Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care

Cost containment in the health care field has become a sought-after necessity because of rising costs and the influence of managed care. Nurses are instrumental in assisting with cost containment of health care by prioritizing which strategy? a. Health promotion b. Alternative birth systems c. Client teaching d. Quality improvement

a. Health promotion

An infant at 33 weeks' gestation dies after 1 week of life in the neonatal intensive care unit. This infant's death rate would be classified under which statistical category? a. neonatal death b. infant death under one month c. preterm gestational death d. postneonatal death

a. neonatal death

A nurse is providing care to several clients. Which client would the nurse identify as being unable to provide consent for health care? a. 14-year-old male b. 20-year-old male c. 17-year-old married female d. 24-year-old pregnant female

a. 14-year-old male

Before World War II women moved from home to hospital births. What was the primary reason for that shift in maternity care? a. They had no other options as many could not afford midwives. b. They were convinced that setting would provide them with natural birth. c. They were convinced that setting would lessen the pain of labor. d. They were convinced that setting would improve birth outcomes.

d. They were convinced that setting would improve birth outcomes.

A nurse has started working at a new clinic that treats local immigrants. Which factor about the clients would be most important for the nurse to acknowledge when caring for them? a. language b. level of enculturation c. ethnic background d. differences in culture

d. differences in culture

The nurse is caring for several families enrolled in Medicaid in the prenatal setting. Which statement by an expectant mother would alert the nurse to assess the family further? a. "We just moved here from another state and I am still getting used to the new town." b. "I plan to give birth in a hospital setting with my family at my side." c. "In my culture, we have family help us care for the baby in our home for several months." d. "My sister-in-law is due to have her baby the same month as our baby is due."

a. "We just moved here from another state and I am still getting used to the new town."

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? a. An infant born at a low birth weight b. An infant born to adolescent parents c. An infant born at 38 weeks' gestation d. An infant born to a 43-year-old mother

a. An infant born at a low birth weight

A nurse is providing care to a pregnant client who is to undergo an amniocentesis. Which action would be most appropriate for the nurse to perform related to the client's informed consent? a. determining the client's understanding of the procedure b. explaining the potential risks and benefits c. describing the procedure in detail d. providing information about alternative methods that are available

a. determining the client's understanding of the procedure

A nurse is providing care to a woman who has just given birth to a healthy newborn. Which action would least likely demonstrate application of the concept of family-centered care? a. encouraging the woman to keep her other children at home b. focusing on the birth as a normal healthy event for the family c. creating opportunities for the family to make informed decisions d. fostering a sense of respect for the mother and the family

a. encouraging the woman to keep her other children at home

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

a. health promotion

The nursing student demonstrates an understanding of fetal mortality rates when compared to the other mortality rates when she correctly describes the fetal mortality rate by which statement? a. "Statistically, fetal mortality rates are calculated based upon the number of infant deaths occurring in the first 3 months of life per 1,000 live births." b. "The fetal mortality rate includes the intrauterine death of a fetus who is 20 weeks of gestation or more per 1,000 live births." c. "Fetal mortality rates encompass the number of infant deaths occurring in the first 28 days of life per 1,000 live births." d. "The death of a fetus in the first 12 weeks of gestation per 1,000 live births comprises the fetal mortality rate."

b. "The fetal mortality rate includes the intrauterine death of a fetus who is 20 weeks of gestation or more per 1,000 live births."

A pregnant client comes to the local health clinic for her scheduled prenatal visit. On her chart, the nurse notices that the client indicated that she resides in an extended family situation. Which arrangement would validate this information? a. She lives with her best friend and her three children. b. She lives with her grandmother, her uncle, her mother, and her younger sister. c. She lives with her husband and her daughter and son, of whom she has joint custody. d. She lives with her mother, stepfather, and his two sons.

b. She lives with her grandmother, her uncle, her mother, and her younger sister.

A group of nursing students are comparing the various changes in maternity care over the course of history and discover that the development of what medical treatment was mostinfluential in moving birth from the home into the hospital setting? a. Infection control and germ theory b. Planned cesarean birth c. Anesthesia and analgesic therapy d. Instruments to assist in birth of infants

c. Anesthesia and analgesic therapy

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. "Are you sure you want to do that?" b. "Have you notified the father?" c. "I don't know of any health care providers who will perform them." d. "I'll put together the information that you will need."

d. "I'll put together the information that you will need."

