Chapter 01: The Past, Present, and Future
Leifer: Introduction to Maternity and Pediatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient chooses to have the certified nurse-midwife (CNM) provide care during her pregnancy.
What does the CNM’s scope of practice include?
a. Practice independent from medical supervision
b. Comprehensive prenatal care
c. Attendance at all deliveries
d. Cesarean sections
ANS: B
The CNM provides comprehensive prenatal and postnatal care, attends uncomplicated deliveries,
and ensures that a backup physician is available in case of unforeseen problems.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: Advance Practice Nursing Roles KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
2. Which medical pioneer discovered the relationship between the incidence of puerperal fever and
unwashed hands?
a. Karl Credé
b. Ignaz Semmelweis
c. Louis Pasteur
d. Joseph Lister
ANS: B
Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by the
unwashed hands of physicians and medical students.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: The Past KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
3. A pregnant woman who has recently immigrated to the United States comments to the nurse, “I
am afraid of childbirth. It is so dangerous. I am afraid I will die.” What is the best nursing
response reflecting cultural sensitivity?
a. “Maternal mortality in the United States is extremely low.”
b. “Anesthesia is available to relieve pain during labor and childbirth.”
c. “Tell me why you are afraid of childbirth.”
d. “Your condition will be monitored during labor and delivery.”
ANS: C
Asking the patient about her concerns helps promote understanding and individualizes patient
care.
DIF: Cognitive Level: Application REF: pp. 6-8 OBJ: 8
, TOP: Cross-Cultural Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation
4. An urban area has been reported to have a high perinatal mortality rate. What information does
this provide?
a. Maternal and infant deaths per 100,000 live births per year
b. Deaths of fetuses weighing more than 500 g per 10,000 births per year
c. Deaths of infants up to 1 year of age per 1000 live births per year
d. Fetal and neonatal deaths per 1000 live births per year
ANS: D
The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.
DIF: Cognitive Level: Comprehension REF: p. 12|Box 1-6
OBJ: 9 TOP: The Present-Child Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. What is the focus of current maternity practice?
a. Hospital births for the majority of women
b. The traditional family unit
c. Separation of labor rooms from delivery rooms
d. A quality family experience for each patient
ANS: D
Current maternity practice focuses on a high-quality family experience for all families,
traditional or otherwise.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: The Present-Maternity Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance
6. Who advocated the establishment of the Children’s Bureau?
a. Lillian Wald
b. Florence Nightingale
c. Florence Kelly
d. Clara Barton
ANS: A
Lillian Wald is credited with suggesting the establishment of a federal Children’s Bureau.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 1 | 2
TOP: The Past KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
7. What was the result of research done in the 1930s by the Children’s Bureau?
a. Children with heart problems are now cared for by pediatric cardiologists.
b. The Child Abuse and Prevention Act was passed.
c. Hot lunch programs were established in many schools.
d. Children’s asylums were founded.
, ANS: C
School hot lunch programs were developed as a result of research by the Children’s Bureau on
the effects of economic depression on children.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 2 | 3
TOP: The Past KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
8. What government program was implemented to increase the educational exposure of preschool
children?
a. WIC
b. Title XIX of Medicaid
c. The Children’s Charter
d. Head Start
ANS: D
Head Start programs were established to increase educational exposure of preschool children.
DIF: Cognitive Level: Knowledge REF: p. 3 OBJ: 3
TOP: Government Influences in Maternity and Pediatric Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
9. What guidelines define multidisciplinary patient care in terms of expected outcome and
timeframe from different areas of care provision?
a. Clinical pathways
b. Nursing outcome criteria
c. Standards of care
d. Nursing care plan
ANS: A
Clinical pathways, also known as critical pathways or care maps, are collaborative guidelines
that define patient care across disciplines. Expected progress within a specified timeline is
identified.
DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 10
TOP: Health Care Delivery Systems KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her mother,
and collected admission data. What is the next step the student will take to develop a nursing
care plan for this child?
a. Identify measurable outcomes with a timeline.
b. Choose specific nursing interventions for the child.
c. Determine appropriate nursing diagnoses.
d. State nursing actions related to the child’s medical diagnosis.
ANS: C
The nurse uses assessment data to select appropriate nursing diagnoses from the NANDA-I list.
Outcomes and interventions are then developed to address the relevant nursing diagnoses.
, DIF: Cognitive Level: Application REF: p. 11 OBJ: 7
TOP: Nursing Process KEY: Nursing Process Step: Nursing Diagnosis
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
11. A nursing student on an obstetric rotation questions the floor nurse about the definition of the
LVN/LPN scope of practice. What resource can the nurse suggest to the student?
a. American Nurses Association
b. State’s board of nursing
c. Joint Commission
d. Association of Women’s Health, Obstetric and Neonatal Nurses
ANS: B
The scope of practice of the LVN/LPN is published by the state’s board of nursing.
DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: 2
TOP: Critical Thinking KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
12. What was recommended by Karl Credé in 1884?
a. All women should be delivered in a hospital setting.
b. Chemical means should be used to combat infection.
c. Podalic version should be done on all fetuses.
d. Silver nitrate should be placed in the eyes of newborns.
ANS: D
In 1884 Karl Credé recommended the use of 2% silver nitrate in the eyes of newborns to reduce
the incidence of blindness.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: Use of Silver Nitrate KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
13. What is the purpose of the White House Conference on Children and Youth?
a. Set criteria for normal growth patterns.
b. Examine the number of live births in minority populations.
c. Raise money to support well-child clinics in rural areas.
d. Promote comprehensive child welfare.
ANS: D
White House Conferences on Children and Youth are held every 10 years to promote
comprehensive child welfare.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 2
TOP: White House Conferences KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
14. How many hours of hospital stay does legislation currently allow for a postpartum patient who
has delivered vaginally without complications?
a. 24
Leifer: Introduction to Maternity and Pediatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient chooses to have the certified nurse-midwife (CNM) provide care during her pregnancy.
What does the CNM’s scope of practice include?
a. Practice independent from medical supervision
b. Comprehensive prenatal care
c. Attendance at all deliveries
d. Cesarean sections
ANS: B
The CNM provides comprehensive prenatal and postnatal care, attends uncomplicated deliveries,
and ensures that a backup physician is available in case of unforeseen problems.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: Advance Practice Nursing Roles KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
2. Which medical pioneer discovered the relationship between the incidence of puerperal fever and
unwashed hands?
a. Karl Credé
b. Ignaz Semmelweis
c. Louis Pasteur
d. Joseph Lister
ANS: B
Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by the
unwashed hands of physicians and medical students.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: The Past KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
3. A pregnant woman who has recently immigrated to the United States comments to the nurse, “I
am afraid of childbirth. It is so dangerous. I am afraid I will die.” What is the best nursing
response reflecting cultural sensitivity?
a. “Maternal mortality in the United States is extremely low.”
b. “Anesthesia is available to relieve pain during labor and childbirth.”
c. “Tell me why you are afraid of childbirth.”
d. “Your condition will be monitored during labor and delivery.”
ANS: C
Asking the patient about her concerns helps promote understanding and individualizes patient
care.
DIF: Cognitive Level: Application REF: pp. 6-8 OBJ: 8
, TOP: Cross-Cultural Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation
4. An urban area has been reported to have a high perinatal mortality rate. What information does
this provide?
a. Maternal and infant deaths per 100,000 live births per year
b. Deaths of fetuses weighing more than 500 g per 10,000 births per year
c. Deaths of infants up to 1 year of age per 1000 live births per year
d. Fetal and neonatal deaths per 1000 live births per year
ANS: D
The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.
