Foundations of Maternal-Newborn and Women's Health Nursing, Exams of Nursing

Download Foundations of Maternal-Newborn and Women's Health Nursing and more Exams Nursing in PDF only on Docsity! Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer A 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 initiated the practice of family-centered care. - correct answer ☑ ☑ ANS: D 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. The Sheppard-Towner Act provided funds for state-managed programs for mothers and children but did not promote family-centered care. The changes in Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer pharmacologic management of labor were not a factor in family-centered maternity care. Family-centered care was a request by parents, not physicians. Expectant parents ask a prenatal nurse educator, "Which setting for childbirth limits the 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 center b. Home birth c. Traditional hospital birth d. Labor, birth, and recovery room d. Labor, birth, and recovery room - correct answer ☑ ☑ 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. Birth centers are set up to allow an increase in parent-infant contact. Home births allow the greatest amount of parent-infant contact. The Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer Which response by the nurse is the most therapeutic when the patient states, "I'm so afraid 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." - correct answer ☑ ☑ ANS: C The response, "What concerns you most about a cesarean birth" focuses on what the patient is saying 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. In which step of the nursing process does the nurse determine the appropriate interventions for the Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer identified nursing diagnosis? a. Planning b. Evaluation c. Assessment d. Intervention - correct answer ☑ ☑ ANS: A The third step in the nursing process involves planning care for problems that were identified during 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 of care is carried out. 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 98.6?F within 2 days. Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer d. Monitor the patient to detect therapeutic response to antibiotic therapy. - correct answer ☑ ☑ 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 of infection is an independent nursing role. Intake and output is an independent nursing role. Monitoring a patient's temperature is an independent nursing role. 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 - correct answer ☑ ☑ 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 Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer 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 prescribed analgesic is unrealistic. Which nursing diagnosis should the nurse identify as a priority for a patient in active labor? a. Risk for anxiety related to upcoming birth b. Risk for imbalanced nutrition related to NPO status c. Risk for altered family processes related to new addition to the family d. Risk for injury (maternal) related to altered sensations and positional or physical changes - correct answer ☑ ☑ ANS: D The nurse should determine which problem needs immediate attention. Risk for injury is the problem 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. Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer Regarding advanced roles of nursing, which statement related to clinical practice is the 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 - correct answer ☑ ☑ 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 post birth care outside of the hospital setting. CNSs work in hospital settings but do not provide primary care services to patients. A CNM is an advanced practice nurse Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer who receives additional certification in the specific area of midwifery. 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 older nurses. b. As a result of decreased RN-to-patient ratios, there is a decrease in patient mortality in the clinical setting. c. Nursing programs are turning away qualified applicants. d. There are adequate classroom and clinical facilities for training RNs. - correct answer ☑ ☑ 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 Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer based practice information as found in peer-reviewed journals. Working as a member of the interdisciplinary team to provide patient care indicates that the nurse is working as a collaborator. Helping the patient to obtain home care post discharge 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 Which patient could safely be cared for by a certified nurse-midwife? a. Gravida 3, para 2, with no complications b. Gravida 1, para 0, with mild hypertension c. Gravida 2, para 1, with insulin-dependent diabetes d. Gravida 1, para 0, with borderline pelvic measurements - correct answer ☑ ☑ ANS: A A certified nurse-midwife (CNM) cares for women who are at low risk for complications. The CNM Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer would not care for a woman with hypertension. The CNM would not care for a woman with insulin-dependent diabetes. The CNM would not care for a woman with borderline pelvic measurements A primipara patient asks about possible support options for her during the labor process. She is apprehensive that her family members will not be prepared to assist her during this time. Which option would be most effective for this patient? a. Reassure the patient that the labor and birth staff consists of highly trained nurses who are well educated to take care of laboring patients so that should be sufficient. b. Encourage the patient to take prepared childbirth classes with her husband because that should provide the best support by a family member. c. Provide information to the patient about obtaining a doula during the labor process. Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer d. Tell the patient that this is a normal feeling based on fear of the unknown and that it will subside once she starts the labor process - correct answer ☑ ☑ ANS: C Providing information about a doula addresses the patient's concern because the doula's designated role is to provide support during labor. Although it is true that labor and birth nurses are trained in their specialty, the patient is voicing concern for support so her feelings should not be minimized. Encouraging the patient to take prepared childbirth classes is also important; however, it does not address the patient's concern for support. Because this patient is a primipara, it is normal to have some anxiety over the unknown process of the labor experience but again this response minimizes the patient's concern. The nurse states to the newly pregnant patient, "Tell me how you feel about being pregnant." Which communication technique is the nurse using with this patient? Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer c. The recognition of improved obstetric outcomes was related to increased usage of hygienic practices. d. A shift to hospital-based births occurred as a result of medical equipment designed to facilitate birth. e. The use of chloroform by midwives led to decreased pain during birth. - correct answer ☑ ☑ ANS: B, C, D Training of granny midwives was done by apprenticeship as opposed to formal medical school training. With the advent of usage of hygienic practices, improved health outcomes were seen with regard to a decrease in sepsis. New equipment such as forceps enabled easier birth. Women of privilege in the nineteenth century delivered at home, attended by a midwife. Chloroform was used by physicians and was not available to midwives. Many communities now offer the availability of free- standing birth centers to provide care for low-risk women during pregnancy, birth, and postpartum. When counseling the newly pregnant patient Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer regarding this option, the nurse should be aware that this type of care setting includes which advantages? (Select all that apply.) a. Staffing by lay midwives b. Equipped for obstetric emergencies c. Less expensive than acute care hospitals d. Safe, homelike births in a familiar setting e. Access to follow-up care for 6 weeks postpartum - correct answer ☑ ☑ ANS: C, D, E Patients who are at low risk and desire a safe, homelike birth are very satisfied with this type of care setting. The new mother may return to the birth center for postpartum follow-up care, breastfeeding assistance, and family planning information for 6 weeks postpartum. Because birth centers do not incorporate advanced technologies into their services, costs are significantly less than in a hospital setting. The major disadvantage of this care setting is that these facilities are not equipped to handle Chapter 01: Maternity and Women's Health Care Today Murray & McKinney: Foundations of Maternal-Newborn and Women's Health Nursing, 7th Edition Exam Question and Answer obstetric emergencies. Should unforeseen difficulties occur, the patient must be transported by ambulance to the nearest hospital. Birth centers are usually staffed by certified nurse-midwives (CNMs). The nurse is assessing a patient's use of complementary and alternative therapies. Which should the nurse document as an alternative or complementary therapy practice? (Select all that apply.) a. Practicing yoga daily b. Drinking green tea in the morning c. Taking omeprazole (Prilosec) once a day d. Using aromatherapy during a relaxing bath e. Wearing a lower back brace when lifting heavy objects - correct answer ☑ ☑ ANS: A, B, D Complementary and alternative (CAM) therapies can be defined as those systems, practices, interventions, modalities, professions, therapies, applications, theories, and claims that are currently not an integral part of the