Chapter 1: 8th edition
Which statement correctly defines the term "perinatal death rate"? A) Number of deaths in utero of a fetus 500 g or more per 1000 live births B) Number of deaths per 1000 live births occurring in the first 28 days of life C) Number of deaths per 1000 live births occurring at birth or in the first 12 months of life D) Number of deaths per 1000 live births beginning when the fetus reaches 500 g and ending 28 days after birth
Ans: Client Needs: Health Promotion and Maintenance Cognitive Level: Remember Page: 10 Feedback: The term "perinatal" refers to the time of birth and that closely following it or the time "around birth."
The nurse is planning an educational session for community members to address the issue of school-age child mortality. Which topic should the nurse identify as the highest priority for this population? A) Cancer B) Assault C) Suicide D) Accidents
Ans: D Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Apply Page: 14 Feedback: For the school-age child between the ages of 5 and 14 years, the number one cause of mortality is from unintentional injuries or accidents. Other top five causes for child mortality include cancer, assault, and suicide.
Which statement best describes the pattern of maternal mortality since World War II? A) It has steadily decreased. B) It has remained constant. C) It has steadily increased. D) After decreasing until the 1960s, it has increased steadily.
Ans: A Client Needs: Health Promotion and Maintenance Cognitive Level: Apply Page: 12 Feedback: Improved prenatal care and early ambulation after birth are factors that have decreased maternal death rates following birth over the past 70 years.
Which trend is currently influencing maternal and child healthcare? A) An expansion of community based services B) Closure of regionalized healthcare centers C) The availability of additional family support D) A reduction in the number of latch key kids
Ans: A Client Needs: Health Promotion and Maintenance Cognitive Level: Remember Page: 15-16 Feedback: The trend for community care is increasing because it has the potential to provide cost-effective health promotion/disease prevention patient care services to large numbers of children and families in an environment that is familiar to them. Regionalization of care is increasing because of the need for more specialized or advanced care. There is also an increase in the number of mothers who must work outside the home because they do not have extended family members to provide care for their children. This has resulted in an increase in the number of latchkey children left home alone after school while their mother works.
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) Practicing high standards of infection control. B) Monitoring maternal glucose levels in mothers with type 1 diabetes. C) Referring to a cardiologist for any arrhythmias. D) Administering oxytocic medications for increased postpartum bleeding. E) Beginning antibiotics prior to birth for a febrile mother.
Ans: A Client Needs: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Analyze Page: 12 Feedback: Few women die giving birth in a developed countries, but it still happens. Health care providers can have the greatest impact on reducing these numbers by implementing good infection control measures, appropriate use of antibiotics during labor and postpartum periods, and use of oxytocics for maternal bleeding to prevent hemorrhage. Diabetes and cardiac arrhythmias are not considered direct causes, that is, they are known and predictable.
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? A) The importance of crossing streets safely B) The importance of immunizations C) Prevention of infection and communicable disease D) Exercise and good nutrition
Ans: A Client Needs: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Apply Page: 11 Feedback: Motor-vehicle accidents are a leading cause of death in this age group.
A client reports feeling increased levels of stress and anxiety before a routine ultrasound. What is an appropriate action by the nurse? A) Encourage the client to meditate for a few minutes. B) Cancel the ultrasound; the client is not conditionally stable. C) Contact the primary care provider to discuss the procedure with the client. D) Tell the client everything will be fine and continue with the ultrasound.
Ans: A Client Needs: Psychosocial Integrity Cognitive Level: Apply Page: 17 Feedback: By allowing the client a few minutes to mediate, she can relax and increase her overall well-being. Nurses should be aware of the use of complementary and alternative therapies and the benefits they can have on clients.
The nurse is reviewing the 2020 National Health Goals and notes that which is a focus of these goals? A) Health promotion and disease prevention B) Early diagnosis of chronic health problems C) Effective use of medication to treat disease D) Reduce the cost of health care and medications
Ans: A Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Analyze Page: 5 Feedback: The 2020 National Health Goals are intended to help citizens more easily understand the importance of health promotion and disease prevention and to encourage wide participation in improving health in the next decade. These goals do not focus on the early diagnosis of chronic problems, use of medications to treat disease, or reduce the cost of health care and medications.
