CH1 Contemporary Maternal, Newborn, and Child Health Nursing exam| 20 questions and answers

A nurse is examining different nursing roles. Which statement best illustrates an advanced practice nursing role? 1. A registered nurse who is the manager of a large obstetric unit 2. A clinical nurse specialist working as a staff nurse on a mother-baby unit 3. A registered nurse who is the circulating nurse at surgical deliveries (cesarean sections) 4. A clinical nurse specialist with whom other nurses consult for this nurse's expertise in caring for high-risk infants Answer: 4 Explanation: 1. A registered nurse who is the manager of a large obstetric unit or one who is a circulating nurse at surgical deliveries (cesarean sections) is defined as a professional nurse, and has graduated from an accredited program in nursing and completed the licensure examination. 2. A clinical nurse specialist working as a staff nurse on a mother-baby unit might have the qualifications for an advanced practice nursing staff but is not working in that capacity. 3. A registered nurse who is the manager of a large obstetric unit or one who is a circulating nurse at surgical deliveries (cesarean sections) is defined as a professional nurse, and has graduated from an accredited program in nursing and completed the licensure examination. 4. A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk infants would illustrate an advanced practice nursing role. This nurse has specialized knowledge and competence in a specific clinical area, and is master's-prepared. What is the major focus of the nurse practitioner (NP)? 1. Leadership 2. Tertiary prevention 3. Physical and psychosocial clinical assessment 4. Independent care of the high-risk, pregnant client Answer: 3 Explanation: 1. Leadership might be a quality of the NP, but it is not the major focus. 2. The NP cannot do tertiary prevention as a major focus. 3. Physical and psychosocial clinical assessment is the major focus of the NP. 4. NPs cannot provide independent care of the high-risk pregnant client, but must work under a physician's supervision. What is the role of the certified nurse-midwife (CNM)? Select all that apply. 1. Give primary care for healthy newborns. 2. Be educated in two disciplines of nursing. 3. Give primary care for high-risk clients who are in hospital settings. 4. Obtain a physician consultation for all technical procedures at delivery. 5. Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth. Answer: 1, 2, 5 Explanation: 1. The CNM is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns. 2. The CNM is educated in the disciplines of nursing and midwifery. 3. CNMs cannot give primary care for high-risk clients who are in hospital settings. The physician provides the primary care. 4. The CNM does not need to obtain a physician consultation for all technical procedures at delivery. Situations in which the client is at risk, such as for a 4th-degree laceration or forceps delivery, would need physician consultation. 5. The CNM is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns. 4) During the hospital admission process, a child's parent asks for information about family-centered care. What should the nurse explain to this parent? 1. Mother is the principal caregiver in each family. 2. Father is the leader in each home; thus, all communications should include him. 3. Family serves as the constant influence and continuing support in the child's life. 4. Child's physician is the key person in ensuring the health of a child is maintained. Answer: 3 Explanation: 1. Culturally competent care recognizes that both matriarchal and patriarchal households exist. 2. Culturally competent care recognizes that both matriarchal and patriarchal households exist. 3. The foundation for the development of trusting relationships and partnerships with families is the recognition that the family is the principal caregiver, knows the unique nature of each individual child best, plays the vital role of meeting the child's needs, and is responsible for ensuring each child's health. 4. The physician is not present during the day-to-day routines in a child's life. A child is not enrolled in the Children's Health Insurance Program (CHIP). What should the nurse do to encourage the family to consider enrolling the child in this program? 1. Assessment of the details of the family's income and expenditures 2. Case management to limit costly, unnecessary duplication of services 3. Advocacy for the child by encouraging the family to investigate its CHIP eligibility 4. Education of the family about the need for keeping regular well-child visit appointments. Answer: 3 Explanation: 1. Financial assessment is more commonly the function of a social worker. 2. The case management activity mentioned will not provide a source of funding. 3. In the role of an advocate, a nurse will advance the interests of another by suggesting the family investigate its CHIP eligibility. 4. The educational effort described will not provide a source of funding. 6) The nurse is evaluating telephone calls made by the mothers of newborns in a community clinic. Which calls should the nurse make a priority? Select all that apply. 