Chapter 01: 21st Century Maternity Nursing
MULTIPLE CHOICE
When providing care for a pregnant woman, the nurse should be aware that one of the most fre... [Show More] quently reported maternal medical risk factors is:
Diabetes mellitus. c. Chronic hypertension.
Mitral valve prolapse (MVP). d. Anemia.
ANS: A
The most frequently reported maternal medical risk factors are diabetes and hypertension associated with pregnancy. Both of these conditions are associated with maternal obesity. There are no studies that indicate MVP is among the most frequently reported maternal risk factors. Hypertension associated with pregnancy, not chronic hypertension, is one of the most frequently reported maternal medical risk factors. Although anemia is a concern in pregnancy, it is not one of the most frequently reported maternal medical risk factors in pregnancy.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 6
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
To ensure optimal outcomes for the patient, the contemporary maternity nurse must incorporate both teamwork and communication with clinicians into her care delivery, The SBAR technique of communication is an easy-to-remember mechanism for communication. Which of the following correctly defines this acronym?
Situation, baseline assessment, response
Situation, background, assessment, recommendation
Subjective background, assessment, recommendation
Situation, background, anticipated recommendation ANS: B
The situation, background, assessment, recommendation (SBAR) technique provides a specific framework for communication among health care providers. Failure to communicate is one of the major reasons for errors in health care. The SBAR technique has the potential to serve as a means to reduce errors.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 14 OBJ: Nursing Process: Assessment, Planning
MSC: Client Needs: Safe and Effective Care Environment
The role of the professional nurse caring for childbearing families has evolved to emphasize:
Providing care to patients directly at the bedside.
Primarily hospital care of maternity patients.
Practice using an evidence-based approach.
Planning patient care to cover longer hospital stays.
ANS: C
Professional nurses are part of the team of health care providers who collaboratively care for patients throughout the childbearing cycle. Providing care to patients directly at the bedside is one of the nurses tasks; however, it does not encompass the concept of the evolved professional nurse. Throughout the prenatal period, nurses care for women in clinics and physicians offices and teach classes to help families prepare for childbirth. Nurses also care for childbearing families in birthing centers and in the home. Nurses have been critically important in developing strategies to improve the well-being of women and their infants and have led the efforts to implement clinical practice guidelines using an evidence-based approach. Maternity patients have experienced a decreased, rather than an increased, length of stay over the past 2 decades.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1 OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement?
Perform a nutrition assessment.
Refer the woman to a social worker.
Advise the woman to see an obstetrician, not a midwife.
Explain to the woman the importance of keeping her prenatal care appointments.
ANS: D
Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality. Nutritional status is an important modifiable risk factor, but a nutrition assessment is not the most important action a nurse should take in this situation. The patient may need assistance from a social worker at some time during her pregnancy, but a referral to a social worker is not the most important aspect the nurse should address at this time. If the woman has identifiable high-risk problems, her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high-risk issues. In addition, advising the woman to see an obstetrician is not the most important aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a patient is to receive.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance
During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year- old Hispanic patient with limited English proficiency. It is important for the nurse to:
Use maternity jargon in order for the patient to become familiar with these terms.
Speak quickly and efficiently to expedite the visit.
Provide the patient with handouts.
Assess whether the patient understands the discussion.
ANS: D
Nurses contribute to health literacy by using simple, common words; avoiding jargon; and evaluating whether the patient understands the discussion. Speaking slowly and clearly and focusing on what is important increase understanding. Most patient education materials are written at too high a level for the average adult and may not be useful for a client with limited English proficiency.
PTS: 1 DIF: Cognitive Level: Application REF: 5
OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance
When managing health care for pregnant women at a prenatal clinic, the nurse should recognize that the most significant barrier to access to care is the pregnant womans:
Age. c. Educational level.
Minority status. d. Inability to pay.
ANS: D
The most significant barrier to health care access is the inability to pay for services; this is compounded by the fact that many physicians refuse to care for women who cannot pay. Although adolescent pregnant clients statistically receive less prenatal care, age is not the most significant barrier. Significant disparities in morbidity and mortality rates exist for minority women; however, minority status is not the most significant barrier to access of care. Disparities in educational level are associated with morbidity and mortality rates; however, educational level is not the most significant barrier to access of care.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 5 OBJ: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
What is the primary role of practicing nurses in the research process?
Designing research studies
Collecting data for other researchers
Identifying researchable problems
Seeking funding to support research studies
ANS: C
When problems are identified, research can be conducted properly. Research of health care issues leads to evidence-based practice guidelines. Designing research studies is only one factor of the research process. Data collection is one factor of research. Financial support is necessary to conduct research, but it is not the primary role of the nurse in the research process.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 9 OBJ: Nursing Process: Diagnosis, Evaluation
MSC: Client Needs: Safe and Effective Care Environment
When the nurse is unsure about how to perform a patient care procedure, the best action would be to:
Ask another nurse.
Discuss the procedure with the patients physician.
Look up the procedure in a nursing textbook.
Consult the agency procedure manual and follow the guidelines for the procedure.
ANS: D
It is always best to follow the agencys policies and procedures manual when seeking information on correct patient procedures. These policies should reflect the current standards of care and state guidelines. Each nurse is responsible for her own practice. Relying on another nurse may not always be safe practice. Each nurse is obligated to follow the standards of care for safe client care delivery. Physicians are responsible for their own client care activity. Nurses may follow safe orders from physicians, but they are also responsible for the activities that they as nurses are to carry out. Information provided in a nursing textbook is basic information for general knowledge. Furthermore, the information in a textbook may not reflect the current standard of care or individual state or hospital policies.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 11
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity [Show Less]
