Ch. 1 Perspectives on Maternal and Child Health Care

A young couple are very excited to learn they are expecting their first child and question the nurse about which test they need to discover its gender. Which procedure will best provide this information to the couple?

Ultrasound

The maternal child health nurse provides care to which client populations working within an appropriate scope of practice? Select all that apply.

a 52-year-old posthysterectomy client a 14-year-old primigravida client a 2-week-old preterm infant

A 15-year-old client has just given birth and states that she does not want her infant to receive any newborn vaccines. What is the appropriate action for the nurse to take?

Withhold the vaccines.

A nurse is working in an ambulatory health care clinic located in a poor neighborhood. Which nursing intervention would provide the greatest benefit for the women and their children seen at this clinic?

Cautioning the parents about home safety issues

The nurse is caring for a 5-year-old girl with meningitis. What action by the nurse may be considered ethical behavior?

Starting intravenous fluids even though the child protests

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?

Certified nurse midwife

Which physician is known as the "Father of Pediatrics"?

Abraham Jacobi

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

It has steadily decreased.

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?

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

The nurse is presenting to a shelter for women and children who experienced intimate partner or family violience and is asked by a participant, "What does the No Child Left Behind Act mean?" How should the nurse best respond?

"It is a Federal program that will ensure all children in classrooms receive up-to-date research-based curriculum."

A nurse is determining whether or not informed consent has been obtained from the family of a child who is going to have abdominal surgery. Which statement by the family would lead the nurse to suspect that informed consent is lacking?

"We had to sign the form right away so the surgery could get scheduled."

The nurse is caring for several families enrolled in Medicaid in the prenatal settinng. Which statement by an expectant mother would alert the nurse to assess the family further?

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

A prenatal nurse is preparing a presentation for clients on the various roles of a midwife in the management of their maternity care. Which information would the nurse include in the presentation to describe their role? Select all that apply.

According to their scope of practice, midwives are the primary obstetrical care providers. Midwives have postgraduate training in the care of normal pregnancy and birth. Midwives have a certified designation from accredited bodies identifying their scope of

The nursing instructor is teaching a session comparing the various steps of the nursing process. The instructor determines the session is successful when the students correctly choose which step as the first one?

Assessment

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.

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?

Breast-feed the infant.

A nurse is analyzing a journal article presenting statistics concerning newborn and infant health. Which condition has been determined to be the most likely cause of infant mortality in the United States?

Congenital abnormalities

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?

Health promotion

The nursing instructor is discussing the infant mortality rate with a group of students. The instructor determines the discussion is successful when the students correctly choose which action as a priority to help decrease infant mortality in the United States?

Improving accessibility to postnatal health care for infants

A nurse is trying to reduce a mother's anxiety about her child being in the hospital. What would be the best way to accomplish this?

Include the mother in the medical decision-making.

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries?

Low birth weight

What societal issues greatly influence delivery of maternal and pediatric health care? Select all that apply.

Low income of families Cost of health care Increased cultural and ethnic diversity of clients

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?

Provide emotional support to empower the client to help herself.

A nurse is investigating an outbreak of syphilis at the local college. Which is the appropriate first action by the nurse to reduce further spread of the infection?

Provide free condoms and educational materials.

While preparing to teach a group of nursing students the history of maternity care, which factor will the instructor include to explain as the etiology of most infections in females after birthing in the 1700s?

Reproductive tract infection

A nurse is conducting a teaching session on sudden infant death syndrome (SIDS) for expectant parents. Which information should the nurse include? Select all that apply.

Sharing a room allows for monitoring of the infant. Place the infant on his or her back to sleep. Maintain neutral temperatures and avoid overheating.

When assessing the postpartum client 2 hours after giving birth, which finding indicates the need for further action?

The fundus is firm and deviated sharply to the right side of the abdomen.

The nurse is caring for a 17-year-old who is scheduled to undergo surgery. What are the nurse's responsibilities with regard to obtaining consent? (Select all that apply.)

The nurse will witness the parent sign the consent forms. The nurse will ensure the parents understand the information contained in the consent. The nurse will ensure the parent signing the consent has the legal authority to do so.

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?

encouraging yearly checkups for all clients.

In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the:

family

A nurse is working in a community designated as having low fertility rates. Which would be an appropriate first-level investigation by the nurse?

local dietary habits

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:

maternal mortality rate.

A new single mother is sharing her concerns about the cost of daycare with her nurse. She is new to the area. The nurse recognizes that which trend is contributing to this client's concerns? Select all that apply.

the increase in the number of single parent families the increased tendency for families to move from one part of the country to another ninety percent of women working outside the home fewer extended family members to help care for a child

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?

health promotion

A nurse is admitting a female client to the cardiac unit diagnosed with a possible myocardial infarction. During the admission assessment, which symptoms would the nurse expect to find? Select all that apply.

nausea unbalanced pain in the right arm

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?

weight control and being knowledgeable about family history of cardiovascular disease

A nursing student asks an experienced nurse to explain the role of evidence-based practice on the maternal child unit. Which statement by the experienced nurse is most appropriate?

"Women have been able to be successful at having a natural birth after a cesarean birth."

The 5-year-old in the emergency room is having glass removed from a wound. Which action constitutes ethical behavior by the nurse?

