Test Bank for Contemporary Maternal-Newborn Nursing, 9e Ladewig et al

Contemporary Maternal-Newborn Nursing, 9e (Ladewig et al.)

Chapter 1   Contemporary Maternal-Newborn Care

1) During a prenatal visit, a client expresses interest in accessing community-based care and services. Which response allows the registered nurse to best describe services that are offered by way of community-based care?

1.  "Most healthcare services provided to childbearing women and their families take place in a hospital setting."

2.  "Community-based care can provide a client with certain primary care services."

3.  "Nurses are the sole providers of services related to home care."

4.  "Due to lack of support from third-party payers, community-based care has decreased."

Answer:  2

Explanation:  1. The majority of health care provided to childbearing women and their families takes place outside of hospital in clinics, offices, community-based organizations, and private homes.

2.                  Primary care includes health promotion and illness prevention, and it features services that are best provided in community-based settings.

3.                  While nurses are the major providers of home care services, healthcare providers in various other fields, such as physical therapy, also offer home care services.

4.                  As third-party payers begin to recognize the importance of primary care in containing costs and maintaining health, community-based care has increased.

Page Ref: 3

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies:

Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 1.2-Describe the use of community-based nursing care in meeting the needs of childbearing families.

MNL LO:  Overview of maternal-newborn nursing.

2) The labor and delivery nurse and a novice nurse are admitting a client who is in labor. The client is making groaning guttural sounds during contractions and answers questions with oneword answers. The labor and delivery nurse is quickly setting up the instruments and sterile field for this delivery while asking admission questions between contractions. The labor and delivery nurse has not completed a pelvic exam. The novice nurse understands that this is an example of:

1.  An expert nurse assessing advanced labor and imminent delivery in the client.

2.  The correct order of steps when admitting a who is in labor.

3.  Inconsistencies in an individual nurse's approach to client care.

4.  Advanced nurse practice.

Answer:  1

Explanation:  1. An expert nurse utilizes multiple aspects of a client's behavior (including the length of each response to a question and sounds the patient produces during contractions) in addition to the more objective findings of the pelvic exam (including dilation of the cervix) in the assessment of a who is in labor. The expert nurse has identified that the grunting and guttural sounds during contractions are involuntary pushing and that the client is very close to delivery.

2.                  Although most nurses have a routine when admitting a client, the order of the steps will vary according to the situation at hand.

3.                  Changing the order of the steps of admission is not being inconsistent; changing the order of the steps of admission is responsive to the needs of the client at that point in time. 

4.                  Advanced nurse practice describes educational and certification achievement and is not used to describe the continuum from novice to expert. 

Page Ref: 4, 5

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies:

Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing

| Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 1.3-Identify the nursing roles available to the maternal-newborn and women's healthcare nurses.

MNL LO:  Overview of maternal-newborn nursing.

3) Currently, one-third of children under 20 years old come from families of minority populations. The new nurse is observing her preceptor assess the client's communication pattern, religious beliefs, level of education, and support system. The new nurse understands that the best reason for her preceptor to assess these areas is to increase the:

1.  Client's cooperation with the plan of care.

2.  Hospitals compliance with the Joint Commission on Accreditation of Healthcare Organizations JCAHO standards. 

3.  Nurse's knowledge of cultural beliefs.

4.  Client's satisfaction with her care. 

Answer:  1

Explanation:  1. Gaining cooperation with the plan of care increases the outcome desired at discharge. When a client's value system is not included in the plan of care, it will decrease compliance with the treatment plan and possibly increase the length of stay and decrease the desired outcome at discharge.

2.                  Although compliance with JCAHO standards is very important, it is more important to gain client cooperation with the plan of care.

3.                  The nurse's knowledge of cultural beliefs increases the ability to care for the client, but without the client's cooperation with the plan of care, the nurse's knowledge is lost.

4.                  Client satisfaction with care is important, but the prime reason for the satisfaction is the nurse's taking time to gain patient cooperation with the plan of care. 

Page Ref: 4, 5

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 1.3-Identify the nursing roles available to the maternal-newborn and women's healthcare nurses.

MNL LO:  Overview of maternal-newborn nursing.

issues.

4.  Demonstrating leadership within his or her specialty and working to improve inpatient care both directly and indirectly.

Answer:  4

Explanation:  1. Physical and psychosocial clinical assessment is the major focus of the nurse practitioner (NP), who provides care in many different clinical settings.

2.                  The certified nurse-midwife (CNM) is qualified to provide independent care of the client with a low-risk pregnancy, while seeking physician consultation as needed.

3.                  Nurse researchers have an advanced doctoral degree, typically a PhD, and assume a leadership role in generating new research.

4.                  The CNS assumes a leadership role within his or her specialty and works to improve inpatient care both directly and indirectly.

Page Ref: 4, 5

Cognitive Level:  Understanding

Client Need&Sub:  Safe and Effective Care Environment | Management of Care

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process:

Evaluation/Leadership

Learning Outcome:  LO 1.3-Identify the nursing roles available to the maternal-newborn and women's healthcare nurses.

MNL LO:  Overview of maternal-newborn nursing.

17) A couple has been attempting pregnancy for the last three years and is looking for assistance from the fertility specialist. The nurse assesses the client's emotional response to infertility.

Which responses could the nurse expect? Select all that apply.

1.  Love, no matter what, they have each other

2.  Failure, they cannot conceive a child

3.  Anger, other people have children

4.  Fear, they may never experience parenthood

5.  Sadness, they may never have a child

Answer:  2, 3, 4, 5

Explanation:  1. This may be the end result of their journey if they fail in attempts to have a child.

2.  Failure is one of the many responses to infertility.

3.  Anger is one of the many responses to infertility.

4.  Fear is one of the many responses to infertility.

5.  Sadness is one of the many responses to infertility.

Page Ref: 7, 8

Cognitive Level:  Analyzing

Client Need&Sub:  Safe and Effective Care Environment | Management of Care

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process:

Assessment/Coordination of care

Learning Outcome:  LO 1.5-Discuss the role of evidence-based practice in improving the quality of nursing care for childbearing families.

MNL LO:  Overview of maternal-newborn nursing.

18) The student is reading an article that states the pregnancy-related mortality rate in the United States in the year 2011 was 17.8. Which statement(s) by the student could be an accurate explanation? Select all that apply.

1.  In 2011, there were 17.8 maternal deaths per 100,000 women of childbearing age in the United States.

2.  In 2011, there were 17.8 maternal deaths per 100,000 live births in the United States.

3.  In 2011, there were 17.8 maternal deaths per 100,000 women in the country in the United States.

4.  In 2011, there were 17.8 maternal deaths per 100,000 pregnancies in the United States. 5. In 2011, there were 17.8 deaths of women from the United States as a result of the childbearing period per 100,000 live births.

Answer:  4, 5

Explanation:  1. This answer states only that the maternal deaths were among women of childbearing age.

2.  This answer states only that the maternal deaths were among live births.

3.  This answer states only that the maternal deaths were among women in the country. 

4.  This answer clarifies that the women were within the 42 weeks of a pregnancy.

5.  This answer clarifies that the women were within the childbearing (conception to 6-weeks postpartum) period.

Page Ref: 8, 9

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Quality improvement | AACN Essential Competencies: Essential II: Basic organizational and systems leadership for quality care and patient safety | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process:

Understanding/Health teaching and health promotion

Learning Outcome:  LO 1.6-Explain how nurses can use descriptive and inferential statistics in clinical practice in maternal—child health nursing.

MNL LO:  Overview of maternal-newborn nursing.