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Test Bank Maternal Child Nursing Care, 6th Edition, Shannon Perry, Exams of Nursing

Chamberlain College of NursingNursing

Test Bank Maternal Child Nursing Care, 6th Edition, Shannon Perry

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Test Bank Maternal Child Nursing Care, 6th Edition, Shannon Perry 2023
Table of Contents
Table of Contents
1
Chapter 01: 21st Century Maternity Nursing
Chapter 02: Community Care: The Family and Culture
Chapter 03: Assessment and Health Promotion
Chapter 04: Reproductive System Concerns
Chapter 05: Infertility, Contraception, and Abortion
Chapter 06: Genetics, Conception, and Fetal Development
Chapter 07: Anatomy and Physiology of Pregnancy
Chapter 08: Nursing Care of the Family During Pregnancy
Chapter 09: Maternal and Fetal Nutrition
Chapter 10: Assessment of High Risk Pregnancy
Chapter 11: High Risk Perinatal Care: Preexisting Conditions
Chapter 12: High Risk Perinatal Care: Gestational Conditions
Chapter 13: Labor and Birth Processes
Chapter 14: Pain Management
Chapter 15: Fetal Assessment During Labor
Chapter 16: Nursing Care of the Family During Labor and Birth
Chapter 17: Labor and Birth Complications
Chapter 18: Maternal Physiologic Changes
Chapter 19: Nursing Care of the Family During the Postpartum Period
Chapter 20: Transition to Parenthood
Chapter 21: Postpartum Complications
Chapter 22: Physiologic and Behavioral Adaptations of the Newborn
Chapter 23: Nursing Care of the Newborn and Family
Chapter 24: Newborn Nutrition and Feeding
Chapter 25: The High Risk Newborn
Chapter 26: 21st Century Pediatric Nursing
Chapter 27: Family, Social, Cultural, and Religious Influences on Child Health Promotion
Chapter 28: Developmental and Genetic Influences on Child Health Promotion
Chapter 29: Communication, History, and Physical Assessment
Chapter 30: Pain Assessment and Management in Children
Chapter 31: The Infant and Family
Chapter 32: The Toddler and Family
Chapter 33: The Preschooler and Family
Chapter 34: The School-Age Child and Family
Chapter 35: The Adolescent and Family
Chapter 36: Impact of Chronic Illness, Disability, and End-of-Life Care for the Child and
Family
Chapter 37: Impact of Cognitive or Sensory Impairment on the Child and Family
Chapter 38: Family-Centered Care of the Child During Illness and Hospitalization
Chapter 39: Pediatric Variations of Nursing Interventions
Chapter 40: Respiratory Dysfunction
Chapter 41: Gastrointestinal Dysfunction
Chapter 42: Cardiovascular Dysfunction
Chapter 43: Hematologic and Immunologic Dysfunction
Chapter 44: Cancer
Chapter 45: Genitourinary Dysfunction
Chapter 46: Cerebral Dysfunction
Chapter 47: Endocrine Dysfunction
Chapter 48: Musculoskeletal or Articular Dysfunction
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Table of Contents

Table of Contents

Chapter 01: 21st Century Maternity Nursing

Chapter 02: Community Care: The Family and Culture

Chapter 03: Assessment and Health Promotion

Chapter 04: Reproductive System Concerns

Chapter 05: Infertility, Contraception, and Abortion

Chapter 06: Genetics, Conception, and Fetal Development

Chapter 07: Anatomy and Physiology of Pregnancy

Chapter 08: Nursing Care of the Family During Pregnancy

Chapter 09: Maternal and Fetal Nutrition

Chapter 10: Assessment of High Risk Pregnancy

Chapter 11: High Risk Perinatal Care: Preexisting Conditions

Chapter 12: High Risk Perinatal Care: Gestational Conditions

Chapter 13: Labor and Birth Processes

Chapter 14: Pain Management

Chapter 15: Fetal Assessment During Labor

Chapter 16: Nursing Care of the Family During Labor and Birth

Chapter 17: Labor and Birth Complications

Chapter 18: Maternal Physiologic Changes

Chapter 19: Nursing Care of the Family During the Postpartum Period

Chapter 20: Transition to Parenthood

Chapter 21: Postpartum Complications

Chapter 22: Physiologic and Behavioral Adaptations of the Newborn

Chapter 23: Nursing Care of the Newborn and Family

Chapter 24: Newborn Nutrition and Feeding

Chapter 25: The High Risk Newborn

Chapter 26: 21st Century Pediatric Nursing

Chapter 27: Family, Social, Cultural, and Religious Influences on Child Health Promotion

