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

Who is responsible for obtaining informed consent from a pregnant woman?

physician, advanced practice nurse, midwife

Fetal deaths later in pregnancy greater than 20 weeks of gestation are known as

stillbirths

What is the definition of fetal mortality rate?

the spontaneous intrauterine death of a fetus at any time during pregnancy per 1,000 live births

What are factors that impact maternal and women's health?

violence, nutrition, lifestyle choices, stress and coping abilities, access to health care, preventive care focus

Who is a certified nurse midwife?

a nurse with advanced practice training in the care of women, specific to pregnancy and birth

A female client comes to the emergency room with pain in her jaw and neck, being dizzy and feeling so tired she just wants to sit or lie down. What priority nursing intervention(s) should the nurse include in this client's plan of care? Select all that apply. a. insert a peripheral IV b. assess the blood pressure c. obtain cardiac enzymes d. assess the level of pain e. perform an electrocardiogram

a, b, c, e

A nurse is conducting a class about breast cancer for a group of young adult women. Which statements by the class indicates to the nurse that the teaching was successful? SATA a. "If someone in the family has breast cancer, my risk would be increased." b. "Being underweight is a major risk factor for developing breast cancer." c. "A diet high in fat can be a risk factor for developing breast cancer." d. "Using condoms and spermicides increase a woman's risk for breast cancer." e. "My risk is increased if I had an irregular menstrual cycle starting at an early age."

a, c, e

The nursing instructor is introducing students to Healthy People 2030, which highlights the major health indicators that need to be addressed. The nurse informs the students that this includes national health goals for maternal, infant, and child health. Which goal(s) would be included? SATA a. reduce infant deaths b. reduce maternal weight gain c. increase the number of scheduled cesarean births d. reduce the rate of fetal deaths at 20 or more weeks of gestation e. increase infant birth weights f. reduce preterm births

a, d, e, f

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? a. health insurance b. transportation c. language d. low health literacy

a. health insurance

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. weight control and being knowledgeable about family history of cardiovascular disease b. regular neurologic exams to note any cognitive or behavioral changes early c. prompt attention to respiratory tract infections d. yearly gynecological exams

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

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? a. breastfeeding b. folic acid supplementation c. sleeping on the back d. newborn development support groups

a. breastfeeding

A nurse is providing care to a 10-month-old infant who is brought to the free clinic by her 18-year-old mother. Which action by the nurse would be the priority at this initial visit? a. conducting an assessment of the infant's cognitive milestones b. obtaining a pregnancy history from the mother c. observing the interaction between the mother and infant d. interviewing the mother about her beliefs

a. conducting an assessment of the infant's cognitive milestones

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. creating opportunities for the family to make informed decisions c. focusing on the birth as a normal healthy event for the family d. fostering a sense of respect for the mother and the family

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

What is informed consent?

an agreement by a client to undergo an operation or medical treatment after being informed of and understanding the risks involved

A nurse is caring for a pregnant woman who has come to the prenatal clinic for a follow-up visit. During the visit, the woman asks the nurse, "I've heard about doulas. Can you explain what this is?" Which response by the nurse would be MOST appropriate? a. "A doula is a nurse with an advanced training in caring for women having a normal pregnancy and birth." b. "A doula is someone who assists you during birth and afterwards offers support to you and your family." c. "A doula is just like a midwife except usually a family member." d. "A doula is someone with advanced medical training who helps you during birth."

b. "A doula is someone who assists you during birth and afterwards offers support to you and your family."

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 2030. 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. "Immunizations may be the cause of some illnesses being seen currently." c. "Environmental quality is directly related to health care." d. "Maintaining a physically active lifestyle is strongly encouraged."

b. "Immunizations may be the cause of some illnesses being seen currently."

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

b. An infant born at a low birth weight

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

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

A healthy client without a primary care provider is exploring the options available for a health care provider to assist with her pregnancy. Which health care provider can the nurse point out as a BEST option? a. Clinical nurse specialist (CNS) b. Certified nurse midwife c. Women's health nurse practitioner (NP) d. Lay midwife

b. Certified nurse midwife

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. Send the client to local women's shelter. b. Document the findings. c. Report the client's spouse to law enforcement authorities. d. Question the client about the pregnancy.

b. Document the findings.

