,MaternitynandnWomen'snHealthnCaren11thnEditionnLowdermilknTestnBankv
Chapter 01: 21st Century Maternity and Women’s Health NursingLowder milk: Materni
n n n n n n n n nv n
ty & Women’s Health Care, 11th Edition
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MULTIPLEnCHOICEv
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1.vInnevaluatingnthenlevelnofnanpregnantnwoman’snrisknofnhavingnanlow-
birthweightn(LBW)ninfant,whichn
nfactornisnthenmostnimportantnfornthennursentonconsider? va.v African-
Americannracev
b. Cigarettensmokingv
c. Poornnutritionalnstatusv
d. Limitednmaternalneducationv
ANS:nAv
FornAfrican-
Americannbirths,nthenincidencenofnLBWninfantsnisntwicenthatnofnCaucasiannbirths.nRacenisnannonvm
odifiablenrisknfactor.nCigarettensmokingnisnannimportantnfactorninnpotentialninfantnmortalitynratves,n
butnitnisnnotnthenmostnimportant.nAdditionally,nsmokingnisnanmodifiablenrisknfactor.nPoornnutrvitionn
isnannimportantnfactorninnpotentialninfantnmortalitynrates,nbutnitnisnnotthen
nmostnimportant.nAvdditionally,nnutritionalnstatusnisnanmodifiablenrisknfactor.nMaternalnedu
cationnisnannimportantnfacvtorninnpotentialninfantnmortalitynrates,nbutnitnisnnotnthenmostnimportant.nA
dditionally,nmaternalnedvucationnisnanmodifiablenrisknfactor.v
v
DIF:vCognitivenLevel:nUnderstand
v REF:np.n6TOP:n n NursingnProcess:nAssessmentv
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MSC:nvClientnNeeds:nHealthnPromotionnandnMaintenance,nAntepartumnCarev
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2. Whatnisnthenprimarynrolenofnpracticingnnursesninvthevresearchnprocess?v
a. DesigningnresearchnstudiesNURnSnNInTGvB.COMv
b. Collectingndatanfornothernresearchersv
c. Identifyingnresearchablenproblemsv
d. Seekingnfundingntonsupportnresearchnstudiesv
ANS:nvCv
Whennproblemsnarenidentified,nresearchncannbenproperlynconducted.nResearchnofnhealthncarenisvsue
snleadsntonevidencebasednpracticenguidelines.nDesigningnresearchnstudiesnisnonlynonenfactornofnthen
researchnproces
s.nDatancollectionnisnanothernfactornofnresearch.nFinancialnsupportisnvnnecessaryntonconductnresearvc
h,nbutnitnisnnotnthenprimarynrolenofnthennurseninnthenresearchnprocess.v
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DIF:vCognitivenLevel:nUnderstandv REF:nnnp.n14
v TOP:nvNursingnProcess:nN/AMSC:n n ClientnNeeds:nSafenandnEffectivenCarenEnvironmentv
v
v
3. An23-year-oldnAfrican-
Americannwomannisnpregnantnwithnhernfirstnchild.nBasednonnthenstatisticsnforninfantnmorta
vlity,nwhichnplannisnmostnimportantnfornthennursentonimplement? va.vPerformnannutritionnass
essment.v
b. Refernthenwomanntonansocialnworker.v
c. Advisenthenwomanntonseenannobstetrician,nnotnanmidwife.v
d. Explainntonthenwomannthenimportancenofnkeepingnhernprenatalncarenappointments.v
ANS:nDv
Consistentnprenatalncarenisnthenbestnmethodnofnpreventingnorncontrollingnrisknfactorsnassociatednvw
ithninfantnmortality.nNutritionalnstatusnisnannimportantnmodifiablenrisknfactor,nbutnitnisnnotnthemnvos
tnimportantnactionnannursenshouldntakeninnthisnsituation.nThenclientnmaynneednassistancenfromnavnsoc
ialnworkernatnsomentimenduringnhernpregnancy,nbutnanreferralntonansocialnworkernisnnotnthenmovstnim
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,MaternitynandnWomen'snHealthnCaren11thnEditionnLowdermilknTestnBankv
portantnaspectnthennursenshouldnaddressnatnthisntime.nIfnthenwomannhasnidentifiablenhighrisknproble