1. Mother who is 16 years old 2. Mother who is breastfeeding 3. Mother who is a single parent 4. Mother who gave birth to twins 2 weeks ago 5. Mother whose baby was born at 30 weeks' gestation Answer: 1, 3, 4, 5 Explanation: 1. Infant mortality rates are higher for infants of teen mothers. 2. There are no data to support the mortality rate of infants who are being breastfed. 3. Infant mortality rates are higher among unmarried mothers. 4. Infant mortality rates are higher among infants born in multiple births. 5. Infant mortality rates are higher among infants born prematurely. 7) What is the maternity nurse's best defense against an accusation of malpractice or negligence? 1. Follows the physician's written orders 2. Acts on the advice of the nurse manager 3. Becomes certified as a nurse-midwife or nurse practitioner 4. Meets the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) standards of practice Answer: 4 Explanation: 1. Following the physician's written orders is not enough to defend the nurse from accusations because the orders and/or advice might be wrong or unethical. 2. Acting on the advice of the nurse manager is not enough to defend the nurse from accusations because the orders and/or advice might be wrong or unethical. 3. Being a certified nurse-midwife or nurse practitioner does not defend the nurse against these accusations if she does not follow the AWHONN standards of practice. 4. Meeting the AWHONN standards of practice would cover the maternity nurse against an accusation of malpractice or negligence because the standards are rigorous and cover all bases of excellent nursing practice. 8) The nurse is coordinating a clinical research trial with pediatric clients. From which clients should the nurse seek assent to participate in the research? Select all that apply. 1. A 9-year-old client who qualifies to test a medication for muscular dystrophy 2. A precocious 4-year-old starting as a participant in a cystic fibrosis research study 3. A 10-year-old starting in an investigative study for clients with precocious puberty 4. A 7-year-old client with leukemia who has elected to receive a newly developed trial medication 5. A 13-year-old client beginning participation in a research program for attention deficit/hyperactivity disorder (ADHD) treatments Answer: 1, 3, 4, 5 Explanation: 1. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments, and give assent. 2. The 4-year-old patient would qualify since the age of assent is 7 years old. 3. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments, and give assent. 4. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments, and give assent. 5. Federal guidelines mandate that research participants 7 years old and older must receive developmentally appropriate information about healthcare procedures and treatments, and give assent. 9) A 12-year-old pediatric client is in need of surgery. Which healthcare member is legally responsible for obtaining informed consent for an invasive procedure? 1. The nurse 2. The physician 3. The social worker 4. The unit secretary Answer: 2 Explanation: 1. The nurse is not legally responsible for obtaining informed consent for an invasive procedure. 2. Informed consent is legal preauthorization for an invasive procedure. It is the physician's legal responsibility to obtain this because it consists of an explanation about the medical condition, a detailed description of treatment plans, the expected benefits and risks related to the proposed treatment plan, alternative treatment options, the client's questions, and the client's or guardian's right to refuse treatment. 3. It is beyond the social worker's scope of practice to obtain informed consent for an invasive procedure. 4. It is beyond the unit secretary's scope of practice to obtain informed consent for an invasive procedure. 10) The nurse tells family members the sex of a newborn baby without first consulting the parents. Which act did this nurse commit? 1. Negligence 2. Malpractice 3. A breach of ethics 4. Breach of privacy Answer: 4 Explanation: 1. Any nurse who fails to meet appropriate standards of care invites allegations of negligence. 2. Any nurse who fails to meet appropriate standards of care invites allegations of malpractice. 3. A breach of ethics would not apply to this situation. 4. A breach of privacy would have been committed in this situation, because it violates the right to privacy of this family. The right to privacy is the right of a person to keep his or her person and property free from public scrutiny (of even other family members). 11) The nurse is reviewing the 1973 Supreme Court decision in Roe v. Wade for a patient asking about an abortion. What should the nurse explain about the induction of a legal abortion? 1. It must be performed at a federally funded clinic. 2. It must be performed before the period of viability. 3. It must be performed at a military hospital overseas. 4. It must be performed to provide tissue for therapeutic research. Answer: 2 Explanation: 1. Whether conducted at a federally funded clinic, abortion can be provided legally if under U.S. laws. 2. Abortion can be performed legally until the period of viability; after viability, the rights of the fetus take precedence. 