Test Bank for Maternal Child Nursing 5th Edition by McKinney

Chapter 01: Foundations of Maternity, Women’s Health, and Child Health Nursing

McKinney: Evolve Resources for Maternal-Child Nursing, 5th Edition

MULTIPLE CHOICE

1. Which factor significantly contributed to the shift from home births to hospital births in the early 20th century?

ANS:  D

Technologic developments were available to physicians, not lay midwives. So in-hospital births increased in order to take advantage of these advancements. Puerperal sepsis has been a known problem for generations. In the late 19th century, Semmelweis discovered how it could be prevented with improved hygienic practices. The development of forceps is an example of a technology advance made in the early 20th century but is not the only reason birthplaces moved. Unlike home births, early hospital births hindered bonding between parents and their infants.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 1                OBJ:   Integrated Process: Teaching-Learning

MSC:  Client Needs: Safe and Effective Care Environment

2. Family-centered maternity care developed in response to

ANS:  C

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. Family-centered care was a request by parents, not physicians. The Sheppard-Towner Act of 1921 provided funds for state-managed programs for mothers and children. The changes in pharmacologic management of labor were not a factor in family-centered maternity care.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 2                OBJ:   Integrated Process: Teaching-Learning

MSC:  Client Needs: Psychosocial Integrity

3. Which setting for childbirth allows the least amount of parent-infant contact?

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. The labor/delivery/recovery/postpartum room setting allows increased parent-infant contact. Birth centers are set up to allow an increase in parent-infant contact. Home births allow an increase in parent-infant contact.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 2                OBJ:   Nursing Process: Planning

MSC:  Client Needs: Health Promotion and Maintenance

4. As a result of changes in health care delivery and funding, a current trend seen in the pediatric setting is

ANS:  C

One effect of managed care has been that pediatric health care delivery has shifted dramatically from the acute care setting to the ambulatory setting in order to provide more cost-efficient care. The number of hospital beds being used has decreased as more care is given in outpatient settings and in the home. The number of children living in poverty has increased over the past decade. One of the biggest changes in health care has been the growth of managed care.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 5                OBJ:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment

5. The Women, Infants, and Children (WIC) program provides

ANS:  D

WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant or breastfeeding and to their children until age 5 years. Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment Program provides for well-child examinations and for treatment of any medical problems diagnosed during such checkups. Children in the WIC program are often referred for immunizations, but that is not the primary focus of the program. Public Law 99-457 is part of the Individuals with Disabilities Education Act that provides financial incentives to states to establish comprehensive early intervention services for infants and toddlers with, or at risk for, developmental disabilities.

PTS:   1                    DIF:    Cognitive Level: Comprehension   REF:   p. 8

OBJ:   Integrated Process: Teaching-Learning

MSC:  Client Needs: Health Promotion and Maintenance

6. In most states, adolescents who are not emancipated minors must have the permission of their parents before

ANS:  D

Minors are not considered capable of giving informed consent, so a surgical procedure would require consent of the parent or guardian. Exceptions exist for obtaining treatment for drug abuse or STDs or for getting birth control in most states.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 17              OBJ:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment

7. The maternity nurse should have a clear understanding of the correct use of a clinical pathway. One characteristic of clinical pathways is that they

ANS:  C

Clinical pathways are standardized, interdisciplinary plans of care devised for patients with a particular health problem. They are used to identify patient outcomes, specify time lines to achieve those outcomes, direct appropriate interventions and sequencing of interventions, include interventions from a variety of disciplines, promote collaboration, and involve a comprehensive approach to care. They are developed by multiple health care professionals and reflect interdisciplinary care. They can be used in multiple settings and for patients throughout the life span. They are not part of the nursing process but can be used in conjunction with the nursing process to provide care to patients.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 7                OBJ:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment

8. The fastest growing group of homeless people is

ANS:  C

Pregnancy and birth, especially for a teenager, are important contributing factors for becoming homeless. People preparing for retirement, migrant workers, and IV substance abusers are not among the fastest growing groups of homeless people.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 14              OBJ:   Nursing Process: Assessment

MSC:  Client Needs: Physiologic Integrity

9. A nurse wishes to work to reduce infant mortality in the United States. Which activity would this nurse most likely participate in?

ANS:  C

Prenatal care is vital to reducing infant mortality and medical costs. This nurse would most likely participate in community service providing prenatal care outreach activities in community centers, particularly in low-income areas. Pamphlets in other languages, enrolling in Medicaid, and working at a women’s shelter all might impact infant mortality, but the greatest effect would be from assisting women to get consistent prenatal care.

PTS:   1                    DIF:    Cognitive Level: Application/Applying

REF:   p. 14              OBJ:   Nursing Process: Implementation

MSC:  Client Needs: Health Promotion and Maintenance

10. The intrapartum woman sees no need for a routine admission fetal monitoring strip. If she continues to refuse, what is the first action the nurse should take?

ANS:  B

Patients must be allowed to make choices voluntarily without undue influence or coercion from others. The physician, especially if unaware of the patient’s decision, should be notified immediately. Both professionals can work to ensure the mother understands the rationale for the action and the possible consequences of refusal. The woman herself is the decision-maker, unless incapacitated. Documentation should occur but is not the first action. This situation does not rise to the level of an ethical issue so there is no reason to call the ethics committee.

PTS:   1                    DIF:    Cognitive Level: Application/Applying

REF:   p. 18              OBJ:   Nursing Process: Implementation

MSC:  Client Needs: Safe and Effective Care Environment

11. Which statement is true regarding the “quality assurance” or “incident” report?

ANS:  D

An incident report is used when something occurs that might result in legal action, such as a patient fall or medication error. It warns the legal department that there may be a problem in a particular patient’s care. Incident reports are not part of the patient’s chart; thus the nurses’ notes should not contain any reference to them.

PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering

REF:   p. 18              OBJ:   Integrated Process: Communication and Documentation

MSC:  Client Needs: Safe and Effective Care Environment

12. Elective abortion is considered an ethical issue because

ANS:  C