Chapter 28: Developmental and Genetic Influences on Child Health Promotion

Chapter 29: Communication, History, and Physical Assessment

Chapter 30: Pain Assessment and Management in Children

Chapter 31: The Infant and Family

Chapter 32: The Toddler and Family

Chapter 33: The Preschooler and Family

Chapter 34: The School-Age Child and Family

Chapter 35: The Adolescent and Family

Chapter 36: Impact of Chronic Illness, Disability, and End-of-Life Care for the Child and

Family

Chapter 37: Impact of Cognitive or Sensory Impairment on the Child and Family

Chapter 38: Family-Centered Care of the Child During Illness and Hospitalization

Chapter 39: Pediatric Variations of Nursing Interventions

Chapter 40: Respiratory Dysfunction

Chapter 41: Gastrointestinal Dysfunction

Chapter 42: Cardiovascular Dysfunction

Chapter 43: Hematologic and Immunologic Dysfunction

Chapter 44: Cancer

Chapter 45: Genitourinary Dysfunction

Chapter 46: Cerebral Dysfunction

Chapter 47: Endocrine Dysfunction

Chapter 48: Musculoskeletal or Articular Dysfunction

Chapter 49: Neuromuscular or Muscular Dysfunction 827

Chapter 01: 21st Century Maternity Nursing

MULTIPLE CHOICE

  1. When providing care for a pregnant woman, the nurse should be aware that one of the most frequently reported maternal medical risk factors is: a. Diabetes mellitus. c. Chronic hypertension. b. 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
  2. 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? a. Situation, baseline assessment, response b. Situation, background, assessment, recommendation c. Subjective background, assessment, recommendation d. 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
  3. The role of the professional nurse caring for childbearing families has evolved to emphasize:

a. Use maternity jargon in order for the patient to become familiar with these terms. b. Speak quickly and efficiently to expedite the visit. c. Provide the patient with handouts. d. 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

  1. 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: a. Age. c. Educational level. b. 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
  2. What is the primary role of practicing nurses in the research process? a. Designing research studies b. Collecting data for other researchers c. Identifying researchable problems d. 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

  1. When the nurse is unsure about how to perform a patient care procedure, the best action would be to: a. Ask another nurse. b. Discuss the procedure with the patients physician. c. Look up the procedure in a nursing textbook. d. 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
  2. From the nurses perspective, what measure should be the focus of the health care system to reduce the rate of infant mortality further? a. Implementing programs to ensure womens early participation in ongoing prenatal care b. Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days c. Expanding the number of neonatal intensive care units (NICUs) d. Mandating that all pregnant women receive care from an obstetrician ANS: A Early prenatal care allows for early diagnosis and appropriate interventions to reduce the rate of infant
  1. A newly graduated nurse is attempting to understand the reason for increasing health care spending in the United States. Her research finds that these costs are much higher compared with other developed countries as a result of: a. A higher rate of obesity among pregnant women. b. Limited access to technology. c. Increased usage of health care services along with lower prices. d. Homogeneity of the population. ANS: A Health care is one of the fastest growing sectors of the U.S. economy. Currently, 17.4% of the gross domestic product is spent on health care. Higher spending in the United States compared with 12 other industrialized countries is related to higher prices and readily accessible technology along with greater obesity rates among women. More than one third of women in the United States are obese. Of the U.S. population, 16% is uninsured and has limited access to health care. Maternal morbidity and mortality are directly related to racial disparities. PTS: 1 DIF: Cognitive Level: Analysis REF: 5 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment
  2. The term used to describe legal and professional responsibility for practice for maternity nurses is: a. Collegiality. c. Evaluation. b. Ethics. d. Accountability. ANS: D Accountability refers to legal and professional responsibility for practice. Collegiality refers to a working relationship with ones colleagues. Ethics refers to a code to guide practice. Evaluation refers to examination of the effectiveness of interventions in relation to expected outcomes. PTS: 1 DIF: Cognitive Level: Evaluation REF: 12 OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance
  3. Through the use of social media technology, nurses can link with other nurses who may share similar interests, insights about practice, and advocate for patients. The most concerning pitfall for nurses using this technology is: a. Violation of patient privacy and confidentiality. b. Institutions and colleagues may be cast in an unfavorable light.

c. Unintended negative consequences for using social media. d. Lack of institutional policy governing online contact. ANS: A The most significant pitfall for nurses using this technology is the violation of patient privacy and confidentiality. Furthermore, institutions and colleagues can be cast in unfavorable lights with negative consequences for those posting information. Nursing students have been expelled from school and nurses have been fired or reprimanded by their Board of Nursing for injudicious posts. The American Nurses Association has published six principles for social networking and nurses. All institutions should have policies guiding the use of social media, and nurses should be familiar with these guidelines. PTS: 1 DIF: Cognitive Level: Analysis REF: 7 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment

