OB Week 1
A nurse manager is interviewing a potential candidate for employment in the perinatal clinic. During the interview, the nurse manager asks the nurse about her understanding of family-centered care. Which statement by the interviewee demonstrates understanding of this concept? A) "Families lack the ability to make health care decisions for themselves." B) "Childbirth rarely affects the relationships within a family." C) "Mothers are the family members affected by childbirth." D) "Sensitivity to and respect for the family's culture is important."
D
Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection? A) Provide treatment for clients who test positive for HIV. B) Monitor viral load counts periodically. C) Educate clients in how to practice safe sex. D) Offer testing for clients who practice unsafe sex.
C
A nurse is reading a journal article describing trends in maternal and newborn health care. The article addresses the length of stay for vaginal and cesarean births during the past decade. The nurse would most likely find which duration as being cited as the average stay for cesarean births? A) 24 to 48 hours B) 72 to 96 hours C) 48 to 72 hours D) 96 to 120 hours
B
A group of nurses are reviewing the steps for developing cultural competence. The students demonstrate understanding when they identify which factor as the final step? A) cultural knowledge B) cultural skills C) cultural encounter D) cultural awareness
C
A group of nurses are discussing the reasons for the United States' low rankings for infant and maternal mortality (27% and 21% respectively) and what impact they could make on them in their practice. Which action could nurses implement to reduce these rates? A) ensuring that all pregnant clients receive their immunizations B) assuring early and adequate prenatal care C) providing more extensive women's shelters D) encouraging all women to eat a balanced diet
B
A nurse is teaching a local women's group about women's health care and changes that have occurred. When describing women's health care today, which statement would the nurse most likely include? A) Women spend 50 cents of every dollar spent on health care. B) Women make almost 90% of all health care decisions. C) Women are still the minority in the United States. D) Men use more health services than women.
B
A nurse is working as part of a committee that is developing facility policies to enhance family-centered care. The committee demonstrates application of the principles of this concept when they implement which guideline? A) Describe to each family that childbirth is a procedure requiring specific steps. B) Provide families with information to encourage them to make informed choices. C) Educate families about the need to maintain the status quo in relationships. D) Limit discussion of information about decision making to family requests for such.
B
A nurse practicing in the community is preparing a presentation for a group of nursing students about this practice setting. Which information would the nurse include as characteristic of this role? A) greater emphasis on direct physical care B) broader assessment to include the environment C) increased dependency on physician D) limited decision making and support
B
The nurse is working with a group of community health members to develop a plan to address the special health needs of women. The group would design educational programs to address which condition as the priority? A) smoking B) heart disease C) diabetes D) cancer
B
A nurse is assigned to care for an Asian American client. The nurse plans his care recognizing that which statement best explains an Asian American's view of illness? A) Illness is caused by supernatural forces. B) Illness is a punishment for sins. C) Illness may be caused by God's will or evil influences. D) Illness is due to an imbalance between yin and yang.
D
A nurse is conducting a presentation to a local women's community group about strategies to promote health and wellness and prevent illness. After the presentation, the nurse determines that the teaching was successful based on which statement by the group when describing health? A) "Health is the state of being completely disease free." B) "It is based on analysis of statistics about diseases and deaths." C) "Health is simply a state of overall wellness." D) It is complete physical, mental, and social well-being."
D
A nurse is engaged in providing family-centered care for a woman and her family. The nurse is providing instrumental support with which activity? A) explaining to the woman and family what to expect during the birth process B) assisting the woman in breathing techniques to cope with labor contractions C) reinforcing the woman's role as a mother after birth D) helping the family obtain extra financial help for prescribed phototherapy
D
A nurse is preparing a teaching plan for a woman who is pregnant for the first time. What would the nurse incorporate into the teaching plan to foster the client's learning? Select all that apply. A) Teach "survival skills" first. B) Use simple, nonmusical language. C) Refrain from using a hands-on approach. D) Avoid repeating information. E) Use visual materials such as photos and videos.
. A, B, E
A nurse is assigned to care for a pregnant woman of Native American descent who is experiencing an illness. The nurse develops a plan of care for this client integrating the client's cultural background and implementing interventions based on the understanding that this client most likely views illness as the result of: A) supernatural forces. B) inadequate diet. C) possession by spirits or demons. D) imbalance between external and internal energy.