A nurse has just assisted in the birth of a premature neonate. The nurse recognizes that which factor, when associated with prematurity, is a leading cause of death in neonates? a. low birth weight b. season of the year c. maternal hemorrhage d. gestational diabetes

a. low birth weight

A group of students are reviewing the historical aspects of birth. The students demonstrate understanding of the information when they identify the use of twilight sleep as a key event during which time frame? a. 1700s b. 1900s c. 1800s d. 2000s

b. 1900s

A client who has just given birth is concerned about the high rate of infant mortality in the United States. She is anxious about the health of her child and wants to know ways to keep her baby healthy. Which recommendation would best meet this goal? a. Give the infant liquid vitamins daily. b. Breast-feed the infant. c. Begin feeding of solids by age 4 months. d. Place the infant on his or her back to sleep.

b. Breast-feed the infant.

A nurse has just started working at a clinic that has a large refugee client population. When providing care to this population group, which aspect would be most important for the nurse to recognize? a. cultural differences b. language c. ethnic background d. lack of understanding of American ways

a. cultural differences

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? 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. Discuss methods of alleviating morning sickness with a client in her first trimester. d. Provide preconceptual health care to a client.

a. Assist in the treatment and recovery of a woman with ovarian cancer.

The nursing instructor is introducing students to Healthy People 2020, which highlights the major health indicators of the 21st century that need to be addressed. The nurse informs the students that this includes national health goals for maternal, infant, and child health. Which goals would be included? Select all that apply. a. Reduce fetal and infant death rates. b. Reduce maternal weight gain. c. Reduce maternal deaths. d. Increase infant birth weights. e. Reduce preterm births. f. Increase the number of scheduled cesareans.

a. Reduce fetal and infant death rates. c. Reduce maternal deaths. d. Increase infant birth weights. e. Reduce preterm births.

A nurse is conducting a presentation for a group of pregnant women about factors affecting maternal and newborn health. When discussing the family as an influential factor, which information would the nurse need to keep in mind? a. The uniqueness of families requires specific methods for support. b. Family implies legal relationships of the people living together. c. Roles of family members exert minimal influence on a newborn's health status d. Family structure has remained relatively constant over time.

a. The uniqueness of families requires specific methods for support.

A nurse is working as part of an interdisciplinary team providing care to women and children at a local community center. The nurse advocates for and provides comprehensive care to the clients across the continuum of care. The nurse is acting as: a. case manager. b. case evaluator. c. quality control monitor. d. education manager.

a. case manager.

A woman comes to the prenatal clinic for a follow-up visit. During the assessment, the nurse notes multiple bruises over the client's arms, thighs, and back that are in various stages of healing. Which action would be most appropriate? a. Question the client about the pregnancy. b. Document the findings. c. Report the client's spouse to law enforcement authorities. d. Send the client to local women's shelter.

b. Document the findings.

A nurse is caring for a critically ill female client who has recently been diagnosed with advanced lung cancer. The family asks the nurse why their mother's cancer is so advanced and was not detected earlier. Which response would be most accurate and appropriate? a. Women have a stronger resistance against lung cancer initially. b. Lung cancer has few early symptoms and is often explained away as some other minor illness. c. Lung cancer progresses faster in women than men. d. Lung cancer is more challenging to diagnose in women than in men.

b. Lung cancer has few early symptoms and is often explained

The nursing faculty is explaining the historical background regarding the reasoning for the introduction of nurseries in the 1900s to her students. Which statement most accurately explains the reason for the nurseries? a. Mothers could not care for their babies after receiving an spinal block. b. Mothers could not care for their babies due to chloroform gas. c. Nurses wanted to be the sole caregiver of the babies to promote better outcomes. d. Mothers wanted to rest after 9 months of pregnancy and labor.

b. Mothers could not care for their babies due to chloroform gas.

A nurse is preparing a breast cancer presentation for a health forum. Which fact would the nurse expect to address in this presentation? a. Black women have the BRCA1 and BRCA2 gene. b. White women respond better to breast cancer treatment. c. Breast cancer is more advanced in Black women when found. d. More Hispanic women smoke, which increases their risk.

c. Breast cancer is more advanced in Black women when found.

A group of nurses are discussing the most recent statistics on death due to prematurity in the United States. Which action, if implemented, would have the greatest impact on improving outcomes? a. Examine health disparities between ethnic groups. b. Track the incidence of violent crime against pregnant women. c. Improve women's access to receiving prenatal care. d. Identify specific national health goals related to maternal and infant health.

c. Improve women's access to receiving prenatal care.