ms,nthennhernhealthncarenmaynneedntonbenprovidednbynanphysician.nHowever,nitncannotvnbenassumed
nthatnallnAfrican-
Americannwomennhavenhighrisknissues.nInnaddition,nadvisingnthenwomanntonseenannobstetriciannisn
notnthenmostnimportantnaspvectnonnwhichthen
nnursenshouldnfocusnatnthisntime,nandnitnisnnotnappropriatenfornannursentonadvisenorvnmanagent
hentypenofncarenanclientnisntonreceive.v
v
DIF:vCognitivenLevel:nUnderstandv REF:nnnp.n6
v TOP:nvNursingnProcess:nPlanningMSC:n n ClientnNeeds:nHealthnPromotionnandnMaintenancev
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4. Duringnanprenatalnintakeninterview,nthennursenisninnthenprocessnofnobtainingnanninitialnassessmen
t ofnan21-yearoldnHispanicnclientnwithnlimitednEnglishnproficiency.nWhichnactionnisthen
v n
nmostnimportantnfornthevnnursentonperform? v
a. Usenmaternitynjargonntonenablenthenclientntonbecomenfamiliarnwithnthesenterms.v
b. Speaknquicklynandnefficientlyntonexpeditenthenvisit.v
c. Providenthenclientnwithnhandouts.v
d. Assessnwhethernthenclientnunderstandsnthendiscussion.v
ANS:nDv
Nursesncontributentonhealthnliteracynbynusingnsimple,ncommonnwords,navoidingnjargon,nandnevalv
uatingnwhethernthenclientnunderstandsnthendiscussion.nSpeakingnslowlynandnclearlynandnfocusingn
vonnwhatnisnimportantnwillnincreasenunderstanding.nMostnclientneducationnmaterialsnarewnvrittenna
tnvanlevelntoonhighnforvthevaveragenadultnandvmaynnotnbenusefulnfornanclientnwithnlimitedv
NvRvIvGvB.CvMvEnglishnproficiency.v
USNT n n n v O v
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DIF:vCognitivenLevel:nApplyv REF:nnnp.n5
v TOP:nvNursingnProcess:nEvaluationMSC:n
n ClientnNeeds:nHealthnPromotionnandnMaintenancev
v
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5. Thennursesnworkingnatnannewlynestablishednbirthingncenternhavenbegunntoncomparentheirnperforv
manceninnprovidingnmaternalnewbornncarenagainstnclinicalnstandards.nThisncomparisonprocessn
vnisnmostncommonlynknownnasvnwhat? v
a. Bestnpracticesnnetworkv
b. Clinicalnbenchmarkingv
c. Outcomes-orientednpracticev
d. Evidence-basednpracticev
ANS:nCv
Outcomes-
orientednpracticenmeasuresntheneffectivenessnofntheninterventionsnandnqualitynofncareagainstn
nbenvchmarksnornstandards.nThentermnbestnpracticenrefersntonanprogramnornservicenthatnhasnb
eennrecogvnizednfornitsnexcellence.nClinicalnbenchmarkingnisnanprocessnusedntoncomparenone’snow
nnperforvmancenagainstnthenperformancenofnthenbestninnannareanofnservice.nThentermnevidencebased
npracticenrefersntonthenprovisionnofncarenbasednonnevidencengainednthroughnresearchnandnclivnicalntr
ials.v
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DIF:vCognitivenLevel:nUnderstandv REF:nnnp.n11
v TOP:nvNursingnProcess:nEvaluationMSC:n
n ClientnNeeds:nSafenandnEffectivenCarenEnvironmentv
v
6. Whichnstatementnbestnexemplifiesncontemporarynmaternitynnursing?v
a. Usenofnmidwivesnfornallnvaginalndeliveriesv
b. Family-centeredncarev
c. Free-standingnbirthnclinicsv
d. Physician-drivenncarev
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, MaternitynandnWomen'snHealthnCaren11thnEditionnLowdermilknTestnBankv
ANS:nBv
Contemporarynmaternitynnursingnfocusesnonnthenfamily’snneedsnandndesires.nFathers,npartners,ngvr
andparents,nandnsiblingsnmaynbenpresentnfornthenbirthnandnparticipateninnactivitiesnsuchnasncuttivngnt
henbaby’snumbilicalncord.nBothnmidwivesnandnphysiciansnperformnvaginalndeliveries.nFreestandin
gnclinicsnarenannexamplenofnalternativenbirthnoptions.nContemporarynmaternitynnursingnivsndrivennb