A
A nurse is conducting a presentation for a local group of community leaders about interventions being used at the various levels of prevention. The nurse determines that additional discussion is needed when a member of the group identifies which intervention as an example of a tertiary prevention level activity in community-based health care? A) teaching women to take folic acid supplements to prevent neural tube defects B) working with women who are victims of domestic violence C) working with clients at an HIV clinic to provide nutritional and CAM therapies D) teaching clients with hypertension how to monitor blood pressure
A
A nurse is conducting an orientation program for a group of newly hired nurses. As part of the program, the nurse is reviewing the issue of informed consent. The nurse determines that the teaching was effective when the group identifies which situation as a violation of informed consent? A) performing a procedure on a 15-year-old without parental consent B) serving as a witness to the signature process on an operative permit C) asking whether the client understands what she is signing following receiving education D) getting verbal consent over the phone for an emergency procedure from the spouse of a unconscious woman
A
A nurse is integrating information about family-centered care when developing a teaching plan for a pregnant woman and her family. Which statement by the woman indicates to the nurse that the teaching was effective? A) "It's not just me affected by the baby. My whole family will be affected." B) "This is a stressful time for our family, so we won't be making any of the health care decisions." C) "Since I'm the mother, this whole process of childbirth will affect me primarily." D) "Childbirth is a medical problem, so it can affect everyone."
A
A nurse is preparing an in-service program for a group of newly hired nurses about trends in care for pregnant women. As part of the program, the nurse is planning to address how hospital stays have changed leading to the use of postpartum home care services. When describing events of the past decade, the nurse would state that the average length of stay in the hospital for vaginal births is: A) 24 to 48 hours or less. B) 72 to 96 hours or less. C) 48 to 72 hours or less. D) 96 to 120 hours or less.
A
A nurse is reading a journal article about the changes in health care delivery and funding that have occurred over the years. Which factor would the nurse expect to find as a current trend seen in maternal and child health care settings? A) increase in ambulatory care B) decrease in family poverty level C) increase in hospitalization of children D) decrease in managed care
A
A nurse is teaching a pregnant client with poor health literacy skills about the process of labor and what to expect. Which action would be most appropriate for the nurse to do when teaching the client? A) Use simple pictures and illustrations to help explain topics. B) Provide the majority of information at one time. C) Use medical terms so the client will recognize them later on. D) Focus the information on potential complications.
A
A nurse working in the community is involved in providing primary prevention. Which intervention would be most appropriate to implement? A) teaching parents of toddlers about ways to prevent poisoning B) working with women who are victims of domestic violence C) working with clients at an HIV clinic to provide nutritional and CAM therapies D) teaching hypertensive clients to monitor blood pressure
A
A pregnant client comes to the emergency department experiencing preterm labor with ruptured membranes. After obtaining the client's history, the nurse would identify which factor as most likely contributing to the possibility of a poor outcome for this client? A) lack of prenatal care B) lack of employment C) lack of adequate nutrition D) lack of formal education
A
After teaching a group of students about the concept of maternal mortality, the instructor determines that additional teaching is needed when the students make which statement? A) "The rate includes accidental causes for deaths." B) "It addresses pregnancy-related causes." C) "The duration of the pregnancy is not a concern." D) "The time frame is typically for a specified year."
A
The family is the basic unit of society. Which statement correctly illustrates the importance of this concept related to how society functions? A) Healthy, well-functioning families provide members of all ages with fulfilling, supporting relationships. B) The family serves as a place that encourages members to autonomously function in pursuit of personal pleasures. C) Society functions best when families determine how they will interface with others without having to deal with the overall consequences. D) Work is an important part of family function but is not necessary for success if one member can fulfill multiple roles
A
The nurse is caring for a 2-week-old newborn girl with a metabolic disorder. Which activity would deviate from the characteristics of family-centered care? A) softening unpleasant information or prognoses B) evaluating and changing the nursing plan of care C) collaborating with the child and family as equals D) showing respect for the family's beliefs and wishes
A
The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which activity would be considered the tertiary level of prevention? A) arranging for a physical therapy session B) teaching parents to administer albuterol C) reminding parent to give a full course of antibiotics D) giving a DTaP vaccination at the proper interval
A
The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority? A) getting telephone consent with two people listening to the verbal consent B) providing emergency care without parental consent C) contacting the child's aunt or uncle to obtain their consent D) asking the courts to grant permission on the child's behalf
A
While a nurse is obtaining a health history, the client tells the nurse that she practices aromatherapy. The nurse interprets aromatherapy as: A) use of essential oils to stimulate the sense of smell to balance the mind and body. B) application of pressure to specific points to allow self-healing. C) use of deep massage of areas on the foot or hand to rebalance body parts. D) participation in chanting and praying to promote healing.
A
A nurse is working as part of group to develop programs that address factors affecting maternal, newborn, and women's health. The group demonstrates understanding of the information when they target programs to address which deficiencies? Select all that apply. A) literacy B) employment opportunities C) mobility D) political representation E) skills
A, B, C, D, E
A nursing group is examining their hospital's maternal outcomes for the previous 5 years. Which identified factors have contributed to the decline in the maternal mortality rate? Select all that apply. A) Increased participation of women in prenatal care B) Use of ultrasound to detect disorders C) Increased use of anesthesia with childbirth D) Closer monitoring for complications associated with hypertension of pregnancy E) Better management of hemorrhage and infection
A, B, D, E
The nursing student correctly identifies African Americans to have consistently higher infant mortality rates than other ethnic groups. What factors that contribute to this problem can nurses have the greatest impact upon? (Check all that apply.) A) Encouraging regular maternal prenatal visits B) Nutritional teaching prior to and during pregnancy C) Improving maternal educational levels D) Supporting maternal choices for alternative birthing methods E) Discouraging use of tobacco and non-prescribed medications during pregnancy.