During an assessment, the nurse asks a patient from a non-English-speaking culture which types of home remedies and herbs the patient uses for health care. What is the purpose of asking the patient this question? A) Analyze for herb-drug interactions B) Understand the patient's philosophy of alternative health care C) Determine the types of medications the patient will need to be prescribed D) Explain to the physician the patient's preference for nontraditional medicine approaches
Ans: A Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Physiological Integrity: Pharmacological and Parenteral Therapies Cognitive Level: Analyze Page: 17 Feedback: Assessing what alternative measures are being used is important because the action of an herb can interfere with prescribed medications. Assessing the use of herbal remedies is not done to understand the patient's philosophy of alternative health care, determine the types of medications the patient will need to be prescribed, or explain the patient's preferences for nontraditional medicine approaches to the physician.
For which reasons would a nurse review infant mortality statistics in the United States? Select all that apply. A) Measures the quality of pregnancy care B) Reviews information on overall nutrition C) Compares health with those of other states D) Determines infant health and available care E) Provides an index of the country's general health
Ans: A, B, D, E Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Analyze Page: 11 Feedback: Infant mortality statistics provide an index of a country's general health, measures the quality of pregnancy care, provides information on overall nutrition, and determines infant health and available care. Infant mortality statistics compares the health with those of other countries and not with those of other states.
Which actions should the nurse perform when supporting the goals of maternal and child health care? Select all that apply. A) Advocates protecting the rights of the mother and fetus B) Teaches family members interventions to improve health C) Adheres to principles that focus on the needs of the mother D) Encourages maternal hospitalization to regain strength and stamina E) Assesses family members for strengths and specific needs or challenges
Ans: A, B, E Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Apply Page: 8 Feedback: Actions that the nurse should perform when supporting the goals of maternal and child health care include advocating the rights for the mother and fetus, teaching health promotion interventions, and assessing the family for strengths and specific needs or challenges. Adhering to principles that focus on the needs of the mother and encouraging maternal hospitalization to regain strength and stamina are not actions that support the goals of maternal and child health care.
The nurse has noticed a change in the type of care needed to support maternal and child health issues. What does the nurse realize as reasons for the changes in care? Select all that apply. A) Smaller families B) Less domestic violence C) More employed mothers D) Stable home environments E) More single-parent families
Ans: A, C, E Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Analyze Page: 10 Feedback: Nursing care for maternal and child is changing because families are smaller, more mothers are employed out of the home, and there are more single-parent families. There is an increase in domestic violence, and families are less stable and more mobile, which influences homelessness.
While providing care to a child, the nurse informs the parents about the treatment plans and helps the parents make decisions about the child's care needs. What do this nurse's actions support? A) Autonomy B) Empowerment C) Accountability D) Informed consent
Ans: B Client Needs 2: Safe, Effective Care Environment: Management of Care Cognitive Level: Analyze Page: 19 Feedback: Nurses promote empowerment of parents and children by respecting their views and concerns, regarding parents as important participants in their own or their child's health, keeping them informed, and helping/supporting them to make decisions about care. The nurse's actions are not being done to support autonomy, accountability, or informed consent.
A 33-week gestation infant 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) neonatal death C) preterm gestational death D) postneonatal death
Ans: B Client Needs: Health Promotion and Maintenance Cognitive Level: Analyze Page: 10 Feedback: The neonatal death rate is the number of deaths of an infant in the first 28 days of life. Gestational age is not a consideration when reporting deaths of infants. The other categories are not classifications for reporting infant deaths.
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) expectant mothers are seeking prenatal care later, resulting in decreases in the number. B) improved prenatal care has reduced the numbers of fetal deaths. C) increases are noted because of the growing number of pregnancies to teen mothers. D) increases are noted due the increasing number of older mothers becoming pregnant.
Ans: B Client Needs: Health Promotion and Maintenance Cognitive Level: Analyze Page: 11 Feedback: The number of fetal deaths in the United States has fallen. This has been attributed to the improvement in the delivery of prenatal care.
