Chapter
01: Foundations of Maternity, Women’s Health, and Child Health Nursing
McKinney: Evolve Resources for Maternal-Child Nursing, 5th Edition MULTIPLE
CHOICE 1. Which factor significantly contri buted to the shift from home births
to hospital births in the early 20th century? a. Puerperal sepsis was
identified as a risk factor in labor and delivery. b. Forceps were developed to
facilitate difficult births. c. The importance of early parental-infant contact
was identified. d. Technologic developments became available to physicians.
ANS: D Technologic developments were available to physicians, not lay midwives.
So in-hospital births increased in order to take advantage of these
advancements. Puerperal sepsis has been a known problem for generations. In the
late 19th century, Semmelweis discovered how it could be prevented with
improved hygienic practices. The development of forceps is an example of a
technology advance made in the early 20th century but is not the only reason
birthplaces moved. Unlike home births, early hospital births hindered bonding
between parents and their infants. PTS: 1 DIF: Cognitive Level:
Knowledge/Remembering REF: p. 1 OBJ: Integrated Process: Teaching-Learning MSC:
Client Needs: Safe and Effective Care Environment 2. Family-centered maternity
care developed in response to a. demands by physicians for family involvement
in childbirth. b. the Sheppard-Towner Act of 1921. c. parental requests that
infants be allowed to remain with them rather than in a nursery. d. changes in
pharmacologic management of labor. ANS: C As research began to identify the benefits
of early extended parent-infant contact, parents began to insist that the
infant remain with them. This gradually developed into the practice of
rooming-in and finally to family-centered maternity care. Family-centered care
was a request by parents, not physicians. The Sheppard-Towner Act of 1921
provided funds for state-managed programs for mothers and children. The changes
in pharmacologic management of labor were not a factor in family-centered
maternity care. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 2
OBJ: Integrated Process: Teaching-Learning MSC: Client Needs: Psychosocial
Integrity 3. Which setting for childbirth allows the least amount of
parent-infant contact? a. Labor/delivery/recovery/postpartum room b. Birth
center c. Traditional hospital birth d. Home birth . ANS: C In the traditional
hospital setting, the mother may see the infant for only short feeding periods,
and the infant is cared for in a separate nursery. The
labor/delivery/recovery/postpartum room setting allows increased parent-infant
contact. Birth centers are set up to allow an increase in parent-infant
contact. Home births allow an increase in parent-infant contact. PTS: 1 DIF:
Cognitive Level: Knowledge/Remembering REF: p. 2 OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance 4. As a result of changes
in health care delivery and funding, a current trend seen in the pediatric
setting is a. increased hospitalization of children. b. decreased number of
children living in poverty. c. an increase in ambulatory care. d. decreased use
of managed care. ANS: C One effect of managed care has been that pediatric
health care delivery has shifted dramatically from the acute care setting to
the ambulatory setting in order to provide more cost-efficient care. The number
of hospital beds being used has decreased as more care is given in outpatient
settings and in the home. The number of children living in poverty has
increased over the past decade. One of the biggest changes in health care has
been the growth of managed care. PTS: 1 DIF: Cognitive Level:
Knowledge/Remembering REF: p. 5 OBJ: Nursing Process: Planning MSC: Client
Needs: Safe and Effective Care Environment 5. The Women, Infants, and Children
(WIC) program provides a. well-child examinations for infants and children
living at the poverty level. b. immunizations for high-risk infants and
children. c. screening for infants with developmental disorders. d.
supplemental food supplies to low-income pregnant or breastfeeding women. ANS:
D WIC is a federal program that provides supplemental food supplies to
low-income women who are pregnant or breastfeeding and to their children until
age 5 years. Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment
Program provides for well-child examinations and for treatment of any medical
problems diagnosed during such checkups. Children in the WIC program are often
referred for immunizations, but that is not the primary focus of the program.
