OB week1

A nurse is preparing to teach insulin administration to a newly diagnosed diabetic adolescent and the adolescent's family. Which strategies would the nurse use to assist the client's learning? Select all that apply.

-Go slow and repeat information often. -Use plain nonmedical language to explain procedures. -Teach the prioritized information.

A nurse is working at a community prenatal drop-in clinic. Which actions best reflect the principles of family nursing within this clinic? Select all that apply.

-Health promotion education activities are planned for the clients and their families. -The clients and their families are included in all decision-making collaborations. -The nurse would seek other health care provider input to plan care.

An ill child will be cared for at home by the parents. What resources will be most advantageous for this family?

effective support people from the family or community to offer help

An example of nurses' primary focus of health care education for clients would be demonstrated as:

encouraging yearly check-ups for all clients.

A nurse is working as a part of a group in determining the health services needed for the people in the area. A review of which aspect would be most helpful for the group in making the determinations?

epidemiology

A pregnant teenager is not certain that she will like home care because she is afraid she will feel lonely. The nurse should suggest that:

everyone could eat together.

A nurse is conducting an assessment of a pregnant woman on a routine follow-up prenatal visit. Assessment findings suggest that the client may have a substance abuse problem. Which action by the nurse would be most appropriate to ensure proper care of the client and the unborn fetus?

initiate a referral to available community services.

When providing care to a child, the nurse should consider which aspect of informed consent as most important?

knowing the laws in the state where care is being provided

The nursing faculty is teaching students about maternal mortality and morbidity rates for African American women, noting that they are often three to four times higher than for white women. This fact can most accurately be contributed to which reason?

lack of access to adequate prenatal care

As part of an education program for pregnant women and their partners, the nurse describes the various settings available for birth. The nurse determines that the program was successful when the group relates which statement about home births?

"Women giving birth at home have control over every part of labor."

A prenatal nurse is preparing a presentation for expectant parents on the use of birthing centers. What information would the nurse likely include? Select all that apply.

-Birthing centers use a noninterventional approach to obstetric care. -Birthing centers allow for freedom to eat and move around during labor. -This setting allows for the ability to give birth in a variety of positions.

A first-time mother is at home on the third day after birth and has bleeding, painful nipples after breastfeeding. She calls the hospital to speak to her postpartum nurse. What is the best plan the nurse can implement for this client?

Arrange for a home visit from a lactation consultant.

The nurse is caring for a family of a different cultural background. In order to provide culturally appropriate and competent care, the nurse should execute which nursing action?

Ask the family for input into their care based on their cultural beliefs.

What is a key element of providing family-centered care?

Communicate specific health information.

Prenatal education provided at a local clinic should include emphasizing to the mother to keep all routine prenatal visits. What is the rationale for this point?

Most pregnancy-related complications are preventable.

The nursing faculty is explaining the historical background regarding the reasoning for the introduction of nurseries in the 1900s to her students. Which statement most accurately explains the reason for the nurseries?

Mothers could not care for their babies due to chloroform gas.

What term is used to represent the number of deaths in the first 28 days of life?

Neonatal death rate

Nurses play important roles in a variety of community settings. Which nursing goal is common to all types of community settings?

Promote the health of a specific group of clients.

A nurse is caring for a 31-year-old pregnant client who is subjected to abuse by her partner. 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 public health nurse is preparing to visit the home of teenage parents with a new infant. Which action would be the priority?

Review previous home visits to validate interventions.

A nurse is developing a plan of care for a client of Muslim faith. Which action demonstrates an understanding of providing culturally competent care?

The client is asked if there are any meal preferences to be included in the care plan.

The nurse who is working with women, children, and families knows the importance of using good communication, both verbal and nonverbal. Which actions are examples of nonverbal communication? Select all that apply.

attending to others nodding active listening

When giving family-centered care, the nurse recognizes the need to view which concept as the constant?

family

The nursing instructor is educating students about the difference in cultural beliefs and practices that affect maternal and children's health. Which descriptor best address the beliefs and practices of Asian Americans?

fosters little involvement of the father during labor and a stoic, quiet appearance of the woman during labor

A nurse is providing care to an African-American woman who has just given birth to a healthy newborn boy. When planning culturally competent care for the woman and her baby, which practice would the nurse anticipate?

liberal use of oil on the baby's scalp and skin

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

lung cancer

Nurses involved with community health nursing focus primarily on:

preventing illnesses.

An example of an intervention taken on the tertiary prevention level of care is:

teaching signs and symptoms of infection to a postoperative client.

A nurse is preparing a breast cancer presentation for a health forum. Which fact would the nurse expect to address in this presentation?

Breast cancer is more advanced in African American women when found.

