(Test Bank) Maternal Child Nursing Care

Perry, 5

Nursing

Test Bank

5th Edition

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Test Bank for Maternal Child Nursing Care, The downloadable file consists of 1402 pages, and the total size of the file is 7.71 MB. Purchase now only for highly discounted price.

Author(s): Perry

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Rn3571 PERRY MATERNAL CHILD NURSING CARE 5TH EDITION STUDYGUIDE 2023 Item Bank: Perry Maternal Child Nursing Care 5th edition Objective: CH 01: 21st Century Maternity Nursing 1. Question Name: 0001 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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. B. Mitral valve prolapse (MVP). C. Chronic hypertension. D. Anemia. Correct Answer: A Explanation/Rationale: 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. 2. Question Name: 0002 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition To ensure op timal 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 f ollowing correctly defines this acronym? A. Situation, baseline assessment, response * B. Situation, background, assessment, recommendation C. Subjective background, assessment, recommendation D. Situation, background, anticipated recommendation Correct Answer: B Explanation/Rationale: ANS: B Rn3571 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 ca re. The SBAR technique has the potential to serve for a means to reduce errors. 3. Question Name: 0003 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition The role of the professional nurse caring for childbearing families has evolved to emphasize: A. Providing care to patients directly at the bedside. B. Primarily hospital care of maternity patients. * C. Practice using an evidence -based approach. D. Planning patient care to cover longer hospital stays. Correct Answer: C Explanation/Rationale: 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 nurse’s tasks; however, it does not encompass the concept of the evolved professional nurse. Throughout the prenatal period, nurses care for women in clinics and physician’s offices and teach classes to help families prepare for childbirth. Nurses also car e 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. 4. Question Name: 0004 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition A 23 -year-old African -American woman is pregnant with her first child. Based in the statistics for infant mortality, which plan is most important for the nurse to implement? A. Perform a nutrition assessment. B. Refer the woman to a social worker. C. Advise the woman to see an obstetrician, not a midwife. * D. Explain to the woman the importance of keeping her prenatal care appointments. Correct Answer: D Rn3571 Explanation/Rationale: ANS: D Consistent prenatal care is the best method of preventi ng 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 in 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. 5. Question Name: 0005 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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: 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. Correct Answer: D Explanation/Rationale: 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 in what is important increase understanding. Most patient education materials are written at too high a level for the average adult and may no t be useful for a client with limited English proficiency. 6. Question Name: 0006 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition When managing health care for pregnant women at a prenata l clinic, the nurse should recognize that the most significant barrier to access to care is the pregnant woman’s: A. Age. Rn3571 B. Minority status. C. Educational level. * D. Inability to pay. Correct Answer: D Explanation/Rationale: 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 signif icant 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. 7. Question Name: 0007 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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 Correct Answer: C Explanation/Rationale: 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 suppor t is necessary to conduct research, but it is not the primary role of the nurse in the research process. 8. Question Name: 0008 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition When the nu rse is unsure about how to perform a patient care procedure, the best action would be to: Rn3571 A. Ask another nurse. B. Discuss the procedure with the patient’s physician. C. Look up the procedure in a nursing textbook. * D. Consult the agency procedure manual and follow the guidelines for the procedure. Correct Answer: D Explanation/Rationale: ANS: D It is always best to follow the agency’s policies and procedures manual when seeking information in correct patient procedures. These policies should reflect the current st andards of care and state guidelines. Each nurse is responsible for her own practice. Relying in 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 responsib le for their own client care activity. Nurses may follow safe orders from physicians, but they are also responsible for the activities that they for nurses are to carry out. Information provided in a nursing textbook is basic information for general knowle dge. Furthermore, the information in a textbook may not reflect the current standard of care or individual state or hospital policies. 9. Question Name: 0009 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursin g Care 5th edition From the nurse’s 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 women’s 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 Correct Answer: A Explanation/Rationale: ANS: A Early pre natal care allows for early diagnosis and appropriate interventions to reduce the rate of infant mortality. An increased length of stay has been shown to foster improved self -care and parental education. However, it does not prevent the incidence of leadin g causes of infant mortality rates, such for low birth weight. Early prevention and diagnosis reduce the rate of infant mortality. NICUs offer care to high -risk infants after they are born. Expanding the number of NICUs would offer better access for high -risk care, but this factor is not the primary focus for further reduction of infant mortality rates. A mandate that all pregnant women receive obstetric care would be nearly impossible to enforce. Furthermore, certified nurse -midwives (CNMs) have Rn3571 demonstra ted reliable, safe care for pregnant women. 