Public Law 99-457 is part of the Individuals with Disabilities Education Act
that provides financial incentives to states to establish comprehensive early
intervention services for infants and toddlers with, or at risk for,
developmental disabilities. PTS: 1 DIF: Cognitive Level: Comprehension OBJ:
Integrated Process: Teaching-Learning MSC: Client Needs: Health Promotion and
Maintenance REF: p. 8 6. In most states, adolescents who are not emancipated
minors must have the permission of their parents before . a. b. c. d. treatment
for drug abuse. treatment for sexually transmitted diseases (STDs). accessing
birth control. surgery. ANS: D Minors are not considered capable of giving
informed consent, so a surgical procedure would require consent of the parent
or guardian. Exceptions exist for obtaining treatment for drug abuse or STDs or
for getting birth control in most states. PTS: 1 DIF: Cognitive Level:
Knowledge/Remembering REF: p. 17 OBJ: Nursing Process: Planning MSC: Client
Needs: Safe and Effective Care Environment 7. The maternity nurse should have a
clear understanding of the correct use of a clinical pathway. One
characteristic of clinical pathways is that they are developed and implemented
by nurses. are used primarily in the pediatric setting. set specific time lines
for sequencing interventions. are part of the nursing process. a. b. c. d. ANS:
C Clinical pathways are standardized, interdisciplinary plans of care devised
for patients with a particular health problem. They are used to identify
patient outcomes, specify time lines to achieve those outcomes, direct
appropriate interventions and sequencing of interventions, include
interventions from a variety of disciplines, promote collaboration, and involve
a comprehensive approach to care. They are developed by multiple health care
professionals and reflect interdisciplinary care. They can be used in multiple
settings and for patients throughout the life span. They are not part of the
nursing process but can be used in conjunction with the nursing process to
provide care to patients. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 7 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective
Care Environment 8. The fastest growing group of homeless people is a. men and
women preparing for retirement. b. migrant workers. c. single women and their
children. d. intravenous (IV) substance abusers. ANS: C Pregnancy and birth,
especially for a teenager, are important contributing factors for becoming
homeless. People preparing for retirement, migrant workers, and IV substance
abusers are not among the fastest growing groups of homeless people. PTS: 1
DIF: Cognitive Level: Knowledge/Remembering REF: p. 14 OBJ: Nursing Process:
Assessment MSC: Client Needs: Physiologic Integrity . 9. A nurse wishes to work
to reduce infant mortality in the United States. Which activity would this
nurse most likely participate in? Creating pamphlets in several different
languages using an interpreter. Assisting women to enroll in Medicaid by their
third trimester. Volunteering to provide prenatal care at community centers.
Working as an intake counselor at a women’s shelter. a. b. c. d. ANS: C
Prenatal care is vital to reducing infant mortality and medical costs. This
nurse would most likely participate in community service providing prenatal
care outreach activities in community centers, particularly in low-income
areas. Pamphlets in other languages, enrolling in Medicaid, and working at a
women’s shelter all might impact infant mortality, but the greatest effect
would be from assisting women to get consistent prenatal care. PTS: 1 DIF:
Cognitive Level: Application/Applying REF: p. 14 OBJ: Nursing Process:
Implementation MSC: Client Needs: Health Promotion and Maintenance 10. The
intrapartum woman sees no need for a routine admission fetal monitoring strip.
If she continues to refuse, what is the first action the nurse should take? a.
Consult the family of the woman. b. Notify the provider of the situation. c.
Document the woman’s refusal in the nurse’s notes. d. Make a referral to the
hospital ethics committee. ANS: B Patients must be allowed to make choices
voluntarily without undue influence or coercion from others. The physician,
especially if unaware of the patient’s decision, should be notified
immediately. Both professionals can work to ensure the mother understands the
rationale for the action and the possible consequences of refusal. The woman
herself is the decision maker, unless incapacitated. Documentation should occur
but is not the first action. This situation does not rise to the level of an
ethical issue so there is no reason to call the ethics committee. PTS: 1 DIF:
Cognitive Level: Application/Applying REF: p. 18 OBJ: Nursing Process:
Implementation MSC: Client Needs: Safe and Effective Care Environment 11. Which
statement is true regarding the “quality assurance” or “incident” report? a.
