Deck 1: Current Issues in Maternal-Newborn Nursing

Question 1

Despite the availability of Children's Health Insurance Programs (CHIPs), the nurse in a pediatric clinic knows that many eligible children are not enrolled. The nursing intervention that can best help eligible children become enrolled is:

A) Assessment of the details of the family's income and expenditures.
B) Case management to limit costly, unnecessary duplication of services.
C) Advocacy for the child by encouraging the family to investigate its CHIP eligibility.
D) Education of the family about the need for keeping regular well-child visit appointments.

Answer 1

Advocacy for the child by encouraging the family to investigate its CHIP eligibility.

Question 2

The nurse manager is consulting with a certified nurse-midwife about a patient. The role of the CNM is to:

A) Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth.
B) Give primary care for high-risk patients who are in hospital settings.
C) Give primary care for healthy newborns.
D) Obtain a physician consultation for any technical procedures at delivery.
E) Be educated in two disciplines of nursing.

Answer 2

Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth.
Give primary care for healthy newborns.
Be educated in two disciplines of nursing.

Question 3

In order to combat the impersonal nature of technology that sometimes interferes with family-focused care, the nurse should take which actions?

A) Advocate within the community for natural childbirth.
B) Make childbirth education classes available.
C) Be instrumental in providing change in the birth environment at work.
D) Suggest that doulas not be allowed to interfere with the childbirth process.
E) Advocate for more home healthcare agencies.

Answer 3

Advocate within the community for natural childbirth.
Make childbirth education classes available.
Be instrumental in providing change in the birth environment at work.
Advocate for more home healthcare agencies.

Question 4

The maternal-child nurse stresses to the recently graduated nurse that primary care focuses on:

A) Health promotion.
B) Illness prevention.
C) Hospital care.
D) Skilled nursing care.
E) Curing disease.

Question 5

The nurse is telling a new patient how technology used in maternal-newborn care has changed the way the nurse cares for her patients. An example of this is:

A) Elective inductions, requested cesareans, epidural anesthesia, and fetal monitoring.
B) Delivering at home with a nurse-midwife and doula.
C) Having the father present as the coach and cut the umbilical cord.
D) Breastfeeding of the new baby on the delivery table.

Question 6

A maternity patient is in need of surgery. The healthcare member who is legally responsible for obtaining informed consent for an invasive procedure is:

A) The nurse.
B) The physician.
C) The unit secretary.
D) The social worker.

Question 7

The nurse working in a community clinic is aware that differences in beliefs between families and healthcare providers are common in which areas?

A) Help-seeking behaviors
B) Pregnancy and childbirth practices
C) Causes of disease or illness
D) What defines a community
E) Educational level

Question 8

The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with patients, the healthcare community, and third-party payers due to research findings that suggest that it:

A) Shortens newborn length of stay.
B) Decreases use of home health agencies.
C) Reduces healthcare costs.
D) Decreases the number of emergency department visits.

Question 9

The nurse manager is planning a presentation on ethical issues in caring for childbearing families. Which example should the nurse manager include to illustrate maternal-fetal conflict?

A) A patient chooses an abortion after her fetus is diagnosed with a genetic anomaly.
B) A 39-year-old nulliparous patient undergoes therapeutic insemination.
C) A family of a child with leukemia requests cord-blood banking at this birth.
D) A cesarean delivery of a breech fetus is court-ordered after the patient refuses.

Question 10

For prenatal care, the patient is attending a clinic held in a church basement. The patient's care is provided by registered nurses and a certified nurse-midwife. This type of prenatal care is an example of:

A) Secondary care.
B) Tertiary care.
C) Community care.
D) Unnecessarily costly care.

Question 11

The nurse at an elementary school is performing TB screenings on all of the students. Permission slips were returned for all but the children of one family. When the nurse phones to obtain permission, the parent states in clearly understandable English that permission cannot be given because the grandmother is out of town for 2 more weeks. Which cultural element is contributing to the dilemma that faces the nurse?