  1. An important development that affects maternity nursing is integrative health care, which: a. Seeks to provide the same health care for all racial and ethnic groups. b. Blends complementary and alternative therapies with conventional Western treatment. c. Focuses on the disease or condition rather than the background of the client. d. Has been mandated by Congress. ANS: B Integrative health care tries to mix the old with the new at the discretion of the client and health care providers. Integrative health care is a blending of new and traditional practices. Integrative health care focuses on the whole person, not just the disease or condition. U.S. law supports complementary and alternative therapies but does not mandate them. PTS: 1 DIF: Cognitive Level: Application REF: 4 OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
  2. Recent trends in childbirth practices in the United States indicate that: a. More than 15% of mothers had late or no prenatal care. b. The percentage of Hispanics, non-Hispanic African Americans, and Caucasians who received prenatal care was essentially the same. c. Births occurring in the hospital accounted for 99% of births. d. Cesarean births have been declining as a percentage of live births.

MSC: Client Needs: Safe and Effective Care Environment

  1. Maternity nursing care that is based on knowledge gained through research and clinical trials is: a. Derived from the Nursing Intervention Classification. b. Known as evidence-based practice. c. At odds with the Cochrane School of traditional nursing. d. An outgrowth of telemedicine. ANS: B Evidence-based practice is based on knowledge gained from research and clinical trials. The Nursing Intervention Classification is a method of standardizing language and categorizing care. Dr. Cochrane systematically reviewed research trials and is part of the evidence-based practice movement. Telemedicine use communication technologies to support health care. PTS: 1 DIF: Cognitive Level: Comprehension REF: 9 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
  2. The level of practice a reasonably prudent nurse provides is called: a. The standard of care. c. A sentinel event. b. Risk management. d. Failure to rescue. ANS: A Guidelines for standards of care are published by various professional nursing organizations. Risk management identifies risks and establishes preventive practices, but it does not define the standard of care. Sentinel events are unexpected negative occurrences. They do not establish the standard of care. Failure to rescue is an evaluative process for nursing, but it does not define the standard of care. PTS: 1 DIF: Cognitive Level: Comprehension REF: 11 OBJ: Nursing Process: Diagnosis MSC: Client Needs: Safe and Effective Care Environment
  3. During a prenatal intake interview, the client informs the nurse that she would prefer a midwife to provide her care during pregnancy and deliver her infant. What information would be most appropriate for the nurse to share with this patient? a. Midwifery care is available only to clients who are uninsured because their services are less expensive than an obstetrician. Costs are often lower than an obstetric provider. b. The client will receive fewer interventions during the birth process. c. The client should be aware that midwives are not certified.

ANS: C

The abbreviations i.u. and I.U. are no longer acceptable because they could be misread as I.V. or the number

  1. The abbreviation q.o.d. or Q.O.D. should be written out as every other day. The period after the Q could be mistaken for an I; the o could also be mistaken for an i. With MSO 4 or MgSO 4 , it is too easy to confuse one medication for another. These medications are used for very different purposes and could put a client at risk for an adverse outcome. They should be written as morphine sulfate and magnesium sulfate. The decimal point should never be missed before a number to avoid confusion (i.e., 0.4 rather than .4). PTS: 1 DIF: Cognitive Level: Analysis REF: 13 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
  2. Healthy People 2020 has established national health priorities that focus on a number of maternal-child health indicators. Nurses are assuming greater roles in assessing family health and providing care across the perinatal continuum. Therefore it is important for the nurse to be aware that significant progress has been made in: a. The reduction of fetal deaths and use of prenatal care. b. Low birth weight and preterm birth. c. Elimination of health disparities based on race. d. Infant mortality and the prevention of birth defects. ANS: A Trends in maternal child health indicate that progress has been made in relation to reduced infant and fetal deaths and increased prenatal care. Notable gaps remain in the rates of low birth weight and preterm births. According to the March of Dimes, persistent disparities still exist between African Americans and non- Hispanic Caucasians. Many of these negative outcomes are preventable through access to prenatal care and the use of preventive health practices. This demonstrates the need for comprehensive community-based care for all mothers, infants, and families. PTS: 1 DIF: Cognitive Level: Knowledge REF: 3 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment MULTIPLE RESPONSE
  3. Which interventions would help alleviate the problems associated with access to health care for maternity patients (Select all that apply)? a. Provide transportation to prenatal visits. b. Provide childcare so that a pregnant woman may keep prenatal visits. c. Mandate that physicians make house calls.

d. Provide low-cost or no-cost health care insurance. e. Provide job training. ANS: A, B, D Lack of transportation to visits, lack of childcare, and lack of affordable health insurance are prohibitive factors associated with lack of prenatal care. House calls are not a cost-effective approach to health care. Although job training may result in employment and income, the likelihood of significant changes during the time frame of the pregnancy is remote. PTS: 1 DIF: Cognitive Level: Implementation REF: 5 OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

