Chapter 01: Maternity and Women’s Health Care Today
Foundations of Maternal-Newborn & Women’s Health Nursing, 7th Edition
MULTIPLE CHOICE
1. A
... [Show More] nurse educator is teaching a group of nursing students about the history of family-centered
maternity care. Which statement should the nurse include in the teaching session?
a.
The Sheppard-Towner Act of 1921 promoted family-centered care.b.
Changes in pharmacologic management of labor prompted family-centered care.c.
Demands by physicians for family involvement in childbirth increased the practice of family-centered
care.
d.
Parental requests that infants be allowed to remain with them rather than in a nursery initiatedthe practice of
family-centered care.
ANS: D
2. Expectant parents ask a prenatal nurse educator, ―Which setting for childbirth limitsthe amount of
parent–infant interaction?‖ Which answer should the nurse provide for these parents in order to
assist them in choosing an appropriate birth setting?
a.
Birth centerb.
Home birthc.
Traditional hospital birthd.
Labor, birth, and recovery roomANS: 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. Birth centers are set up to allow an increase inparent–infant contact. Home
births allow the greatest amount of parent–infant contact. The labor, birth, recovery, and postpartum room
setting allows for increased parent–infant contact. DIF: Cognitive Level: Understanding OBJ: Nursing Process
Step: Planning
MSC: Patient Needs: Health Promotion and Maintenance
3. Which statement best describes the advantage of a labor, birth, recovery, andpostpartum
(LDRP) room?
a.
The family is in a familiar environment.b.
They are less expensive than traditional hospital rooms.c.
The infant is removed to the nursery to allow the mother to rest.d.
The woman’s support system is encouraged to stay until discharge.ANS: D
Sleeping equipment is provided in a private room. A hospital setting is never a familiar environment to
new parents. An LDRP room is not less expensive than a traditional hospitalroom. The baby remains with
the mother at all times and is not removed to the nursery for
routine care or testing. The father or other designated members of the mother’s support systemare
encouraged to stay at all times.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: AssessmentMSC:
Patient Needs: Health Promotion and Maintenance
4. Which nursing intervention is an independent function of the professional nurse?a.
Administering oral analgesicsb.
Requesting diagnostic studiesc.
Teaching the patient perineal cared.
Providing wound care to a surgical incision
ANS: C
Nurses are now responsible for various independent functions, including teaching, counseling, and
intervening in nonmedical problems. Interventions initiated by the physician and carried outby the nurse
are called dependent functions. Administrating oral analgesics is a dependent function; it is initiated by a
physician and carried out by a nurse. Requesting diagnostic studies is a dependent function. Providing
wound care is a dependent function; however, the physicianprescribes the type of wound care through
direct orders or protocol.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: AssessmentMSC:
Patient Needs: Safe and Effective Care Environment
5. Which response by the nurse is the most therapeutic when the patient states, ―I’m soafraid to
have a cesarean birth‖?
a.
―Everything will be OK.‖
b.
―Don’t worry about it. It will be over soon.‖c.
―What concerns you most about a cesarean birth?‖d.
―The physician will be in later and you can talk to him.‖
ANS: C
The response, ―What concerns you most about a cesarean birth‖ focuses on what the patient issaying and
asks for clarification, which is the most therapeutic response. The response, ―Everything will be ok‖ is
belittling the patient’s feelings. The response, ―Don’t worry about it. It will be over soon‖ will indicate
that the patient’s feelings are not important. The response, ―The physician will be in later and you can
talk to him‖ does not allow the patient to verbalize her feelings when she wishes to do that.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: ImplementationMSC:
Patient Needs: Psychosocial Integrity
6. In which step of the nursing process does the nurse determine the appropriate
interventions for the identified nursing diagnosis?
a.
Planning
b.
Evaluation
c.
Assessmentd.
Intervention
ANS: A
The third step in the nursing process involves planning care for problems that were identifiedduring
assessment. The evaluation phase is determining whether the goals have been met. During the
assessment phase, data are collected. The intervention phase is when the plan ofcare is carried out.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: PlanningMSC:
Patient Needs: Safe and Effective Care Environment
7. Which goal is most appropriate for the collaborative problem of wound infection?
a.
The patient will not exhibit further signs of infection.b.
Maintain the patient’s fluid intake at 1000 mL/8 hour.c.
The patient will have a temperature of 98.6F within 2 days.d.
Monitor the patient to detect therapeutic response to antibiotic therapy.ANS:
D
In a collaborative problem, the goal should be nurse-oriented and reflect the nursing interventions of
monitoring or observing. Monitoring for complications such as further signs ofinfection is an
independent nursing role. Intake and output is an independent nursing role.
Monitoring a patient’s temperature is an independent nursing role.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
8. Which nursing intervention is written correctly?
a.
Force fluids as necessary.b.
Observe interaction with the infant.c.
Encourage turning, coughing, and deep breathing.d.
Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
ANS: D
Interventions might not be carried out if they are not detailed and specific. ―Force fluids‖ is not specific; it
does not state how much or how often. Encouraging the patient to turn, cough, and breathe deeply is not
detailed or specific. Observing interaction with the infant does not state how often this procedure should
be done. Assisting the patient to ambulate for 10 minutes withina certain timeframe is specific.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
9. The patient makes the statement: ―I’m afraid to take the baby home tomorrow.‖ Which
response by the nurse would be the most therapeutic?
a.
―You’re afraid to take the baby home?‖b.
―Don’t you have a mother who can come and help?‖c.
―You should read the literature I gave you before you leave.‖d.
