) Streptococci were identified as the major cause of puerperal fever.

The majority of births occurred in the home with female midwives. Explanation: During the 18th century (1700s), female midwives attended the majority of all births and these births occurred in the home setting. Louis Pasteur demonstrated that streptococci were the major cause of puerperal fever during the 19th century (1800s). The use of twilight sleep, in which heavy doses of narcotics were used during labor, occurred during the early 20th century (1900s). Books on childbirth education became readily available during the 20th century (1900s).

Which of the following is the best definition of "maternal mortality"? a) The number of deaths of women of childbearing years per 100,000 births. b) The number of deaths of women in childbirth per 1000 births c) The number of near deaths of women of childbearing years per 1000 births d) The number of deaths of women related to childbearing per 100,000 births

The number of deaths of women related to childbearing per 100,000 births Correct Explanation: So few women die in childbirth in a developed country that this statistic is based on 100,000, not the usual 1000 number. p11

Infant mortality, a standard measurement of the quality of health care in the country, measures which of the following? a) The number of babies who die at birth each year b) The number of deaths per 10,000 live births every year c) The number of deaths per 1000 live births yearly in children under age 12 months d) The number of babies who die of communicable diseases each year

The number of deaths per 1000 live births yearly in children under age 12 months Correct Explanation: The infant year is birth to 12 months; mortality refers to deaths.

Which of the following does the nurse recognize as true about violence and abuse? a) The nurse should screen for these in every patient encounter. b) Rates are decreasing. c) The nurse is not legally responsible for reporting other people's behavior. d) Families are more stable than in the past.

The nurse should screen for these in every patient encounter. Correct Explanation: Both child and intimate partner abuse is increasing in incidence. Families are more mobile than previously. Screening for child or intimate partner abuse should be included in all family contacts. Nurses must be aware of the legal responsibilities for reporting abuse.

The nursing student identifies the statement "Most pregnancy-related complications are preventable" to be which of the following? a) True b) False

True Explanation: Most pregnancy-related complications are preventable. The most common are: ectopic pregnancy, preterm labor, hemorrhage, emboli, hypertension, infection, stroke, diabetes, and heart disease.

The nursing student correctly chooses which of the following to be the World Health Organization's definition of health? a) a state of complete physical, mental and social well-being b) absence of disease c) a low mortality rate d) a low morbidity rate

a state of complete physical, mental and social well-being Correct 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 or an analysis of mortality and morbidity statistics.

The nurse working in labor and delivery correctly informs the nursing student that amniocentesis was first performed in 1966 to do which of the following? a) assess the health of the mother b) predict the ease of delivery c) assess the sex of the baby d) assess fetal growth

assess fetal growth Correct Explanation: Amniocentesis was first performed in 1966 to assess fetal growth. It was not used to assess the sex of the baby or the health of the mother. It also does not predict the ease of delivery. p7

The rate of fetal deaths in the United States has a) increased because of the increasing number of older mothers becoming pregnant. b) increased because of the growing number of pregnancies to teen mothers. c) fallen in recent decades. d) remained at a stable rate for the last several decades with little change.

fallen in recent decades. Correct 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. p12

The nursing student demonstrates an understanding of the different mortality rates when she correctly identifies the fetal mortality rate as which of the following? a) the death of a fetus in the first 12 weeks of gestation per 1,000 live births b) the number of infant deaths occurring in the first 28 days of life per 1,000 live births c) the intrauterine death of a fetus who is 20 weeks of gestation or more per 1,000 live births d) the number of infant deaths occurring in the first 3 months of life per 1,000 live births

the intrauterine death of a fetus who is 20 weeks of gestation or more per 1,000 live births Explanation: The fetal mortality rate refers to the intrauterine death of a fetus who is 20 weeks of gestation or more per 1,000 live births. The infant mortality rate is the number of deaths occurring in the first 12 months of life while the neonatal rate is the number of infant deaths occurring in the first 28 days of life per 1,000 live births. p12

