Old's Maternity Ch 15

The school nurse is planning a presentation on pregnancy for 13- and 14-year-olds who are currently pregnant. When planning the content of this presentation, what should the nurse keep in mind about these teens? 1. They are working on independence and autonomy. 2. They are no longer developing a sense of achievement. 3. They are confident in their own identity. 4. They are in control of their impulses.

Answer: 1 Explanation: 1. The developmental tasks of adolescence include developing an identity, gaining autonomy and independence, developing intimacy in a relationship, developing comfort with one's own sexuality, and developing a sense of achievement. Teens in early adolescence will not have achieved all of these tasks yet.

The nurse is working with a group of pregnant teens. Which statement indicates that teaching has been successful? 1. "Pregnant teens are more likely to quit school prior to graduation." 2. "Because I am young, I have a low risk for preeclampsia." 3. "My baby could come late because I am a teenager." 4. "I am more likely to use birth control after I have this baby."

Answer: 1 Explanation: 1. Many teenage mothers drop out of school during their pregnancy and then are less likely to complete their schooling.

The nurse seeks to involve the adolescent father in the prenatal care of his girlfriend. What is the rationale for this nursing strategy? 1. Having the father more involved with the birth 2. Avoiding conflict between the adolescent father and pregnant teenager 3. Including his name of the birth certificate 4. Avoiding legal action by the adolescent father's family

Answer: 1 Explanation: 1. Many young fathers genuinely want to be involved with their children and would have more contact and input if they could.

A nurse working in an adolescent clinic that deals with birth control, pregnancy, and referrals for adoption has a number of clients in early adolescence. Clients in that age group are how old? 1. 11-16 years old 2. 11-14 years old 3. 14 and 15 years old 4. 12-15 years old

Answer: 2 Explanation: 2. The age range for early adolescence is age 14 and under.

The nurse discussing different pregnancy programs explains that which of the following is critical to the success of an adolescent pregnancy-prevention program? 1. Including role models from the same cultural and racial backgrounds 2. Focusing on the adolescent female 3. Having short-term, informal programs available twice per year 4. Focusing on the expectations of the adolescents' parents

Answer: 1 Explanation: 1. The National Campaign to Prevent Teen and Unplanned Pregnancy's task forces found that the programs most effective at preventing teen pregnancy include models from the same cultural and racial backgrounds as the participants.

The nurse is working with male teens whose partners are pregnant. What statement by the father-to-be requires that the nurse intervene? 1. He will be the only other person who will be present for the birth, although his girlfriend wants her mother to be with her. 2. He was very sexually active at an earlier age and he has had more sexual partners than his girlfriend. 3. The pregnancy does not seem real to him, and he is not sure what he should do to plan for the future. 4. He does not want to be married.

Answer: 1 Explanation: 1. Even if the adolescent father has been included in the health care of the client throughout the pregnancy, it is not unusual for her to want her mother as her primary support person during labor and birth. Overriding his girlfriend's expressed desire could be an indication that their relationship is abusive.

The 19-year-old pregnant woman begins a job to "save money for the baby." What is the most significant developmental task the nurse understands this statement to demonstrate? 1. Striving for gaining autonomy and independence 2. Completed development of a sense of identity 3. Attainment of a sense of achievement 4. Having developed an intimate relationship

Answer: 1 Explanation: 1. Having a job is how most teens develop financial independence and autonomy.

After telling a mother that her 13-year-old daughter is pregnant, the nurse would expect the mother to respond with which statement? 1. "We had such high hopes for you." 2. "But you have always been a happy child." 3. "I've always liked that boy." 4. "This is just one of those things that happen."

Answer: 1 Explanation: 1. When an adolescent pregnancy is first revealed to the teen's mother, the result is often anger, shame, or sorrow. The degree of negative response will be determined by the age of the teen, the family expectations for the teen, and the presence or absence of other teen pregnancies in the family or support network.

In planning a program to reduce teen pregnancy rates, the nurse uses an evidence-based approach. The nurse learns that more research is needed for which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Teen pregnancy rate in the United States 2. Use of birth control by adolescents 3. Prevention of sexually transmitted infections 4. Long-active, reversible contraception is highly effective for teens 5. Intrauterine devices are safe and effective when used by adolescents

Answer: 1, 2, 3 Explanation: 1. The teen pregnancy rate in the United States requires more research. 2. The use of birth control by adolescents requires more research. 3. Preventing sexually transmitted infections in teenagers requires more research.

