Test Bank Foundations
of Maternal-Newborn
and Women's Health
Nursing, 8th Edition by
Murray Chapter 1-28 |
All Chapters
,Chapter 01: Maternity and Women’s Health Care Today Foundations of
Maternal-Newborn & Women’s Health Nursing, 8th Edition
MULTIPLE CHOICE
1. 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.
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 pharmacologic management of labor were not a factor in family-
centered maternity care. Family-centered care was a request by parents, not
physicians.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Planning MSC: Patient Needs: Health Promotion and Maintenance
2. Expectant parents ask a prenatal nurse educator, “Which setting for
N R I G
childbirth limits the amount of parent–infant interacUtionS?” NWhTich
answOer 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
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 labor, birth, recovery, and postpartum room
setting allows for increased parent–infant contact.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step:
Planning MSC: Patient Needs: Health Promotion and Maintenance
,3. Which statement best describes the advantage of a labor, birth, recovery, and
postpartum (LDRP) room?
a. The family is in a familiar environment.
b. They are less expensive than traditional hospital rooms.
c. The infant is removed to the nursery to allow the mother to rest.
d. The woman’s support system is encouraged to stay until discharge.
ANS: D
, Sleeping equipment is provided in a private room. A hospital setting is never a
familiar environment to new parents. An LDRP room is not less expensive than
a traditional hospital room. The baby remains with the mother at all times and is
not removed to the nursery for routine care or testing. The father or other
designated members of the mother’s support system are encouraged to stay at all
times.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step:
Assessment MSC: Patient Needs: Health Promotion and Maintenance
4. Which nursing intervention is an independent function of the professional nurse?
a. Administering oral analgesics
b. Requesting diagnostic studies
c. Teaching the patient perineal care
d. Providing wound care to a surgical incision
ANS: C
Nurses are now responsible for various independent functions, including
teaching, counseling, and intervening in nonmedical problems.
Interventions initiated by the physician and carried out by the nurse are called
dependent functions. Administrating oral analgesics is a dependent function; it is
initiated by a physician and carried out by a nurse.
Requesting diagnostic studies is a dependent function. Providing wound care is
a dependent function; however, the physician prescribes the type of wound care
through direct orders or protocol.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step:
Assessment MSC: Patient Needs: Safe and Effective Care
Environment
5. 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.”
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.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Implementation MSC: Patient Needs: Psychosocial Integrity
6. In which step of the nursing process does the nurse determine the
appropriate interventions for the identified nursing diagnosis?
a. Planning
b. Evaluation
,c. Assessment
d. Intervention
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.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step:
Planning MSC: Patient Needs: Safe and Effective Care Environment
7. 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.
d. Monitor the patient to detect therapeutic response to antibiotic therapy.
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.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Planning MSC: Patient Needs: Safe and Effective Care
Environment
8. 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 10NmUinRuSteIs NatG8TABM., C2 OPMM,
and 6 PM.
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 deeply is not detailed or
specific. Observing interaction with the infant does not state how often this
procedure should be done. Assisting the patient to ambulate for 10 minutes
within a certain timeframe is specific.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Planning MSC: Patient Needs: Safe and Effective Care
Environment
9. The patient makes the statement: “I’m afraid to take the baby home
tomorrow.” Which response by the nurse would be the most therapeutic?
a. “You’re afraid to take the baby home?”
b. “Don’t you have a mother who can come and help?”
c. “You should read the literature I gave you before you leave.”
d. “I was scared when I took my first baby home, but everything worked out.”
,ANS: A
, This response uses reflection to show concern and open communication. The other
choices are blocks to communication. Asking if the patient has a mother who can
come and assist blocks further communication with the patient. Telling the patient
to read the literature before leaving does not allow the patient to express her
feelings further. Sharing your own birth experience is inappropriate.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Implementation MSC: Patient Needs: Psychosocial Integrity
10. The nurse is writing an expected outcome for the nursing diagnosis— acute
pain related to tissue trauma, secondary to vaginal birth, as evidenced by
patient stating pain of 8 on a scale of 10. Which expected outcome is correctly
stated for this problem?
a. Patient will state that pain is a 2 on a scale of 10.
b. Patient will have a reduction in pain after administration of
the prescribed analgesic.
c. Patient will state an absence of pain 1 hour after administration of the
prescribed analgesic.
d. Patient will state that pain is a 2 on a scale of 10, 1 hour after the
administration of the prescribed analgesic.
ANS: D
The outcome should be patient-centered, measurable, realistic, and attainable
and within a specified timeframe. 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.
DIF: Cognitive Level:
N R I G B . C M
Applic atUion S N OTB J: N uOrs ing Process Step:
Planning MSC: Patient Needs: Physiologic Integrity
11. 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
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.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Implementation MSC: Patient Needs: Safe and Effective Care
Environment
12. 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.
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 postbirth 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 who receives additional
certification in the specific area of midwifery.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Evaluation MSC: Patient Needs: Management of Care: Legal
Rights and Responsibilities
13. 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.
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
inNtheRworIkfoGrce Bba.seCd oMn current research by the IOM. Increased
nurse-to-patient ratios haveUresulted
S N inT decreased patient mortality in the clinical
setting.
There are currently numerous limitations of both classroom and clinical
facilities necessary to train new nurses adequately.
DIF: Cognitive Level: Application OBJ: Nursing Process Step:
Implementation MSC: Patient Needs: Health Promotion:
Teaching/Learning
14. A hospital has achieved Magnet status. Which indicators would be
consistent with this type of certification?
a. There is stratification of communication in a directed manner
between nursing staff and administration.
b. There is increased job satisfaction of nurses, with a lower staff turnover rate.
c. Physicians are certified in their respective specialty areas.
d. All nurses have baccalaureate degrees and certification in their
clinical specialty area.
ANS: B
Magnet status is a certification offered by the ANCC (American Nurses
Credentialing Center) in which hospitals apply based on designated criteria
that consider nurse job satisfaction, staff patterns, strength,