Holding the child's hand in order to facilitate removal of the glass

A nursing student is preparing a presentation illustrating the Human Genome Project. Which function will the student point out as being the primary focus?

Identification of human genes and functions

A nurse receives a phone call from the neighbor of the laboring client she is caring for, inquiring on the status of the baby. Which is the appropriate response by the nurse?

"Let me transfer you to the client."

Before World War II women moved from home to hospital births. What was the primary reason for that shift in maternity care?

They were convinced that setting would improve birth outcomes.

A nurse is reviewing a labor plan with an admitting client to the labor and birth unit. The client states that she has been drinking a significant amount of herbal teas lately to help with uterine contractions. Which is the priority action by the nurse?

Determine the type of herbal teas recently consumed.

The nurse is caring for a child who says, "I'm tired being in the hospital and I miss my own home." Which response by the nurse is most appropriate?

"What can we do to make your room seem more like home?"

The nurse knows that children can give assent (agree) to participate in research. At what intellectual age does the American Academy of Pediatrics suggest minors may first do this?

7 years

The maternal child health nurse is providing care to the following clients. Which client would the nurse assess as being in the health restoration phase?

A 29-year-old G1P1L1 is assessed for ongoing complications from eclampsia, one week postpartum. Blood pressure is 128/92 mm Hg, heart rate 78 bpm, respiratory rate 22 breaths/min, temperature 98.8° F (37° C). Client states no headaches, no vision changes, and no seizure activity.

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

An infant born at a low birth weight

In an effort to improve the health status of women and their children, several national campaigns have been implemented. The campaign that reduced the incidence of Sudden Infant Death Syndrome (SIDS) by 50% was the:

Back to Sleep Campaign.

After teaching nursing students about the trends in women and cancer in the United States, the nurse educator concludes that learning has taken place when the students make which statements? Select all that apply.

Cancer is the second leading cause of death among women. African American women are more likely than white women to get breast cancer. Lung cancer is the number-one killer of women in the United States. Lung cancer has the lowest survival rate in the United States of any cancer.

A nurse is providing cardiopulmonary resuscitation (CPR) to an infant with chronic health problems when the mother of the child tells the nurse to discontinue CPR. Which is the most appropriate action by the nurse?

Discontinue all resuscitation efforts.

The nurse is in the process of administering medications to clients on the unit and notices one new mother is in the process of attempting to breast-feed her newborn infant. The nurse makes several suggestions to assist this mother. Which action should the nurse prioritize related to this interaction?

Document the care given

The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role?

Facilitating return to school by working with the school nurse

The nursing instructor is teaching a group of students about the history of maternity and family care. The instructor determines the session is successful when the students correctly choose which major change resulting from research by Klaus and Kennell?

Family-centered care of today

Which nursing intervention would best demonstrate evidence-based practice in maternal-child health care?

Family-centered pediatric care

The nurse is caring for a 7-year-old boy with cystic fibrosis whose parents are intensely interested in all aspects of his condition and care. Which is the most effective way of advocating for this child and family?

Helping parents access the area's multidisciplinary cystic fibrosis clinic

The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation?

Meet with the physician and disclose the concerns of the family; refer the case to the institutional ethics committee if not resolved.

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?

Practicing high standards of infection control.

A nursing instructor is teaching a session investigating infant mortality as a standard measurement of the quality of health care in the country. The instructor determines the session is successful when the students correctly choose which factors as contributing to the high numbers of deaths in the United States? Select all that apply.

Preterm births Maternal complications Congenital deformities and chromosomal abnormalities

The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject best supports the emphasis on preventive care?

Showing the mother how to teach hand washing to her child

A nurse is faced with an ethical conflict involving the care of a child. The child's parents disagree with the physician about the use of a feeding tube. The nurse sees the benefits and limitations of both parties' views. What action would be most appropriate?

Take the issue to the Institutional Ethics Committee for advice.

The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?

The importance of crossing streets safely

When describing birth during the 18th century, which description would be most accurate regarding maternal care during pregnancy and birth?

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

The nurse is admitting a client to the emergency clinic and notes that the client's gender expression is different than the gender noted in the driver's license and insurance documentation. What is the nurse's best response?

The nurse should communicate with the client based on the client's preferred pronoun.

A 15-year-old with leukemia tells the nurse that she wants to file for emancipation in order to control her own treatment plan. How does the nurse explain the process? Select all that apply.

The process is governed by individual state laws. The minor must be at least 14 years of age. The minor must demonstrate the ability to manage financial affairs.

A nurse admits a young boy who lives in a homeless shelter with his pregnant teenage mother. What would nurse realize to be a priority when planning his case management?

The toddler's situation puts him at risk for higher incidence of disease and limited access to appropriate care.

A nurse is teaching a parenting class about key issues that threaten children's health today. Which statements by the participants would indicate comprehension of those key issues? (Select all that apply.)

Unintentional injuries are a leading cause of injury after 1 year of age. Childhood obesity is a continuing threat to children's health. Allergies are a serious threat to childhood health.

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:

improved prenatal care has reduced the numbers of fetal deaths.

A nurse is providing teaching to a parenting class on childhood mortality prevention. Which topic would be the priority for the nurse to include?

seat belt safety