What makes the area of maternal-child health nursing a more extensive area for consideration of legal issues than other areas of nursing? A) Age of the clients B) Caring for a fetus, an unseen client C) Risk of labor and birth D) Lack of evidence-based information
Ans: B Client Needs: Health Promotion and Maintenance Cognitive Level: Analyze Page: 19-20 Feedback: When providing care for the pregnant client, the fetus is unseen and unable to speak. Care for the maternal-child couplet, therefore, takes on a greater risk for legal and ethical issues as the fetus is not "born" nor of age to give consent for procedures.
What makes the area of family nursing a difficult arena to provide care at times? A) The presence of family in the hospital rooms B) Family members who might not agree on treatments and a plan of care C) Family-centered care plans and use of community areas in acute care settings D) Nurses having different values from families
Ans: B Client Needs: Psychosocial Integrity Cognitive Level: Apply Page: 5 Feedback: The family may not agree of the plan of care or treatment plans with each other or for their children. This is a difficult situation as the children do not have their rights to make their own decisions and the family needs to agree.
The nurse is caring for a mother who has just given birth to twins of 28 weeks' gestation, each weighing 2 kg. What is the health risk for the mother and the twins? A) Child mortality B) Neonatal death C) Infant mortality D) Maternal mortality
Ans: B Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Analyze Page: 11 Feedback: Neonatal death reflects the quality of care available to women during pregnancy and childbirth and the quality of care available to infants during the first month of life. The leading causes of death during this time are prematurity with associated low birth weight. Child mortality is the number of people who die during childhood years. Infant mortality is the number of infants who die before the age of 1 year. Maternal mortality is the number of women who die from activities related to childbirth.
The nurse notes that statistics on maternal mortality had improved but are again becoming elevated. What does the nurse realize as a reason for this change in maternal mortality rates? A) Earlier prenatal care B) Gestational hypertension C) Increased vaginal deliveries D) Treatment for chronic diseases
Ans: B Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Physiological Integrity: Physiological Adaptation Cognitive Level: Analyze Page: 12 Feedback: This increasing rate in maternal mortality is associated with more cesarean births, more gestational hypertension related to preexisting hypertensive disorders, and lack of health insurance for many Americans. This increase is not because of earlier prenatal care, increased vaginal deliveries, or treatment for chronic diseases.
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? A) "We were trained to take a manual blood pressure, so I never use an automatic one." B) "Women have been able to be successful at having a natural birth after a cesarean birth." C) "Women should lay flat with their legs in the lithotomy position to give birth to a baby." D) "Only women need to experience bonding with the infant for the first 3 months of life."
Ans: B Client Needs: Safe, Effective Care Environment: Management of Care Cognitive Level: Analyze Page: 7-8 Feedback: Evidence-based practice brings together research, clinical expertise, and client preference to increase nursing outcomes. The research has increasingly indicated that it is safe for women to give birth vaginally following a cesarean birth (VBAC).
The nurse is providing care to a new mother and infant according to the Quality & Safety Education for Nurses competency approach. Which action should the nurse perform to demonstrate the skill for the competency of safety? A) Assess the mother for preferences based on personal values. B) Ensure the mother and newborn have intact identification bands. C) Introduce all members of the care team to the mother and family. D) Document patient care using computerized spreadsheets and forms.
Ans: B Client Needs: Safe, Effective Care Environment: Management of Care Cognitive Level: Apply Page: 8 Feedback: Action to demonstrate the skill of the competency of safety is to ensure that the mother and newborn have intact identification bands. Assessing the mother for preferences based on personal values is the skill associated with patient-centered care. Introducing all members of the care team to the mother and family is the skill associated with teamwork and collaboration. Documenting patient care using computerized spreadsheets and forms is the skill associated with quality improvement.
What is a current trend in child health care? A) Children are hospitalized for observation more than previously. B) Health promotion rather than health restoration is stressed. C) Child health care is moving out of regional centers. D) Nursing roles are decreasing because of the increasing role of families.
Ans: B Client Needs: Safe, Effective Care Environment: Management of Care Cognitive Level: Remember Page: 16 Feedback: It is recognized that keeping individuals well is more cost effective for a system than helping ill individuals return to wellness.