A) Permissible physical contact with strangers
B) Beliefs about the concepts of health and illness
C) Religion and social beliefs
D) Presence and influence of the extended family

Question 12

The nursing instructor explains to the class that according to the 1973 Supreme Court decision in Roe v. Wade, abortion is legal if induced:

A) Before the 30th week of pregnancy.
B) Before the period of viability.
C) To provide tissue for therapeutic research.
D) Can be done any time if mother, doctor, and hospital all agree.

Question 13

A nursing student investigating potential career goals is strongly considering becoming a nurse practitioner (NP). The major focus of the NP is on:

A) Leadership.
B) Physical and psychosocial clinical assessment.
C) Independent care of the high-risk, pregnant patient.
D) Tertiary prevention.

Question 14

A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role?

A) A registered nurse who is the manager of a large obstetrical unit
B) A registered nurse who is the circulating nurse at surgical deliveries (cesarean sections)
C) A clinical nurse specialist working as a staff nurse on a motherbaby unit
D) A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants

Question 15

Several student nurses are discussing advanced practice, and know that the term advanced practice nurse includes nurses who are:

A) Nurse practitioners.
B) Certified nurse-midwives.
C) Clinical nurse specialists.
D) Certified registered nurses.
E) Professional nurses.

Question 16

The registered nurse who has completed a master's degree program and passed a national certification exam has clinic appointments with patients who are pregnant or seeking well-woman care. The role of this nurse would be considered:

A) Professional nurse.
B) Certified registered nurse (RNC).
C) Clinical nurse specialist.
D) Nurse practitioner.

Question 17

The nurse reviewing charts for quality improvement notes that a patient experienced a complication during labor. The nurse is uncertain whether the labor nurse took the appropriate action during the situation. What is the best method for the nurse to take to determine what the appropriate action should have been?

A) Call the nurse manager of the labor and delivery unit and ask what the nurse should have done.
B) Ask the departmental chair of the obstetrical physicians what the best nursing action should have been.
C) Examine other charts to find cases of the same complication, and determine how it was handled in those situations.
D) Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization.

Question 18

A nurse who tells family members the sex of a newborn baby without first consulting the parents would have committed:

A) A breach of privacy.
B) Negligence.
C) Malpractice.
D) A breach of ethics.

Question 19

While a child is being admitting to the hospital, the parent receives information about the pediatric unit's goals, including the statement that the unit practices family-centered care. The parent asks why that is important. The nurse responds that in the family-centered care paradigm, the:

A) Mother is the principal caregiver in each family.
B) Child's physician is the key person in ensuring the health of a child is maintained.
C) Family serves as the constant influence and continuing support in the child's life.
D) Father is the leader in each home; thus, all communications should include him.

Question 20

The nurse is reviewing care of patients on a mother-baby unit. Which situation should be reported to the supervisor?

A) A 2-day-old infant has breastfed every 3 hours and voided 4 times.
B) An infant was placed in the wrong crib after examination by the physician.
C) The patient who delivered by cesarean birth yesterday received oral narcotics.
D) A primiparous patient who delivered today is requesting discharge within 24 hours.

Question 21

The nurse is preparing a report on the number of births by three service providers at the facility (certified nurse-midwives, family practitioners, and obstetricians). This is an example of:

A) Inferential statistics.
B) Descriptive statistics.
C) Evidence-based practice.
D) Secondary use of data.

Question 22

The nursing instructor is preparing clinical pathways to use in class because they provide:

A) Essential nursing activities.
B) Basic guidelines for outcomes.
C) Information that allows the nurse to evaluate patient responses.
D) Examples of all steps of the nursing process.
E) For the organizing of patient care.

Question 23

The nurse is serving on a panel to evaluate the hospital staff's reliance on evidence-based practice in their decision-making processes. Which practices characterize the basic competencies related to evidence-based practice?