10. Question Name: 0010 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition Alternative and complementary therapies: A. Replace conventional Western modalities of treatment. B. Are used by only a small number of American adults. * C. Recognize the value of clients’ input into their health care. D. Focus primarily in the disease an individual is experiencing. Correct Answer: C Explanation/Rationale: ANS: C Many popular alternative healing modalities offer human -centered care based in philosophies that recognize the value of the patient’s input and honor the individual’s beliefs, values, and desires. Alternative and complementary therapies are part of an integr ative approach to health care. An increasing number of American adults are seeking alternative and complementary health care options. Alternative healing modalities offer an holistic approach to health, focusing in the whole person, not just the disease. 11. Question Name: 0011 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition A 38 -year-old Hispanic woman delivered a 9-pound, 6 -ounce girl vaginally after being in labor for 43 hours. The baby died 3 days later from sepsis. in what grounds would the woman potentially have a legitimate legal case for negligence? A. She is Hispanic. B. She delivered a girl. * C. The standards of care were not met. D. She refused fetal monitoring. Correct Answer: C Explan ation/Rationale: ANS: C Not meeting the standards of care is a legitimate factor for a case of negligence. The client’s race is not a factor for a case of negligence. The infant’s gender is not a factor for a case of negligence. Although fetal monitoring i s the standard of care, the client has the right to refuse treatment. This refusal is not a case for negligence; however, informed consent should be Rn3571 properly obtained, and the client should sign an against medical advice form for refusal of any treatment that is within the standard of care. 12. Question Name: 0012 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition A newly graduated nurse is attempting to understand the reason for increasing he alth care spending in the United States. Her research finds that these costs are much higher compared with other developed countries for 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. Correct Answer: A Explanation/Rationale: 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 in 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 obe se. 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. 13. Question Name: 0013 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition The term used to describe legal and professional responsibility for practice for maternity nurses is: A. Collegiality. B. Ethics. C. Evaluation. * D. Accountability. Correct Answer: D Explanation/Rationale: ANS: D Accountab ility refers to legal and professional responsibility for practice. Collegiality refers to a working relationship with one’s colleagues. Ethics refers to a code to guide practice. Evaluation refers to examination of the effectiveness of interventions in relation to expected outcomes. Rn3571 14. Question Name: 0014 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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. Correct Answer: A Explanation/Rationale: 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 f ired 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. 15. Question Name: 0015 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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 in the disease or condition rather than the background of the client. D. Has been mandated by Congress. Correct Answer: B Explanation/Rationale: 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 pract ices. Integrative health care focuses in the whole person, not just the disease or condition. U.S. law supports complementary and alternative therapies but does not mandate them. Rn3571 16. Question Name: 0016 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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, an d 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 for a percentage of live births. Correct Answer: C Explanation/Rationale: ANS: C Almos t all births occur within the hospital setting. Only 5.2% of Caucasians mothers had either late care or no care. There are disparities in the receipt of prenatal care by ethnicity: 12.2% of Hispanic women and 11.8% of non -Hispanic black women received eith er late or no prenatal care. The percentage of cesarean births is increasing. 17. Question Name: 0017 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition Recent trends in childbirth practice indicate that: A. Delayed pushing is now discouraged in the second stage of labor. B. Episiotomy rates are increasing. C. Midwives perform more episiotomies than physicians. * D. Newborn infants remain with the mother and are encouraged to breastfeed. Correct Answer: D Explanation/Rationale: ANS: D Breastfeeding is encouraged for newborns immediately after birth. Delayed pushing is encouraged for several reasons. Episiotomy rates are declining. Midwives perform fewer episiotomies than physicians. 18. Question Name: 0018 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition The nurse caring for a pregnant client should be aware that the U.S. birth rate shows which trend? * A. Births to unmarried women are more likely to have less favorable outcomes. B. Birth rates for women 40 to 44 years old are beginning to decline. Rn3571 C. Cigarette smoking among pregnant women continues to increase. D. The rates of maternal death owing to racial disparity are elevated in the United States. Correct Answer: A Explanation/Rationale: ANS: A Low-birth -weight infants and preterm birth are more likely because of the large number of teenagers in the unmarried group. Birth rates for women in their early 40s continue to increase. Fewer pregnant women smoke. In the United States, there is significant racial disparity in the rates of maternal death. 