INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK

Chapter 01: The Past, Present, and Future MULTIPLE CHOICE 1. A patient chooses to have the certified nurse midwife (CNM) provide care during her pregnancy. What does the CNMs scope of practice include? a. Practice independent from medical supervision b. Comprehensive prenatal care c. Attendance at all deliveries d. Cesarean sections ANS: B The CNM provides comprehensive prenatal and postnatal care, attends uncomplicated deliveries, and ensures that a backup physician is available in case of unforeseen problems. DIF: Cognitive Level: Comprehension REF: Page 6 TOP: Advance Practice Nursing Roles KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. Which medical pioneer discovered the relationship between the incidence of puerperal fever and unwashed hands? a. Karl Cred b. Ignaz Semmelweis c. Louis Pasteur d. Joseph Lister ANS: B Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by the unwashed hands of physicians and medical students. NURSINGTB.COM DIF: Cognitive Level: Knowledge REF: Page 2 TOP: The Past KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control 3. A pregnant woman who has recently immigrated to the United States comments to the nurse, I am afraid of childbirth. It is so dangerous. I am afraid I will die. What is the best nursing response reflecting cultural sensitivity? a. Maternal mortality in the United States is extremely low. b. Anesthesia is available to relieve pain during labor and childbirth. c. Tell me why you are afraid of childbirth. d. Your condition will be monitored during labor and delivery. ANS: C Asking the patient about her concerns helps promote understanding and individualizes patient care. DIF: Cognitive Level: Application REF: Page 7 TOP: Cross-Cultural Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation 4. An urban area has been reported to have a high perinatal mortality rate. What information does this provide? a. Maternal and infant deaths per 100,000 live births per year b. Deaths of fetuses weighing more than 500 g per 10,000 births per year c. Deaths of infants up to 1 year of age per 1000 live births per year d. Fetal and neonatal deaths per 1000 live births per year ANS: D The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year. DIF: Cognitive Level: Comprehension REF: Page 12 OBJ: 9 TOP: The Present-Child Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 5. What is the focus of current maternity practice? a. Hospital births for the majority of women b. The traditional family unit c. Separation of labor rooms from delivery rooms d. A quality family experience for each patient ANS: D Current maternity practice focuses on a high-quality family experience for all families, traditional or otherwise. DIF: Cognitive Level: Comprehension REF: Page 6 TOP: The Present-Maternity Care KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance 23. The nurse is assessing a 1-year-old infant in the pediatric office. What finding should the nurse report to the physician immediately? a. Respiratory rate of 60 breaths per minute b. Pulse rate of 100 beats per minute c. Minimal verbalization d. Fussy behavior NURSINGTB.COM ANS: A Respirations of a 1-year-old should be 20 to 40 breaths per minute. Increased respiratory rate can lead to distress and should be reported immediately. Pulse rate of 100 to 140 beats/minute is normal. Minimal verbalization and fussy behavior are not emergency situations or abnormal for this age. DIF: Cognitive Level: Application REF: Page 400 OBJ: 2 TOP: 12-Month-Old Physical Characteristics KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 24. A new mother is voicing concern she is breastfeeding her newborn too frequently. How often does the nurse instruct this mother she should expect her newborn to feed? a. Every 2 to 3 hours b. Every 4 to 6 hours c. Every 6 to 8 hours d. Every 8 to 10 hours ANS: A Breastfed infants may require feedings at 2- to 3-hour intervals because breast milk is more easily digested. A flexible but regular schedule that provides a rest period between feedings is best for the parent and infant. DIF: Cognitive Level: Application REF: Page 403 TOP: 12-Month-Old Physical Characteristics KEY: Nursing Process Step: Intervention MSC: NCLEX: Health Promotion and Maintenance: Growth and Development MULTIPLE RESPONSE 25. The nurse cautions that children who have unmet hunger needs will likely display which characteristic(s)? (Select all that apply.) a. Irritability b. Ineffective feeding patterns c. No predictable sleep-wake cycle d. Distrust e. Effective parent bonding ANS: A, B, C, D Children who experience frequent hunger do not have effective parental bonding. All other options are probable outcomes for a child who has unmet hunger needs. DIF: Cognitive Level: Comprehension REF: Page 404 OBJ: 3 TOP: Hunger KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 26. The nurse is preparing to outline principles of discipline for parents of an infant. What information should the nurse include? (Select all that apply.) a. Firmly say No. b. Distract the child to another activity. c. Bribe the child with a sweet treat. d. Remain consistent. e. Ignore the child until behavior improves. ANS: A, B, D Parental approval is important to the infant, and setting limits early is important (Anderson, 2008). Principles of discipline for an infant include lowering the voice to say no firmly, removing the child from the situation, distraction, and consistency. NURSINGTB.COM DIF: Cognitive Level: Comprehension REF: Page 393 OBJ: 4 TOP: Discipline KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 27. What should the teaching plan include about infant fall precautions? (Select all that apply.) a. Remove all unsteady furniture. b. Keep crib rails up and in locked position. c. Steady infant with hand when on changing table. d. Use tray attachment on high chair as restraint. e. Keep infant seat on the floor. ANS: A, B, C, E The tray attachment to a high chair is an inadequate restraint. All other options are good precautions to prevent an infant from a fall. DIF: Cognitive Level: Comprehension REF: Page 409 TOP: Fall Prevention KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk 28. The nurse is aware that the 7-month-old can signal feeding readiness by which action(s)? (Select all that apply.) a. Pulling spoon toward mouth b. Biting at spoon with upper and lower incisors c. Pointing to food bowl d. Bouncing up and down with excitement at sight of food e. Manipulating finger foods ANS: A, E The 7-month-old pulls the spoon toward his or her mouth and can manipulate finger foods. The 7-month-old does not have upper incisors and has not developed adequately to recognize the food container or exhibit excitement related to the sight of food. DIF: Cognitive Level: Comprehension REF: Page 404 OBJ: 3 TOP: Feeding Skills KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 29. The nurse is educating parents of a 2-month-old about immunizations. What immunizations against illness should their child receive? (Select all that apply.) a. Pertussis (whooping cough) b. Influenza c. Diptheria d. Tetanus e. Polio ANS: A, B, C, D, E The first DPT, polio, and flu immunizations are given at the age of 2 months. DIF: Cognitive Level: Knowledge REF: Page 396 OBJ: 6 TOP: Immunizations KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection 30. What will the nurse take into consideration when educating parents regarding infant nutrition? (Select all that apply.) a. Cultural practices b. Sex of the infant c. Parental knowledge d. Infants developmental level e. Parent-child interaction NURSINGTB.COM ANS: A, C, D, E Parents have many concerns about feeding their infant during the first year of life. This is a period when readiness to receive nutrition education is usually high; therefore the nurse looks for opportunities to provide accurate information. Assessment of parental knowledge; infant development, behavior, and readiness; parent- child interaction; and cultural and ethnic practices is important. Sex of the infant does not enter into nutritional education. DIF: Cognitive Level: Comprehension REF: Page 403 OBJ: 10 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 31. Parents of an infant inform the nurse they are planning home preparation of solid foods. What directions should the nurse provide? (Select all that apply.) a. Boil foods in a large amount of water. b. Do not freeze foods. c. Add 1 teaspoon of salt per cup. d. Puree food in electric blender. e. Add sugar sparingly. ANS: D, E Home-prepared infant food can be strained and pureed in an electric blender. Sugar should be added sparingly. Food should be boiled in small amounts of water and not over cooked to avoid destroying nutrients. Foods may be frozen in ice cube trays and defrosted for use. DIF: Cognitive Level: Comprehension REF: Page 407 OBJ: 12 | 13 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development COMPLETION 32. The nurse explains that the second process of self-mobility an infant learns is seen at the age of 9 months, when the infant begins to . ANS: creep At 7 months the infant begins to crawl, using arms and dragging trunk and legs. At 9 months the infant begins to creep, holding his or her trunk above the floor. The next self-mobility activity is cruising, where the child walks from one piece of furniture to the next before it begins to walk independently. DIF: Cognitive Level: Application REF: Page 395 OBJ: 3 TOP: Creeping KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 33. The nurse cautions parents to place their infant in the position, rather than on his or her stomach, to reduce the risk of sudden infant death syndrome (SIDS). ANS: supine The supine or side-lying position has been found to reduce possible aspiration and is believed to reduce the risk of SIDS. DIF: Cognitive Level: Application REF: Page 401 TOP: Positions for Sleep KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk NURSINGTB.COM 34. is characterized by periods of unexplained irritability and crying in a healthy, well-fed infant. ANS: Colic Colic is characterized by periods of unexplained irritability and crying in a healthy, well-fed infant. DIF: Cognitive Level: Knowledge REF: Page 401 TOP: Colic KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: Physiological Adaptation 35. The nurse explains that an infants prehensile development is progressive and logical. Arrange the development in the order from the simplest to the most complex. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Hands held open most of the time b. Grasps with thumb on one side and three fingers on the other c. Picks up toy with squeeze action d. Thumb and forefinger hold object e. Hands held closed most of the time ANS: E, A, C, B, D The development advances from the newborns closed hands to the open star hands of the older infant, to the squeeze action, to a grasp with thumb and fingers, to the pincher movement of thumb and forefinger. DIF: Cognitive Level: Analysis REF: Page 394 OBJ: 3 TOP: Prehensile Development KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development