OB Mini Quiz 1
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
72 to 96 hours
When assessing a family for possible barriers to health care, the mother reports several problems she has been having when coming to her local clinic. The nurse would consider which reported problem as having the greatest impact on this family's health care? A. health care workers' attitudes B. language barrier C. transportation to the clinic D. family finances
D. family finances
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. reinforcing the woman's role as a mother after birth C. assisting the woman in breathing techniques to cope with labor contractions D. helping the family obtain extra financial help for prescribed phototherapy
D. helping the family obtain extra financial help for prescribed phototherapy
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?
Increase in ambulatory care
A nurse is providing care to a woman in labor. After assessment of the fetus, the nurse documents the fetal lie. Which term would the nurse most likely use?
Longitudinal
A nurse is providing family-centered care to a pregnant woman and her family. When implementing care, which action by the nurse would be most appropriate?
asking the woman about her plans for labor and birth
During a follow-up prenatal visit, a pregnant woman asks the nurse, "How long do you think I will be in labor?" Which response by the nurse would be most appropriate?
"It's difficult to predict how your labor will progress, but we'll be there for you the entire time." It is difficult to predict how a labor will progress and therefore equally difficult to determine how long a woman's labor will last. There is no way to estimate the likely strength and frequency of uterine contractions, the extent to which the cervix will soften and dilate, and how much the fetal head will mold to fit the birth canal. We cannot know beforehand whether the complex fetal rotations needed for an efficient labor will take place properly. All of these factors are unknowns when a woman starts labor. Telling the woman an approximate time would be inappropriate because there is no way to determine the length of labor. It is highly individualized. Although fetal size and maternal and fetal health are important considerations, these responses do not address the woman's concern.
Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station? +1 -2 0 -1
0
A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which movement would the nurse most likely include? Select all that apply. A) Internal rotation B) Abduction C) Descent D) Pronation E) Flexion
A) Internal rotation C) Descent E) Flexion through the passageway are called the cardinal movements of labor and include engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion. The fetus does not undergo abduction or pronation.
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 2020. The nurse determines that additional discussion and clarification is needed when the group makes which statement? A. "Immunizations may be the cause of some illnesses being seen currently." B. "Obesity, drug use, and smoking are major problems." C. "Maintaining a physically active lifestyle is strongly encouraged" D. "Environmental quality is directly related to health care."
A. "Immunizations may be the cause of some illnesses being seen currently."
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 means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective." B. "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. "It refers to the use of complementary and alternative medicine in place of traditional therapies for a condition." D. "It means that complementary and alternative medicine is used together with conventional therapies to reduce pain or discomfort."
A. "It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective."
A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which symptom? A. moderately strong contractions every 4 minutes, lasting about 1 minute B. contractions noted in the front of abdomen that stop when she walks C. increased energy level with alternating strong and weak contractions D. pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds
A. moderately strong contractions every 4 minutes, lasting about 1 minute
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. showing respect for the family's beliefs and wishes C. collaborating with the child and family as equals D. evaluating and changing the nursing plan of care
A. softening unpleasant information or prognoses
When integrating the principles of family-centered care into the birthing process, the nurse would base his or her care upon which belief? A. Birth results in changes in relationships. B. Families require little information to make appropriate decisions for care. C. Birth is viewed as a medical event. D. Families are unable to make informed choices due to stress.