The nurse working in labor and birth explains that the historical rationale for performing an amniocentesis in 1966, when this procedure was introduced, was to accomplish which assessment?

assess fetal growth

Advocacy for the client is an important aspect of community-based nursing. What is one way a nurse can advocate for a child client?

assisting the family to apply for Medicaid or other forms of health care reimbursement

A community-based nurse has a different set of skills than those of counterparts who work in a hospital. Community-based nurses also face unique issues and challenges. What is one of the unique aspects of community-based nursing?

autonomous

A pregnant client is to undergo a procedure. Prior to the procedure, a nurse determines that informed consent has been obtained from the client, offering protection for the client based on which principle?

autonomy

A young couple is preparing to leave the hospital and go home after the birth of their baby. While preparing their care plan, the nurse can demonstrate recognition of their cultural differences by asking:

"Do you have any treatment preferences you would like me to include in the care plan?"

After teaching a group of nursing students about family-centered care, which statement made by the students would best indicate that the teaching was successful?

"Family-centered care recognizes the concept of family as the constant."

A pregnant woman experiencing morning sickness has asked her nurse about ways to reduce or alleviate it. After receiving education and information from the nurse, which statement would indicate that the client understood the information?

"I'll discuss with my primary care provider whether it is a good idea for me to use sea-bands."

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."

A nurse is making a home visit to a Hispanic American woman who gave birth vaginally to healthy female five days ago. Which statement by the client would the nurse interpret as indicative of the client's culture?

"I'm not taking a bath or washing my hair until 40 days have passed."

A nurse preceptor and a new nurse are discussing culture and its impact on women's health. The new nurse asks, "Where does a person first learn about culture?" Which response by the preceptor would be most appropriate?

"It begins first with the family."

A couple is trying to decide where they want to have their baby: at home, a birthing center, or the hospital. Which statement would indicate to the nurse that the couple needs more information to decide?

"My mom had me at home, so I can have this baby at home as well."

The nursing student demonstrates an understanding of fetal mortality rates when compared to the other mortality rates when she correctly describes the fetal mortality rate by which statement?

"The fetal mortality rate includes the intrauterine death of a fetus who is 20 weeks of gestation or more per 1,000 live births."

After teaching a group of nursing students about the concept of maternal mortality, the nurse determines that additional teaching is needed when one of the students makes which statement?

"The rate includes accidental causes of maternal deaths."

At a prenatal class, the nurse is told by a client that her mother advises her not raise her hands above her head during pregnancy in order to avoid umbilical cord problems. What is the nurse's best response?

"This is a belief from your mother's culture about what to avoid during pregnancy."

A nurse is conducting a class about breast cancer for a group of young adult women. Which statements by the class indicates to the nurse that the teaching was successful? Select all that apply.

-"A diet high in fat can be a risk factor for developing breast cancer." -"If someone in the family has breast cancer, my risk would be increased." -"My risk is increased if I had an irregular menstrual cycle starting at an early age."

A woman comes to the community clinic for a visit. During the visit, the client tells the nurse that she is thinking about using some complementary and alternative measures to deal with illness. Which suggestions by the nurse would be appropriate? Select all that apply.

-"Even if you use these therapies, make sure that you get medical care if you become sick." -"Just remember that if it says 'natural', it doesn't always mean it is safe." -"If you use any other therapies, be sure to tell any health care providers about them."

A prenatal nurse is preparing a presentation on the trends in childhood mortality rates in order to strategize for program funding. Which statements would the nurse likely include in the presentation? Select all that apply.

-Disparities exist by gender, age, race, and ethnicity. -Leading causes of childhood mortality include suicide. -Unintentional injury remains a leading cause of mortality in children.

The nurse is preparing for a public health campaign with a focus on current trends with family-centered care. What information would the nurse include in the presentation? Select all that apply.

-Family-centered care promotes greater family decision-making abilities. -Family-centered care requires sensitivity to the client's and family's beliefs. -The client's family is considered in health care to be an expert partnership.

Which are potential capabilities of umbilical cord blood? Select all that apply.

-If a family member develops a disease, umbilical cord blood can be used in treatment. -Umbilical cord blood is used for admission laboratory studies in newborns. -Transfusion therapies use umbilical cord blood in various treatments. -It can be used for bone marrow transplants if needed later in the child's life.

The nursing instructor is introducing students to Healthy People 2020, which highlights the major health indicators of the 21st century that need to be addressed. The nurse informs the students that this includes national health goals for maternal, infant, and child health. Which goals would be included? Select all that apply.

-Reduce maternal deaths. -Reduce fetal and infant death rates. -Reduce preterm births. -Increase infant birth weights.

A nurse working in the neonatal intensive care unit assists a family during the discharge of the premature newborn. What would the nurse prioritize in assessing the family's preparedness to care for the newborn? Select all that apply.

