Question 1

Alternative and complementary therapies:

Accepted Answer

Many popular alternative healing modalities offer human-centered care based on philosophies that recognize the value of the patient's input and honor the individual's beliefs,values,and desires.Alternative and complementary therapies are part of an integrative approach to health care.An increasing number of American adults are seeking alternative and complementary health care options.Alternative healing modalities offer a holistic approach to health,focusing on the whole person,not just the disease.

Question 2

To ensure patient safety,the practicing nurse must have knowledge of the current Joint Commission's "Do Not Use" list of abbreviations.Which of the following is acceptable for use?

Accepted Answer

The abbreviations "i.u." and "I.U." are no longer acceptable because they could be misread as "I.V." or the number "10." The abbreviation "q.o.d.or Q.O.D." should be written out as "every other day." The period after the "Q" could be mistaken for an "I"; the "o" could also be mistaken for an "i." With MSO₄ or MgSO₄,it is too easy to confuse one medication for another.These medications are used for very different purposes and could put a patient at risk for an adverse outcome.They should be written as morphine sulfate and magnesium sulfate.The decimal point should never be missed before a number to avoid confusion (i.e.,0.4 rather than .4).

Question 3

Through the use of social media technology,nurses can link with other nurses who may share similar interests,insights about practice,and advocate for patients.The most concerning pitfall for nurses using this technology is:

Accepted Answer

The most significant pitfall for nurses using this technology is the violation of patient privacy and confidentiality.Furthermore,institutions and colleagues can be cast in unfavorable lights with negative consequences for those posting information.Nursing students have been expelled from school and nurses have been fired or reprimanded by their Board of Nursing for injudicious posts.The American Nurses Association has published six principles for social networking and nurses.All institutions should have policies guiding the use of social media,and nurses should be familiar with these guidelines.

Question 4

When providing care for a pregnant woman,the nurse should be aware that one of the most frequently reported maternal medical risk factors is:

Accepted Answer

The most frequently reported maternal medical risk factors are diabetes and hypertension associated with pregnancy.Both of these conditions are associated with maternal obesity.There are no studies that indicate MVP is among the most frequently reported maternal risk factors.Hypertension associated with pregnancy,not chronic hypertension,is one of the most frequently reported maternal medical risk factors.Although anemia is a concern in pregnancy,it is not one of the most frequently reported maternal medical risk factors in pregnancy.

Question 5

While obtaining a detailed history from a woman who has recently emigrated from Somalia,the nurse realizes that the patient has undergone female genital mutilation (FGM).The nurse's best response to this patient is:

Accepted Answer

"The extent of your circumcision will affect the potential for complications" is the most appropriate response.The patient may experience pain,bleeding,scarring,or infection and may require surgery before childbirth.With the growing number of immigrants from countries where FGM is practiced,nurses will increasingly encounter women who have undergone the procedure.Although this practice is not prevalent in the United States,it is very common in many African and Middle Eastern countries for religious reasons.Responding with,"This is a very abnormal practice and rarely seen in the United States" is culturally insensitive.The infibulation may have occurred during infancy or childhood.The patient will have little to no recollection of the event.She would have considered this to be a normal milestone during her growth and development.The International Council of Nurses has spoken out against this procedure as harmful to a woman's health.

Question 6

The role of the professional nurse caring for childbearing families has evolved to emphasize:

Accepted Answer

Professional nurses are part of the team of health care providers who collaboratively care for patients throughout the childbearing cycle.Providing care to patients directly at the bedside is one of the nurse's tasks; however,it does not encompass the concept of the evolved professional nurse.Throughout the prenatal period,nurses care for women in clinics and physician's offices and teach classes to help families prepare for childbirth.Nurses also care for childbearing families in birthing centers and in the home.Nurses have been critically important in developing strategies to improve the well-being of women and their infants and have led the efforts to implement clinical practice guidelines using an evidence-based approach.Maternity patients have experienced a decreased,rather than an increased,length of stay over the past two decades.

Question 7

An important development that affects maternity nursing is integrative health care,which:

Accepted Answer

Integrative health care tries to mix the old with the new at the discretion of the patient and health care providers.Integrative health care is a blending of new and traditional practices.Integrative health care focuses on the whole person,not just the disease or condition.U.S.law supports complementary and alternative therapies but does not mandate them.

Question 8

To ensure optimal outcomes for the patient,the contemporary maternity nurse must incorporate both teamwork and communication with clinicians into her care delivery.The SBAR technique of communication is an easy-to-remember mechanism for communication.Which of the following correctly defines this acronym?

Accepted Answer

The situation,background,assessment,recommendation (SBAR)technique provides a specific framework for communication among health care providers.Failure to communicate is one of the major reasons for errors in health care.The SBAR technique has the potential to serve as a means to reduce errors.

Question 9

A 23-year-old African-American woman is pregnant with her first child.Based on the statistics for infant mortality,which plan is most important for the nurse to implement?

Accepted Answer

Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality.Nutritional status is an important modifiable risk factor,but a nutrition assessment is not the most important action a nurse should take in this situation.The patient may need assistance from a social worker at some time during her pregnancy,but a referral to a social worker is not the most important aspect the nurse should address at this time.If the woman has identifiable high risk problems,her health care may need to be provided by a physician.However,it cannot be assumed that all African-American women have high risk issues.In addition,advising the woman to see an obstetrician is not the most important aspect on which the nurse should focus at this time,and it is not appropriate for a nurse to advise or manage the type of care a patient is to receive.

Question 10

The term used to describe legal and professional responsibility for practice for maternity nurses is:

Accepted Answer

Accountability refers to legal and professional responsibility for practice.Collegiality refers to a working relationship with one's colleagues.Ethics refers to a code to guide practice.Evaluation refers to examination of the effectiveness of interventions in relation to expected outcomes.