A. Birth results in changes in relationships.
The nursing student correctly identifies African Americans to have consistently higher infant mortality rates than other ethnic groups. What factors that contribute to this problem can nurses have the greatest impact upon? (Check all that apply.) A. Discouraging use of tobacco and non-prescribed medications during pregnancy. B. Improving maternal educational levels C. Nutritional teaching prior to and during pregnancy D. Encouraging regular maternal prenatal visits E. Supporting maternal choices for alternative birthing methods
A. Discouraging use of tobacco and non-prescribed medications during pregnancy. C. Nutritional teaching prior to and during pregnancy D. Encouraging regular maternal prenatal visits
A nurse is providing family-centered care to a pregnant woman and her family. When implementing care, which action by the nurse would be most appropriate? A. asking the woman about her plans for labor and birth B.making the decisions for the woman C.focusing on medical procedures associated with birth D.informing the woman what pain relief methods will be used during labor
A. asking the woman about her plans for labor and birth
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. becoming familiar with other culturally diverse lifestyles B. advocating for social justice to eliminate disparities. C. reviewing personal biases and prejudices D. seeking resources to further understanding of other cultures E. performing a competent cultural assessment F. examining personal sociocultural heritage
A. becoming familiar with other culturally diverse lifestyles D. seeking resources to further understanding of other cultures
A nurse is reading a journal article about health status goals and how they have evolved over the years. Which issue would the nurse most likely identify as the focus of these goals in the past century? A. morbidity and mortality analysis B.health promotion C.wellness D.disease prevention
A. morbidity and mortality analysis
A nurse is assigned to care for a pregnant woman of Native American descent who is experiencing an illness. The nurse develops a plan of care for this client integrating the client's cultural background and implementing interventions based on the understanding that this client most likely views illness as the result of: A. supernatural forces B. imbalance between external and internal energy (WRONG) C. inadequate diet D. possession by spirits or demons
A. supernatural forces The maternal bony pelvis consists of the true and false portions. The true pelvis is made up of three planes—the inlet, the mid pelvis, and the outlet. The bony pelvis is more important part of the passageway because it is relatively unyielding. The false pelvis lies above the imaginary linea terminalis. The true pelvis is the bony passageway through which the fetus must travel.
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.participation in chanting and praying to promote healing. C.use of deep massage of areas on the foot or hand to rebalance body parts. D.application of pressure to specific points to allow self-healing.
A. use of essential oils to stimulate the sense of smell to balance the mind and body.
A pregnant woman comes to the labor and birth unit in labor. The woman tells the nurse, "Yesterday, I had this burst of energy and cleaned everything in site, but I don't know why," Which response by the nurse would be most appropriate? A."You had a burst of adrenalin, which is common before labor." B."You were looking forward to the birth of your baby." C."You were trying to get everything ready for your baby." D."You felt your mind telling you that you were about to go into labor."
A."You had a burst of adrenalin, which is common before labor."
A group of students are reviewing an article describing information related to indicators for women's health and the results of a national study. Which would the students identify as being satisfactory for women? Select all that apply. A.Mammograms B.Health insurance coverage C.Colorectal cancer screening D.Smoking cessation E.Violence against women
A.Mammograms C.Colorectal cancer screening
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.Focus the information on potential complications. C.Provide the majority of information at one time. D.Use medical terms so the client will recognize them later on.
A.Use simple pictures and illustrations to help explain topics.
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 make almost 90% of all health care decisions. B.Men use more health services than women. C.Women spend 50 cents of every dollar spent on health care. D.Women are still the minority in the United States.
A.Women make almost 90% of all health care decisions.
The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which part as the presenting part? A.buttocks B.face C.shoulder D.occiput
A.buttocks The second letter denotes the presenting part which in this case is "S" or the sacrum or buttocks. The letter "O" would denote the occiput or vertex presentation. The letter "M" would denote the mentum (chin) or face presentation. The letter "A" would denote the acromion or shoulder presentation.
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.decision making in isolation B.improved access to resources C.greater environmental structure D.increased time available for education
A.decision making in isolation
When preparing a teaching plan for a group of women during their first pregnancy, the nurse reviews how maternity care has changed over the years. Which information would the nurse include when discussing events occurring in the 20th century? A.development of free-standing birth centers B.performance of the first cesarean birth C.epidemics of puerperal fever D.X-ray developed to assess pelvic size
A.development of free-standing birth centers
The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects with pregnant women? A.folic acid B.vitamin C C.calcium D.iron
A.folic acid
A nurse is preparing a presentation for a local community group about health status and children's health. Which rate would the nurse include as one of the most significant measures? A.infant mortality rate B.maternal mortality rate C.fetal mortality rate D.neonatal mortality rate
A.infant mortality rate
A pregnant client comes to the emergency department experiencing preterm labor with ruptured membranes. After obtaining the client's history, the nurse would identify which factor as most likely contributing to the possibility of a poor outcome for this client? A.lack of prenatal care B.lack of adequate nutrition C.lack of employment D.lack of formal education
A.lack of prenatal care
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.permits others access to allow refusal of medical insurance coverage B.serves as a communication tool for the interdisciplinary team C.demonstrates education the family has received if legal matters arise D.verifies meeting client education standards set by the Joint Commission
A.permits others access to allow refusal of medical insurance coverage
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.teaching hypertensive clients to monitor blood pressure C.working with clients at an HIV clinic to provide nutritional and CAM therapies D.working with women who are victims of domestic violence
A.teaching parents of toddlers about ways to prevent poisoning
A woman telephones her health care provider and reports that her water just broke. Which suggestion by the nurse would be most appropriate? A) "Call us back when you start having contractions." B) "Come to the clinic or emergency department for an evaluation." C) "Drink 3 to 4 glasses of water and lie down." D) "Come in as soon as you feel the urge to push."
