Foundations of Maternal Newborn and Women’s Health Nursing, 6th edition by Murray – Test Bank

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Foundations of Maternal Newborn and Women’s Health Nursing, 6th edition by Murray – Test Bank

MULTIPLE CHOICE

1. The nurse is teaching a parenting class to new parents. Which statement should the nurse include in the teaching session about the characteristics of a healthy family?

a.	Adults agree on the majority of basic parenting principles.
b.	The parents and children have rigid assignments for all the family tasks.
c.	Young families assume total responsibility for the parenting tasks, refusing any assistance.
d.	The family is overwhelmed by the significant changes that occur as a result of childbirth.

ANS: A

Adults in a healthy family communicate with each other, so there is minimal discord in areas such as discipline and sleep schedules. Healthy families remain flexible in their role assignments. Members of a healthy family accept assistance without feeling guilty. Healthy families can tolerate irregular sleep and meal schedules, which are common during the months after childbirth.

PTS: 1 DIF: Cognitive Level: Application REF: 9

OBJ:Nursing Process Step: Implementation

MSC: Client Needs: Health Promotion and Maintenance

2. Which factor significantly contributed to the shift from home births to hospital births in the early twentieth century?

a.	The number of hospital births decreased.
b.	Forceps were developed to facilitate difficult births.
c.	The importance of early parent-infant contact was identified.
d.	Puerperal sepsis was identified as a risk factor in labor and birth.

ANS: B

The development of forceps to facilitate difficult births by physicians was a strong factor in the decrease of home births and increase of hospital births. With the shift toward hospital births, the numbers increased. The shift to hospital births decreased the amount of parental-infant contact. Puerperal sepsis has been a known problem for generations. In the late nineteenth century, Semmelweis discovered how it could be prevented.

PTS: 1 DIF: Cognitive Level: Understanding REF: 1

OBJ:Nursing Process Step: Assessment

MSC: Client Needs: Safe and Effective Care Environment

3. A nurse is teaching a group of nursing students about the history of family-centered maternity care. Which statement should the nurse include in the teaching session?

a.	The Sheppard-Towner Act of 1921 promoted family-centered care.
b.	Changes in pharmacologic management of labor prompted family-centered care.
c.	Demands by physicians for family involvement in childbirth increased the practice of family-centered care.
d.	Parental requests that infants be allowed to remain with them rather than in a nursery initiated the practice of family-centered care.

ANS: D

As research began to identify the benefits of early extended parent-infant contact, parents began to insist that the infant remain with them. This gradually developed into the practice of rooming-in and finally to family-centered maternity care. The Sheppard-Towner Act provided funds for state-managed programs for mothers and children but did not promote family-centered care. The changes in pharmacologic management of labor were not a factor in family-centered maternity care. Family-centered care was a request by parents, not physicians.

PTS: 1 DIF: Cognitive Level: Application REF: 2, 3

OBJ: Nursing Process Step: Planning MSC: Client Needs: Health Promotion and Maintenance

4. Which statement explains why below poverty level African-Americans have the highest infant mortality rate in the United States?

a.	Their diets are deficient in protein.
b.	Infectious diseases are more prevalent.
c.	More African-American infants are born with congenital anomalies.
d.	Inadequate prenatal care is associated with low-birth-weight infants.

ANS: D

Inadequate prenatal care is the major factor associated with low-birth-weight infants, who are less likely to survive. A deficiency in protein is not a risk factor associated with infant mortality. Infectious disease is not more prevalent in the African-American population. There is not a higher incidence of congenital anomalies in the African-American population.

PTS: 1 DIF: Cognitive Level: Understanding REF: 2

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

5. Which situation is most representative of an extended family?

a.	It includes adoptive children.
b.	It is headed by a single parent.
c.	It contains children from previous marriages.
d.	It is composed of children, parents, and grandparents living in the same house.

ANS: D

An extended family is defined as a family having members from three generations living under the same roof. A family with adoptive children is a nuclear family. A single-parent family is headed by a single parent. A blended family is one that contains children from previous marriages.