  1. Which of the following statements indicate that the nurse is practicing appropriate family-centered care techniques (Select all that apply)? a. The nurse commands the mother to do as she is told. b. The nurse allows time for the partner to ask questions. c. The nurse allows the mother and father to make choices when possible. d. The nurse informs the family about what is going to happen. e. The nurse tells the patients sister, who is a nurse, that she cannot be in the room during the delivery. ANS: B, C Including the partner in the care process and allowing the couple to make choices are important elements of family-centered care. The nurse should never tell the mother what to do. Family-centered care involves collaboration between the health care team and the client. Unless an institutional policy limits the number of attendants at a delivery, the client should be allowed to have whomever she wants present (except when the situation is an emergency and guests are asked to leave). PTS: 1 DIF: Cognitive Level: Analysis REF: 8 OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity MATCHING Medical errors are a leading cause of death in the United States. The National Quality Forum has recommended numerous safe practices that nursing can promote to reduce errors. Match each safe practice with the correct statement. a. Ask the patient to teach back. b. Comply with CDC guidelines.

nurses should be familiar with these guidelines.

  1. ANS: C PTS: 1 DIF: Cognitive Level: Application REF: 5 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in 2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of harm from the environment of care, processes, and systems. These are only a few of the recommended practices; however, nurses should be familiar with these guidelines.

Meeting nutritional requirements is a fundamental health promotion behavior. Although creating a family budget may be helpful, it does not indicate that funds will be allotted to meet health needs if money is scarce. Often families cannot afford preventive care and rely on emergency departments for their health care needs. Socialization of children may be important, but it is not directly related to the health care of individuals in a family unit. Birth control may be important, but it is not a basic survival health care function. PTS: 1 DIF: Cognitive Level: Comprehension REF: 28 OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

  1. The nurse should be aware that the criteria used to make decisions and solve problems within families are based primarily on family: a. Rituals and customs. c. Boundaries and channels. b. Values and beliefs. d. Socialization processes. ANS: B Values and beliefs are the most prevalent factors in the decision-making and problem-solving techniques of families. Although culture may play a part in the decision-making process of a family, ultimately values and beliefs dictate the course of action taken by family members. Boundaries and channels affect the relationship between the family members and the health care team, not the decisions within the family. Socialization processes may help families with interactions with the community, but they are not the criteria used for decision making within the family. PTS: 1 DIF: Cognitive Level: Comprehension REF: 25 OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity
  2. Using the family stress theory as an intervention approach for working with families experiencing parenting, the nurse can help the family change internal context factors. These include: a. Biologic and genetic makeup. b. Maturation of family members. c. The familys perception of the event. d. The prevailing cultural beliefs of society. ANS: C The family stress theory is concerned with the familys reaction to stressful events; internal context factors include elements that a family can control such as psychologic defenses. It is not concerned with biologic and genetic makeup, maturation of family members, or the prevailing cultural beliefs of society. PTS: 1 DIF: Cognitive Level: Comprehension REF: 20 OBJ: Nursing Process: Diagnosis MSC: Client Needs: Psychosocial Integrity
  3. While working in the prenatal clinic, you care for a very diverse group of patients. When planning interventions for these families, you realize that acceptance of the interventions will be most influenced by:

a. Educational achievement. c. Subcultural group. b. Income level. d. Individual beliefs. ANS: D The patients beliefs are ultimately the key to acceptance of health care interventions. However, these beliefs may be influenced by factors such as educational level, income level, and ethnic background. Educational achievement, income level, and subcultural group all are important factors. However, the nurse must understand that a womans concerns from her own point of view will have the most influence on her compliance. PTS: 1 DIF: Cognitive Level: Application REF: 22 OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity

  1. The nurses care of a Hispanic family includes teaching about infant care. When developing a plan of care, the nurse bases interventions on the knowledge that in traditional Hispanic families: a. Breastfeeding is encouraged immediately after birth. b. Male infants typically are circumcised. c. The maternal grandmother participates in the care of the mother and her infant. d. Special herbs mixed in water are used to stimulate the passage of meconium. ANS: C In Hispanic families, the expectant mother is influenced strongly by her mother or mother-in-law. Breastfeeding often is delayed until the third postpartum day. Hispanic male infants usually are not circumcised. Olive or castor oil may be given to stimulate the passage of meconium. PTS: 1 DIF: Cognitive Level: Application REF: 26 OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity
  2. The womans family members are present when the home care maternal-child nurse arrives for a postpartum and newborn visit. What should the nurse do? a. Observe the family members interactions with the newborn and one another. b. Ask the woman to meet with her and the baby alone. c. Do a brief assessment on all family members present. d. Reschedule the visit for another time so that the mother and infant can be assessed privately. ANS: A