-The family's knowledge of newborn care -The mother's and the family's concerns -The family's available support system

A nurse is changing job roles such that the nurse will now be primarily providing home care to children rather than seeing them in a health care facility. The nurse knows that which skills or traits will be needed when working in this new environment? Select all that apply.

-acute care nursing skills -great flexibility -ability to teach family members how to give care -ability to encourage frustrated family members

The nursing student demonstrates an understanding of what is included in postpartum home visits when the student identifies which actions? Select all that apply.

-bridging the gap between discharge and ambulatory follow-up for mothers and their newborns -identifying potential or developing complications for the mother and newborn -monitoring the physical and emotional well-being of the family members

The nursing instructor is teaching a class on labor and birth. She lists the advantages of a home birth and then lists which disadvantages of home births? Select all that apply.

-danger to mother if emergency arises -limited availability of pain medication -danger to baby if emergency arises

A nurse is providing care to a women who has experienced a heart attack. When reviewing the woman's medical record, the nurse would identify which factors as placing the woman at risk for this condition? Select all that apply.

-history of preeclampsia -repeated fluctuations in weight gain and loss -history of type 2 diabetes-

A nurse is working as part of a team to address health literacy issues in the community. Which indicators would the team use to determine that efforts are effective in addressing these issues? Select all that apply.

-lower morbidity rates -increased use of preventive services -improved health outcomes -decreased emergency department visits

Infant mortality is a standard measurement of the quality of health care in the country. Which factors contribute to the high numbers of deaths in the United States? Select all that apply.

-preterm births -maternal complications -congenital deformities and chromosomal abnormalities

The nursing student has learned the importance of documenting care in the client's chart. The student understands that documentation is equally important in regards to client education because it aids in which actions? Select all that apply.

-verifies standards set by JCAHO which holds health care providers accountable for education of clients -testifies to the education that the client has received if legal matters arise -serves as a communication tool for all team members -informs third party payers of the services that were provided for reimbursement purposes

A group of students are reviewing the historical aspects of birth. The students demonstrate understanding of the information when they identify the use of twilight sleep as a key event during which time frame?

1900s

Much of the care of the pediatric client has been shifted from the hospital setting to a community setting suitable for the care being provided. Which community care setting is appropriate for assessing vision and hearing in children?

schools

A nurse is assigned to perform a blood pressure evaluation on a pregnant client. This type of care is referred to as:

secondary prevention.

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 visiting the home of a mother and her newborn. The woman's family members are present when the nurse arrives. What is the nurse's best approach to the situation?

Assess the family members' interactions with the newborn and one another.

Which action should a nurse perform to avoid disrupting family routine when visiting to provide home care?

Avoid coming during mealtimes.

A 40-year-old pregnant client tells her nurse that she would like to give birth in a birthing center because she wants several friends and family members to be there and will have more freedom at the center. What would be the most important factor for the nurse to point out when discussing this option with the client?

Birthing centers do not always have pediatricians on staff if the newborn has special needs.

An important change in maternal and child health care that nurses must often explain is the new emphasis on ambulatory care. The goal of this change in emphasis is meant to achieve which outcome?

Minimize the separation of children from their parents.

During a prenatal visit, a nurse suspects that a client is using CAM therapy. Based on review of the client's medical record, the nurse determines that the primary care provider is unaware of the client's action. Which action by the nurse would be most appropriate?

Have the client tell the primary care provider about this therapy.

Which statement is not an advantage of home care?

It can increase self-confidence because it allows sick people to rest while others take care of them.

The nurse is informing a young pregnant client of the many different maternal community health services that are available. The nurse tells the client about the group that provides mother-to-mother support for breast-feeding, nutrition, and infant care problem-solving strategies. What is the name of this group?

La Leche League

A new mother who is nervous about her baby developing sudden infant death syndrome (SIDS) asks the nurse how to prevent it. Which suggestion would be most appropriate for the nurse to make?

Lay the newborn on the back, not the stomach to sleep.

The nurse notes that an older adult client receives only one visitor and asks the client if family members could be called. The client states, "I consider her to be all of my family." What would the nurse consider in responding to the client?

The client defines who is and who is not part of the family without undue influence.

A nurse has moved into a new community and will begin practicing at the local health department. Why is it important for this nurse to become familiar with the community where the nurse will work?

The health of a community influences the health of its individuals.

The community health nurse is seeing a mother and newborn for the first home visit. Which information best indicates an understanding of visiting clients in their home?

The home visit is a way of monitoring the well-being of all family members.

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 obstetrical nurse notes that a Muslim client has not been eating any of the meals supplied to her. Which actions performed by the nurse best demonstrate cultural competence?

The nurse becomes familiar with the Muslim client's meal practices.

