Test bank for maternity nursing an introductory text 10th edition leifer

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 4 OBJ: 19 TOP: Community-Based Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance... PTS: 1 DIF: Cog

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Leifer: Maternity Nursing, 10th Edition

Chapter 1: Contemporary Maternity Care, Family, and Cultural Considerations Test Bank

MULTIPLE CHOICE

1 A disadvantage of free standing birth centers is that:

1 many lack adequate technology and medical care to deal with complications

2 they are often more expensive than hospital-based delivery settings

3 the presence of family members increases the risk of postpartum infection

4 mothers are expected to leave freestanding birthing centers shortly after delivery

ANS: 1

Many of these centers do not have the technology or medical care readily available to assist

in an emergency

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 2

KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

2 The role of the nurse has evolve to emphasize:

1 managing care to cure health problems once they have been identified

2 participating in or leading the activities of a team of interdisciplinary health care

providers

3 providing direct care to patients at the bedside

4 planning patient care to cover longer hospital stays

ANS: 2

The nurse must work with the interdisciplinary health care team to identify needs within the community and create cost-effective approaches to comprehensive preventive and

therapeutic care Creativity, problem solving, coordination of multidisciplinary caregivers, case management, assessment, and referral are just some of the essential skills required of a nurse providing community-based care

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 4

OBJ: 19 TOP: Community-Based Nursing

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance

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3 Symbols, actions, gestures, facial expressions, and body positions are examples of:

1 subtle communication

2 listening

3 nonverbal language

4 observation

ANS: 3

These are all examples of nonverbal language—means of communicating a message without words

4 A health care system in which physicians and hospitals contract with insurers to provide service at a discounted rate to members is a:

1 health maintenance organization

2 diagnosis-related group

3 preferred provider organization

4 federally managed insurance plan

ANS: 3

A preferred provider organization (PPO) is a network of providers who agree to provide care

at a discount to individuals covered under the plan

5 Unlike a nursing care plan, a clinical pathway:

1 is based on traditional nursing interventions

2 presents criteria for hospital discharge

3 spells out the progress expected each day

4 includes only the nursing needs and care

ANS: 3

Clinical pathways guide the daily care and expected progress of the patient They reflect a multidisciplinary focus and are based on research and standards of care The nursing care plan applies patient and nursing responses based on structured problem-solving approaches

to clinical problems

OBJ: 11 TOP: Clinical Pathways

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6 The nurse is working with a pregnant woman who is employed at minimum wage She has three small children Her mother cares for the children so she can work, but she says she cannot afford to feed her children properly The nurse should refer her to the:

1 Women, Infants, and Children program

2 National Institutes of Health

3 local Medicare office

4 Job Corps

ANS: 1

The woman’s immediate need is to feed herself and her children The Women, Infants, and Children (WIC) program provides supplemental food and education for the indigent

PTS: 1 DIF: Cognitive Level: Application REF: Page 4

OBJ: 5 TOP: Specific Government Influences in Maternal/Infant Care KEY: Nursing Process Step: Implementation

7 In the United States, birth certificates are used to:

1 provide statistics on maternal mortality rates

2 supplement data obtained in the U.S Census

3 guide the allocation of resources for mothers and infants

4 document outcomes of all pregnancies in the 50 states and the District of

Columbia

ANS: 3

Birth certificates document live births and provide information about maternal and infant health that is used in determining the allocation of health resources

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 5 Table 1-1 OBJ: 7 TOP: Statistics Important to Maternal/Infant Care

8 The effect of standards of care on nursing is to:

1 establish minimum criteria for competent nursing care

2 allow other professions to determine what constitutes nursing care

3 encourage lawsuits by presenting unrealistic expectations of nurses

4 specify what action a nurse with a master’s degree would take in a given situation ANS: 1

Standards of care provide a minimum standard by which to judge the quality of care

provided They are based on expectations of what a reasonable nurse with similar education and experience would do in like circumstances Therefore expectations of an LP/VN and an MSN would differ in some ways The standards have come from professional nursing organizations, not other professions

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9 The nurse’s employer wants LP/VNs to begin doing some procedures that are now being performed only by RNs Which of the following is the best source of information about taking on these new tasks?

1 The National League for Nursing

2 The National Federation of Licensed Practical Nurses

3 The American Nurses Association Division of Practice

4 The Joint Commission

ANS: 2

The National Federation of Licensed Practical Nurses (NFLPN) describes the role of

LPN/LVNs in clinical practice today In addition, nursing actions must be in accordance with the nurse practice acts of the state in which the nurse is practicing

10 The nurse is interviewing a returning patient in the prenatal clinic The nurse has recorded the patient’s name, age, month of gestation, number and ages of children, and chief

complaint (backache) This illustrates which step of the nursing process?

1 Assessment

2 Planning

3 Implementation

4 Evaluation

ANS: 1

Assessment includes the collection of objective and subjective patient data

OBJ: 13 TOP: Nursing Process

KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A

11 In the prenatal clinic, a patient who is in her eighth month of pregnancy complains of

backaches Further questioning reveals that the pain is in the lower back region and is worse

at the end of the day The patient has no discomfort on voiding She is working part-time as a file clerk She has children ages 2 and 5 years The nurse thinks the patient’s backaches are probably due to improper bending and lifting This attempt to determine the nature of the patient’s complaint and possible causes reflects which step of the nursing process?

1 Assessment

2 Diagnosis

3 Planning

4 Evaluation

ANS: 2

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To make a diagnosis, the nurse pulls together related data that pinpoint a problem and help to reveal contributing factors

KEY: Nursing Process Step: Diagnosis MSC: NCLEX: N/A

12 A patient in the prenatal clinic has backaches related to improper lifting and bending The nurse demonstrates good body mechanics and explains how they can reduce back strain This illustrates which step of the nursing process?