Question 11

When managing health care for pregnant women at a prenatal clinic,the nurse should recognize that the most significant barrier to access to care is the pregnant woman's:

Accepted Answer

The most significant barrier to health care access is the inability to pay for services; this is compounded by the fact that many physicians refuse to care for women who cannot pay.Although adolescent pregnant patients statistically receive less prenatal care,age is not the most significant barrier.Significant disparities in morbidity and mortality rates exist for minority women; however,minority status is not the most significant barrier to access of care.Disparities in educational level are associated with morbidity and mortality rates; however,educational level is not the most significant barrier to access of care.

Question 12

The level of practice a reasonably prudent nurse provides is called:

Accepted Answer

Guidelines for standards of care are published by various professional nursing organizations.Risk management identifies risks and establishes preventive practices,but it does not define the standard of care.Sentinel events are unexpected negative occurrences.They do not establish the standard of care.Failure to rescue is an evaluative process for nursing,but it does not define the standard of care.

Question 13

Healthy People 2020 has established national health priorities that focus on a number of maternal-child health indicators.Nurses are assuming greater roles in assessing family health and providing care across the perinatal continuum.Therefore,it is important for the nurse to be aware that significant progress has been made in:

Accepted Answer

Trends in maternal child health indicate that progress has been made in relation to reduced infant and fetal deaths and increased prenatal care.Notable gaps remain in the rates of low birth weight and preterm births.According to the March of Dimes,persistent disparities still exist between African-Americans and non-Hispanic Caucasians.Many of these negative outcomes are preventable through access to prenatal care and the use of preventive health practices.This demonstrates the need for comprehensive community-based care for all mothers,infants,and families.

Question 14

During a prenatal intake interview,the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic patient with limited English proficiency.It is important for the nurse to:

Accepted Answer

Nurses contribute to health literacy by using simple,common words; avoiding jargon; and evaluating whether the patient understands the discussion.Speaking slowly and clearly and focusing on what is important increase understanding.Most patient education materials are written at too high a level for the average adult and may not be useful for a patient with limited English proficiency.

Question 15

A 38-year-old Hispanic woman delivered a 9-pound,6-ounce girl vaginally after being in labor for 43 hours.The baby died 3 days later from sepsis.On what grounds would the woman potentially have a legitimate legal case for negligence?

Accepted Answer

Not meeting the standards of care is a legitimate factor for a case of negligence.The patient's race is not a factor for a case of negligence.The infant's gender is not a factor for a case of negligence.Although fetal monitoring is the standard of care,the patient has the right to refuse treatment.This refusal is not a case for negligence; however,informed consent should be properly obtained,and the patient should sign an against medical advice form for refusal of any treatment that is within the standard of care.

Question 16

The nurse caring for a pregnant patient should be aware that the U.S.birth rate shows which trend?

Accepted Answer

Low-birth-weight infants and preterm birth are more likely because of the large number of teenagers in the unmarried group.Birth rates for women in their early 40s continue to increase.Fewer pregnant women smoke.In the United States,there is significant racial disparity in the rates of maternal death.

Question 17

When the nurse is unsure about how to perform a patient care procedure,the best action would be to:

Accepted Answer

It is always best to follow the agency's policies and procedures manual when seeking information on correct patient procedures.These policies should reflect the current standards of care and state guidelines.Each nurse is responsible for her own practice.Relying on another nurse may not always be safe practice.Each nurse is obligated to follow the standards of care for safe patient care delivery.Physicians are responsible for their own patient care activity.Nurses may follow safe orders from physicians,but they are also responsible for the activities that they as nurses are to carry out.Information provided in a nursing textbook is basic information for general knowledge.Furthermore,the information in a textbook may not reflect the current standard of care or individual state or hospital policies.

Question 18

Maternity nursing care that is based on knowledge gained through research and clinical trials is:

Accepted Answer

Evidence-based practice is based on knowledge gained from research and clinical trials.The Nursing Intervention Classification is a method of standardizing language and categorizing care.Dr.Cochrane systematically reviewed research trials and is part of the evidence-based practice movement.Telemedicine uses communication technologies to support health care.

Question 19

A newly graduated nurse is attempting to understand the reason for increasing health care spending in the United States.Her research finds that these costs are much higher compared with other developed countries as a result of:

Accepted Answer

Health care is one of the fastest growing sectors of the U.S.economy.Currently,17.5% of the gross domestic product is spent on health care.Higher spending in the United States compared with 12 other industrialized countries is related to higher prices and readily accessible technology along with greater obesity rates among women.More than one third of women in the United States are obese.Of the U.S.population,16% is uninsured and has limited access to health care.Maternal morbidity and mortality are directly related to racial disparities.

Question 20

From the nurse's perspective,what measure should be the focus of the health care system to reduce the rate of infant mortality further?

Accepted Answer

Early prenatal care allows for early diagnosis and appropriate interventions to reduce the rate of infant mortality.An increased length of stay has been shown to foster improved self-care and parental education.However,it does not prevent the incidence of leading causes of infant mortality rates,such as low birth weight.Early prevention and diagnosis reduce the rate of infant mortality.NICUs offer care to high risk infants after they are born.Expanding the number of NICUs would offer better access for high risk care,but this factor is not the primary focus for further reduction of infant mortality rates.A mandate that all pregnant women receive obstetric care would be nearly impossible to enforce.Furthermore,certified nurse-midwives (CNMs)have demonstrated reliable,safe care for pregnant women.

Quiz 1: 21st Century Maternity Nursing