The nurse working in a maternity clinic suspects that a client and her children are in an abusive relationship. While waiting for test results, the nurse decides to teach the client about partner abuse. What would be the best rationale for the nurse's decision?

The nurse knows that children exposed to family violence are likely to be abused.

A nurse is conducting a presentation for a group of pregnant women about factors affecting maternal and newborn health. When discussing the family as an influential factor, which information would the nurse need to keep in mind?

The uniqueness of families requires specific methods for support.

The nurse is caring for a Hispanic client who is in labor. The client appears to closely follow traditional cultural behaviors. Which behavior would most likely to be noted by the nurse?

The woman reports a desire to have her extended family present during the labor and birth.

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 addressing a group of women on the issue of women's health during their reproductive years. Which reason does the nurse provide regarding the need for comprehensive, community-centered care to women during this time period?

Women's health care needs change with their reproductive goals.

The nurse is providing care to a client who comes to the clinic for a follow-up visit. Which skill would be most important for the nurse to use when communicating with the client?

active listening

A client with hypertension tells her nurse that she would like to use an herbal substance (CAM) to lower her blood pressure instead of taking the antihypertensive medication. The nurse should:

advise the client to speak with her primary care provider about combining herbal substances with her medication.

The development of what medical treatment was most influential in moving birth from the home into the hospital?

anesthesia and analgesic therapy

The nurse is discussing health care provider options with a client. The client feels her primary care provider was too busy for her during her last pregnancy and wants to know what her options are for receiving care during her current pregnancy and for labor and birth. Which option could the nurse suggest to this client?

certified nurse midwife

When discussing a health concern with a woman at the local community clinic, the nurse recognizes that the cornerstone of all disease management programs is:

client education.

Which factor is most critical to effective home care?

commitment to home care from family and other essential people

A nurse is making a home visit to a postpartum client. Which action would be inappropriate for the nurse to perform when making the visit?

conducting a well-baby visit to start the child's immunizations

The nurse is conducting a postpartum home visit. Which action would not necessarily be a responsibility of a visit?

conducting a well-baby visit to start the child's immunizations

A nurse is working in the community providing tertiary prevention. The nurse is most likely performing which activity?

counseling victims of long-term abuse who are experiencing numerous problems

The nurse is providing care to a pregnant client from the Middle East. The client tells the nurse that she will not make a decision without her husband's approval. The nurse interprets this statement as reflecting:

cultural difference.

A nurse has just started working at a clinic that has a large refugee client population. When providing care to this population group, which aspect would be most important for the nurse to recognize?

cultural differences

A nurse is providing care to a pregnant client who is to undergo an amniocentesis. Which action would be most appropriate for the nurse to perform related to the client's informed consent?

determining the client's understanding of the procedure

A nurse has started working at a new clinic that treats local immigrants. Which factor about the clients would be most important for the nurse to acknowledge when caring for them?

differences in culture

The nurse reinforces to the client that prenatal care is associated with improved pregnancy outcomes. Which basic components of good prenatal care should the nurse describe for the client? Select all that apply.

early and continuing risk assessment health promotion medical and psychosocial interventions follow up

A nurse working in the emergency department has witnessed women arriving in labor and experiencing complications that have led to poor outcomes. When reviewing the medical records of these clients, the nurse notes that a lack of which factor appears to be a common thread?

prenatal care

A nurse is developing a prenatal education program for the local health clinic. The nurse plans to emphasize the need for maintaining routine prenatal visits based on the understanding that most pregnancy-related complications can be:

prevented.

The experienced nurse has seen many changes in health care throughout the last few decades. One such change has been to move from acute care settings out into the community with an emphasis on which areas? Select all that apply.

health promotion illness prevention

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.

Infants in the United States are at highest risk for death statistically in comparison to other modernized countries. Which initiative, if implemented, would have the greatest impact on improving these numbers?

improving accessibility to postnatal health care for infants

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?

increasing the number of women receiving prenatal care

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 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?

neonatal death

A nurse is conducting research in preparation for developing programs to improve maternal and newborn health. The nurse is reviewing statistics revealing the number of infant deaths occurring in the first 28 days of life. The nurse is researching which rate?

neonatal mortality rate

A nurse is conducting an in-service program for a group of maternal-neonatal nurses about factors affecting maternal and newborn health. As part of the presentation the nurse describes how the family has changed over the years. The nurse determines that the teaching was successful when the group identifies which family structure as having been considered the traditional structure?

nuclear

The nurse is conducting a drug education program in a fourth-grade class. This is an example of:

primary prevention.

A nurse is caring for a Turkish American client. The nurse understands that there could be major cultural differences between the nurse and the client. The nurse contemplates assigning this client to a staff member who is of the same culture as the client. What is a potential consequence?

stereotyping of the client