The report assures the legal department that no problem exists. b. Reports are
a permanent part of the patient’s chart. c. The nurse’s notes should contain,
“Incident report filed, and copy placed in chart.” d. This report is a form of
documentation of an event that may result in legal action. ANS: D An incident
report is used when something occurs that might result in legal action, such as
a patient fall or medication error. It warns the legal department that there
may be a problem in a particular patient’s care. Incident reports are not part
of the patient’s chart; thus the nurses’ notes should not contain any reference
to them. PTS: 1 REF: p. 18 DIF: Cognitive Level: Knowledge/Remembering OBJ:
Integrated Process: Communication and Documentation . MSC: Client Needs: Safe
and Effective Care Environment 12. Elective abortion is considered an ethical
issue because a. abortion law is unclear about a woman’s constitutional rights.
b. the Supreme Court ruled that life begins at conception. c. a conflict exists
between the rights of the woman and the rights of the fetus. d. it requires
third-party consent. ANS: C Elective abortion is an ethical dilemma because two
opposing courses of action are available. The belief that induced abortion is a
private choice is in conflict with the belief that elective pregnancy
termination is taking a life. Abortion laws are clear concerning a woman’s
constitutional rights. The Supreme Court has not ruled on when life begins.
Abortion does not require third-party consent. PTS: 1 DIF: Cognitive Level:
Knowledge/Remembering REF: p. 11 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Safe and Effective Care Environment 13. Which woman would be
most likely to seek prenatal care? a. A 15-year-old who tells her friends, “I
don’t believe I’m pregnant.” b. A 20-year-old who is in her first pregnancy and
has access to a free prenatal clinic. c. A 28-year-old who is in her second
pregnancy and abuses drugs and alcohol. d. A 30-year-old who is in her fifth
pregnancy and delivered her last infant at home. ANS: B The patient who
acknowledges the pregnancy early, has access to health care, and has no reason
to avoid health care is most likely to seek prenatal care. Being in denial
about the pregnancy increases the risk of not seeking care. This patient is
also 15, and other social factors may discourage her from seeking care as well.
Women who abuse substances are less likely to receive prenatal care. Some women
see pregnancy and delivery as a natural occurrence and do not seek health care.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 14 OBJ:
Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
14. A woman who delivered her baby 6 hours ago complains of headache and
dizziness. The nurse administers an analgesic but does not perform any
assessments. The woman then has a tonic-clonic seizure, falls out of bed, and
fractures her femur. How would the actions of the nurse be interpreted in
relation to standards of care? a. Negligent: the nurse failed to assess the
woman for possible complications b. Negligent: because the nurse medicated the
woman c. Not negligent: the woman had signed a waiver concerning the use of
side rails d. Not negligent: the woman did not inform the nurse of her symptoms
as soon as they occurred ANS: A . There are four elements to malpractice, which
is negligence in the performance of professional duties: duty, breach of duty,
damage, and proximate cause. The nurse was negligent because she or he did not
perform any assessments, which is the first step of the nursing process and is
a standard of care. By not assessing the patient, the nurse did not meet
established standards of care, and thus is guilty of professional negligence,
or malpractice. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 16
OBJ: Nursing Process: Evaluation MSC: Client Needs: Safe and Effective Care
Environment 15. Which patient situation fails to meet the first requirement of
informed consent? a. The patient does not understand the physician’s
explanations. b. The physician gives the patient only a partial list of
possible side effects and complications. c. The patient is confused and
disoriented. d. The patient signs a consent form because her husband tells her
to. ANS: C The first requirement of informed consent is that the patient must
be competent to make decisions about health care. Full disclosure of
information is an important element of the consent, but first the patient has
to be competent to sign. Understanding is an important element of the consent,
but first the patient has to be competent to sign. Voluntary consent is an
important element of the consent, but first the patient has to be competent to
sign. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 17 OBJ:
Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care
Environment 16. Which situation reflects a potential ethical dilemma for the
nurse? a. A nurse administers analgesics to a patient with cancer as often as
the provider’s order allows. b. A neonatal nurse provides nourishment and care
to a newborn who has a defect that is incompatible with life. c. A labor nurse,
whose religion opposes abortion, is asked to assist with an elective abortion.
