Maternal-Child Nursing 3rd edition McKinney, James, Murray, Ashwill Test Bank

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  • Published: 2008
  • ISBN-10: 1416058966
  • ISBN-13: 978-1416058960

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maternal child nursing 3rd edition mckinney test bank

McKinney: Maternal-Child Nursing, 3rd Edition

Test Bank

Chapter 1: Foundations of Maternity, Women’s Health, and Child Health Nursing

MULTIPLE CHOICE

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

a.Puerperal sepsis was identified as a risk factor in labor and delivery.
b.Forceps were developed to facilitate difficult births.
c.The importance of early parental-infant contact was identified.
d.The number of hospital births decreased.

ANS: B

A Puerperal sepsis has been a known problem for generations. In the late nineteenth century, Semmelweis discovered how it could be prevented.

B The development of forceps to facilitate difficult births by physicians was a strong factor in the decrease of home births and increase of hospital births.

C The shift to hospital births decreased the parental-infant contact.

D With the shift toward hospital births, the numbers increased.

DIF:Cognitive Level: KnowledgeREF:p. 2

OBJ:Nursing Process Step: Assessment

MSC: Client Needs: Safe and Effective Care Environment

2.Family-centered maternity care developed in response to:

a.demands by physicians for family involvement in childbirth.
b.the Sheppard-Towner Act of 1921.
c.parental requests that infants be allowed to remain with them rather than in a nursery.
d.changes in pharmacologic management of labor.

ANS: C

A Family-centered care was a request by parents, not physicians.

B The Sheppard-Towner Act provided funds for state-managed programs for mothers and children.

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.

D The changes in pharmacologic management of labor were not a factor in family-centered maternity care.

DIF:Cognitive Level: KnowledgeREF:pp. 3-4

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

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

a.Labor/delivery/recovery/postpartum room
b.Birth center
c.Traditional hospital birth
d.Home birth

ANS: C

A The labor/delivery/recovery/postpartum room setting allows increased parent-infant contact.

B Birth centers are set up to allow an increase in parent-infant contact.

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.

D Home births allow an increase in parent-infant contact.

DIF:Cognitive Level: KnowledgeREF:p. 3

OBJ:Nursing Process Step: 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:

a.increased hospitalization of children.
b.decreased number of children living in poverty.
c.an increase in ambulatory care.
d.decreased use of managed care.

ANS: C

A Hospitalization for children has decreased.

B Health care delivery has not altered the number of children living in poverty.

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. One of the biggest changes in health care has been the growth of managed 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 last decade.

D Managed care has increased in order to control cost.

DIF:Cognitive Level: KnowledgeREF:p. 6

OBJ:Nursing Process Step: Planning

MSC: Client Needs: Safe and Effective Care Environment

5.The Women-Infants-Children (WIC) program provides:

a.well-child examinations for infants and children living at the poverty level.
b.immunizations for high-risk infants and children.
c.screening for infants with developmental disorders.
d.supplemental food supplies to low-income women who are pregnant or breastfeeding.

ANS: D

A 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.

B Children in the WIC program are often linked with immunizations, but that is not the primary focus of the program.

C Public Law 99-457 provides financial incentives to states to establish comprehensive early intervention services for infants and toddlers with, or at risk for, developmental disabilities.

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.

DIF:Cognitive Level: ComprehensionREF:p. 9

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity

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

a.treatment for drug abuse.
b.treatment for sexually transmitted diseases (STDs).
c.accessing birth control.
d.surgery.

ANS: D

A Most states allow minors to obtain treatment for drug or alcohol abuse without parental consent.

B Most states allow minors to obtain treatment for STDs without parental consent.

C In most states minors are allowed access to birth control without parental consent.

D If a minor receives surgery without proper informed consent, assault and battery charges against the care provider can result. This does not apply to an emancipated minor (a minor child who has the legal competency of an adult because of circumstances involving marriage, divorce, parenting of a child, living independently without parents, or enlistment in the armed services).

