1. A group of nurses are discussing the reasons for the United States' low rankings for infant and maternal mortality and what impact they could make on these mortality rates in their practice. Which action could nurses implement to reduce these rates? A. ensuring that all pregnant clients receive their immunizations B. assuring early and adequate prenatal care C. providing more extensive women's shelters D. encouraging all women to eat a balanced diet Answer: B Rationale: The lack of prenatal care during pregnancy is a major contributing factor to a poor outcome. Prenatal care is well known to prevent complications of pregnancy and to support the birth of healthy infants. Infant mortality commonly includes problems occurring at birth or shortly thereafter. Thus, assuring early and adequate prenatal care would have the greatest impact on decreasing these rates. Receiving immunizations will help prevent some infant diseases, but it does not have a major impact on overall maternal and infant mortality. Providing more extensive women's shelters would be helpful for those women who have experience intimate partner violence. Encouraging women to eat balanced diets helps, but it does not prevent genetic factors that could be detected by ensuring early and adequate prenatal care. Question format: Multiple Choice Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 10-12 2. When integrating the principles of family-centered care into the birthing process, the nurse would base care upon which belief? A. Birth is viewed as a medical event. B. Families are unable to make informed choices due to stress. C. Birth results in changes in relationships. D. Families require little information to make appropriate decisions for care. Answer: C Rationale: Family-centered care is based on the following principles: Birth affects the entire family, and relationships will change; birth is viewed as a normal, healthy event in the life of the family; and families are capable of making decisions about their own care if given adequate information and professional support. Question format: Multiple Choice Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Integrated Process: Caring Reference: p. 6-7
3. When preparing a teaching plan for a group of women during their first pregnancy, the nurse reviews how maternity care has changed over the years. Which information would the nurse include when discussing events occurring in the 20th century? A. Epidemics of puerperal fever B. Performance of the first cesarean birth C. X-ray developed to assess pelvic size D. Development of free-standing birthing centers (LDRPs) Answer: D Rationale: In the 20th century (1900s), free-standing birth centers (LDRPs) were developed. Puerperal fever epidemics, the first cesarean birth, and X-ray to assess pelvic size were events occurring during the 19th century (1800s). Question format: Multiple Choice Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Teaching/Learning Reference: p. 4 4. The nurse is working with a group of community health members to develop a plan to address the special health needs of women. The group would design educational programs to address which priority condition? A. Smoking B. Heart disease C. Diabetes D. Cancer Answer: B Rationale: The group needs to address cardiovascular disease, the number one cause of death in women regardless of racial or ethnic group. Smoking is related to heart disease and the development of cancer. However, heart disease and cancer can occur in any woman regardless of her smoking history. Cancer is the second leading cause of death, with women having a one in three lifetime risk of developing cancer. Diabetes is another important health condition that can affect women. However, it is not the major health problem that heart disease is. Question format: Multiple Choice Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process Reference: p. 12-13 5. A nurse is conducting an orientation program for a group of newly hired nurses. As part of the program, the nurse is reviewing the issue of informed consent. The nurse determines that the
teaching was effective when the group identifies which situation as a violation of informed consent? A. Performing a procedure on a 15-year-old without parental consent B. Serving as a witness to the signature process on an operative permit C. Asking whether the client understands what she is signing following receiving education D. Getting verbal consent over the phone for an emergency procedure from the spouse of a unconscious woman Answer: A Rationale: In most states, only clients over the age of 18 can legally provide consent for health care. Serving as a witness to the signature process, asking whether the client understands what she is signing, and getting verbal consent over the phone for emergency procedures are all key to informed consent and are not violations. Question format: Multiple Choice Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Analyze Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Nursing Process Reference: p. 30-31 6. A pregnant woman is to undergo an invasive procedure to evaluate the status of her fetus. To ensure informed consent, which action would be the priority responsibility of the nurse providing care to this woman? A. Asking relevant questions to determine the client's understanding B. Providing a detailed description of the risks and benefits of the procedure C. Explaining the exact steps that will occur during the procedure D. Offering suggestions for alternative options for treatment Answer: A Rationale: The nurse's responsibilities related to informed consent include: Ensuring the consent form is completed with signatures from the client; serving as a witness to the signature process; and determining whether the client understands what she is signing by asking her pertinent questions. The physician, advanced practice nurse, or midwife is responsible for informing the client about the procedure and obtaining consent by providing a detailed description of the procedure or treatment, its potential risks and benefits, and alternative methods available. Question format: Multiple Choice Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Nursing Process Reference: p. 30-31 7. The family is the basic unit of society. Which statement correctly illustrates the importance of this concept related to how society functions?
A. Healthy, well-functioning families provide members of all ages with fulfilling, supporting relationships. B. The family serves as a place that encourages members to autonomously function in pursuit of personal pleasures. C. Society functions best when families determine how they will interface with others without having to deal with the overall consequences. D. Work is an important part of family function but is not necessary for success if one member can fulfill multiple roles. Answer: A Rationale: The family is the basic unit of society. In order for this to work well, members of the family must work together. Families make a central contribution to enhance the quality of our society. Families must consider how their actions will impact others, and one member cannot fulfill all roles within the family. Question format: Multiple Choice Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process Reference: p. 14 8. A nursing group is examining their hospital's maternal outcomes for the previous 5 years. Which identified factors have contributed to the decline in the maternal mortality rate? Select all that apply. A. Increased participation of women in prenatal care B. Use of ultrasound to detect disorders C. Increased use of anesthesia with birth D. Closer monitoring for complications associated with hypertension of pregnancy E. Better management of hemorrhage and infection Answer: A, B, D, E Rationale: The following factors have contributed to the decline in the maternal mortality rate: increased participation of women in prenatal care; greater detection of disorders such as ectopic pregnancy or placenta previa; prevention of related complications through the use of ultrasound; increased control of complications associated with hypertension of pregnancy; and decreased use of anesthesia with birth. Question format: Multiple Select Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process Reference: p. 10-11
9. The nursing student correctly identifies black infants to have consistently higher infant mortality rates than other ethnic groups in the United States. What factors that contribute to this problem can nurses have the greatest impact upon? Select all that apply. A. encouraging regular maternal prenatal visits B. nutritional teaching prior to and during pregnancy C. improving maternal educational levels D. supporting maternal choices for alternative birthing methods E. discouraging use of tobacco and nonprescribed medications during pregnancy Answer: A, B, E Rationale: Causes of increased infant mortality rates include preterm birth, congenital anomalies and chromosomal defects, SIDS, use of tobacco, and medications not approved by the health care provider. Improved maternal education levels will not prevent infant deaths, and support of alternative birthing methods and locations may lead to complications. Question format: Multiple Select Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 10-11 10. The nurse instructs the new mother about some health promotion strategies that could significantly improve her infant's health and chance of survival. These strategies would include which actions? Select all that apply. A. breastfeeding B. placing infant on stomach to sleep C. placing infant on back to sleep D. mothers joining support groups E. formula feeding Answer: A, C, D Rationale: Certain health promotion strategies after birth can significantly improve an infant's health and chances of survival. Breastfeeding has been shown to reduce rates of infection in infants and to improve their long-term health. Placing an infant on his or her back when sleeping will reduce the incidence of sudden-infant death syndrome. Encouraging mothers to join support groups to prevent postpartum depression and learn sound childrearing practices will improve the health of both the mothers and their infants. Question format: Multiple Select Chapter 1: Perspectives on Maternal, Newborn, and Women's Health Care Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference: p. 10-11