A, B, E
A pregnant woman asks the nurse about giving birth in a birthing center. She says, "I'm thinking about using one, but I'm not sure." Which information about birthing centers would the nurse need to integrate into the explanation about this birth setting? Select all that apply. A) an alternative for women who are uncomfortable with a home birth B) the longer length of stay needed when compared to hospital births C) focus on supporting women through labor instead of managing labor D) view of labor and birth as a normal process requiring no intervention E) care provided primarily by obstetricians with midwives as backup care
A, C, D
The nurse instructs the new mother about some health promotion strategies that could significantly improve her infant's health and chance of survival. These would include which of the following? (Check all that apply.) A) breastfeeding B) placing infant on stomach to sleep C) placing infant on back to sleep D) mothers joining support groups E) formula feeding
A, C, D
A nurse is considering a change in employment from the acute care setting to community-based nursing. The nurse is focusing her job search on ambulatory care settings. Which possible settings would the nurse most likely find? Select all that apply. A) urgent care center B) hospice care C) immunization clinic D) primary care provider's office E) day surgery center F) nursing home
A, D, E
The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which educational program would the group most likely identify as the priority? A) risk reduction strategies for diabetes B) methods for smoking cessation C) ways to adopt a heart-healthy lifestyle D) importance of cancer screening and early detection
C
A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the client understood the information? A) "I like having the privacy, but it might be too expensive for me to set up in my home." B) "I want to have more control, but I am concerned if an emergency would arise." C) "It is safer because I will have a midwife." D) "The midwife is trained to resolve any emergency, and she can bring any pain meds."
B
When integrating the principles of family-centered care into the birthing process, the nurse would base his or her care upon which belief? A) Birth is viewed as a medical event. B) Families are unable to make informed choices due to stress. C) Birth results in changes in relationships. D) Families require little information to make appropriate decisions for care.
C
A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the teaching was effective? A) "I like having the privacy, but it might be too expensive for me to set up in my home." B) "I want to have more control, but I am concerned if an emergency would arise." C) "It is safer because I will have a midwife." D) "The midwife is trained to resolve any emergency, and she can bring any pain meds."
B
The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects with pregnant women? A) calcium B) folic acid C) vitamin C D) iron
B
When providing care to women and their families in today's current health care system, which information would be most important for the nurse to keep in mind? A) Women spend 95 cents of every dollar spent on health care. B) Women make almost 90% of all health care decisions. C) Women are still considered the minority in the United States. D) Men use more health services than women.
B
A group of students are reviewing an article describing information related to indicators for women's health and the results of a national study. Which would the students identify as being satisfactory for women? Select all that apply. A) Smoking cessation B) Colorectal cancer screening C) Violence against women D) Health insurance coverage E) Mammograms
B, E
A client asks the nurse, "I read an article on the internet that was talking about integrative medicine. What is that?" Which response by the nurse would be most appropriate? A) "It refers to the use of complementary and alternative medicine in place of traditional therapies for a condition." B) "It means that complementary and alternative medicine is used together with conventional therapies to reduce pain or discomfort." C) "It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective." D) "It refers to situations when a client and his or her family prefer to use an unproven method of treatment over a proven one."
C
A nurse is conducting a refresher course for a group of nurses on documenting client care and education in the medical record and the purposes that it serves. The nurse determines that the group needs additional teaching when they identify which as a reason for documentation? A) serves as a communication tool for the interdisciplinary team B) demonstrates education the family has received if legal matters arise C) permits others access to allow refusal of medical insurance coverage D) verifies meeting client education standards set by the Joint Commission
C
A nurse is conducting an in-service education program on documenting client care and education for a group of nurses returning to the workforce. The nurse determines that additional teaching is needed when the group identifies which information as a reason for documentation? A) The client's medical record serves as a communication tool for the interdisciplinary team. B) The record documents the education the family has received if legal matters arise. C) The record allows others to view a client's medical history at any time to refuse medical insurance coverage. D) The documentation verifies client education standards set by JCAHO.
C
A nurse is conducting an in-service program for a group of nurses on the health of women and their families, incorporating information from Healthy People 2020. The nurse determines that additional discussion and clarification is needed when the group makes which statement? A) "Obesity, drug use, and smoking are major problems." B) "Maintaining a physically active lifestyle is strongly encouraged" C) "Immunizations may be the cause of some illnesses being seen currently." D) "Environmental quality is directly related to health care."
