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Chapter 01: The Past, Present, and Future
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MULTIPLE CHOICE n
1. A patient chooses to have the certified nurse-midwife (CNM) provide care during her
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n pregnancy. What does the CNM’s scope of practice include? n n n n n n n n
a. Practice independent from medical supervision n n n n
b. Comprehensive prenatal care n n
c. Attendance at all deliveries n n n
d. Cesarean sections n
ANS: B n
The CNM provides comprehensive prenatal and postnatal care, attends uncomplicated
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deliveries, and ensures that a backup physician is available in case of unforeseen problems.
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DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5 n n n n n n n
TOP: Advance Practice Nursing Roles
n KEY: Nursing Process Step: Implementation n n n n n n n
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
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2. Which medical pioneer discovered the relationship between the incidence of puerperal fever and
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nunwashed hands? n
a. Karl Credé n
b. Ignaz Semmelweis n
c. Louis Pasteur n
d. Joseph Lister n
ANS: B n
Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by the unwashed
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hands of physicians and medical students.
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DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: n n n n
n1 TOP: The Past KEY: Nursing Process Step: N/A
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MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
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3. A pregnant woman who has recently immigrated to the United States comments to the nurse, “I
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nam afraid of childbirth. It is so dangerous. I am afraid I will die.” What is the best nursing
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nresponse reflecting cultural sensitivity? n n n
a. “Maternal mortality in the United States is extremely low.” n n n n n n n n
b. “Anesthesia is available to relieve pain during labor and childbirth.” n n n n n n n n n
c. “Tell me why you are afraid of childbirth.” n n n n n n n
d. “Your condition will be monitored during labor and delivery.”
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ANS: C n
Asking the patient about her concerns helps promote understanding and individualizes patient
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care.
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DIF: Cognitive Level: Application REF: pp. 6-8 OBJ: 8 n n n n n n n
TOP: Cross-Cultural Care n KEY: Nursing Process Step: Implementation n n n n n
MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation
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,4. An urban area has been reported to have a high perinatal mortality rate. What information does
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n this provide?
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a. Maternal and infant deaths per 100,000 live births per year n n n n n n n n n
b. Deaths of fetuses weighing more than 500 g per 10,000 births per year
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c. Deaths of infants up to 1 year of age per 1000 live births per year
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d. Fetal and neonatal deaths per 1000 live births per year
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ANS: D n
The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.
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DIF: Cognitive Level: Comprehension REF: p. 13 | Box 1.6 n n n n n n n
OBJ:
n n 9 TOP: The Present-Child Care n n n
KEY: n Nursing Process Step: Implementation n n n
MSC: n NCLEX: Safe, Effective Care Environment: Coordinated Care n n n n n n
5. What is the focus of current maternity practice?
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a. Hospital births for the majority of women n n n n n n
b. The traditional family unit n n n
c. Separation of labor rooms from delivery rooms n n n n n n
d. A quality family experience for each patient
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ANS: D n
Current maternity practice focuses on a high-quality family experience for all families, traditional
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or otherwise.
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DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5 n n n n n
TOP: The Present-Maternity Care
n n KEY: Nursing Process Step: N/A n n n n n n
MSC: NCLEX: Health Promotion and Maintenance
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6. Who advocated the establishment of the Children’s Bureau?
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a. Lillian Wald n
b. Florence Nightingale n
c. Florence Kelly n
d. Clara Barton n
ANS: A n
Lillian Wald is credited with suggesting the establishment of a federal Children’s Bureau.
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DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 1 | 2 n n n n n n n
TOP: The Past
n KEY: Nursing Process Step: Implementation
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MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
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7. What was the result of research done in the 1930s by the Children’s Bureau?
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a. Children with heart problems are now cared for by pediatric cardiologists. n n n n n n n n n n
b. The ChildAbuse and Prevention Act was passed.
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c. Hot lunch programs were established in many schools.
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d. Children’s asylums were founded. n n n
ANS: C n
School hot lunch programs were developed as a result of research by the Children’s Bureau on the
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effects of economic depression on children.
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DIF: Cognitive Level: Knowledge n n REF: p. 4 n n n OBJ: 2 | 3 n n n n
, TOP: The Past KEY: Nursing Process Step: N/A
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MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
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8. What government program was implemented to increase the educational exposure of
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npreschool children? n
a. WIC
b. Title XIX of Medicaid n n n
c. The Children’s Charter n n
d. Head Start n
ANS: D n
Head Start programs were established to increase educational exposure of preschool children.
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DIF: Cognitive Level: Knowledge REF: p. 3 OBJ: 3 n n n n n n n
TOP: Government Influences in Maternity and Pediatric Care
n KEY: Nursing Process Step: N/A n n n n n n n n n n
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
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9. What guidelines define multidisciplinary patient care in terms of expected outcome and
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ntimeframe from different areas of care provision? n n n n n n
a. Clinical pathways n
b. Nursing outcome criteria n n
c. Standards of care n n
d. Nursing care plan n n
ANS: A n
Clinical pathways, also known as critical pathways or care maps, are collaborative guidelines that
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define patient care across disciplines. Expected progress within a specified timeline is identified.
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DIF: Cognitive Level: Knowledge REF: p. 13 OBJ: 10 n n n n n
TOP: Health Care Delivery Systems
n n KEY: Nursing Process Step: N/A n n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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10. A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her mother, and
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ncollected admission data. What is the next step the student will take to develop a nursing care plan
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nfor this child?
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a. Identify measurable outcomes with a timeline. n n n n n
b. Choose specific nursing interventions for the child. n n n n n n
c. Determine appropriate nursing diagnoses. n n n
d. State nursing actions related to the child’s medical diagnosis.
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ANS: C n
The nurse uses assessment data to select appropriate nursing diagnoses. Outcomes and
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interventions are then developed to address the relevant nursing diagnoses.
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DIF: Cognitive Level: Application REF: p. 12 OBJ: 7 n n n n n n n
TOP: Nursing Process n KEY: Nursing Process Step: Nursing Diagnosis n n n n n n
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
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11. A nursing student on an obstetric rotation questions the floor nurse about the definition of the
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nLVN/LPN scope of practice. What resource can the nurse suggest to the student?
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a. American Nurses Association n n