Chapter 2 OB
A nurse is conducting a presentation for a local group of community leaders about interventions being used at the various levels of prevention. The nurse determines that additional discussion is needed when a member of the group identifies which intervention as an example of a tertiary prevention level activity in community-based health care? A) teaching women to take folic acid supplements to prevent neural tube defects B) working with women who are victims of domestic violence C) working with clients at an HIV clinic to provide nutritional and CAM therapies D) teaching clients with hypertension how to monitor blood pressure
A
A nurse is preparing an in-service program for a group of newly hired nurses about trends in care for pregnant women. As part of the program, the nurse is planning to address how hospital stays have changed leading to the use of postpartum home care services. When describing events of the past decade, the nurse would state that the average length of stay in the hospital for vaginal births is: A) 24 to 48 hours or less. B) 72 to 96 hours or less. C) 48 to 72 hours or less. D) 96 to 120 hours or less.
A
A nurse is reading a journal article about the changes in health care delivery and funding that have occurred over the years. Which factor would the nurse expect to find as a current trend seen in maternal and child health care settings? A) increase in ambulatory care B) decrease in family poverty level C) increase in hospitalization of children D) decrease in managed care
A
A nurse is teaching a pregnant client with poor health literacy skills about the process of labor and what to expect. Which action would be most appropriate for the nurse to do when teaching the client? A) Use simple pictures and illustrations to help explain topics. B) Provide the majority of information at one time. C) Use medical terms so the client will recognize them later on. D) Focus the information on potential complications.
A
A nurse working in the community is involved in providing primary prevention. Which intervention would be most appropriate to implement? A) teaching parents of toddlers about ways to prevent poisoning B) working with women who are victims of domestic violence C) working with clients at an HIV clinic to provide nutritional and CAM therapies D) teaching hypertensive clients to monitor blood pressure
A
The nurse is caring for a 2-week-old newborn girl with a metabolic disorder. Which activity would deviate from the characteristics of family-centered care? A) softening unpleasant information or prognoses B) evaluating and changing the nursing plan of care C) collaborating with the child and family as equals D) showing respect for the family's beliefs and wishes
A
The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which activity would be considered the tertiary level of prevention? A) arranging for a physical therapy session B) teaching parents to administer albuterol C) reminding parent to give a full course of antibiotics D) giving a DTaP vaccination at the proper interval
A
While a nurse is obtaining a health history, the client tells the nurse that she practices aromatherapy. The nurse interprets aromatherapy as: A) use of essential oils to stimulate the sense of smell to balance the mind and body. B) application of pressure to specific points to allow self-healing. C) use of deep massage of areas on the foot or hand to rebalance body parts. D) participation in chanting and praying to promote healing.
A
A nurse is preparing a teaching plan for a woman who is pregnant for the first time. What would the nurse incorporate into the teaching plan to foster the client's learning? Select all that apply. A) Teach "survival skills" first. B) Use simple, nonmusical language. C) Refrain from using a hands-on approach. D) Avoid repeating information. E) Use visual materials such as photos and videos.
A, B, E
A pregnant woman asks the nurse about giving birth in a birthing center. She says, "I'm thinking about using one, but I'm not sure." Which information about birthing centers would the nurse need to integrate into the explanation about this birth setting? Select all that apply. A) an alternative for women who are uncomfortable with a home birth B) the longer length of stay needed when compared to hospital births C) focus on supporting women through labor instead of managing labor D) view of labor and birth as a normal process requiring no intervention E) care provided primarily by obstetricians with midwives as backup care
A, C, D
A nurse is considering a change in employment from the acute care setting to community-based nursing. The nurse is focusing her job search on ambulatory care settings. Which possible settings would the nurse most likely find? Select all that apply. A) urgent care center B) hospice care C) immunization clinic D) primary care provider's office E) day surgery center F) nursing home
A, D, E
A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the client understood the information? A) "I like having the privacy, but it might be too expensive for me to set up in my home." B) "I want to have more control, but I am concerned if an emergency would arise." C) "It is safer because I will have a midwife." D) "The midwife is trained to resolve any emergency, and she can bring any pain meds."
B
A nurse is reading a journal article describing trends in maternal and newborn health care. The article addresses the length of stay for vaginal and cesarean births during the past decade. The nurse would most likely find which duration as being cited as the average stay for cesarean births? A) 24 to 48 hours B) 72 to 96 hours C) 48 to 72 hours D) 96 to 120 hours
B
A nurse is teaching a local women's group about women's health care and changes that have occurred. When describing women's health care today, which statement would the nurse most likely include? A) Women spend 50 cents of every dollar spent on health care. B) Women make almost 90% of all health care decisions. C) Women are still the minority in the United States. D) Men use more health services than women.
B
A nurse practicing in the community is preparing a presentation for a group of nursing students about this practice setting. Which information would the nurse include as characteristic of this role? A) greater emphasis on direct physical care B) broader assessment to include the environment C) increased dependency on physician D) limited decision making and support
B
A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the teaching was effective? A) "I like having the privacy, but it might be too expensive for me to set up in my home." B) "I want to have more control, but I am concerned if an emergency would arise." C) "It is safer because I will have a midwife." D) "The midwife is trained to resolve any emergency, and she can bring any pain meds."