DIF:Cognitive Level: ApplicationREF:p. 18

OBJ:Nursing Process Step: 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:

a.are developed and implemented by nurses.
b.are used primarily in the pediatric setting.
c.set specific time lines for sequencing interventions.
d.are part of the nursing process.

ANS: C

A Clinical pathways are developed by multiple health care professionals and reflect interdisciplinary interventions.

B They are used in multiple settings and for patients throughout the life span.

C Clinical pathways measure outcomes of patient care. Each pathway outlines specific time lines for sequencing interventions.

D The steps of the nursing process are assessment, diagnosis, planning, intervention, and evaluation.

DIF:Cognitive Level: ApplicationREF:p. 7

OBJ:Nursing Process Step: Planning

MSC: Client Needs: Safe and Effective Care Environment

8.The fastest-growing group of homeless people is:

a.men and women preparing for retirement.
b.migrant workers.
c.single women and their children.
d.intravenous substance abusers.

ANS: C

A Most people contemplating retirement have made provisions.

B Migrant workers may seek health care only when absolutely necessary; however, not all are homeless.

C Pregnancy and birth, especially for a teenager, are important contributing factors for becoming homeless.

D Not all substance abusers are homeless.

DIF:Cognitive Level: KnowledgeREF:p.14

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity

9.The United States ranks twenty-eighth in infant mortality rates of the world. Which factor has a significant impact on decreasing the mortality rate of infants?

a.Resolving all language and cultural differences
b.Enrolling the pregnant woman in the Medicaid program by the eighth month of pregnancy
c.Ensuring early and adequate prenatal care
d.Providing more women’s shelters

ANS: C

A Language and cultural differences are not infant mortality issues but must be addressed to improve overall health care.

B Medicaid provides health care for poor pregnant women, but the process may take weeks to take effect. The eighth month is too late to apply and receive benefits for this pregnancy.

C Because preterm infants form the largest category of those needing expensive intensive care, early pregnancy intervention is essential for decreasing infant mortality rates.

D The women in shelters have the same difficulties in obtaining health care as do other poor people, particularly lack of transportation and inconvenient hours of the clinics.

DIF:Cognitive Level: ComprehensionREF:p. 2

OBJ:Nursing Process Step: Assessment

MSC: Client Needs: Health Promotion and Maintenance

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

a.Consult with the family of the woman.
b.Notify the physician.
c.Document the woman’s refusal in the nurse’s notes.
d.Make a referral to the hospital ethics committee.

ANS: B

A The client must be allowed to make choices voluntarily without undue influence or coercion from others.

B Clients must be allowed to make choices voluntarily without undue influence or coercion from others. The physician, especially if unaware of the client’s decision, should be notified immediately. The nurse should notify the physician of the refusal of the agency’s protocol and document all aspects of the explanations given by the nurse, as well as any instructions from the physician.

C Documentation is important, but it should not be the first action.

D Fetal monitoring is not usually considered an ethical problem.

DIF:Cognitive Level: ApplicationREF:p. 18

OBJ:Nursing Process Step: Implementation

MSC: Client Needs: Safe and Effective Care Environment

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

a.The report assures the legal department that no problem exists.
b.Reports are a permanent part of the patient’s chart.
c.The nurse’s notes should contain, “Incident report filed, and copy placed in chart.”
d.This report is a form of documentation of an event that may result in legal action.

ANS: D

A The report is a warning to the legal department to be prepared for a potential legal action.

B Incident reports are not a part of the patient’s chart.

C Incident reports are not mentioned in the nurse’s notes.

D Documentation on the chart should include all factual information regarding the client’s condition that would be recorded in any situation. Incident reports are not mentioned in the nurse’s notes. The nurse completes an incident report when something occurs that might result in a legal action against the clinic or hospital or is a variance from the standard of care.

