,Chapter 01_LO 01_Q01
The Labor and Delivery nurse and a nurse new to the Labor and Delivery unit are
admitting a laboring client. The client is making groaning guttural sounds during
contractions, and answering questions with one-word answers. The Labor and Delivery
nurse simultaneously is quickly setting up the instruments and sterile field for this
delivery while asking the admission questions between contractions. The experienced
Labor and Delivery nurse has not yet completed a pelvic exam. The nurse new to Labor
and Delivery understands that this is an example of:
1. An expert nurse assessing advanced labor and imminent delivery in the
client.
2. The correct order of steps when admitting laboring clients.
3. Inconsistencies in an individual nurse’s approach to client care.
4. Advanced nurse practice.
Correct answer: 1
Rationale:
1. An expert nurse utilizes multiple aspects of a client’s behavior (including the length of
each response to a question, and sounds the patient produces during contractions) in
addition to the more objective findings of the pelvic exam (including dilation of the
cervix) in the assessment of a laboring client. The expert nurse has identified that the
grunting and guttural sounds during contractions are involuntary pushing, and that the
client is very close to delivery.
2. Although most nurses have a routine when admitting a client, the order of the steps
will vary according to the situation at hand.
3. Changing the order of the steps of admission is not being inconsistent; changing the
order of the steps of admission is responsive to the needs of the client at that point in
time.
4. Advanced nurse practice describes educational and certification achievement, and is
not used to describe the continuum from novice to expert.
Cognitive level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Assessment
Chapter 1 Page 1 of 14
,Learning Outcome: 1.1 Distinguish between the education, qualifications, and scope of
practice in nurses caring for childbearing families.
Chapter 01 LO01 Q02
Currently, one-third of children under 20 years old come from families of minority
populations. The new nurse is observing her preceptor assess the patient’s
communication pattern, religious beliefs, level of education, and support system. The
new nurse understands that the best reason for her preceptor to assess these areas is to
increase the:
1. Patient’s cooperation with the plan of care.
2. Hospital’s compliance with JCAHO standards.
3. Nurse’s knowledge of cultural beliefs.
4. Patient’s satisfaction with her care.
Correct answer: 1
Rationale:
1. Gaining cooperation with the plan of care increases the outcome desired at
discharge. When a patient’s value system is not included in the plan of care, it
will decrease compliance with the treatment plan and possibly increase the length
of stay, and decrease the desired outcome at discharge.
2. Although compliance with JCAHO standards is very important, it is more
important to gain patient cooperation with the plan of care.
3. The nurse’s knowledge of cultural beliefs increases the ability to care for the
patient, but without patient cooperation with the plan of care, the nurse’s
knowledge is lost.
4. Patient satisfaction with care is important, but the prime reason for the satisfaction
is the nurse’s taking time to gain patient cooperation with the plan of care.
Cognitive Level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Planning
Chapter 1 Page 2 of 14
, Learning Outcome: 1.1 Distinguish between the education, qualifications, and scope of
practice in nurses caring for childbearing families.
Chapter 01_LO2 _Q03
The client is attending a clinic held in a church basement for her prenatal care. The
client’s care is provided by registered nurses and a certified nurse-midwife. This type of
prenatal care is an example of:
1. Secondary care.
2. Tertiary care.
3. Community care.
4. Unnecessarily costly care.
Correct Answer: 3
Rationale:
1. Secondary care is specialized care; an example is checking the hemoglobin A1C
of a diabetic at an endocrine clinic.
2. Tertiary care is very specialized, and includes trauma units and neonatal intensive
care units.
3. Prenatal care is primary care. Community care is often provided at clinics in
neighborhoods to facilitate access by clients to primary care, including prenatal care and
prevention of illness.
4. Community care decreases costs while improving client outcomes, and is not
unnecessarily expensive.
Cognitive level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Implementation
Learning Outcome: 1.2 Describe the use of community-based nursing care in meeting the
needs of childbearing families.