B) "Come to the clinic or emergency department for an evaluation." When the amniotic sac ruptures, the barrier to infection is gone and there is the danger of cord prolapse if engagement has not occurred. Therefore, the nurse should suggest that the woman come in for an evaluation. Calling back when contractions start, drinking water, and lying down are inappropriate because of the increased risk for infection and cord prolapse. Telling the client to wait until she feels the urge to push is inappropriate because this occurs during the second stage of labor.
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 the safest method for giving birth because there are no interferences." D) "The midwife is trained to resolve any emergency, and she can bring any pain meds.
B) "I want to have more control, but I am concerned if an emergency would arise." Home births have many advantages, such as having more control over the birth, being the least expensive option, creating a good relationship with a midwife, minimizing interferences, and having more flexibility in the comfort of your home. However, the limited availability of pain medication and danger to the mother and baby if an emergency arises are two of the main disadvantages. Thus, it is not considered the safest method for delivery
A client is in the third stage of labor. Which finding would alert the nurse that the placenta is separating? A. mucous plug is expelled B. uterus becomes globular C. umbilical cord shortens D. fetal head at vaginal opening
B. uterus becomes globular
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. the longer length of stay needed when compared to hospital births B. view of labor and birth as a normal process requiring no intervention C. care provided primarily by obstetricians with midwives as backup care D. focus on supporting women through labor instead of managing labor E. an alternative for women who are uncomfortable with a home birth
B. view of labor and birth as a normal process requiring no intervention D. focus on supporting women through labor instead of managing labor E. an alternative for women who are uncomfortable with a home birth Birthing centers are an alternative for women who are uncomfortable with a home birth but do not want a hospital birth. A birthing center offers a home-like setting but with close proximity to a hospital in case of complications. Typically the normal discharge time in birthing centers ranges from 4 to 24 hours, shorter than that for a hospital birth. Labor and birth are viewed as a normal process and midwives, not obstetricians, support the woman through labor rather than manage labor. Most centers use a noninterventional view of labor and birth.
A nurse is reading a journal article about the trends in health care and health care delivery over the past several centuries. When reading about the practices during the 18th century, which information would the nurse most likely find? A. Use of physicians for birth B. Absence of men attending childbirth C. Use of twilight sleep for childbirth D. Epidemics of puerperal fever
B. Absence of men attending childbirth
A nursing group is examining their hospital's maternal outcomes for the previous 5 years. Which identified factors have contributed to the decline in the maternal mortality rate? Select all that apply. A. Increased use of anesthesia with childbirth B. Better management of hemorrhage and infection C. Increased participation of women in prenatal care D. Closer monitoring for complications associated with hypertension of pregnancy E. Use of ultrasound to detect disorders
B. Better management of hemorrhage and infection C. Increased participation of women in prenatal care D. Closer monitoring for complications associated with hypertension of pregnancy E. Use of ultrasound to detect disorders
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."It is safer because I will have a midwife." B."I want to have more control, but I am concerned if an emergency would arise." C."The midwife is trained to resolve any emergency, and she can bring any pain meds." D."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."
A nurse manager is interviewing a potential candidate for employment in the perinatal clinic. During the interview, the nurse manager asks the nurse about her understanding of family-centered care. Which statement by the interviewee demonstrates understanding of this concept? A."Childbirth rarely affects the relationships within a family." B."Sensitivity to and respect for the family's culture is important." C."Families lack the ability to make health care decisions for themselves." D."Mothers are the family members affected by childbirth."
B."Sensitivity to and respect for the family's culture is important."
After teaching a group of students about the concept of maternal mortality, the instructor determines that additional teaching is needed when the students make which statement? A."The time frame is typically for a specified year." B."The rate includes accidental causes for deaths." C."It addresses pregnancy-related causes." D."The duration of the pregnancy is not a concern."