DIF:Cognitive Level: ApplicationREF:p. 17

OBJ:Nursing Process Step: Implementation

MSC: Client Needs: Safe and Effective Care Environment

12.Which of these situations best reflects the deontologic theory?

a.Initiating resuscitative measures on a 90-year-old patient with terminal cancer
b.Using experimental medications for the treatment of acquired immunodeficiency syndrome (AIDS)
c.Supporting the transplant of fetal tissue and organs
d.Approving of a physician-assisted suicide

ANS: A

A In the deontologic theory, life must be maintained at all costs, regardless of quality of life.

B In the deontologic theory, life must be maintained at all costs, regardless of quality of life.

C In the deontologic theory, life must be maintained at all costs, regardless of quality of life.

D In the deontologic theory, life must be maintained at all costs, regardless of quality of life.

DIF:Cognitive Level: ComprehensionREF:p. 1

OBJ: Nursing Process Step: Planning MSC: Client Needs: Psychosocial Integrity

13.Elective abortion is considered an ethical issue because:

a.abortion law is unclear about a woman’s constitutional rights.
b.the Supreme Court ruled that life begins at conception.
c.a conflict exists between the rights of the woman and the rights of the fetus.
d.it requires third-party consent.

ANS: C

A Abortion laws are clear concerning a woman’s constitutional rights.

B The Supreme Court has not ruled on when life begins.

C Elective abortion is an ethical dilemma because two opposing courses of action are available.

D Abortion does not require third-party consent.

DIF:Cognitive Level: ComprehensionREF:p. 12

OBJ:Nursing Process Step: Assessment

MSC: Client Needs: Safe and Effective Care Environment

14.Which woman would be most likely to seek prenatal care?

a.A 15-year-old who tells her friends, “I don’t believe I am pregnant”
b.A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic
c.A 28-year-old who is in her second pregnancy and abuses drugs and alcohol
d.A 30-year-old who is in her fifth pregnancy and delivered her last infant at home with the help of her mother and sister

ANS: B

A Being in denial about the pregnancy will prevent her from seeking health care.

B The client who acknowledges the pregnancy early, has access to health care, and has no reason to avoid health care is most likely to seek prenatal care.

C Substance abusers are less likely to seek health care.

D Some women see pregnancy and delivery as a natural occurrence and do not seek health care.

DIF:Cognitive Level: ComprehensionREF:pp. 8, 15

OBJ:Nursing Process Step: Assessment

MSC: Client Needs: Health Promotion and Maintenance

15.A woman who delivered her baby 6 hours ago complains of headache and dizziness. The nurse administers an analgesic but does not perform any assessments. The woman then has a grand mal seizure, falls out of bed, and fractures her femur. How would the actions of the nurse be interpreted in relation to standards of care?

a.Negligent because the nurse failed to assess the woman for possible complications
b.Negligent because the nurse medicated the woman
c.Not negligent because the woman had signed a waiver concerning the use of side rails
d.Not negligent because the woman did not inform the nurse of her symptoms as soon as they occurred

ANS: A

A By not assessing the woman, the nurse failed to meet the established standards of care. The first element of negligence relates to whether the nurse has a duty to provide care to the woman. The care that the nurse provides must meet the established standards of care.

B By not first assessing the woman, the nurse does not meet the established standards of care.

C The nurse could be found negligent.

D The nurse is responsible for assessing the woman.

DIF:Cognitive Level: ApplicationREF:p. 17

OBJ:Nursing Process Step: Evaluation

MSC: Client Needs: Health Promotion and Maintenance

16.What client situation fails to meet the first requirement of informed consent?

a.The client does not understand the physician’s explanations.
b.The physician gives the client only a partial list of possible side effects and complications.
c.The client is confused and disoriented.
d.The client signs a consent form because his wife tells him to.

ANS: C

A Understanding is an important element of the consent, but first the client has to be competent to sign.