DIF: Cognitive Level: Comprehension REF: p. 12|Box 1-6
OBJ: 9 TOP: The Present-Child Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
5. What is the focus of current maternity practice?
a. Hospital births for the majority of women
b. The traditional family unit
c. Separation of labor rooms from delivery rooms
d. A quality family experience for each patient
ANS: D
Current maternity practice focuses on a high-quality family experience for all families,
traditional or otherwise.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5
TOP: The Present-Maternity Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance
6. Who advocated the establishment of the Children’s Bureau?
a. Lillian Wald
b. Florence Nightingale
c. Florence Kelly
d. Clara Barton
ANS: A
Lillian Wald is credited with suggesting the establishment of a federal Children’s Bureau.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 1 | 2
TOP: The Past KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
7. What was the result of research done in the 1930s by the Children’s Bureau?
a. Children with heart problems are now cared for by pediatric cardiologists.
b. The Child Abuse and Prevention Act was passed.
c. Hot lunch programs were established in many schools.
d. Children’s asylums were founded.
, ANS: C
School hot lunch programs were developed as a result of research by the Children’s Bureau on
the effects of economic depression on children.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 2 | 3
TOP: The Past KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care
8. What government program was implemented to increase the educational exposure of preschool
children?
a. WIC
b. Title XIX of Medicaid
c. The Children’s Charter
d. Head Start
ANS: D
Head Start programs were established to increase educational exposure of preschool children.
DIF: Cognitive Level: Knowledge REF: p. 3 OBJ: 3
TOP: Government Influences in Maternity and Pediatric Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
9. What guidelines define multidisciplinary patient care in terms of expected outcome and
timeframe from different areas of care provision?
a. Clinical pathways
b. Nursing outcome criteria
c. Standards of care
d. Nursing care plan
ANS: A
Clinical pathways, also known as critical pathways or care maps, are collaborative guidelines
that define patient care across disciplines. Expected progress within a specified timeline is
identified.
DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 10
TOP: Health Care Delivery Systems KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her mother,
and collected admission data. What is the next step the student will take to develop a nursing
care plan for this child?
a. Identify measurable outcomes with a timeline.
b. Choose specific nursing interventions for the child.
c. Determine appropriate nursing diagnoses.
d. State nursing actions related to the child’s medical diagnosis.
ANS: C
The nurse uses assessment data to select appropriate nursing diagnoses from the NANDA-I list.
Outcomes and interventions are then developed to address the relevant nursing diagnoses.
, DIF: Cognitive Level: Application REF: p. 11 OBJ: 7
TOP: Nursing Process KEY: Nursing Process Step: Nursing Diagnosis
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
11. A nursing student on an obstetric rotation questions the floor nurse about the definition of the
LVN/LPN scope of practice. What resource can the nurse suggest to the student?
a. American Nurses Association
b. State’s board of nursing
c. Joint Commission
d. Association of Women’s Health, Obstetric and Neonatal Nurses
ANS: B
The scope of practice of the LVN/LPN is published by the state’s board of nursing.
DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: 2
TOP: Critical Thinking KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
12. What was recommended by Karl Credé in 1884?
a. All women should be delivered in a hospital setting.
b. Chemical means should be used to combat infection.
c. Podalic version should be done on all fetuses.
d. Silver nitrate should be placed in the eyes of newborns.
ANS: D
In 1884 Karl Credé recommended the use of 2% silver nitrate in the eyes of newborns to reduce
the incidence of blindness.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: Use of Silver Nitrate KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
13. What is the purpose of the White House Conference on Children and Youth?
a. Set criteria for normal growth patterns.
b. Examine the number of live births in minority populations.
c. Raise money to support well-child clinics in rural areas.
d. Promote comprehensive child welfare.
ANS: D
White House Conferences on Children and Youth are held every 10 years to promote
comprehensive child welfare.
DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 2
TOP: White House Conferences KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
14. How many hours of hospital stay does legislation currently allow for a postpartum patient who
has delivered vaginally without complications?
a. 24