The nursing student demonstrates an understanding of what is meant by maternal mortality rate when she correctly defines it as which of the following? a) the number of deaths immediately after delivery per 100,000 live births b) the number of deaths from labor per 100,000 live births c) the number of deaths from delivery per 100,000 live births d) the number of deaths from any cause during the pregnancy cycle per 100,000 live births

the number of deaths from any cause during the pregnancy cycle per 100,000 live births Correct Explanation: The maternal mortality rate is the number of deaths from any cause during the pregnancy cycle per 100,000 live births. p11

The nursing student correctly identifies which of the following groups to have consistently higher infant mortality rates than other ethnic groups? (Check all that apply.) a) American-Indian b) African-American c) Asian-American d) Alaska-Native e) Anglo-Saxon white

• African-American • American-Indian • Alaska-Native Explanation: The March of Dimes in 2006 identified African-American, American-Indian, and Alaska Native infants to have consistently higher infant mortality rates than other ethnic groups. p 13

The nurse understands the importance of family-centered care and knows that it is extremely important during the labor and delivery process. She identifies which of the following to be basic principles of this type of care? (Check all that apply.) a) Childbirth only affects the mother and father. b) Families are capable of making decisions about their own care if given adquate information and professional support. c) Childbirth does not place any added stress on a family unit. d) Childbirth is considered a normal, healthy event in the life of a family. e) Childbirth affects the entire family, and relationships will change.

• Families are capable of making decisions about their own care if given adquate information and professional support. • Childbirth is considered a normal, healthy event in the life of a family. • Childbirth affects the entire family, and relationships will change. Correct Explanation: Family-centered care includes the following basic principles when applied to childbirth: childbirth is considered a normal, healthy event in the life of a family, childbirth affects the entire family and relationships will change, and families are capable of making decisions about their own care if given adequate information and professional support.

A new mother who is single is sharing her concerns about the cost of daycare with her nurse. She is new to the area. The nurse recognizes that which of the following trends are likely contributing to this patient's concerns? (Select all that apply.) a) Fewer extended family members to help care for a child b) The increase in the number of single parent families c) Ninety percent of women working outside the home d) The increase in child and intimate partner violence e) The increase tendency for families to move from one part of the country to another f) The increasing use of the Internet to monitor health and ask health questions

• 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 increase tendency for families to move from one part of the country to another Explanation: In this patient'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.

Which of the following factors have contributed to the decline in the maternal mortality rate? Select all that apply. a) Better control of hemorrhage and infection b) Increased use of anesthesia with childbirth c) Increased participation of women in prenatal care d) Use of ultrasound to detect disorders e) Increased control of complications associated with hypertension of pregnancy

• Increased participation of women in prenatal care • Use of ultrasound to detect disorders • Increased control of complications associated with hypertension of pregnancy • Better control of hemorrhage and infection Explanation: The following factors have contributed to the decline in the maternal mortality rate: increased participation of women in prenatal care, greater detection of disorders such as ectopic pregnancy or placenta previa and prevention of related complications through the use of ultrasound, increased control of complications associated with hypertension of pregnancy, and decreased use of anesthesia with childbirth. p11

A nurse has just learned that her hospital has been named a magnet hospital by the American Nurses' Credentialing Center. Which of the following are most likely true of this hospital? (Select all that apply.) a) Nurses are involved in data collection and decision-making about patient care b) All nurse managers and leaders have either a BSN or MSN c) The hospital is the most profitable in its region d) The patient mortality rate is nearly zero e) There is a low staff nurse turnover rate f) There is a high level of nursing job satisfaction

• Nurses are involved in data collection and decision-making about patient care • All nurse managers and leaders have either a BSN or MSN • There is a low staff nurse turnover rate • There is a high level of nursing job satisfaction Correct Explanation: Magnet hospitals typically demonstrate a high level of nursing job satisfaction and a low staff nurse turnover rate, and have policies in place that include nurses in data collection and decision-making about patient care. These hospitals demonstrate they value staff nurses, involve them in research-based practice, and encourage and reward them for obtaining additional degrees in nursing. By 2013, all nurse managers and nurse leaders in magnet designated hospitals must have either a BSN or MSN. A hospital's profitability is not necessarily related to magnet status, and a patient mortality rate of nearly zero is not likely.

Which of the following are areas of leading health indicators in the Healthy People initiative? Select all that apply. a) Physical activity b) Technology c) Obesity and overweight d) Immunization e) Injury and violence

• Obesity and overweight • Physical activity • Injury and violence • Immunization Explanation: Obesity and overweight, physical activity, injury and violence, and immunization all represent areas of leading health indicators.