B."The rate includes accidental causes for deaths."
Assessment of a woman in labor reveals that the fetus is in a cephalic presentation and engagement has occurred. The nurse interprets this finding to indicate that the presenting part is at which station? A.-2 B.0 C.-1 D.+1
B.0 Fetal engagement signifies the entrance of the largest diameter of the fetal presenting part (usually the fetal head) into the smallest diameter of the maternal pelvis. The fetus is said to be engaged in the pelvis when the presenting part reaches 0 station.
Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection? A.Monitor viral load counts periodically. B.Educate clients in how to practice safe sex. C.Provide treatment for clients who test positive for HIV. D.Offer testing for clients who practice unsafe sex.
B.Educate clients in how to practice safe sex.
The family is the basic unit of society. Which statement correctly illustrates the importance of this concept related to how society functions? A.Work is an important part of family function but is not necessary for success if one member can fulfill multiple roles. B.Healthy, well-functioning families provide members of all ages with fulfilling, supporting relationships. C.The family serves as a place that encourages members to autonomously function in pursuit of personal pleasures. D.Society functions best when families determine how they will interface with others without having to deal with the overall consequences.
B.Healthy, well-functioning families provide members of all ages with fulfilling, supporting relationships.
A nurse is assigned to care for an Asian American client. The nurse plans his care recognizing that which statement best explains an Asian American's view of illness? A.Illness is caused by supernatural forces. B.Illness is due to an imbalance between yin and yang. C.Illness may be caused by God's will or evil influences. D.Illness is a punishment for sins.
B.Illness is due to an imbalance between yin and yang.
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. Refrain from using a hands-on approach. B.Use visual materials such as photos and videos. C.Avoid repeating information. D.Teach "survival skills" first. E.Use simple, nonmusical language.
B.Use visual materials such as photos and videos. D.Teach "survival skills" first. E.Use simple, nonmusical language.
A nurse is providing care to a pregnant woman in labor. The woman is in the first stage of labor. When describing this stage to the client, which event would the nurse identify as the major change occurring during this stage? A.placental separation B.cervical dilation C.regular contractions D.fetal movement through the birth canal
B.cervical dilation The primary change occurring during the first stage of labor is progressive cervical dilation. Contractions occur during the first and second stages of labor. Fetal movement through the birth canal is the major change during the second stage of labor. Placental separation occurs during the third stage of labor.
A client is admitted to the labor and birthing suite in early labor. On review of her prenatal history, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted? A. anthropoid B.gynecoid C.android D.platypelloid
B.gynecoid The most favorable pelvic shape for vaginal delivery is the gynecoid shape. The anthropoid pelvis is favorable for vaginal birth but it is not the most favorable shape. The android pelvis is not considered favorable for a vaginal birth because descent of the fetal head is slow and failure of the fetus to rotate is common. Women with a platypelloid pelvis usually require cesarean birth.
The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which phase? A.decrement B.increment C.peak D.acme
B.increment Each contraction has three phases: increment or the buildup of the contraction; acme or the peak or highest intensity; and the decrement or relaxation of the uterine muscle fibers. The time from the onset to the highest intensity corresponds to the increment.
Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in: A.active phase of the first stage. B.latent phase of the first stage. C.transition phase of the first stage. D.perineal phase of the second stage.
B.latent phase of the first stage.
A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction? A.white blood cell count of 12,000 cells/mm3 B.respiratory rate of 10 breaths/minute C.heart rate increase from 76 bpm to 90 bpm D.blood pressure rise from 110/60 mm Hg to 120/74
B.respiratory rate of 10 breaths/minute During labor, the mother experiences various physiologic responses including an increase in heart rate by 10 to 20 bpm, a rise in blood pressure by up to 35 mm Hg during a contraction, an increase in white blood cell count to 25,000 to 30,000 cells/mm3, perhaps as a result of tissue trauma, and an increase in respiratory rate with greater oxygen consumption due to the increase in metabolism. A drop in respiratory rate would be a cause for concern.
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. working with clients at an HIV clinic to provide nutritional and CAM therapies B.teaching women to take folic acid supplements to prevent neural tube defects C.teaching clients with hypertension how to monitor blood pressure D.working with women who are victims of domestic violence
B.teaching women to take folic acid supplements to prevent neural tube defects
A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: A.pelvic phase of the second stage of labor. B.transition phase of the first stage of labor. C.latent phase of the first stage of labor. D.active phase of the first stage of labor.