19. Question Name: 0019 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition Maternity nursing care that is based in knowledge gained through research and clinical trials is: A. Derived from the Nursing Intervention Classification. * B. Known for evidence -based practice. C. At odds with the Cochrane School of traditional nursing. D. An outgrowth of telemedicine. Correct Answer: B Explanation/Rationale: ANS: B Evidence -based practice is based in knowledge gained from research and clinical trials. The Nursing Intervention Classification is a method of standardizing language and categorizing care. Dr. Coch rane systematically reviewed research trials and is part of the evidence -based practice movement. Telemedicine uses communication technologies to support health care. 20. Question Name: 0020 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition The level of practice a reasonably prudent nurse provides is called: * A. The standard of care. B. Risk management. C. A sentinel event. D. Failure to rescue. Correct Answer: A Explanation/Rationale: Rn3571 ANS: A Guidelin es 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. 21. Question Name: 0021 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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 pr ocess. C. The client should be aware that midwives are not certified. D. Delivery can take place only at the client’s home or in a birth center. Correct Answer: B Explanation/Rationale: ANS: B This patient will be able to participate actively in all decisi ons related to the birth process and is likely to receive fewer interventions during the birth process. Midwifery services are available to all low -risk pregnant women, regardless of the type of insurance they have. Midwifery care in all developed countrie s is strictly regulated by a governing body, which ensures that core competencies are met. In the United States, this body is the American College of Nurse - Midwives. Midwives can provide care and delivery at home, in freestanding birth centers, and in community and teaching hospitals. 22. Question Name: 0022 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition While obtaining a detailed history from a woman who has recently emigrated from Somali a, the nurse realizes that the client has undergone female genital mutilation (FGM). The nurse’s best response to this patient is: A. “This is a very abnormal practice and rarely seen in the United States.” B. “Do you know who performed this so that it can be reported to the authorities?” C. “We will be able to restore your circumcision fully after delivery.” * D. “The extent of your circumcision will affect the potential for complications.” Rn3571 Correct Answer: D Explanation/Rationale: ANS: D “The extent of your circum cision will affect the potential for complications” is the most appropriate response. The patient may experience pain, bleeding, scarring, or infection and may require surgery before childbirth. With the growing number of immigrants from countries where FGM is practiced, nurses will increasingly encounter women who have undergone the procedure. Although this practice is not prevalent in the United States, it is very common in many African and Middle Eastern countries for religious reasons. Responding with, “This is a very abnormal practice and rarely seen in the United States” is culturally insensitive. The infibulation may have occurred during infancy or childhood. The client will have little to no recollection of the event. She would have considered this to be a normal milestone during her growth and development. The International Council of Nurses has spoken out against this procedure for harmful to a woman’s health. 23. Question Name: 0023 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition To ensure patient safety, the practicing nurse must have knowledge of the current Joint Commission’s “Do Not Use” list of abbreviations. Which of the following is acceptable for use? A. q.o.d. or Q.O.D. B. MSO4 or MgSO4 * C. International Unit D. Lack of a leading zero Correct Answer: C Explanation/Rationale: ANS: C The abbreviations “i.u.” and “I.U.” are no longer acceptable because they could be misread for “I.V.” or the number “10.” The abbreviation “q.o.d. or Q.O .D.” should be written out for “every other day.” The period after the “Q” could be mistaken for an “I”; the “o” could also be mistaken for an “i.” With MSO4 or MgSO4, it is too easy to confuse one medication for another. These medications are used for ver y different purposes and could put a client at risk for an adverse outcome. They should be written for 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). Rn3571 24. Ques tion Name: 0024 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition Healthy People 2020 has established national health priorities that focus in 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 in race. D. Infant mortality and the prevention of birth defects. Correct Answer: A Explanation/Rationale: 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 a nd 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 . 25. Question Name: 0025 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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. Correct Answer: ABD Explanation/Rationale: 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 -effect ive 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. Rn3571 26. Question Name: 0026 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal Child Nursing Care 5th edition 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 moth er to do for 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 patient’s si ster, who is a nurse, that she cannot be in the room during the delivery. Correct Answer: BC Explanation/Rationale: 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). Rn3571 PERRY MATERNAL CHILD NURSING CARE 5TH EDITION STUDYGUIDE 2023 Item Bank: Perry Maternal Child Nursing Care 5th edition Objective: CH 02: Community Care: The Family and Culture 1. Question Name: 0001 Type: MC Objective: CH 02: Community Care: The Family and Culture Item Bank: Perry Maternal Child Nursing Care 5th edition A married couple lives in a single -family house wit h their newborn son and the husband’s daughter from a previous marriage. in the basis of the information given, what family form best describes this family? * A. Married -blended family B. Extended family C. Nuclear family D. Same -sex family Correct Answer: A