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

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

A nurse compares the average length of stay of postpartum women of today with the past and notes the stay is shorter. Which factor has most influenced this trend of shorter hospital stays? a. more cooperative efforts between caregivers and families b. efforts to contain health care costs c. wellness focus in the health care system

b. efforts to contain health care costs

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 maintenance b. health promotion c. health rehabilitation d. health restoration

b. health promotion

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. 1800s c. 1900s d. 2000s

c. 1900s

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 had nurse midwives in attendance for births. b. Hospitals allowed for the father to be involved in the birthing process. c. Giving birth in a hospital suggested affluence, and the hospital provided pain management. d. Mothers who planned hospital births were provided with birth classes.

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

A nurse is caring for a client who wishes to undergo an abortion (elective termination of pregnancy). The nurse has concerns because abortion is against her personal convictions, and this is interfering with her professional duty. Which action should the nurse take to follow the American Nurses Association's (ANA) code of ethics for nurses? a. Provide emotional support to the client while caring for her. b. Not allow her personal convictions to interfere with her profession. c. Make arrangements for alternate care providers to tend to this client. d. Involve the client's family in convincing the client against having an abortion.

c. Make arrangements for alternate care providers to tend to this client.

The nurse is providing care to a pregnant client from the Middle East. The client tells the nurse that she will not make a decision without her husband's approval. The nurse interprets this statement as reflecting: a. traditional values b. family preference c. cultural difference d. cultural submission

c. cultural difference

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

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. binuclear b. single-parent c. nuclear d. blended

c. nuclear

The philosophy of family-centered care recognizes the family as the

constant

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? a. Answer the partner's questions honestly and without hesitation. b. Ask the partner for identification first before sharing any information. c. Tell the partner that no information can be shared with him or her at this time. d. Check the medical record for written client approval with whom to share information.

d. Check the medical record for written client approval with whom to share information.

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.

Infant mortality in the United States is associated with

low birth weight, prematurity, and congenital abnormalities

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. explaining the potential risks and benefits b. providing information about alternative methods that are available c. describing the procedure in detail d. determining the client's understanding of the procedure

d. determining the client's understanding of the procedure

Four key components of informed consent

disclosure, comprehension, competency, voluntariness

What is the nurse's role in the informed consent process?

ensuring the form is completed with signatures, serving as a witness to the signature process, and determining the client and family's understanding of what is being signed

What are some barriers to health care?

finances, transportation, language and culture, the health care delivery system

The 4 major direct causes of maternal death in the United States

hypertension (preeclampsia and eclampsia), hemorrhage, placenta previa, abortions

In how many states is informed consent a legal document?

in all 50 states

Which statement best describes the pattern of maternal mortality since World War II? a. it has steadily increased b. it has steadily decreased c. it has remained constant

b. it has steadily decreased

A nurse is reviewing the statistical outcomes related to fetal deaths nationwide and notes that the numbers have changed over the last several decades. The BEST explanation would be: a. increases are noted because of the growing number of pregnancies to teen mothers. b. improved prenatal care has reduced the numbers of fetal deaths. c. increases are noted due the increasing number of older mothers becoming pregnant. d. expectant mothers are seeking prenatal care later, resulting in decreases in the number.

b. improved prenatal care has reduced the numbers of fetal deaths.

A nurse is leading a discussion with a local women's group about the importance of cancer screening and early detection. One of the women asks the nurse, "Which cancer kills the most women?" Which response by the nurse would be most accurate? a. uterine cancer b. lung cancer c. cervical cancer d. breast cancer

b. lung cancer

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. provide emotional support to empower the client to help herself c. counsel the client's partner to refrain from subjecting his partner to violence d. introduce the client to a women's rights group

b. provide emotional support to empower the client to help herself

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. infant death under one month b. preterm gestational death c. postneonatal death d. neonatal death

d. neonatal death