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NUR 300 WI Maternity & Women’s Health Care 12th Edition - Chapter 1 (2019/2020) – Central Michigan University | 21st Century Maternity and Women’s Health Nursing

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NUR 300 WI Maternity & Women’s Health Care 12th Edition - Chapter 1 – Central Michigan University Chapter 1: 21st Century Maternity and Women’s Health Nursing MULTIPLE CHOICE 1. In eva... luating the level of a pregnant womans risk of having a low-birth-weight (LBW) infant, which factor is the most important for the nurse to consider? a. African-American race b. Cigarette smoking c. Poor nutritional status d. Limited maternal education For African-American births, the incidence of LBW infants is twice that of Caucasian births. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant mortality rates, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor nutrition is an important factor in potential infant mortality rates, but it is not the most important. Additionally, nutritional status is a modifiable risk factor. Maternal education is an important factor in potential infant mortality rates, but it is not the most important. Additionally, maternal education is a modifiable risk factor. DIF: Cognitive Level: Understand REF: IM: TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance, Antepartum Care 2. What is the primary role of practicing nurses in the research process? a. Designing research studies b. Collecting data for other researchers c. Identifying researchable problems d. Seeking funding to support research studies When problems are identified, research can be properly conducted. Research of health care issues leads to evidence-based practice guidelines. Designing research studies is only one factor of the research process. Data collection is another factor of research. Financial support is necessary to conduct research, but it is not the primary role of the nurse in the research process. DIF: Cognitive Level: Understand REF: im: 14 TOP: Nursing Process: N/A MSC: Client Needs: Safe and Effective Care Environment 3. A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? a. Perform a nutrition assessment. b. Refer the woman to a social worker. c. Advise the woman to see an obstetrician, not a midwife. d. Explain to the woman the importance of keeping her prenatal care appointments. Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality. Nutritional status is an important modifiable risk factor, but it is not the most important action a nurse should take in this situation. The client may need assistance from a social worker at some time during her pregnancy, but a referral to a social worker is not the most important aspect the nurse should address at this time. If the woman has identifiable high-risk problems, then her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high-risk issues. In addition, advising the woman to see an obstetrician is not the most important aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to receive. DIF: Cognitive Level: Understand REF: IM: TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 4. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic client with limited English proficiency. Which action is the most important for the nurse to perform? a. Use maternity jargon to enable the client to become familiar with these terms. b. Speak quickly and efficiently to expedite the visit. c. Provide the client with handouts. d. Assess whether the client understands the discussion. Nurses contribute to health literacy by using simple, common words, avoiding jargon, and evaluating whether the client understands the discussion. Speaking slowly and clearly and focusing on what is important will increase understanding. Most client education materials are written at a level too high for the average adult and may not be useful for a client with limited English proficiency. DIF: Cognitive Level: Apply REF: im: 5 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 5. The nurses working at a newly established birthing center have begun to compare their performance in providing maternal-newborn care against clinical standards. This comparison process is most commonly known as what? a. Best practices network b. Clinical benchmarking c. Outcomes-oriented practice d. Evidence-based practice Outcomes-oriented practice measures the effectiveness of the interventions and quality of care against benchmarks or standards. The term best practice refers to a program or service that has been recognized for its excellence. Clinical benchmarking is a process used to compare ones own performance against the performance of the best in an area of service. The term evidence-based practice refers to the provision of care based on evidence gained through research and clinical trials. DIF: Cognitive Level: Understand REF: im: 11 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe and Effective Care Environment 6. Which statement best exemplifies contemporary maternity nursing? a. Use of midwives for all vaginal deliveries b. Family-centered care c. Free-standing birth clinics d. Physician-driven care Contemporary maternity nursing focuses on the familys needs and desires. Fathers, partners, grandparents, and siblings may be present for the birth and participate in activities such as cutting the babys umbilical cord. Both midwives and physicians perform vaginal deliveries. Free-standing clinics are an example of alternative birth options. Contemporary maternity nursing is driven by the relationship between nurses and their clients. DIF: Cognitive Level: Understand REF: pp. 8-9 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 16. While obtaining a detailed history from a woman who has recently immigrated from Somalia, the nurse realizes that the client has undergone female genital mutilation. What is the nurses most appropriate response in this situation? a. This is a very abnormal practice and rarely seen in the United States. b. Are you aware of who performed this mutilation so that it can be reported to the authorities? c. We will be able to restore fully your circumcision after delivery. d. The extent of your circumcision will affect the potential for complications. The extent of the circumcision is important. The client may experience pain, bleeding, scarring, or infection and may require surgery before childbirth. Although this practice is not prevalent in the United States, it is very common in many African and Middle Eastern countries for religious reasons. Mentioning that the practice is abnormal and rarely seen in the United States is culturally insensitive. The infibulation may have occurred during infancy or childhood; consequently, the client will have little to no recollection of the event. She would have considered this to be a normal milestone during her growth and development. The International Council of Nurses has spoken out against this procedure as harmful to a womans health. DIF: Cognitive Level: Analyze REF: im: 9 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 17. To ensure client safety, the practicing nurse must have knowledge of The Joint Commissions current Do Not Use list of abbreviations. Which term is acceptable for use regarding medication administration? a. q.o.d. or Q.O.D. b. MSO4 or MgSO4 c. International Unit d. Lack of a leading zero I.U. and i.u. are no longer acceptable because they could be misread as I.V. or the number 10. Q.O.D. should be written out as every other day. The period after the Q could be mistaken for an I and the o could also be mistaken for an i. Confusing one medication for another is too easy. Medications are used for very different purposes and could place a client at risk for an adverse outcome. For example, these medications should be written as morphine sulfate and magnesium sulfate. The decimal point should never be missed before a number (e.g., 0.4 rather than .4). A leading zero is the preferred form. DIF: Cognitive Level: Remember REF: im: 13 TOP: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 18. Maternity nurses can enhance communication among health care providers by using the SBAR technique. The acronym SBAR stands for what? a. Situation, background, assessment, recommendation b. Situation, baseline, assessment, recommendation c. Subjective, background, analysis, recommendation d. Subjective, background, analysis, review SBAR is an easy-to-remember, useful, and concrete mechanism for communicating important information that requires a clinicians immediate attention. Baseline iusssneodt dasispcart of SBAR. Subjective and analysisare not specific to the SBAR acronym. Subjective, analysis, and review are not specific to the SBAR acronym. DIF: Cognitive Level: Apply REF: im: 14 TOP: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 19. Healthy People 2020 has established national health priorities that focus on a number of maternal-child health indicators. Nurses are assuming greater roles in assessing family health and are providing care across the perinatal continuum. Which of these priorities has made the most significant progress? a. Reduction of fetal deaths and use of prenatal care b. LBW infants and preterm births c. Elimination of health disparities based on race d. Infant mortality and the prevention of birth defects Trends in maternal child health indicate that progress has been made in relation to reduced infant and fetal deaths and increased prenatal care. Notable gaps remain in the rates of LBW infants and preterm births. According to the March of Dimes, persistent disparities still exist between African-Americans and non-Hispanic Caucasians. Many of these negative outcomes are preventable through access to prenatal care and the use of preventive health practices. These preventable negative outcomes demonstrate the need for comprehensive community-based care for all mothers, infants, and families. DIF: Cognitive Level: Remember REF: pp. 3, 4 TOP: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment MULTIPLE RESPONSE 1. Greater than one third of women in the United States are now obese (body mass index [BMI] of 30 or greater). Less than one quarter of women in Canada exhibit the same BMI. Obesity in the pregnant woman increases both maternal medical risk factors and negative outcomes for the infant. The nurse is about to perform an assessment on a client who is 28 weeks pregnant and has a BMI of 35. What are the most frequently reported complications for which the nurse must be alert while assessing this client? (Select all that apply.) a. Potential miscarriage b. Diabetes c. Fetal death in utero d. Decreased fertility e. Hypertension The two most frequently reported maternal medical risk factors associated with obesity are hypertension associated with pregnancy and diabetes. Decreased fertility, miscarriage, fetal death, and congenital anomalies are also associated with obesity. These clients often experience longer hospital stays and increased use of health services. DIF: Cognitive Level: Apply REF: im: 7 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 2. The Patient Protection and Affordable Care Act (ACA) was signed into law by President Obama in early 2010. The Act provides some immediate benefits, and other provisions will take place over the next several years. The practicing nurse should have a thorough understanding of how these changes will benefit his or her clients. Which outcomes are goals of the ACA? (Select all that apply.) a. Insurance affordability b. Improve public health c. Treatment of illness d. Elimination of Medicare and Medicaid e. Cost containment , B, E The ACA goals are to make insurance more affordable, contain costs, and strengthen Medicare and Medicaid. The Act contains provisions that promote the prevention of illness and improve access to public health. The ultimate goal of the Act is to improve the quality of care for all Americans while reducing waste, fraud, and abuse of the current system. DIF: Cognitive Level: Comprehend REF: im: 5 TOP: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 3. Which statements indicate that the nurse is practicing appropriate family-centered care techniques? (Select all that apply.) a. The nurse commands the pregnant woman to do as she is told. b. The nurse allows time for the partner to ask questions. c. The nurse allows the mother and father to make choices when possible. d. The nurse informs the family about what is going to happen. e. The nurse tells the clients sister, who is a nurse, that she cannot be in the room during the delivery. Including the partner in the care process and allowing the couple to make choices are important elements of family-centered care. The nurse should never tell the client what to do. Family- centered care involves collaboration between the health care team and the client. Unless an institutional policy limits the number of attendants at a delivery, the client should be allowed to have whomever she wants present (except when the situation is an emergency and guests are asked to leave). DIF: Cognitive Level: Analyze REF: pp. 8-9 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 4. Which methods help alleviate the problems associated with access to health care for the maternity client? (Select all that apply.) a. Provide transportation to prenatal visits. b. Provide child care to enable a pregnant woman to keep prenatal visits. c. Increase the number of providers that will care for Medicaid clients. d. Provide low-cost or no-cost health care insurance. e. Provide job training. Lack of transportation to prenatal visits, child care, access to skilled obstetric providers, and affordable health insurance are prohibitive factors associated with the lack of prenatal care. Although job training may result in employment and income, the likelihood of significant changes during the time frame of the pregnancy is remote. [Show More]

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