The nurse works in a maternal and child care area that supports health promotion. Which activities will the nurse perform to support this philosophy of health care? Select all that apply. A) Planning care B) Patient teaching C) Family counseling D) New mother advocacy E) Identifying nursing diagnoses
Ans: B, C, D Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Apply Page: 7 Feedback: Extensive changes in the scope of maternal and child health nursing have occurred as health promotion has become a greater priority in care. The nursing activities for health promotion include teaching, counseling, and advocacy. Planning care and identifying nursing diagnoses are a part of the nursing process and not specific to health promotion.
A nurse is providing teaching to a parenting class on childhood mortality prevention. Which topic would be the priority for the nurse to include? A) immunizations B) sex education C) seat belt safety D) obesity
Ans: C Client Needs: Health Promotion and Maintenance Cognitive Level: Apply Page: 13-14 Feedback: The leading cause of death in children is unintentional injuries and is often preventable. Seatbelt safety would be a priority topic for the nurse to discuss as that is the one that could result in an injury.
A new mother asks the nurse if all of the new baby's injections can be given in one visit because the mother is losing income from missing work because of the office visits. What does this new mother's issue indicate to the nurse? A) The mother needs to find an alternative employer. B) The mother's income is more important that the baby's health. C) Missing work does not support the baby's health maintenance visits. D) The federal government needs to do more to support well-baby visits.
Ans: C Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Analyze Page: 16-17 Feedback: An area that needs additional research is finding effective stimuli to encourage women to bring children for health maintenance visits. The mother losing income because of missing work for well-baby visits will deter health maintenance visits for the baby going forward. This mother's issue does not indicate that the mother needs to find another job, that the mother's income is more important that the baby's health, or that the federal government needs to do more to support well-baby visits.
During a care conference, a nurse provides everyone with a copy of the latest research on improving the success of breast-feeding for first-time mothers. Which Quality & Safety Education for Nurses competency does this nurse's action support? A) Quality improvement B) Patient-centered care C) Evidence-based practice D) Teamwork and collaboration
Ans: C Client Needs: Safe, Effective Care Environment: Management of Care Client Needs 2: Health Promotion and Maintenance Cognitive Level: Analyze Page: 7 Feedback: Providing research material supports the Quality & Safety Education for Nurses competency of evidence-based practice because the nurse is integrating the best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. Providing research evidence does not support the Quality & Safety Education for Nurses competencies of quality improvement, patient-centered care, or teamwork and collaboration.
The nurse has been hired to provide care to patients on a maternal and child unit. What will the nurse use as a guide to legally provide care to this patient population? A) Code of ethics B) Nursing research C) Standards of practice D) Evidence-based guidelines
Ans: C Client Needs: Safe, Effective Care Environment: Management of Care Cognitive Level: Apply Page: 19 Feedback: Understanding standards of care can help nurses practice within appropriate legal parameters. The Code of Ethics will help with ethical situations. Nursing research and evidence-based guidelines will help with providing care that is based upon best practices.
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? A) offering increased WICC availability B) reducing the number of home births C) increasing the education level of parents D) increasing the number of women receiving prenatal care
Ans: D Client Needs: Health Promotion and Maintenance Cognitive Level: Apply Page: 11 Feedback: 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.
More nurses are stepping into the role of the advanced practice nurse. Which nurse's role would be to provide care for children under the age of 18? A) Women's health nurse practitioner B) Case manager C) Clinical nurse specialist D) Pediatric nurse practitioner
Ans: D Client Needs: Health Promotion and Maintenance Cognitive Level: Remember Page: 10 Feedback: The pediatric nurse practitioner's primary role is to provide care for children ages 18 and under. The other advanced practice roles care for different client populations.
The nurse is providing care in an organization that supports the maternal and child care continuum. Which type of patient care area is an example of this approach? A) Primary care B) Team nursing C) Case management D) Family-centered care
Ans: D Client Needs: Safe, Effective Care Environment: Safety and Infection Control Client Needs 2: Health Promotion and Maintenance Cognitive Level: Analyze Page: 4 Feedback: Keeping the family at the center of care is important because the level of a family's functioning is important to the health status of its members. A healthy family establishes an environment conducive to growth and health-promoting behaviors to sustain family members during crises. A family-centered approach enables nurses to better understand individuals and their effect on others and, in turn, to provide more holistic care. Primary nursing, team nursing, and case management do not necessary take into consideration the maternal and child care continuum.