A nurse working with adolescents recognizes risk factors for pregnancy include which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Low socioeconomic status 2. A belief in invulnerability 3. A highly functional family 4. Physical, emotional, or sexual abuse 5. Accurate information about contraception

Answer: 1, 2, 4 Explanation: 1. Poverty is a major risk factor for adolescent pregnancy. 2. The sense of invulnerability and "it won't happen to me" thinking can lead adolescents to participate in sexual activity with an overly optimistic view of the outcomes of the risks associated with their actions. 4. Physical, emotional, or sexual abuse increases the risk of teenage pregnancy.

The nurse is planning a prenatal class for a group of pregnant adolescents. The nurse will establish which goals for the class? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Provide anticipatory guidance 2. Prepare the participants for labor and birth 3. Avoid discussion of the client's conflicts 4. Provide community resources if asked 5. Help the participants develop coping skills

Answer: 1, 2, 5 Explanation: 1. Goals for a prenatal class designed for adolescents must include anticipatory guidance. 2. Goals for a prenatal class designed for adolescents must include preparing the participants for labor and the birth of their baby. 5. Goals for a prenatal class designed for adolescents must include helping the participants develop adequate coping skills.

Which statements might a pregnant teenager be likely to make at her initial prenatal examination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I didn't know I could get pregnant the first time I had sex." 2. "Several of my friends go to clinics to get contraception." 3. "It's no big deal; two of my best friends have babies, too." 4. "I was 13 years old when I had sex the first time." 5. "My family and my boyfriend are really happy and supportive."

Answer: 1, 3, 4 Explanation: 1. Many factors contribute to the high teenage pregnancy rate, and one of them is lack of knowledge about conception. 3. Many factors contribute to the high teenage pregnancy rate, and one of them is a decreased social stigma of being a young and single mother. 4. Many factors contribute to the high teenage pregnancy rate, and one of them is a younger age at onset of sexual activity.

The nurse is evaluating the expected outcomes of care for a pregnant adolescent. For the evaluation, the nurse will ask which of the following questions? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Was a trusting relationship developed? 2. Did the adolescent explore financial options open to teen parents? 3. Did the adolescent make plans for continuing her education? 4. Can the adolescent problem-solve? 5. Did the adolescent follow recommendations?

Answer: 1, 4, 5 Explanation: 1. A trusting relationship must be developed with the adolescent client. 4. The adolescent must be able to appropriately problem-solve. 5. The adolescent must follow the recommendations of the healthcare team to deliver a healthy baby.

The nurse's goals for prenatal classes may include which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Increasing self-esteem 2. Preparing the participants for childrearing 3. Offering information on the risks of breastfeeding 4. Providing anticipatory guidance about pregnancy 5. Helping participants develop more adaptive coping skills

Answer: 1, 4, 5 Explanation: 1. Goals for prenatal classes would include increasing self-esteem. 4. Goals for prenatal class would include providing anticipatory guidance about pregnancy. 5. Goals for prenatal class would include helping participants develop more adaptive coping skills.

A 16-year-old is making her first prenatal visit to the clinic in her fourth month of pregnancy. What is the nurse's first responsibility? 1. Contact the social worker. 2. Develop a trusting relationship. 3. Schedule the client for prenatal classes. 4. Teach the client about proper nutrition.

Answer: 2 Explanation: 2. Developing a trusting relationship with the pregnant adolescent is essential. Honesty and respect for the individual and a caring attitude promote the client's self-esteem.

The nurse is working in a teen pregnancy clinic. In order to give the pregnant adolescent a role in her prenatal care, the nurse should allow the teen to do which of the following? 1. Choose the type of prenatal vitamin she takes 2. Measure and record her weight at each visit 3. Choose the schedule of her prenatal visits 4. Decide whether she wants her labor to be induced

Answer: 2 Explanation: 2. Having the client weigh herself and record her weight provides her the opportunity to participate in her own care plan.

Which of the following is the most prevalent medical complication of pregnant adolescents? 1. Constipation 2. Preeclampsia-eclampsia 3. Heartburn 4. Rapid enlargement and sensitivity of breasts

Answer: 2 Explanation: 2. Preeclampsia-eclampsia is the most prevalent medical complication of pregnant adolescents and is typically characterized by high blood pressure, proteinuria, and edema.

In planning a conference for adolescents, the nurse researches the most common socioeconomic and cultural factors that contribute to adolescent pregnancy. Which true statements should be included in this conference? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Economic status has a relatively low impact on an adolescent's sexual activity. 2. Nearly three quarters of all teens ages 15-19 have had sex at least once. 3. Poor self-esteem contributes to adolescent pregnancy. 4. 38% percent of sexually active students use a condom. 5. Sexual abuse is not an issue with teen mothers.

Answer: 2, 3 Explanation: 2. By 19 years of age, 70% of all teens have had intercourse. 3. This is a true statement. Poor self-esteem is a major contributing factor in adolescent pregnancy.

