TEST BANK Foundations of Maternal -Newborn and Women's Health Nursing 8th Edition by Sharon Murray, Emily McKinney, Karen S. Holub, Renee Jones, and Kristin L. Scheffer TEST BANK Table of Contents
Chapter 01 Clinical Judgement and the Nursing Process
1
Chapter 02 Social, Ethical, and Legal Issues
8
Chapter 03 Reproductive Anatomy and Physiology
21
Chapter 04 Hereditary and Environmental Influences on Childbearing
28
Chapter 05 Conception and Prenatal Development
36
Chapter 06 Maternal Adaptations to Pregnancy
43
Chapter 07 Antepartum Assessment, Care, and Education
55
Chapter 08 Nutrition for Childbearing
65
Chapter 09 Prenatal Diagnosis and Fetal Assessment During the Antepartum Period
76
Chapter 10 Complications of Pregnancy
87
Chapter 11 The Childbearing Family with Special Needs
106
Chapter 12 Processes of Birth
113
Chapter 13 Pain Management During Childbirth
126
Chapter 14 Intrapartum Fetal Surveillance
140
Chapter 15 Nursing Care During Labor and Birth
153
Chapter 16 Intrapartum Complications
172
Chapter 17 Postpartum Adaptations and Nursing Care
186
Chapter 18 Postpartum Maternal Complications
202
Chapter 19 Critical Care Obstetrics
215
Chapter 20 Normal Newborn-Processes of Adaptation
219
Chapter 21 Assessment of the Normal Newborn
228
Chapter 22 Care of the Normal Newborn
238
Chapter 23 Infant Feeding
253
Chapter 24 High-Risk Newborn Complications Associated with Gestational Age and Development
265
Chapter 25 High-Risk Newborn-Acquired and Congenital Conditions
273
Chapter 26 Family Planning
280
Chapter 27 Infertility
289
Chapter 28 Women’s Health
294 Chapter 01: Clinical Judgement and the Nursing Process 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: Pati ent Needs: Health Promotion and Maintenance 2. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth limits the amount of parent –infant interaction?” Which answer 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 amo unt 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 mothe r to rest. d. The woman’s support system is encouraged to stay until discharge. ANS: D 1 | P a g e 2 | P a g e 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 th e 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 Promotio n 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 a re 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 t herapeutic 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 r esponse, “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 t o 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 3 | P a g e 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 i s 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 p atient 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. 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 independ ent 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 corre ctly? a. Force fluids as necessary. b. Observe interaction with the infant. c. Encourage turning, coughing, and deep breathing. d. Assist to ambulate for 10 minutes at 8 AM, 2 PM, 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 interac tion 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 4 | P a g e This response uses reflection to show concern and open communication. The other choices are blocks to communication. Asking if t he 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 inappr opriate. 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 h er 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 unre alistic. DIF: Cognitive Level: Application OBJ: Nursing 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 s afety 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