―I was scared when I took my first baby home, but everything worked out.‖ANS:
A
This response uses reflection to show concern and open communication. The other choices areblocks to
communication. Asking if the patient has a mother who can come and assist blocks further
communication with the patient. Telling the patient to read the literature before leaving does not allow
the patient to express her feelings further. Sharing your own birth experience is inappropriate.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: ImplementationMSC:
Patient Needs: Psychosocial Integrity
10. The nurse is writing an expected outcome for the nursing diagnosis—acute pain related to
tissue trauma, secondary to vaginal birth, as evidenced by patient stating painof 8 on a scale of 10.
Which expected outcome is correctly stated for this problem?
a.
Patient will state that pain is a 2 on a scale of 10.b.
Patient will have a reduction in pain after administration of the prescribed analgesic.c.
Patient will state an absence of pain 1 hour after administration of the prescribed analgesic.d.
Patient will state that pain is a 2 on a scale of 10, 1 hour after the administration of the
prescribed analgesic.
ANS: D
The outcome should be patient-centered, measurable, realistic, and attainable and within a specified
timeframe. Patient stating that her pain is now 2 on a scale of 10 lacks a timeframe. Patient having a
reduction in pain after administration of the prescribed analgesic lacks a measurement. Patient stating an
absence of pain 1 hour after the administration of prescribedanalgesic is unrealistic.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Physiologic Integrity
11. Which nursing diagnosis should the nurse identify as a priority for a patient in activelabor?
a.
Risk for anxiety related to upcoming birthb.
Risk for imbalanced nutrition related to NPO statusc.
Risk for altered family processes related to new addition to the familyd.
Risk for injury (maternal) related to altered sensations and positional or physical changesANS: D
The nurse should determine which problem needs immediate attention. Risk for injury is theproblem that
has the priority at this time because it is a safety problem. Risk for anxiety, imbalanced nutrition, and
altered family processes are not the priorities at this time.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: ImplementationMSC:
Patient Needs: Safe and Effective Care Environment
12. Regarding advanced roles of nursing, which statement related to clinical practice isthe most
accurate?
a.
Family nurse practitioners (FNPs) can assist with childbirth care in the hospital setting.b.
Clinical nurse specialists (CNSs) provide primary care to obstetric patients.c.
Neonatal nurse practitioners provide emergency care in the postbirth setting to
high-risk infants.
d.
A certified nurse midwife (CNM) is not considered to be an advanced practice nurse.ANS: C
Neonatal NPs provide care for the high-risk neonate in the birth room and in the neonatal intensive care
unit, as needed. FNPs do not participate in childbirth care; however, they can take care of uncomplicated
pregnancies and postbirth care outside of the hospital setting. CNSswork in hospital settings but do not
provide primary care services to patients. A CNM is an advanced practice nurse who receives additional
certification in the specific area of midwifery.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Evaluation MSC:
Patient Needs: Management of Care: Legal Rights and Responsibilities
13. Which statement is true regarding the shortage of nurses in the United States?a.
There are a larger proportion of younger nurses in the workforce as compared with oldernurses.
b.
As a result of decreased RN-to-patient ratios, there is a decrease in patient mortality in theclinical
setting.
c.
Nursing programs are turning away qualified applicants.d.
There are adequate classroom and clinical facilities for training RNs.ANS:
C
According to an Institute of Medicine (IOM) report, by the year 2020, 80% of new RNs should hold
baccalaureate degrees. Despite this need, baccalaureate and master’s programs are turning away qualified
applicants due to an insufficient number of faculty. There are a larger proportion of older nurses in the
workforce based on current research by the IOM. Increased nurse-to-patient ratios have resulted in
decreased patient mortality in the clinical setting. There are currently numerous limitations of both
classroom and clinical facilities necessary to train newnurses adequately.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: ImplementationMSC:
Patient Needs: Health Promotion: Teaching/Learning
14. A hospital has achieved Magnet status. Which indicators would be consistent withthis type
of certification?
a.
There is stratification of communication in a directed manner between nursing staff and
administration.
b.
There is increased job satisfaction of nurses, with a lower staff turnover rate.c.
Physicians are certified in their respective specialty areas.d.
All nurses have baccalaureate degrees and certification in their clinical specialty area.ANS: B
Magnet status is a certification offered by the ANCC (American Nurses Credentialing Center) in which
hospitals apply based on designated criteria that consider nurse job satisfaction, staff patterns, strength,
quality of nursing staff, and open communication. It is not based on physicianstatus. Also, certification is
not required for all nurses at this point. The expectation with Magnet status is that nurses will continue to
expand their knowledge by earning additional degrees and certification.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion: Teaching/Learning
15. Which of the following statements highlights the nurse’s role as a researcher?a.
Reading peer-reviewed journal articlesb.
Working as a member of the interdisciplinary team to provide patient carec.
Helping patient to obtain home care postdischarge from the hospitald.
Delegating tasks to unlicensed personnel to allow for more teaching time with patientsANS: A
A nurse in a researcher role should look to improve her or his knowledge base by reading and reviewing
evidence-based practice information as found in peer-reviewed journals. Working as amember of the
interdisciplinary team to provide patient care indicates that the nurse is working as a collaborator. Helping
the patient to obtain home care postdischarge from the hospital indicates that the nurse is working as a
patient advocate. Delegating tasks to unlicensed personnel in order to allow for more teaching time with
patients indicates that the nurse is working as a manager.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: AssessmentMSC:
Patient Needs: Health Promotion: Teaching/Learning
16. Which patient could safely be cared for by a certified nurse-midwife?................ [Show Less]