The nurse is preparing an in-service presentation for a group of middle-school nurses. Which statements by the nurse would indicate that the middle-school nurse understood the role of culture in adolescent pregnancy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Studies show that 85% of teen mothers are middle class, and give birth to gain adult status." 2. "Teenage pregnancy is the leading reason why adolescent women drop out of school." 3. "Teens of color are more likely to become pregnant." 4. "Intelligence and academic ability are positively associated with delayed sexual activity, greater use of contraception, and lower rates of pregnancy." 5. "Over 50% of adolescents who have had an abortion or recent birth become pregnant again within two years."

Answer: 2, 3, 4 Explanation: 2. An estimated 30% to 40% of female teenage dropouts are mothers. 3. In the United States, the adolescent birth rate is higher among African American and Hispanic teens than among white teens. To some degree, the higher teenage pregnancy rate in these groups reflects the impact of poverty because a disproportionately higher number of African American and Hispanic youths live in poverty. 4. Teens with future goals (i.e., college or job) tend to use birth control more consistently compared with other teens; if they become pregnant, they are also more likely to have abortions.

The nurse is working with a community group to reduce teen pregnancy rates. Alternatives for the group to consider include which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Avoidance of sex education in schools 2. High-quality reproductive health services 3. Developmentally appropriate sex education 4. Sexuality curriculum based on community beliefs 5. Provision of strategies to enhance life skills

Answer: 2, 3, 5 Explanation: 2. Having access to high-quality reproductive health services is important in reducing adolescent pregnancy rates. 3. Providing developmentally appropriate sex education is an approach that reduces adolescent pregnancy. 5. Programs that provide strategies to enhance life skills are more successful in reducing adolescent pregnancy rates.

When working with pregnant adolescents, the nurse plans on assessing which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. High-birth-weight infants 2. Pelvic measurements 3. For sexually transmitted infections 4. Low blood pressure readings 5. Hemoglobin and hematocrit

Answer: 2, 3, 5 Explanation: 2. Teenagers are more likely to have cephalopelvic disproportion. 3. Teenagers are more likely to have sexually transmitted infections. 5. Teenagers are more likely to be anemic, so the hemoglobin and hematocrit must be assessed.

The nurse who is counseling a group of middle-school girls on pregnancy avoidance should include which statement? 1. "Although sexuality is common in the media, peer pressure to have sex is not an important factor." 2. "It has become far less acceptable to give birth during your teenage years than it used to be." 3. "Although condom use is growing, there is still an increasing rate of STIs among teens." 4. "You have learned enough from your friends and families to understand how pregnancy occurs."

Answer: 3 Explanation: 3. Condom use is increasing, but the rate of STI infections, including HIV, is also rising.

A 14-year-old girl is brought to the clinic by her mother. The nurse determines that the teen is about 28 weeks pregnant. The mother states, "We knew she was gaining weight, but we can't tell anyone she is pregnant." The nurse understands that the client's mother's behavior exemplifies which of the following? 1. Low self-esteem 2. Anger 3. Shame 4. Ignorance

Answer: 3 Explanation: 3. In families who foster educational and career goals for their children, adolescent pregnancy is often a shock. Anger, shame, and sorrow are common reactions.

Which statement made by the pregnant adolescent would indicate to the nurse that she understood her increased risk of physiologic complications during pregnancy? 1. "It's no big deal that I started prenatal care in my seventh month." 2. "My anemia and eating mostly fast food are not important." 3. "I need to take good care of myself so my baby doesn't come early." 4. "Smoking and using crack cocaine won't harm my baby."

Answer: 3 Explanation: 3. In the adolescent age group, prenatal care is the critical factor that most influences pregnancy outcome.

The nurse has been asked by a community organization to give a presentation on prevention of teen pregnancy. Which statement indicates appropriate steps toward reduction of the local teen pregnancy rate? 1. Abstinence-only education will be offered in the school and clinics. 2. Classes on how to parent will be mandatory in high school. 3. A low-cost reproductive health clinic will be planned. 4. Parents will be encouraged to avoid discussing sexual activity.

Answer: 3 Explanation: 3. Key strategies for prevention of unintended teen pregnancy and sexual health promotion include the provision of services that ensure accessible and high-quality reproductive health care; sex education programs that provide developmentally appropriate, evidence-based curricula; and youth development strategies to enhance life skills. A low-cost reproductive health clinic would be able to provide these services.

The pregnant 16-year-old is seeing the nurse during a prenatal visit. Based on the client's developmental level, which statement would the nurse expect the client to make? 1. "My friends and I all wear totally different styles of clothing." 2. "Having a baby will change my college plans." 3. "I drink alcohol at parties most weekends." 4. "My mom is my best friend."

Answer: 3 Explanation: 3. Middle adolescence (15-17) is a time of experimentation, including drinking alcohol, using other drugs, and sex.