PTS: 1 DIF: Cognitive Level: Understanding REF: 9

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

6. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth allows for the least amount of parent-infant interaction?” Which answer should the nurse give to the parents?

a.	Birth center
b.	Home birth
c.	Traditional hospital birth
d.	Labor, birth, and recovery room

ANS: C

In the traditional hospital setting, the mother may see the infant for only short feeding periods, and the infant is cared for in a separate nursery. Birth centers are set up to allow an increase in parent-infant contact. Home births allow an increase in parent-infant contact. The labor, birth, recovery, and postpartum room setting allows increased parent-infant contact.

PTS: 1 DIF: Cognitive Level: Understanding REF: 3

OBJ: Nursing Process Step: Planning MSC: Client Needs: Health Promotion and Maintenance

7. A woman giving birth in the 1960s may have been given a narcotic plus scopolamine for pain control. What is the major problem with this medication regimen?

a.	It lacked continuous pain control.
b.	It was expensive and available only to women who could afford the medications.
c.	The father had to assume the role of decision maker while the mother was on medication.
d.	It caused confusion and disorientation so that the mother could not see the infant for several hours postbirth.

ANS: D

The combination of narcotics and scopolamine produced heavy sedation and disorientation. The new mother was not fully awake and oriented for several hours postbirth. The bonding process had to be delayed. The narcotic plus scopolamine did allow for continuous pain control. The combination was not expensive and would be given to any mother. The father was almost always the decision maker during the 1960s.

PTS: 1 DIF: Cognitive Level: Understanding REF: 2

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity

8. Which is an advantage to labor, birth, recovery, and postpartum (LDRP) rooms?

a.	The family is in a familiar environment.
b.	They are less expensive than traditional hospital rooms.
c.	The infant is removed to the nursery to allow the mother to rest.
d.	The woman’s support system is encouraged to stay until discharge.

ANS: D

Sleeping equipment is provided and the support system is encouraged to stay. A hospital setting is never a familiar environment. An LDRP room is not less expensive than a traditional hospital room. The concept is to have the baby with the mother at all times.

PTS: 1 DIF: Cognitive Level: Understanding REF: 3

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

9. A single client who has just delivered a baby asks the nurse where she can receive help in getting formula for her baby. Which is the nurse’s best response?

a.	Medicaid can help with buying formula.
b.	Head Start is a program that helps provide formula.
c.	The Women, Infants, and Children (WIC) program can assist you in getting formula.
d.	The National Center for Family Planning has a program that helps with obtaining formula.

ANS: C

The Women, Infants, and Children (WIC) program provides supplemental food and nutrition for single mothers with children up to 5 years old. Medicaid provides funds to facilitate access to care by pregnant women and young children. Head Start provides educational opportunities for low-income children of preschool age. The National Center for Family Planning is a clearinghouse for contraceptive information.

PTS: 1 DIF: Cognitive Level: Application REF: 2

OBJ:Nursing Process Step: Implementation

MSC: Client Needs: Health Promotion and Maintenance

10. A client at 36 weeks of gestation states, “Why can’t I have an induction now? My sister delivered at 36 weeks and her baby is fine.” Which information about infants born at 34 to 36 weeks should the nurse consider when answering?

a.	Birth by induction is low for this gestational age.
b.	Infants born at 34 to 36 weeks have mature lungs and do well at birth.
c.	The birth of infants between 34 to 36 weeks has declined as more births are going to term or post term.
d.	Infants born at 34 to 36 weeks are immature and have more health complications than infants born at term.

ANS: D

Late preterm births (34 to 36 completed weeks of gestation) have more health complications and higher death rates than infants born at term because the babies are immature. Birth by induction of labor or cesarean has risen markedly in this group. Infants born at 34 to 36 weeks may not have mature lungs and may need assistance with ventilation after birth. Late preterm births (34 to 36 weeks of gestation) increased 20% from 1990 to 2006.

PTS: 1 DIF: Cognitive Level: Application REF: 13

OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Health Promotion and Maintenance