1 Assessment

2 Diagnosis

3 Planning

4 Implementation

ANS: 4

In the implementation step, the nurse actually carries out interventions to address the nursing diagnosis

KEY: Nursing Process Step: Implementation

13 The nurse has demonstrated good body mechanics to a prenatal patient She then asks the patient to practice by picking up her 2-year-old This illustrates which step of the nursing process?

1 Assessment

2 Planning

3 Implementation

4 Evaluation

ANS: 4

By having her return the demonstration, you are evaluating whether she understands and can perform the activities as advised

KEY: Nursing Process Step: Evaluation

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14 The nurse who understands cultural differences and adapts clinical practice to a patient’s culture is said to have:

1 cultural competence

2 empathy

3 open-mindedness

4 compassion

ANS: 1

Cultural competence requires knowledge and appreciation of other cultures that permit adaptation of nursing care to accommodate the patient’s cultural beliefs and practices PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 10

OBJ: 15 TOP: Culture KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

15 The family type in which several families live together and share responsibilities is called:

1 nuclear

2 blended

3 cohabiting

4 communal

ANS: 4

This definition describes the communal family

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 12, Box 1-5

16 The nurse’s interview with a new prenatal patient reveals that the patient is taking herbs that she believes will promote her baby’s health The nurse’s most appropriate response is:

1 “That’s a great idea! Herbs are natural products and cannot be harmful.”

2 “It’s your choice if you want to take herbs, but the doctor won’t like it.”

3 “It is important to let your doctor know everything you are taking.”

4 “That is nonsense and could actually harm you or your baby.”

ANS: 3

Nurses should not advocate or discourage use of herbal and folk remedies However, health care providers need to know what the patient is taking because herbals and other remedies may affect traditional medicines Also, the patient may not know whether the herbals are potentially harmful to her or her fetus

OBJ: 18 TOP: Complementary and Alternative Therapies

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiologic Integrity

17 The best definition of family is:

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1 at least one parent in a household with one or more children.

2 two or more individuals who share bonds and emotional closeness and who

consider themselves a family

3 a husband and wife with at least one child

4 several individuals related by marriage or blood who make up a single household

and share financial resources

ANS: 2

The U.S Census Bureau definition of family (two or more people who reside together and who are related by blood, marriage, or adoption) is useful for statistical purposes, but is limited when assessing a family for health purposes A broader definition considers a family

as “two or more people who live in the same household, share a common emotional bond, and perform certain interrelated social tasks.”

KEY: Nursing Process Step: N/A MSC: NCLEX:N/A

18 The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted primarily to:

1 protect patient confidentiality and privacy

2 render insurance companies accountable for payment for services

3 ensure that a person could move his or her health insurance from one place of

employment to another

4 prevent cultural, ethnic, or gender-based discrimination against patients

ANS: 1

Patient privacy is protected by federal law and regulated by accrediting agencies The

Privacy Act of 1974 and HIPAA require a patient’s consent before any identifying

information (name, Social Security number, diagnosis) is disclosed from the medical records

PTS: 1 DIF: Cognitive Level: Comprehension

REF: Page 7, 8, Fast Focus 1-1 OBJ: 14

TOP: Patient Privacy and HIPAA Rights KEY: Nursing Process Step: N/A

MSC: NCLEX:N/A

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19 The number of fetal deaths and number of neonatal deaths per 1000 live births per year is called

ANS:

Perinatal mortality

Vital statistics depict the status of health of the nation’s women and children and help the government allocate resources to meet identified needs

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 5, Box 1-2 OBJ: 7 TOP: Statistics Important to Maternal and Newborn Care

20 The nurse writes on the nursing care plan: “The newborn will maintain a patent airway as evidenced by regular, unlabored respirations with no cyanosis or pallor.” This is the

step of the nursing process

ANS:

Planning

The nursing process uses this step to plan comprehensive nursing care, stated as specific, individualized, measurable goals

KEY: Nursing Process Step: Planning MSC: NCLEX: N/A

21 therapies for health problems are remedies differing from the usual treatment and not generally recommended by health care providers Nontraditional methods

or treatments used in conjunction with conventional therapy are known as

therapies

ANS:

Alternative, complementary

Alternative therapies are not based on empirical science, may be dangerous, and are often dispensed or used by unlicensed people Complementary therapies integrated with standard medical treatment may increase the self-healing ability of the body

PTS: 1 DIF: Cognitive Level: ComprehensionCognitive Level: Knowledge REF: Page 12 OBJ: 17

LOC: Complementary and Alternative Therapies

KEY: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity

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SHORT ANSWER

NIC, NOC, and NANDA diagnoses aid in the critical thinking aspect of patient care To understand how each relates to patient care, it is necessary to understand what each

component means Define each of the following terms

22 NIC (Nursing Intervention Classification):

ANS:

NIC: set of actions or interventions in nursing care

NIC, NOC, and NANDA diagnoses serve to standardize the language regarding patient status and nursing activities that enable nurses to work in the managed care environment, promote research, and develop a reimbursement system for nursing services rendered

REF: 8, Nursing Care Plan 1-1, Appendix F OBJ: 12

TOP: NIC, NOC, and NANDA KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

23 NOC (Nursing Outcome Criteria):

ANS:

NOC: outcomes expressed in a measurable continuum that reflects the patient’s response to the interventions

MSC: NCLEX: N/A

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24 NANDA diagnoses:

ANS:

NANDA diagnoses: nursing diagnoses approved by NANDA International (formerly North American Nursing Diagnosis Association)

MSC: NCLEX: N/A

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