A) Recognizing which clinical practices are supported by good evidence
B) Recognizing and including clinical practice supported by intuitive evidence
C) Using data in clinical work to evaluate outcomes of care
D) Including quality-improvement measures in clinical practice
E) Appraising and integrating scientific bases into practice

Question 24

As a clinician, the nurse must meet what basic competencies related to evidence-based practice?

A) Recognize which clinical practices are supported by sound evidence.
B) Recognize that superiors, such as charge nurses, are the ones who know which clinical practices are supported by sound evidence.
C) Use data in clinical work to evaluate outcomes of care.
D) Integrate scientific basics into practice.
E) Will be able to identify which practices have no sound evidence to support their use.

Question 25

The nurse is reviewing the files of the expectant families scheduled to be seen in the clinic today. Which family might find cord-blood banking to be especially useful?

A) A family with a history of leukemia
B) A family with a history of infertility
C) A family that wishes to select the sex of a future child
D) A family that wishes to avoid a future intrauterine fetal surgery

Question 26

The maternal-newborn nurse recognizes that cord-blood banking has ethical issues related to which of the following questions?

A) Who owns the blood?
B) How is informed consent obtained?
C) How will confidentiality be maintained?
D) Will standards of care be met fairly?
E) What external agents force or restrict a therapy?

Question 27

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, the nurse includes information about prevention of:

A) Cancer by reducing the use of pesticides in the home.
B) Accidental injury by reducing the risk of pool and traffic accidents.
C) Heart disease by incorporating heart-healthy foods into the child's diet.
D) Pneumonia by providing a diet high in vitamin C from fruits and vegetables.

Question 28

The nurse manager is examining the descriptive statistics of increasing teen pregnancy rates in the community. Which inferential statistical research would the nurse manager find most useful in investigating the reasons for increased frequency of teen pregnancy?

A) What providers do pregnant teens see for prenatal care?
B) What are the ages of the parents of pregnant teens in the community?
C) Do pregnant teens drink caffeinated beverages?
D) What do pregnant teens do for recreation?

Question 29

The recently graduated nurse recognizes that standards provide information and guidelines for:

A) Nurses in their practice.
B) Devlopment of policies and protocols.
C) Developing basic nursing care.
D) Writing a state's nurse practice act.
E) Who can and cannot consent to treatment.

Question 30

The nurse researcher will use descriptive statistics for a research project that has been assigned. A characteristic of descriptive statistics is that:

A) They can answer specific questions.
B) They can generate theories.
C) They allow the investigator to draw conclusions.
D) They are the starting point for the formation of a research question.

Question 31

The maternal-newborn nurse reviewing charts recognizes that negligence occurs when there is:

A) No notification to the physician of change in condition.
B) A failure to give an ordered medication.
C) An infant placed in the wrong crib.
D) Compliance with medication administration principles.
E) Compliance with the standards of care.

Question 32

Based on research comparing home and hospital births, the nurse understands that questions remain to be answered about outcomes, such as:

A) Does nutrition affect home birth outcomes?
B) Does exercise affect home birth outcomes?
C) Do mortality and morbidity rates differ for home versus hospital births?
D) Do multiparous women have more problems than first-time mothers?
E) Do high-risk births cause fewer complications with a home birth?

Question 33

The nurse is explaining the difference between descriptive statistics and inferential statistics to a group of student nurses. To illustrate descriptive statistics, the nurses uses as an example:

A) A positive correlation between breastfeeding and infant weight gain.
B) The infant mortality rate in the state of Oklahoma.
C) A causal relationship between the number of sexual partners and sexually transmitted diseases.
D) The total number of spontaneous abortions in drug-abusing women as compared with non-drug-abusing women.

Question 34

Therapeutic insemination has legal concerns for the donor of the sperm. To eliminate legal issues, the clinic nurse will have the donor:

A) Sign a form waiving all parental rights.
B) Furnish accurate health information.
C) Agree to adopt the child.
D) Furnish a complete family tree.
E) Sign an agreement if married to the recipient.