Prep-U Ch. 1

The nurse is reviewing the medical records of several infants. Which infant is at highest risk for death according to the infant mortality rate in the United States?

An infant born at a low birth weight. Rationale: Infant mortality in the United States is associated with low birth weight, prematurity, and congenital abnormalities, among other concerns. An infant born to young or older parents, or at 38 weeks' gestation, would not be considered low birth weight or premature nor considered to be at higher risk for congenital abnormalities.

A nurse who specializes in maternal and child health care performs many varied functions in diverse settings over the course of a year. Which action would be outside the nurse's scope of practice?

Assist in the treatment and recovery of a woman with ovarian cancer. Rationale: 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 is conducting a presentation for a group of pregnant women about appropriate health promotion strategies to address issues related to infant mortality. Which strategy would the nurse encourage to reduce the infant's risk for infection after birth?

Breastfeeding Rationale: After birth, other health promotion strategies 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 long-term health. Emphasizing the importance of placing an infant on his or her back to sleep will reduce the incidence of SIDS. Newborn development support groups will help provide education about normal child development and child rearing. Folic acid supplementation is used during pregnancy to prevent neural tube defects.

Which statement best describes the pattern of maternal mortality since World War II?

It has steadily decreased. Rationale: Improved prenatal care and early ambulation after birth are factors that have decreased maternal death rates following birth over the past 70 years.

The nurse is reviewing the nursing care plan on a pediatric client admitted to the hospital with a respiratory illness. Which goal is written correctly?

The client will have an oxygen saturation of greater than 95% on room air within 8 hours. Rationale: Goals must be specific, measurable, and have a time frame. The goal identified as "The client will have an oxygen saturation of greater than 95% on room air within 8 hours" includes both measurable, objective information (the oxygen saturation on room air and a time frame). It is client-centered and appropriate. The goals of "breathing better" and "better respiratory rate and oxygen saturation" are vague and do not have a measurable outcome. What is considered "better" is subjective and not measurable. Not having a time frame makes the goal inaccurate as well. The goal of the client walking a specific distance on room air would be a good goal if a date/time frame were included in the goal.

A program designed to decrease the infant mortality rate in the United States would probably make the greatest impact if it focused on which aspect of care?

increasing the number of women receiving prenatal care. Rationale: Receiving prenatal care has proven to be a major strategy for reducing infant mortality. The other interventions will not directly impact infant mortality rates to the degree that prenatal care will.

A pregnant client wishes to qualify for services from the Special Supplemental Nutrition Program for Women, Infants, and Children (SNAP). What medical criteria will the nurse use to determine qualification for these services? Select all that apply.

age of the mother, history of poor pregnancy outcomes, weight of the mother. Rationale: The SNAP program is a federally funded program with the goal of enhancing the nutritional status of women and children. Women and children must first meet income eligibility, and a trained health professional screens applicants for nutritional risk factors based on federal guidelines. These risk factors may be either medically based or diet based. Individuals with pregnancy complications, young maternal age, who have had poor pregnancy outcomes, and those who are underweight represent clients with medically-based risk factors. The number of pregnancies and previous cesarean births are not included in these risk factors.

The nursing process is a scientific method and proven form of problem solving. It includes what component?

planning Rationale: The nursing process is a proven form of problem solving based on the scientific method. The nursing process consists of five components: Assessment, Nursing diagnosis, Outcome identification and planning, Implementation, and Evaluation.

The pediatric nurse is reviewing statistics on the risks of morbidity and mortality among children. What does the nurse identify as the largest risk to all children and adolescents in the United States?

unintentional (accidental) injury Rationale: Unintentional injury, frequently as the result of motor vehicle accidents, is the largest risk to all children and adolescents in the United States.

The nurse is providing care to a woman who has just given birth to a healthy term neonate. The woman's partner arrives and asks about the neonate's status. Which action by the nurse would be appropriate?

Check the medical record for written client approval with whom to share information. Rationale: In maternal and newborn health care, information is shared only with the client, legal partner, parents, legal guardians, or individuals as established in writing by the client or the child's parents. This law promotes the security and privacy of health care and health information for all clients. Therefore, the nurse needs to check the medical record for written documentation that allows the partner to have this information. Any other action would be inappropriate.

A nurse is working as part of a larger community group to develop programs to address current barriers to health care being experienced by women. The community is in the city with a large population of low-income families. On which factor should the group focus their efforts to address a main barrier to access to care?

Health Insurance Rationale: Although transportation, language and culture, and low health literacy are barriers to health care, health insurance is a major factor affecting access to health care. The existence of financial barriers is one of the most important factors that limits access to care. Many families do not have health insurance so they cannot afford to see health care providers for maintenance and prevention services. Many do not have enough health insurance to cover services they need or cannot pay for services.