C
A nurse is developing a plan of care for a pregnant client to address the continuum of care from pregnancy through childbirth. Which aspect would the nurse include as essential to enhancing the woman's birthing experience? A) ensuring adherence to strict specific routines B) involving a pediatric physician for care of the child after birth C) educating the client about the importance of a support person D) assigning several nurses to act as the woman's support team
C
A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy, labor, and childbirth. Which would be most important for the nurse to incorporate into that plan? A) Adhering to strict, specific routines B) Involving a pediatric physician C) Educating the client about the importance of a support person D) Assigning several nurses as a support team
C
A nurse is educating a client about a care plan. Which question would be appropriate to assess whether the client is learning? A) "Did you graduate from high school; how many years of schooling did you have?" B) "Do you have someone in your family who would understand this information?" C) "Many people have trouble remembering information; is this a problem for you?" D) "Would you prefer that the doctor give you more detailed medical information?"
C
A nurse is participating in an online continuing education course that addresses maternal and newborn health. The nurse is engaging in an interactive activity that requires checking off the causes associated with pregnancy-related mortality. Which condition if checked by the nurse as a cause indicates the need to go back and review the information? A) hemorrhage B) embolism C) precipitous labor D) infection
C
A nurse is preparing a presentation for a local community group about health status and children's health. Which rate would the nurse include as one of the most significant measures? A) fetal mortality rate B) neonatal mortality rate C) infant mortality rate D) maternal mortality rate
C
A nurse is providing care to a group of childbearing families at the local family health clinic. The families range in cultures, different from the nurse's own culture. Which action would be the priority for the nurse? A) Adapt to the practices of the family's culture. B) Determine similarities between both cultures. C) Assess personal feelings about that culture. D) Learn as much as possible about that culture.
C
A nurse is reading a journal article comparing community-based nursing with nursing in the acute care setting. Which factor would the nurse most likely find as being associated with community-based nursing? A) increased time available for education B) improved access to resources C) decision making in isolation D) greater environmental structure
C
The nurse is preparing the discharge plan for a woman whose newborn requires ventilatory support at home. Which action by the nurse would be most appropriate to do when assuming the role of discharge planner? A) Confer with the client's parents. B) Teach new self-care skills to the client. C) Determine if there is a need for back-up power. D) Discuss coverage with the insurance company.
C
A nurse is developing cultural competence. Which actions indicate that the nurse is in the process of developing cultural knowledge? Select all that apply. A) examining personal sociocultural heritage B) reviewing personal biases and prejudices C) seeking resources to further understanding of other cultures D) becoming familiar with other culturally diverse lifestyles E) performing a competent cultural assessment F) advocating for social justice to eliminate disparities.
C, D
A nurse is presenting an informational session at an employment fair that is aimed at community-based health care opportunities. During the session, the nurse describes community-based nursing interventions. The nurse determines that additional clarification is needed when the group identifies which action as a community-based nursing intervention? A) conducting childbirth education classes B) counseling a pregnant teen with anemia C) consulting with a parent of a child who is vomiting D) performing epidemiologic investigations
D
A nurse is providing family-centered care to a pregnant woman and her family. When implementing care, which action by the nurse would be most appropriate? A) making the decisions for the woman B) focusing on medical procedures associated with birth C) informing the woman what pain relief methods will be used during labor D) asking the woman about her plans for labor and birth
D
A nurse is reading a journal article about health status goals and how they have evolved over the years. Which issue would the nurse most likely identify as the focus of these goals in the past century? A) disease prevention B) health promotion C) wellness D) morbidity and mortality analysis
D
A nurse is reading a journal article about the trends in health care and health care delivery over the past several centuries. When reading about the practices during the 18th century, which information would the nurse most likely find? A) use of physicians for birth B) epidemics of puerperal fever C) use of twilight sleep for childbirth D) absence of men attending childbirth
D
The nurse is making a home visit to a client who had a cesarean birth 3 days ago. Assessment reveals that the client is complaining of intermittent pain, rating it as 8 on a scale of 1 to 10. She states, "I'm pretty tired. And with this pain, I haven't been drinking and eating like I should. The medication helps a bit but not much. My mom has been helping with the baby." Her incision is clean, dry, and intact. The nurse would identify which problem as the priority for this client? A) integrity of the incision B) fatigue C) inadequate nutrition D) acute pain
D
When assessing a family for possible barriers to health care, the mother reports several problems she has been having when coming to her local clinic. The nurse would consider which reported problem as having the greatest impact on this family's health care? A) language barrier B) health care workers' attitudes C) transportation to the clinic D) family finances
D
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? A) epidemics of puerperal fever B) performance of the first cesarean birth C) X-ray developed to assess pelvic size D) development of free-standing birth centers
D
