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Chapter 01: The Past, Present, and Future

MULTIPLE CHOICE

1. A patient chooses to have the certified nurse midwife (CNM) provide care during her

pregnancy. What does the CNMs scope of practice include?

a. Practice independent from medical supervision

b. Comprehensive prenatal care

c. Attendance at all deliveries

d. Cesarean sections

ANS: B

The CNM provides comprehensive prenatal and postnatal care, attends uncomplicated

deliveries, and ensures that a backup physician is available in case of unforeseen

problems.

DIF: Cognitive Level: Comprehension REF: Page 6 OBJ: 12

TOP: Advance Practice Nursing Roles KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of

Disease

2. Which medical pioneer discovered the relationship between the incidence of puerperal

fever and unwashed hands?

a. Karl Cred

b. Ignaz Semmelweis

c. Louis Pasteur

d. Joseph Lister

ANS: B

Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by

the unwashed hands of physicians and medical students.

DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 1

TOP: The Past KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

3. A pregnant woman who has recently immigrated to the United States comments to the

nurse, I am afraid of childbirth. It is so dangerous. I am afraid I will die. What is the best

nursing response reflecting cultural sensitivity?

a. Maternal mortality in the United States is extremely low.

b. Anesthesia is available to relieve pain during labor and childbirth.

c. Tell me why you are afraid of childbirth.

d. Your condition will be monitored during labor and delivery.

ANS: C

Asking the patient about her concerns helps promote understanding and individualizes

patient care.

DIF: Cognitive Level: Application REF: Page 7-8 OBJ: 8

TOP: Cross-Cultural Care KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation

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4. An urban area has been reported to have a high perinatal mortality rate. What information

does this provide?

a. Maternal and infant deaths per 100,000 live births per year

b. Deaths of fetuses weighing more than 500 g per 10,000 births per year

c. Deaths of infants up to 1 year of age per 1000 live births per year

d. Fetal and neonatal deaths per 1000 live births per year

ANS: D

The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.

DIF: Cognitive Level: Comprehension REF: Page 12, Box 1-6

OBJ: 9 TOP: The Present-Child Care

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

5. What is the focus of current maternity practice?

a. Hospital births for the majority of women

b. The traditional family unit

c. Separation of labor rooms from delivery rooms

d. A quality family experience for each patient

ANS: D

Current maternity practice focuses on a high-quality family experience for all families,

traditional or otherwise.

DIF: Cognitive Level: Comprehension REF: Page 6 OBJ: 7

TOP: The Present-Maternity Care KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance

6. Who advocated the establishment of the Childrens Bureau?

a. Lillian Wald

b. Florence Nightingale

c. Florence Kelly

d. Clara Barton

ANS: A

Lillian Wald is credited with suggesting the establishment of a federal Childrens Bureau.

DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 1 | 2

TOP: The Past KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. What was the result of research done in the 1930s by the Childrens Bureau?

a. Children with heart problems are now cared for by pediatric cardiologists.

b. The Child Abuse and Prevention Act was passed.

c. Hot lunch programs were established in many schools.

d. Childrens asylums were founded.

ANS: C

School hot lunch programs were developed as a result of research by the Childrens Bureau

on the effects of economic depression on children.

DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 2 | 3

TOP: The Past KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

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8. What government program was implemented to increase the educational exposure of

preschool children?

a. WIC

b. Title XIX of Medicaid

c. The Childrens Charter

d. Head Start

ANS: D

Head Start programs were established to increase educational exposure of preschool

children.

DIF: Cognitive Level: Knowledge REF: Page 3 OBJ: 5

TOP: Government Influences in Maternity and Pediatric Care KEY: Nursing Process Step:

N/A

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. What guidelines define multidisciplinary patient care in terms of expected outcome and

timeframe from different areas of care provision?

a. Clinical pathways

b. Nursing outcome criteria

c. Standards of care

d. Nursing care plan

ANS: A

Clinical pathways, also known as critical pathways or care maps, are collaborative

guidelines that define patient care across disciplines. Expected progress within a specified

timeline is identified.

DIF: Cognitive Level: Knowledge REF: Page 12 OBJ: 14

TOP: Health Care Delivery Systems KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

10. A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her

mother, and collected admission data. What is the next step the student will take to develop

a nursing care plan for this child?

a. Identify measurable outcomes with a timeline.

b. Choose specific nursing interventions for the child.

c. Determine appropriate nursing diagnoses.

d. State nursing actions related to the childs medical diagnosis.

ANS: C

The nurse uses assessment data to select appropriate nursing diagnoses from the NANDAI list. Outcomes and interventions are then developed to address the relevant nursing

diagnoses.

DIF: Cognitive Level: Application REF: Page 11 OBJ: 13

TOP: Nursing Process KEY: Nursing Process Step: Nursing Diagnosis

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

11. A nursing student on an obstetric rotation questions the floor nurse about the definition

of the LVN/LPN scope of practice. What resource can the nurse suggest to the student?

a. American Nurses Association

b. States board of nursing

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