When describing birth during the 18th century, which description would be most accurate regarding maternal care during pregnancy and birth? a. Heavy doses of narcotics were used during labor. b. Books on birth education became readily available. c. The majority of births occurred in the home with female midwives in attendance. d. Streptococci were identified as the major cause of puerperal fever.

c. The majority of births occurred in the home with female midwives in attendance.

The nurse is organizing health information to teach a client basic principles that will help maintain wellness in the family. Which actions should the nurse prioritize in this teaching? a. teaching insulin injection techniques b. medication administration c. encouraging yearly checkups for all clients. d. assisting in understanding a treatment

c. encouraging yearly checkups for all clients.

A nurse is conducting research in preparation for developing programs to improve maternal and newborn health. The nurse is reviewing statistics revealing the number of infant deaths occurring in the first 28 days of life. The nurse is researching which rate? a. fetal mortality rate b. perinatal mortality rate c. neonatal mortality rate d. infant mortality rate

c. neonatal mortality rate

The World Health Organization's definition of health was approved in 1948 and included a definition of health as "a state of complete physical, mental, and social well-being." What data was not a part of this definition? a. the idea that access to health care and use of health care facilities are not the primary influence on current health b. mental health viewed as a state of well-being in a person who can cope with stress and be a contributing member of society c. the new understanding of disease at cellular, individual, and societal levels d. the WHO's beliefs that the main determinants for health are our environment, who we are, what we do, and society in general

c. the new understanding of disease at cellular, individual, and societal levels

A group of women are attending a community presentation regarding the leading health concerns of women. Which interventions should the nurse recommend to have the greatest impact on the leading cause of death? a. yearly gynecological exams b. prompt attention to respiratory tract infections c. weight control and being knowledgeable about family history of cardiovascular disease d. regular neurological exams to note any cognitive or behavioral changes early

c. weight control and being knowledgeable about family history of cardiovascular disease

The nursing student correctly identifies which statement to be the contributing factor that made hospitals more attractive for births in the early 1900s? a. Hospitals allowed for the father to be involved in the birthing process. b. Hospitals had nurse midwives in attendance for births. c. Mothers who planned hospital births were provided with birth classes. d. Giving birth in a hospital suggested affluence, and the hospital provided pain management.

d. Giving birth in a hospital suggested affluence, and the hospital provided pain management.

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

d. It has steadily decreased.

A nurse is doing a literature search on maternal mortality and finds that direct causes comprise the majority of maternal deaths. Direct causes are noted to be unpredictable reasons. Which action would be most appropriate to implement that would have the greatest impact on reducing these numbers? a. Monitoring maternal glucose levels in mothers with type 1 diabetes. b. Administering oxytocic medications for increased postpartum bleeding. c. Referring to a cardiologist for any arrhythmias. d. Practicing high standards of infection control. e. Beginning antibiotics prior to birth for a febrile mother.

d. Practicing high standards of infection control.

A nurse is caring for a 31-year-old pregnant client who is subjected to intimate partner violence. The client has developed a feeling of hopelessness and does not feel confident in dealing with the situation at home, which makes her feel suicidal. Which nursing intervention should the nurse offer to help the client deal with her situation? a. Help the client understand the legal impact of her situation to help protect her. b. Counsel the client's partner to refrain from subjecting his partner to violence. c. Introduce the client to a women's rights group. d. Provide emotional support to empower the client to help herself.

d. Provide emotional support to empower the client to help herself.

A client, 6 hours post-birth, has a severe postpartum hemorrhage that the health care providers are unable to control. She succumbed to the hemorrhage in the intensive care unit. The client's death would become part of the: a. maternal morbidity rate. b. neonatal morbidity rate. c. neonatal mortality rate. d. maternal mortality rate.

d. maternal mortality rate.

A nurse is conducting an in-service program for a group of maternal-neonatal nurses about factors affecting maternal and newborn health. As part of the presentation the nurse describes how the family has changed over the years. The nurse determines that the teaching was successful when the group identifies which family structure as having been considered the traditional structure? a. blended b. single-parent c. binuclear d. nuclear

d. nuclear

The nurse working in a free health clinic is providing care to a 1-year-old girl and her single teenage mother. Which action would be most important initially? a. discussing family health history b. assessing the child's cognitive level c. obtaining food stamps for the family d. observing the mother/child interaction

d. observing the mother/child interaction