d. A postpartum nurse provides information about adoption to a new mother who
feels she cannot adequately care for her infant. ANS: C A dilemma exists in
this situation because the nurse is being asked to assist with a procedure that
she or he believes is morally wrong. The other situations do not contain
elements of conflict for the nurse. PTS: 1 DIF: Cognitive Level:
Comprehension/Understanding REF: p. 11 OBJ: Nursing Process: Assessment MSC:
Client Needs: Safe and Effective Care Environment 17. When planning a parenting
class, the nurse should explain that the leading cause of death in children 1
to 4 years of age in the United States is a. premature birth. b. congenital
anomalies. . c. accidental death. d. respiratory tract illness. ANS: C Although
the rates have dropped, unintentional injury (accidents) are still the leading
cause of death for children aged 1 to 19. The other options contribute to
morbidity and mortality in children but are not the leading cause. PTS: 1 DIF:
Cognitive Level: Knowledge/Remembering REF: p. 10 | Table 1.3 OBJ: Integrated
Process: Teaching-Learning MSC: Client Needs: Safe and Effective Care
Environment 18. A nurse is floated to a different unit. The nurse does not know
how to perform a treatment that has been prescribed for one of his or her
assigned patients. What should the nurse’s first action be? a. Delay the
treatment until another nurse can do it. b. Make the child’s parents aware of
the situation. c. Inform the nursing supervisor of the problem. d. Arrange to
have the child transferred to another unit. ANS: C Nurses who work outside
their usual areas of expertise must assess their own skills and avoid
performing tasks or taking on responsibilities in areas in which they are not
competent. This nurse should inform the supervisor of the situation. The nurse
could endanger the child by delaying the intervention until another nurse is
available. Telling the child’s parents would most likely increase their anxiety
and will not resolve the difficulty. Transfer to another unit delays needed
treatment and would create unnecessary disruption for the child and family.
PTS: 1 DIF: Cognitive Level: Application/Applying REF: p. 19 OBJ: Nursing
Process: Implementation MSC: Client Needs: Safe and Effective Care Environment
19. The mother of a 5-year-old female inpatient on the pediatric unit asks the
nurse if she could provide information regarding the recommended amount of
television viewing time for her daughter. The nurse responds that the
appropriate amount of time a child should be watching television is a. 1 to 2
hours per day. b. 2 to 3 hours per day. c. 3 to 4 hours per day. d. 4 hours or
more. ANS: A The American Academy of Pediatrics (2013) encourages parents to
monitor their children’s media exposure and limit their children’s screen time
(TV, computer, video games) to no more than 1 to 2 hours per day. The other
options all contain more screen time than is recommended. PTS: 1 DIF: Cognitive
Level: Comprehension/Understanding REF: p. 15 OBJ: Integrated Process:
Teaching-Learning MSC: Client Needs: Health Promotion and Maintenance . 20.
Family-centered care (FCC) describes safe, quality care that recognizes and
adapts to both the physical and psychosocial needs of the family. Which nursing
practice coincides with the principles of FCC? a. The newborn is returned to
the nursery at night so that the mother can receive adequate rest before
discharge. b. The father is encouraged to go home after the baby is delivered.
c. All patients are routinely placed on the fetal monitor. d. The nurse’s
assignment includes both mom and baby and increases the nurse’s responsibility
for education. ANS: D Family-centered care increases the responsibilities of
nurses. In addition to the physical care provided, nurses assume a major role
in teaching, counseling, and supporting families. The other options do not
provide family-centered care because they increase family separation or use
technology routinely, which may not be needed. PTS: 1 DIF: Cognitive Level:
Comprehension/Understanding REF: p. 2 OBJ: Integrated Process: Caring MSC:
Client Needs: Health Promotion and Maintenance 21. Which statement related to
nursing care of the child at home is most correct? a. The technology-dependent
infant can safely be cared for at home. b. Home care increases readmissions to
the hospital for a child with chronic conditions. c. There is increased stress
for the family when a sick child is being cared for at home. d. The family of
the child with a chronic condition is likely to be separated from their support
system if the child is cared for at home. ANS: A Greater numbers of
technology-dependent infants and children are now cared for at home. The
numbers include those needing ventilator assistance, total parenteral
nutrition, IV medications, apnea monitoring, and other device-assisted nursing
care. Optimal home care can reduce the rate of readmission to the hospital for
children with chronic conditions. Consumers often prefer home care because of
the decreased stress on the family when the patient is able to r.
Version | latest |
Category | TEST BANK |
Included files | |
Pages | 611 |
Language | English |
Comments | 0 |
Sales | 0 |
{{ userMessage }}