ynthenrelationshipnbetweennnursesnandntheirnclients.v
v
DIF:vCognitivenLevel:nUnderstandv REF:nnnpp.n8-9
v TOP:nvNursingnProcess:nPlanningMSC:n n ClientnNeeds:nHealthnPromotionnandnMaintenancev
v
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7. An38-year-oldnHispanicnwomannvaginallyndeliverednan9-
pound,n6ouncenbabyngirlnafternbeinginnvnlabornforn43nhours.nThenbabyndiedn3ndaysnlaternfromnsep
sis.nOnnwvhatngroundsncouldnthenwomannhavenanlegitimatenlegalncasenfornnegligence?va.vInexper
iencednmaternitynnursenwasnassignedntoncarenfornthenclient.v
b. Clientnwasnpastnhernduendatenbyn3ndays.v
c. Standardnofncarenwasnnotnmet.v
d. Clientnrefusednelectronicnfetalnmonitoring.v
ANS:nCv
Notnmeetingnthenstandardnofncarenisnanlegitimatenfactornfornancasenofnnegligence.nAnninexperivence
dnmaternitynnursenwouldnneedntondisplayncompetencynbeforenbeingnassignedntocanvrenfornc
lientsnonnhisnornhernoNwUnR.nTShIisNcGlieTnBtnm.aCyOhMavenbeennpastnhernduendate;nho
wever,navtermnpregnancynoftenngoesnbeyondn40nweeksnofngestation.nAlthoughnfetalnmonitoringnisnt
hevstandardnofncare,nthenclientnhasnthenrightntonrefusentreatment.nThisnrefusalnisnnotnancasenfornnegli
gevnce,nbutninformednconsentnshouldnbenproperlynobtained,nandnthenclientnshouldnhavensignednanna
gvainstnmedicalnadvicenformnwhennrefusingnanyntreatmentnthatnisnwithinnthenstandardofn ncare.v
v
DIF:vCognitivenLevel:nAnalyze
v REF:np.n13TOP:n
n NursingnProcess:nImplementatiovnv
v
MSC:nvClientnNeeds:nSafenandnEffectivenCarenEnvironmentv
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8.vWhennthennursenisnunsurenhowntonperformnanclientncarenprocedurenthatnisnhighnrisknandnlowvnv
olume,nhisnornhernbestnactionninnthisnsituationnwouldnbenwhat?va.vAsknanothernnurse.v
b. Discussnthenprocedurenwithnthenclient’snphysician.v
c. Looknupnthenprocedureninnannursingntextbook.v
d. Consultnthenagencynprocedurenmanual,nandnfollownthenguidelinesnfornthenprocedure.v
ANS:nDv
Followingnthenagency’snpoliciesnandnproceduresnmanualnisnalwaysnbestnwhennseekingninformatiov
nnonncorrectnclientnprocedures.nThesenpoliciesnshouldnreflectnthencurrentnstandardsnofcaren
nandnthevnindividualnstate’snguidelines.nEachnnursenisnresponsiblenfornhisnornhernownnpractic
e.nRelyingnonnvanothernnursenmaynnotnalwaysnbenansafenpractice.nEachnnursenisnobligatedntonfollown
thenstandardsnvofncarenfornsafenclientncarendelivery.nPhysiciansnarenresponsiblenforntheirownn
nclientncarenactivity.nvNursesnmaynfollownsafenordersnfromnphysicians,nbutntheynarenalsonres
ponsiblenfornthenactivitiesntvhatnthey,nasnnurses,narentoncarrynout.nInformationnprovidedninnannursing
ntextbooknisnbasicninformavtionnforngeneralnknowledge.nFurthermore,ntheninformationninnantextboo
knmaynnotnreflectnthencurrventnstandardnofncarenornthenindividualnstatenornhospitalnpolicies.v
v
DIF:vCognitivenLevel:nUnderstandv REF:nvp.n13v
TOP:nvNursingnProcess:nImplementationv MSC:nvClientnNeeds:nPhysiologicnIntegrityv
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9. ThenNationalnQualitynForumnhasnissuednanlistnofn“nevernevents”nspecificallynpertainingntonvmatern
alnandnchildnhealth.nThesenincludenallnofnthenfollowingnexcept:va.vinfantndischargedntonthenwrongnpe
rson.v
b. kernicterusnassociatednwithnthenfailurentonidentifynandntreatnhyperbilirubinemia.v
c. artificialninseminationnwithnthenwrongndonornspermnornegg.v
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