3. Whether or not conducted at a military hospital overseas, abortion can be provided legally if under U.S. laws. 4. Abortion cannot be used to provide tissue for therapeutic research. 12) Which family might find cord blood banking to be especially useful? 1. A family with a history of leukemia 2. A family with a history of infertility 3. A family that wishes to select the sex of a future child 4. A family that wishes to avoid a future intrauterine fetal surgery Answer: 1 Explanation: 1. Families with a history of leukemia might find cord blood banking useful because cord blood, like bone marrow and embryonic tissue, contains regenerative stem cells, which can replace diseased cells in the affected individual. 2. A family with a history of infertility would not be helped by cord blood banking. 3. A family that wishes to select the sex of a future child would not be helped by cord blood banking. 4. A family that wishes to avoid a future intrauterine surgery would not be helped by cord blood banking. 13) A nurse is providing guidance to a group of parents of children in the infant-to-preschool age group. After reviewing statistics on the most common cause of death in this age group, what information should the nurse include about prevention? 1. Reduce the use of pesticides in the home to prevent cancer. 2. Review swimming pool and traffic accidents to prevent accidental injury. 3. Incorporate heart-healthy foods into the child's diet to prevent heart disease. 4. Provide a diet high in vitamin C from fruits and vegetables to prevent pneumonia. Answer: 2 Explanation: 1. Cancer is not a common cause of death for this age group. 2. Unintentional injuries are the most common cause of death for children between 1 and 19 years old. In children 1 to 4 years old, this is followed by drowning; fire and burns; suffocation; and pedestrian-related injuries. 3. Heart disease is not a common cause of death for this age group. 4. Pneumonia is not a common cause of death for this age group. 14) Which practices characterize the basic competencies related to evidence-based practice? Select all that apply. 1. Clinical practice supported by data 2. Clinical practice that promotes quality 3. Clinical practice supported by good evidence 4. Clinical practice supported by intuitive evidence 5. Clinical practice that provides a useful approach to problem solving Answer: 1, 2, 3, 5 Explanation: 1. Supported by data is a hallmark characteristic of the basic competencies related to evidence-based practice. 2. Promoting quality is a hallmark characteristic of the basic competencies related to evidence-based practice. 3. Supported by good evidence is a hallmark characteristic of the basic competencies related to evidence-based practice. 4. Clinical practice supported by intuitive evidence does not provide valid evidence and data for the proper actions. 5. Providing a useful approach to problem solving is a hallmark characteristic of the basic competencies related to evidence-based practice. 15) The maternal-child nurse is caring for a teenager who is 16 weeks pregnant. What actions should the nurse perform when advocating for this client? Select all that apply. 1. Understand what the client needs. 2. Know the needs of the client's family. 3. Compile a list of community resources. 4. Coordinate services to meet quality measures. 5. Examine policies to ensure meeting the client's needs. Answer: 1, 2, 3, 5 Explanation: 1. To be an effective advocate, the nurse must be aware of the individual's needs. 2. To be an effective advocate, the nurse must be aware of the family's needs. 3. To be an effective advocate, the nurse must be aware of the healthcare services available in the hospital and the community. The nurse can then assist the family to make informed choices about these services and to act in their best interests. 4. Case management is a process of coordinating the delivery of healthcare services in a manner that focuses on quality outcomes. 5. To be an effective advocate, nurses must also ensure that the policies and resources of healthcare agencies meet the psychosocial needs of childbearing women and of children and their families. 16) The nurse is establishing criteria for a medical or healthcare home for children. What should the nurse include when planning this approach to care? Select all that apply. 1. Providers partner with the family. 2. Children are known by the provider. 3. Home visits are made when necessary. 4. Specialty care can be accessed if necessary. 5. Communication with family occurs routinely. Answer: 1, 2, 4, 5 Explanation: 1. Criteria for a medical or healthcare home for children include partnering with the family in the child's care. 2. Criteria for a medical or healthcare home for children include being well known by a physician or nurse who provides the usual source of sick care. 3. Home visits are a part of home care. 4. Criteria for a medical or healthcare home for children include having access to specialty care. 5. Criteria for a medical or healthcare home for children include spending adequate time communicating clearly with the family.