OB Units 1, 2, 3 Exam with Complete Solutions

Before the twentieth century, a primary cause of maternal death was: a. Contagious diseases. b. Lack of care. c. Postpartum infection. - ANSWER-c. Postpartum Infection Rationale: The primary causes of maternal death prior to the twentieth century were hemorrhage, toxemia, preeclampsia, and infections. Contagious disease was a primary cause of infant deaths before the twentieth century. Wealthy women had midwives to attend home births. Charity cases would seek help in a hospital and would be cared for by medical students. During the prenatal interview, the client states her wish to deliver in a facility other than a hospital setting because of the lower cost. The nurse is aware that the client is referring to a: a. Labor, birth, recovery, and postpartum room. b. Birth center. c. Labor, birth, and recovery room. - ANSWER-b. Birth Center Rationale: A birth center is a free-standing building separate from a hospital. It is usually less expensive than traditional hospitals. A labor, birth, recovery, and postpartum room is usually found within the hospital setting. A plan of client care that identifies client outcomes and specifies time lines for achievement of those outcomes is termed: a. Outcomes management. b. Case management. c. Clinical pathway. - ANSWER-c. Clinical pathway. Rationale: Clinical pathways include not only outcomes but also specific timelines for the achievement of the outcomes. Outcomes management is the practice of lowering health care costs while maintaining the quality of care. Case management is the practice of using collaboration to ensure optimal outcomes and lowering cost. Evidence-based practice is best defined as: a. Clinical practice guidelines based on research. b. Clinical practice guidelines based on past successes. c. Clinical practice guidelines based on cost containment. - ANSWER-a. Clinical practice guidelines based on research. Rationale: Evidence-based practice is based on research data that improves the quality and outcomes of client care. To rely on tradition or habit does not improve client care. Cost containment is not a part of evidence-based practice. A newly admitted infant girl lives with her mother, stepfather, and two stepbrothers. The nurse understands that this family is considered a: a. Traditional family. b. Single-parent family. c. Blended family. - ANSWER-c. Blended family. Rationale: Blended families are formed when divorced or widowed parents remarry and bring children from a previous marriage into the new relationship. A traditional family usually includes a father, mother, and children from that union. A single-parent family is headed by one parent who must function as the homemaker, caregiver, and provider. During client teaching, the nurse notices that a new mother of Southeast Asian descent continues to look down at the floor and speaks softly only when asked direct questions. The nurse interprets this behavior as: a. Disinterest in the teaching. b. A cultural behavior. c. A feeling of inferiority. - ANSWER-b. Cultural Behavior Rationale: Prolonged eye contact is considered rude with many individuals from this culture. The lack of eye contact is often interpreted as disinterest in the Western cultures; however, it is a common behavior in other cultures. Looking down at the floor and speaking only when spoken to can be interpreted as a sign of inferiority in the Western culture; however, it is a common behavior in other cultures. Case management is a practice model that uses a systematic approach to identify specific clients and to manage care collaboratively to ensure optimal outcomes. True or False? - ANSWER-True. Semmelweis discovered that puerperal infections could be prevented by proper _____________________. - ANSWER-Hygiene. The health care birth system that uses health maintenance organizations and preferred provider organizations is termed ______________________. - ANSWER-Managed care. A major concern about the use of complementary and alternative medicine is _________________. - ANSWER-Safety. In a Muslim family, the decisions about health care are usually made by the ____________. - ANSWER-Male head of household. Preparation for advanced practice nursing requires at least a(n): a. Associate degree in nursing. b. Baccalaureate degree in nursing. c. Master's degree in nursing. d. Doctoral degree in nursing. - ANSWER-c. Master's degree in Nursing All advanced practice nursing degrees require at least a master's degree in nursing; some may require a doctoral degree. When assessing a client, the nurse states, "Tell me more about your last labor." This is the communication technique of: a. Clarifying. b. Paraphrasing. c. Reflecting. d. Summarizing. - ANSWER-a. Clarifying. Clarifying is following up on a client statement to understand content and the feelings expressed. The client states to the nurse, "I wonder if today will be better than yesterday." Which of the following statements by the nurse would be therapeutic? a. "Today is always better than yesterday." b. "Was yesterday so bad?" c. "It's normal to be depressed after giving birth." d. "Tell me what you mean about yesterday." - ANSWER-d. "Tell me what you mean about yesterday." Correct Rationale: This statement uses clarification, which is a therapeutic communication technique. All the other choices will block communication. Which of the following teaching methods is best used with adolescents? a. Printed material b. Videos c. Lectures - ANSWER-b. Videos Rationale: Teenagers often learn well from videos, computer-based lessons, and group discussions. Individuals in their 30s benefit more from printed material. The nurse meets with the dietitian to develop a plan to increase the nutritional intake of a client. The nurse at this point is acting in the role of a: a. Collaborator b. Researcher c. Advocate d. Manager - ANSWER-a. Collaborator Rationale: A collaborator works with other members of the health care team to coordinate and manage a client's care. The postpartum client complains of pain, and the nurse collects the following data: pain located in perineum, is sharp and is a 7 (on a scale of 1 to 10). The nurse is using which level of the nursing process? a. Assessment b. Analysis c. Planning d. Evaluation - ANSWER-a. Assessment Rationale: The assessment stage is the process of collecting data. This type of assessment is a focused assessment because information is gathered specifically related to an actual health problem (pain). One hour after administering pain medication to the client, the nurse assesses that the pain level has been reduced from a 7 (on a scale of 1 to 10) to a 2. The nurse is using which step of the nursing process? a. Assessment b. Planning c. Implementation d. Evaluation - ANSWER-d. Evaluation Rationale: The evaluation step determines the effectiveness of the plan. The nurse should assess the status of the client prior to and after intervention. In this question, the pain was assessed prior to medication and after medication reached its peak. Select which of the following statements are principles of teaching and learning. (Select all that apply). -Readiness of the client to learn is a principle. - Developing goals should be the nurse's responsibility. Repetition increases competence. - To motivate the learner; positive or negative feedback may be used. -Teaching should proceed from the simple to the complex. - ANSWER--Readiness of the client to learn is a principle.