Chapter 01_LO03 _Q04
Chapter 1 Page 3 of 14
The Labor and Delivery nurse and a nurse new to the Labor and Delivery unit are
admitting a laboring client. The client is making groaning guttural sounds during
contractions, and answering questions with one-word answers. The Labor and Delivery
nurse simultaneously is quickly setting up the instruments and sterile field for this
delivery while asking the admission questions between contractions. The experienced
Labor and Delivery nurse has not yet completed a pelvic exam. The nurse new to Labor
and Delivery understands that this is an example of:
1. An expert nurse assessing advanced labor and imminent delivery in the
client.
2. The correct order of steps when admitting laboring clients.
3. Inconsistencies in an individual nurse’s approach to client care.
4. Advanced nurse practice.
Correct answer: 1
Rationale:
1. An expert nurse utilizes multiple aspects of a client’s behavior (including the length of
each response to a question, and sounds the patient produces during contractions) in
addition to the more objective findings of the pelvic exam (including dilation of the
cervix) in the assessment of a laboring client. The expert nurse has identified that the
grunting and guttural sounds during contractions are involuntary pushing, and that the
client is very close to delivery.
2. Although most nurses have a routine when admitting a client, the order of the steps
will vary according to the situation at hand.
3. Changing the order of the steps of admission is not being inconsistent; changing the
order of the steps of admission is responsive to the needs of the client at that point in
time.
4. Advanced nurse practice describes educational and certification achievement, and is
not used to describe the continuum from novice to expert.
Cognitive level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Assessment
Chapter 1 Page 1 of 14
,Learning Outcome: 1.1 Distinguish between the education, qualifications, and scope of
practice in nurses caring for childbearing families.
Chapter 01 LO01 Q02
Currently, one-third of children under 20 years old come from families of minority
populations. The new nurse is observing her preceptor assess the patient’s
communication pattern, religious beliefs, level of education, and support system. The
new nurse understands that the best reason for her preceptor to assess these areas is to
increase the:
1. Patient’s cooperation with the plan of care.
2. Hospital’s compliance with JCAHO standards.
3. Nurse’s knowledge of cultural beliefs.
4. Patient’s satisfaction with her care.
Correct answer: 1
Rationale:
1. Gaining cooperation with the plan of care increases the outcome desired at
discharge. When a patient’s value system is not included in the plan of care, it
will decrease compliance with the treatment plan and possibly increase the length
of stay, and decrease the desired outcome at discharge.
2. Although compliance with JCAHO standards is very important, it is more
important to gain patient cooperation with the plan of care.
3. The nurse’s knowledge of cultural beliefs increases the ability to care for the
patient, but without patient cooperation with the plan of care, the nurse’s
knowledge is lost.
4. Patient satisfaction with care is important, but the prime reason for the satisfaction
is the nurse’s taking time to gain patient cooperation with the plan of care.
Cognitive Level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Planning
Chapter 1 Page 2 of 14
, Learning Outcome: 1.1 Distinguish between the education, qualifications, and scope of
practice in nurses caring for childbearing families.
Chapter 01_LO2 _Q03
The client is attending a clinic held in a church basement for her prenatal care. The
client’s care is provided by registered nurses and a certified nurse-midwife. This type of
prenatal care is an example of:
1. Secondary care.
2. Tertiary care.
3. Community care.
4. Unnecessarily costly care.
Correct Answer: 3
Rationale:
1. Secondary care is specialized care; an example is checking the hemoglobin A1C
of a diabetic at an endocrine clinic.
2. Tertiary care is very specialized, and includes trauma units and neonatal intensive
care units.
3. Prenatal care is primary care. Community care is often provided at clinics in
neighborhoods to facilitate access by clients to primary care, including prenatal care and
prevention of illness.
4. Community care decreases costs while improving client outcomes, and is not
unnecessarily expensive.
Cognitive level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Implementation
Learning Outcome: 1.2 Describe the use of community-based nursing care in meeting the
needs of childbearing families.
Chapter 01_LO03 _Q04
Chapter 1 Page 3 of 14