B.transition phase of the first stage of labor.
A group of nurses are discussing the reasons for the United States' low rankings for infant and maternal mortality (27% and 21% respectively) and what impact they could make on them in their practice. Which action could nurses implement to reduce these rates? A. providing more extensive women's shelters B. ensuring that all pregnant clients receive their immunizations C. assuring early and adequate prenatal care D. encouraging all women to eat a balanced diet
C. assuring early and adequate prenatal care
A nurse is developing a plan of care for a pregnant client to address the continuum of care from pregnancy through childbirth. Which aspect would the nurse include as essential to enhancing the woman's birthing experience? A. involving a pediatric physician for care of the child after birth B. ensuring adherence to strict specific routines C. educating the client about the importance of a support person D. assigning several nurses to act as the woman's support team
C. educating the client about the importance of a support person
A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which factors would the nurse most likely include when discussing measures to promote coping for a positive labor experience? Select all that apply. A. fear of loss of control B. view of birth as a stressor C. presence of a support partner D. low anxiety level E. participation in a pregnancy exercise program
C. presence of a support partner D. low anxiety level E. participation in a pregnancy exercise program
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. "It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective." ntegrative medicine combines mainstream medical therapies and CAM therapies for which there is some scientific evidence of safety and effectiveness (NCCAM, 2011). These include acupuncture, reflexology, therapeutic touch, meditation, yoga, herbal therapies, nutritional supplements, homeopathy, naturopathic medicine, and many more used for the promotion of health and well-being. Complementary medicine is used together with conventional medicine, such as using aromatherapy to reduce discomfort after surgery or to reduce pain during a procedure or during early labor. Alternative medicine is used in place of conventional medicine, such as eating a special natural diet to control nausea and vomiting or to treat cancer instead of undergoing surgery, chemotherapy, or radiation that has been recommended by a conventional doctor.
A woman has been in labor for some time, but her membranes have not yet ruptured. Artificial rupture of membranes is being considered. Which assessment findings would support the decision to perform the procedure? Select all that apply. A. Uterine contractions every 2 minutes B. Cervical effacement 50% C. Fetal head at -2 station D. Vertex presentation E. Cervical dilation of 4 cm
C. Fetal head at -2 station E. Cervical dilation of 4 cm
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. Men use more health services than women B. Women are still considered the minority in the United States C. Women make almost 90% of all health care decisions D. Women spend 95 cents of every dollar spent on health care
C. Women make almost 90% of all health care decisions
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. limited decision making and support B. greater emphasis on direct physical care C. broader assessment to include the environment D. increased dependency on physician
C. broader assessment to include the environment
A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy, labor, and childbirth. Which would be most important for the nurse to incorporate into that plan? A. Involving a pediatric physician B. assigning several nurses as a support team C. educating the client about the importance of a support person D. Adhering to strict, specific routines
C. educating the client about the importance of a support person
The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority? A. providing emergency care without parental consent B. contacting the child's aunt or uncle to obtain their consent C. getting telephone consent with two people listening to the verbal consent D. asking the courts to grant permission on the child's behalf
C. getting telephone consent with two people listening to the verbal consent
A nurse is integrating information about family-centered care when developing a teaching plan for a pregnant woman and her family. Which statement by the woman indicates to the nurse that the teaching was effective? A."Childbirth is a medical problem, so it can affect everyone." B."Since I'm the mother, this whole process of childbirth will affect me primarily." C."It's not just me affected by the baby. My whole family will be affected." D."This is a stressful time for our family, so we won't be making any of the health care decisions."
C."It's not just me affected by the baby. My whole family will be affected."
A nurse is working as part of a committee that is developing facility policies to enhance family-centered care. The committee demonstrates application of the principles of this concept when they implement which guideline? A.Describe to each family that childbirth is a procedure requiring specific steps. B.Educate families about the need to maintain the status quo in relationships. C.Provide families with information to encourage them to make informed choices. D.Limit discussion of information about decision making to family requests for such.
C.Provide families with information to encourage them to make informed choices.