B
The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects with pregnant women? A) calcium B) folic acid C) vitamin C D) iron
B
When providing care to women and their families in today's current health care system, which information would be most important for the nurse to keep in mind? A) Women spend 95 cents of every dollar spent on health care. B) Women make almost 90% of all health care decisions. C) Women are still considered the minority in the United States. D) Men use more health services than women.
B
A client asks the nurse, "I read an article on the internet that was talking about integrative medicine. What is that?" Which response by the nurse would be most appropriate? A) "It refers to the use of complementary and alternative medicine in place of traditional therapies for a condition." B) "It means that complementary and alternative medicine is used together with conventional therapies to reduce pain or discomfort." C) "It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective." D) "It refers to situations when a client and his or her family prefer to use an unproven method of treatment over a proven one."
C
A group of nurses are reviewing the steps for developing cultural competence. The students demonstrate understanding when they identify which factor as the final step? A) cultural knowledge B) cultural skills C) cultural encounter D) cultural awareness
C
A nurse is conducting a refresher course for a group of nurses on documenting client care and education in the medical record and the purposes that it serves. The nurse determines that the group needs additional teaching when they identify which as a reason for documentation? A) serves as a communication tool for the interdisciplinary team B) demonstrates education the family has received if legal matters arise C) permits others access to allow refusal of medical insurance coverage D) verifies meeting client education standards set by the Joint Commission
C
Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection? A) Provide treatment for clients who test positive for HIV. B) Monitor viral load counts periodically. C) Educate clients in how to practice safe sex. D) Offer testing for clients who practice unsafe sex.
C
A nurse is conducting an in-service education program on documenting client care and education for a group of nurses returning to the workforce. The nurse determines that additional teaching is needed when the group identifies which information as a reason for documentation? A) The client's medical record serves as a communication tool for the interdisciplinary team. B) The record documents the education the family has received if legal matters arise. C) The record allows others to view a client's medical history at any time to refuse medical insurance coverage. D) The documentation verifies client education standards set by JCAHO.
C
A nurse is educating a client about a care plan. Which question would be appropriate to assess whether the client is learning? A) "Did you graduate from high school; how many years of schooling did you have?" B) "Do you have someone in your family who would understand this information?" C) "Many people have trouble remembering information; is this a problem for you?" D) "Would you prefer that the doctor give you more detailed medical information?"
C
A nurse is providing care to a group of childbearing families at the local family health clinic. The families range in cultures, different from the nurse's own culture. Which action would be the priority for the nurse? A) Adapt to the practices of the family's culture. B) Determine similarities between both cultures. C) Assess personal feelings about that culture. D) Learn as much as possible about that culture.
C
A nurse is reading a journal article comparing community-based nursing with nursing in the acute care setting. Which factor would the nurse most likely find as being associated with community-based nursing? A) increased time available for education B) improved access to resources C) decision making in isolation D) greater environmental structure
C
The nurse is preparing the discharge plan for a woman whose newborn requires ventilatory support at home. Which action by the nurse would be most appropriate to do when assuming the role of discharge planner? A) Confer with the client's parents. B) Teach new self-care skills to the client. C) Determine if there is a need for back-up power. D) Discuss coverage with the insurance company.
C
A nurse is developing cultural competence. Which actions indicate that the nurse is in the process of developing cultural knowledge? Select all that apply. A) examining personal sociocultural heritage B) reviewing personal biases and prejudices C) seeking resources to further understanding of other cultures D) becoming familiar with other culturally diverse lifestyles E) performing a competent cultural assessment F) advocating for social justice to eliminate disparities.
C, D
A nurse is engaged in providing family-centered care for a woman and her family. The nurse is providing instrumental support with which activity? A) explaining to the woman and family what to expect during the birth process B) assisting the woman in breathing techniques to cope with labor contractions C) reinforcing the woman's role as a mother after birth D) helping the family obtain extra financial help for prescribed phototherapy
D
A nurse is presenting an informational session at an employment fair that is aimed at community-based health care opportunities. During the session, the nurse describes community-based nursing interventions. The nurse determines that additional clarification is needed when the group identifies which action as a community-based nursing intervention? A) conducting childbirth education classes B) counseling a pregnant teen with anemia C) consulting with a parent of a child who is vomiting D) performing epidemiologic investigations
D
The nurse is making a home visit to a client who had a cesarean birth 3 days ago. Assessment reveals that the client is complaining of intermittent pain, rating it as 8 on a scale of 1 to 10. She states, "I'm pretty tired. And with this pain, I haven't been drinking and eating like I should. The medication helps a bit but not much. My mom has been helping with the baby." Her incision is clean, dry, and intact. The nurse would identify which problem as the priority for this client? A) integrity of the incision B) fatigue C) inadequate nutrition D) acute pain
D