Several adolescent female students are waiting to be seen by the school sexual health clinic nurse. Which student should the nurse see first? 1. 14-year-old whose 17-year-old sister is pregnant 2. 15-year-old who reports using condoms regularly 3. 16-year-old who had chlamydia treated 2 weeks ago 4. 17-year-old with a history of child abuse

Answer: 3 Explanation: 3. This client is the top priority. Teenagers 15 to 19 years old have a high incidence of STIs. The incidence of chlamydial infection is increased in this age group. The presence of such infections during a pregnancy greatly increases the risk to the fetus.

The nurse is talking with the parents of a pregnant 15-year-old. Which statement by one of the parents is expected? 1. "We're very happy for her. It will be easier to focus on education with a new baby." 2. "I'm not going to get involved. She understands how her health insurance works." 3. "Her father told her to stop dating that boy. Now look at the trouble she's gotten into." 4. "An abortion is the best choice for her. She can deal with our Catholic priest later."

Answer: 3 Explanation: 3. This statement indicates anger, which is to be expected when a parent finds out about a teen daughter's pregnancy.

During the initial prenatal visit, the pregnant teenager states that she does not know how she got pregnant. The nurse can help to educate her regarding anatomy by doing what? 1. Allowing her to witness a pelvic exam on another teenager 2. Encouraging her to ask her mother about the physiology of pregnancy 3. Including anatomic models and drawings in the teaching session 4. Discussing the process of fetal development with the client

Answer: 3 Explanation: 3. To teach the client about anatomy and physiology, use simple explanations and lots of audiovisuals.

The nurse has given a community presentation on adolescent pregnancy. Which statements indicate that further teaching is necessary? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Low educational achievement is major risk factor for adolescent pregnancy." 2. "Teens who are on a low economic trajectory are more likely to become pregnant." 3. "When a teen plans to attend college, abortion is less likely." 4. "In the United States, the adolescent birth rate is higher among white teens." 5. "Teens from low-income households are less likely to become pregnant."

Answer: 3, 4, 5 Explanation: 3. Teens with future goals (i.e., college or job) tend to use birth control more consistently compared with other teens; if they become pregnant, they are also more likely to have abortions. 4. In the United States, the adolescent birth rate is higher among African American and Hispanic teens than among white teens. 5. Poverty is a major risk factor for adolescent pregnancy. As many as 85% of births to unmarried teens occur to those from poor or low-income families.

The nurse is teaching a pregnant 14-year-old client who is at 10 weeks' gestation about the expected body changes that will occur during pregnancy. Which client statement indicates that additional information is needed? 1. "My breasts are going to get even bigger than they've gotten over the past couple of years." 2. "My belly will gradually get more round, especially from the middle of pregnancy on." 3. "I will feel my baby move in about 16 weeks." 4. "My diet can stay the same even though I'm pregnant."

Answer: 4 Explanation: 4. Because the adolescent is at risk for anemia, she will need education regarding the importance of iron in her diet.

The nurse is working at a clinic for pregnant teens. What issues related to development will the nurse expect to encounter in most of the pregnant clients? 1. Peer pressure to stop using alcohol once pregnancy is diagnosed 2. Contraception failure that resulted in this pregnancy 3. The father of the baby's being emotionally supportive to the client 4. Feelings of not living up to parents' expectations

Answer: 4 Explanation: 4. Pregnant teens face risk factors based on the developmental tasks of adolescence. One of these is developing an identity. If the adolescent feels she has not lived up to parental expectations by becoming pregnant, she could adopt a negative identity.

The nurse developing a care plan for a pregnant teen knows that what plan is best suited to pregnant teens? 1. Assess menstrual history and the presence of any food allergies. 2. Inquire about family relationships and location of the home. 3. Ask what her body image is, then correct her misconceptions. 4. Determine whether there are substance abuse issues.

Answer: 4 Explanation: 4. Substance abuse issues are important to assess during pregnancy of teens.

The nurse working in an adolescent prenatal clinic knows which of the following about the clients who are 15-17 years old? 1. They are more at ease with their individuality. 2. They see authority as resting with parents. 3. They are able to solve problems and make decisions. 4. They seek independence and identify with their peer group.

Answer: 4 Explanation: 4. Teens who are in middle adolescence (15-17 years old) seek independence and identify with their peer group.

Recommendations for parents to help their teens avoid pregnancy include which of the following? 1. Parents need to encourage frequent and steady dating. 2. Parents need to let their children set their own goals for the future. 3. Parents need to have their children taught about sex by school programs and community resources. 4. Parents should be clear about their own sexual attitudes and values.

Answer: 4 Explanation: 4. This is true. Parents should be clear about their own sexual attitudes and values in order to communicate clearly with children.