A nurse is conducting a class for a group of nurses new to the labor and birth unit about labor and the passage of the fetus through the birth canal. As part of the class, the nurse explains that specific diameters of the fetal skull can affect the birth process. Which diameter would the nurse identify as being most important? Select all that apply. A.Diagonal conjugate B.Occipitomental C.Suboccipitobregmatic D.Biparietal E.Occipitofrontal
C.Suboccipitobregmatic D.Biparietal
A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping, and lower back pain. The nurse determines that which event has most likely occurred? A. bloody show B.cervical dilation C.lightening D.Braxton-Hicks contractions
C.lightening Lightening occurs when the fetal presenting part begins to descend into the maternal pelvis. The uterus lowers and moves into the maternal pelvis. The shape of the abdomen changes as a result of the change in the uterus. The woman usually notes that her breathing is much easier. However, she may complain of increased pelvic pressure, cramping, and lower back pain. Although cervical dilation also may be occurring, it does not account for the woman's complaints. Bloody show refers to passage of the mucous plug that fills the cervical canal during pregnancy. It occurs with the onset of labor. Braxton-Hicks contractions increase in strength and frequency and aid in moving the cervix from a posterior position to an anterior position. They also help in ripening and softening the cervix.
A nurse is conducting an in-service program for a group of nurses working in the labor and birth suite of the facility. After teaching the group about the factors affecting the labor process, the nurse determines that the teaching was successful when the group identifies which component as part of the true pelvis? Select all that apply. A. pelvic floor muscles B.vagina C.pelvic outlet D.pelvic inlet E.cervix F.mid pelvis
C.pelvic outlet D.pelvic inlet F.mid pelvis
The nurse instructs the new mother about some health promotion strategies that could significantly improve her infant's health and chance of survival. These would include which of the following? (Check all that apply.) A. formula feeding B.placing infant on stomach to sleep C.placing infant on back to sleep D.breastfeeding E.mothers joining support groups
C.placing infant on back to sleep D.breastfeeding E.mothers joining support groups Certain health promotion strategies after birth can significantly improve an infant's health and chances of survival. Breastfeeding has been shown to reduce rates of infection in infants and to improve their long-term health. Placing an infant on his or her back when sleeping will reduce the incidence of sudden-infant death syndrome. Encouraging mothers to join support groups to prevent postpartum depression and learn sound childrearing practices will improve the health of both the mothers and their infants.
A nurse is participating in an online continuing education course that addresses maternal and newborn health. The nurse is engaging in an interactive activity that requires checking off the causes associated with pregnancy-related mortality. Which condition if checked by the nurse as a cause indicates the need to go back and review the information? A.infection B.hemorrhage C.precipitous labor D.embolism
C.precipitous labor
A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor? A.lithotomy B.knee-chest C.upright D.supine
C.upright The use of any upright position helps to reduce the length of labor. Research validates that nonmoving back-lying positions such as supine and lithotomy positions during labor are not healthy. The knee-chest position would assist in rotating the fetus in a posterior position.
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) Impaired skin integrity related to cesarean birth incision B) Fatigue related to effects of surgery and caretaking activities C) Imbalanced nutrition, less than body requirements, related to poor fluid and food intake D) Acute pain related to incision and cesarean birth
D) Acute pain related to incision and cesarean birth The client reports a pain rating of 8 out of 10 and states that the medication is helping only a bit. She also mentions that the pain is interfering with her ability to eat and drink. Therefore, the priority nursing diagnosis is acute pain related to incision and cesarean birth. Her incision is clean, dry, and intact, so impaired skin integrity is not the problem. She is fatigued, but her complaints of pain supersede her fatigue. Although her nutritional intake is reduced, it is due to the pain.
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. Teach new self-care skills to the client. B. Confer with the client's parents. C. Discuss coverage with the insurance company. D. Determine if there is a need for back-up power.
D. Determine if there is a need for back-up power.
A nurse is conducting a continuing education program for a group of nurses working in the perinatal unit. After reviewing information about the maternal bony pelvis with the group, the nurse determines that the teaching was successful based on which statement by the group? A. The bony pelvis plays a lesser role during labor than soft tissue. B. The false pelvis is the passageway through which the fetus travels. C. The false pelvis lies below the imaginary linea terminalis. D. The pelvic outlet is associated with the true pelvis.
D. The pelvic outlet is associated with the true pelvis.
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 documentation verifies client education standards set by JCAHO. C. The record documents the education the family has received if legal matters arise. D. The record allows others to view a client's medical history at any time to refuse medical insurance coverage.