The nursing student correctly identifies which of the following to be responsible for opening the door to childbirth education classes and bringing fathers back into the picture? (Check all that apply.) a) focusing on relaxation techniques b) using only midwives c) advocating birth without medication d) advocating pain management

• advocating birth without medication • focusing on relaxation techniques Explanation: "Natural childbirth" in the 1950's advocated birth without medication and focused on relaxation techniques. These techniques opened the door to childbirth education classes and helped to bring the father back into the picture. Giving pain medication and only using midwives did not play a role in getting classes introduced or getting the father more involved.

The nursing student demonstrates an understanding of maternal and newborn nursing when she correctly identifies which of the following as its components? (Check all that apply.) a) care of the woman before pregnancy b) care of the woman and her fetus during pregnancy c) care of the newborn during the first 6 weeks after birth d) care of the woman after pregnancy e) care of the newborn during the first year of life

• care of the woman before pregnancy • care of the woman and her fetus during pregnancy • care of the newborn during the first 6 weeks after birth • care of the woman after pregnancy Correct Explanation: Maternal and newborn nursing encompasses a wide scope of practice typically associated with childbearing. It includes care of the woman before pregnancy, care of the woman and her fetus during pregnancy, care of the woman after pregnancy, and care of the newborn, usually during the first 6 weeks after birth.

The nursing instructor is informing the students about the changes that have taken place due to the poor mortality rate of women during childbirth. She instructs the students that during the 17th and 18th centuries which of the following contributed to deaths during childbirth? (Check all that apply.) a) exhaustion b) dehydration c) infection d) hemorrhage e) seizures f) lack of prenatal vitamins

• exhaustion • dehydration • infection • hemorrhage • seizures Explanation: During the 17th and 18th centuries, women giving birth often died as a result of exhaustion, dehydration, infection, hemorrhage, or seizures. Although prenatal vitamins are known to help prevent certain complications, the lack of them at this time did not add to the high incidence of deaths.

The nursing student corrrectly identifies which of the following to have profound effects on a person's health and illness throughout life? (Check all that apply.) a) number of members in immediate family b) use of herbs c) habits and practices established in early childhood d) habits and practices established during pregnancy e) religious beliefs

• habits and practices established during pregnancy • habits and practices established in early childhood Explanation: Habits and practices established during pregnancy and in early childhood can both have a profound effect on a person's health and illness throughout life. Religious beliefs, the use of herbs, and the number of members in a person's immediate family have not been proven to contribute to a person's health.

The labor and delivery nurse is precepting a nursing student. She informs the student that there are indicators for infant mortality. She includes which of the following as predictors of infant mortality? Select all that apply. a) low birthweight b) first-born c) prematurity d) high birthweight

• low birthweight • prematurity Correct Explanation: Congenital anomalies remain the leading cause of infant mortality, but low birthweight and prematurity are major indicators of infant health and significant predictors of infant mortality. Being the first baby born to a mother is not indicative of a problem. p12-13

The nursing instructor is teaching students about the many different roles that nurses play in helping a person to live a healthier life. These include which of the following? (Check all that apply.) a) providing financial planning b) providing comfort c) providing information and advice d) providing emotional support e) providing advocacy f) providing direct care

• providing comfort • providing information and advice • providing emotional support • providing advocacy • providing direct care Correct Explanation: Nurses fill a variety of roles in helping patients to live healthier lives by providing direct care, emotional support, comfort, information, advice, advocacy, support, and counseling. Nurses do not get involved in providing financial planning for patients.

The nursing instructor is introducing the students to Healthy People 2010 which highlights the major health indicators of the 21st century that need to be addressed. She informs the students that this includes national health goals for maternal, infant and child health which include which of the following? (Check all that apply.) a) increase low birth weights b) increase the number of cesareans c) reduce low birth weights d) reduce maternal deaths e) reduce fetal and infant deaths f) reduce preterm births

• reduce low birth weights • reduce maternal deaths • reduce fetal and infant deaths • reduce preterm births Correct Explanation: The National Health Goals identified by Healthy People 2010 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.