B Full disclosure of information is an important element of the consent, but first the client has to be competent to sign.

C The first requirement of informed consent is that the client must be competent to make decisions about health care.

D Voluntary consent is an important element of the consent, but first the client has to be competent to sign.

DIF:Cognitive Level: ComprehensionREF:p. 18

OBJ:Nursing Process Step: Assessment

MSC: Client Needs: Safe and Effective Care Environment

17.Which situation reflects a potential ethical dilemma for the nurse?

a.A nurse administers analgesics to a client with cancer as often as the physician’s order allows.
b.A neonatal nurse provides nourishment and care to a newborn having a defect that is incompatible with life.
c.A labor nurse, whose religion opposes abortion, is asked to assist with an elective abortion.
d.A postpartum nurse provides information about adoption to a new mother who feels she cannot adequately care for her infant.

ANS: C

A There is no element of conflict for the nurse, therefore a dilemma does not exist.

B There is no element of conflict for the nurse, therefore a dilemma does not exist.

C A dilemma exists in this situation because the nurse is being asked to assist with a procedure that she or he believes is morally wrong. The other situations do not contain elements of conflict for the nurse.

D There is no element of conflict for the nurse, therefore a dilemma does not exist.

DIF:Cognitive Level: AnalysisREF:p. 11

OBJ:Nursing Process Step: Assessment

MSC: Client Needs: Safe and Effective Care Environment

MULTIPLE RESPONSE

1.Many communities now offer the availability of free-standing birth centers to provide care for low-risk women during pregnancy, birth, and postpartum. When counseling the newly pregnant woman regarding this option, the nurse should be aware that this type of care setting includes which advantages? Choose those that apply.

a.Less expensive than acute-care hospitals
b.Access to follow-up care for 6 weeks postpartum
c.Equipped for obstetric emergencies
d.Safe, home-like births in a familiar setting
e.Staffing by lay midwives

ANS: A, B, D

Correct A, B, D. Women who are at low risk and desire a safe, home-like birth are very satisfied with this type of care setting. The new mother may return to the birth center for postpartum follow-up care, breastfeeding assistance, and family planning information for 6 weeks postpartum. Since birth centers do not incorporate advanced technologies into their services, costs are significantly less than a hospital setting.

Incorrect C, E. The major disadvantage of this care setting is that these facilities are not equipped to handle obstetric emergencies. Should unforeseen difficulties occur, the woman must be transported by ambulance to the nearest hospital. Birth centers are usually staffed by certified nurse-midwives (CNMs); however, in some states lay midwives may provide this service.

DIF:Cognitive Level: ComprehensionREF:p. 4

OBJ:Nursing Process Step: Planning

MSC: Client Needs: Safe and Effective Care Environment

2.In an effort to reduce prohibitive health care costs, many facilities have incorporated the use of unlicensed assistive personnel into their care delivery model. Nurses supervising these employees must be aware of what each such employee is competent to do within his or her scope of practice. Which tasks can be delegated with supervision? Choose the tasks that apply.

a.Blood draws
b.Medication administration
c.Nursing assessment
d.Housekeeping tasks
e.Other diagnostic tests, such as electrocardiograms (ECGs or EKGs)

ANS: A, B, D, E

Correct A, B, D, E. With proper supervision and adequate instruction, unlicensed assistive personnel may perform all of these functions. In long-term care settings, these personnel are often responsible for medication administration under the direction of the registered nurse (RN).

Incorrect C. The nurse is always responsible for client assessments and must make critical judgments to ensure client safety. Use of the expert nurse to complete housekeeping or other mundane tasks is not a good use of human resources. For more information about the use of unlicensed personnel, refer to www.awhonn.org.

DIF:Cognitive Level: ApplicationREF:p. 20

OBJ:Nursing Process Step: Implementation

MSC: Client Needs: Safe and Effective Care Environment

maternal child nursing 3rd edition mckinney test bank

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