D. The record allows others to view a client's medical history at any time to refuse medical insurance coverage.
The fetus of a nulliparous woman is in a shoulder presentation. The nurse would most likely prepare the client for which type of birth? A. forceps-assisted B. vaginal C. vacuum extraction D. cesarean
D. cesarean The fetus is in a transverse lie with the shoulder as the presenting part, necessitating a cesarean birth. Vaginal birth, forceps-assisted, and vacuum extraction births are not appropriate.
The nurse is working with a group of community health members to develop a plan to address the special health needs of women. The group would design educational programs to address which condition as the priority? A. Smoking B. Cancer C. Diabetes D. Heart disease
D. Heart disease
A nurse is conducting a presentation to a local women's community group about strategies to promote health and wellness and prevent illness. After the presentation, the nurse determines that the teaching was successful based on which statement by the group when describing health? A. "It is based on analysis of statistics about diseases and deaths." B. "Health is simply a state of overall wellness." C. "Health is the state of being completely disease free." D. It is complete physical, mental, and social well-being."
D. It is complete physical, mental, and social well-being."
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. reminding parent to give a full course of antibiotics B. giving a DTaP vaccination at the proper interval C. teaching parents to administer albuterol D. arranging for a physical therapy session
D. arranging for a physical therapy session
A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor? A. contractions every 5 minutes, cervical dilation 3 cm B. contractions every 3 minutes, cervical dilation 5 cm C. contractions every 21/2 minutes, cervical dilation 7 cm D. contractions every 1 minute, cervical dilation 9 cm
D. contractions every 1 minute, cervical dilation 9 cm The transition phase is characterized by strong contractions occurring every 1 to 2 minutes and cervical dilation from 8 to 10 cm. Contractions every 5 minutes with cervical dilation of 3 cm is typical of the latent phase. Contractions every 3 minutes with cervical dilation of 5 cm and contractions every 21/2 minutes with cervical dilation of 7 cm suggest the active phase of labor.
When assessing cervical effacement of a client in labor, the nurse assesses which characteristic? A. extent of opening to its widest diameter B. passage of the mucous plug C. fetal presenting part D. degree of thinning
D. degree of thinning Effacement refers to the degree of thinning of the cervix. Cervical dilation refers to the extent of opening at the widest diameter. Passage of the mucous plug occurs with bloody show as a premonitory sign of labor. The fetal presenting part is determined by vaginal examination and is commonly the head (cephalic), pelvis (breech), or shoulder.
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."Would you prefer that the doctor give you more detailed medical information?" D."Many people have trouble remembering information; is this a problem for you?"
D."Many people have trouble remembering information; is this a problem for you?"
A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? A. "I'm feeling contractions mostly in my back." B."My contractions are about 6 minutes apart and regular." C."If I try to talk to my partner during a contraction, I can't." D."The contractions slow down when I walk around."
D."The contractions slow down when I walk around." False labor is characterized by contractions that are irregular and weak, often slowing down with walking or a position change. True labor contractions begin in the back and radiate around toward the front of the abdomen. They are regular and become stronger over time; the woman may find it extremely difficult if not impossible to have a conversation during a contraction.
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.48 to 72 hours or less. B.96 to 120 hours or less. C.72 to 96 hours or less. D.24 to 48 hours or less.
D.24 to 48 hours or less.
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.48 to 72 hours B.24 to 48 hours C.96 to 120 hours D.72 to 96 hours
D.72 to 96 hours
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.Learn as much as possible about that culture. B.Adapt to the practices of the family's culture. C.Determine similarities between both cultures. D.Assess personal feelings about that culture.
D.Assess personal feelings about that culture.
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
D.cultural awareness
A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? A.footling B.complete C.full D.frank
D.frank In a frank breech, the buttocks present first, with both legs extended up toward the face. In a full or complete breech, the fetus sits cross-legged above the cervix. In a footling breech, one or both legs are presenting.
A nurse is describing how the fetus moves through the birth canal. Which component would the nurse identify as being most important in allowing the fetal head to move through the pelvis? A. fontanelles B.frontal bones C.biparietal diameter D.sutures
D.sutures
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?
Determine if there is a need for back-up power.
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?
performing epidemiologic investigations
