Deck 1: Contemporary Maternal-Newborn Nursing

Question 1

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

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

Answer 1

B

Question 2

The nurse is telling a new client how advanced technology has permitted the physician to do which of the following?

A) Treat the fetus and monitor fetal development.
B) Deliver at home with a nurse-midwife and doula.
C) Have the father act as the coach and cut the umbilical cord.
D) Breastfeed a new baby on the delivery table.

Answer 2

A

Question 3

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

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

Answer 3

A

Question 4

The nurse at an elementary school is performing T B 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 5

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 which of the following?

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 6

The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect?

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

Question 7

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 what communication dynamic is characteristic of the family-centered care paradigm?

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

Question 8

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 during surgical deliveries (cesarean sections)
C) A clinical nurse specialist working as a staff nurse on a mother-baby unit
D) A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants

Question 9

The registered nurse who has completed a master's degree program and passed a national certification exam has clinic appointments with clients who are pregnant or seeking well-woman care. What is the role of this nurse considered to be?

A) Professional nurse
B) Certified registered nurse (R N C)
C) Clinical nurse specialist
D) Nurse practitioner

Question 10

A maternity client is in need of surgery. Which healthcare member is legally responsible for obtaining informed consent for an invasive procedure?

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

Question 11

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

Question 12

Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following?

A) There is less trauma to the mother.
B) More childbirth education classes are available.
C) They are instrumental in providing change in the birth environment at work.
D) They advocate for more home healthcare agencies.

Question 13

A nursing student investigating potential career goals is strongly considering becoming a nurse practitioner (N P). The major focus of the N P is on which of the following?

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

Question 14

For prenatal care, the client is attending a clinic held in a church basement. The client's care is provided by registered nurses and a certified nurse-midwife. What is this type of prenatal care?

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

Question 15

Client safety goals, which are evaluated and updated regularly, are requirements for what?

A) Clinical practice guidelines
B) Scope of practice
C) Accreditation
D) Standards of care

Question 16

A fetus has been diagnosed with myelomeningocele. Which of the following surgeries would be performed to correct this condition?

A) Tubal ligation
B) Intrauterine fetal surgery
C) Cesarean section
D) Sterilization

Question 17

The nurse reviewing charts for quality improvement notes that a client experienced a complication during labor. The nurse is uncertain whether the labor nurse took the appropriate action during the situation. What is the best way for the nurse 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 would 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

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 19

The nurse manager is consulting with a certified nurse-midwife about a client. What is the role of the C N M?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

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 clients 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.

Question 20

The current emphasis on federal healthcare reform has yielded what unexpected benefit?

A) Assessment of the details of the family's income and expenditures
B) Case management to limit costly, unnecessary duplication of services
C) Many healthcare providers and consumers are becoming more aware of the vitally important role nurses play in providing excellent care to clients and families
D) Education of the family about the need for keeping regular well-child visit appointments

Question 21

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?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

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 22

The nurse is ensuring that a patient has provided informed consent before agreeing to an amniocentesis. In which order should the nurse validate that informed consent was provided by the patient?
1. Information provides risk and benefits
2. Information provided clearly and concisely
3. Information included treatment alternatives
4. Information explaining the right to refuse treatment
5. Information reviews consequences if no treatment provided

Question 23

The Quality and Safety Education for Nurses (Q S E N) project focused on competencies in which areas?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Client-centered care
B) Teamwork and collaboration
C) Evidence-based practice
D) Family planning
E) Injury and violence prevention

Question 24

A group of nurses are meeting as identified in the image below. Which behavior are the nurses demonstrating during this meeting?

A) Privacy
B) Advocacy
C) Collaboration
D) Informed consent

Question 25

The nurse is reviewing the Quality and Safety Education for Nurses (Q S E N) competencies while preparing an in-service program to address safety in the neonatal intensive care unit. In which order should the nurse present these competencies?
1. Safety
2. Informatics
3. Patient-centered care
4. Quality improvement
5. Evidence-based practice
6. Teamwork and collaboration

Question 26

The manager of a maternal-child care area is preparing information to share with nursing staff regarding the leading causes of infant death in the United States. In which order, from most to least frequent, should the manager provide this information?
1. S I D S
2. Low birth weight
3. Unintentional injuries
4. Maternal complications
5. Congenital malformation

Question 27

The nurse is explaining the difference between descriptive statistics and inferential statistics to a group of student nurses. To illustrate descriptive statistics, what would the nurse use 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 infections
D) The total number of spontaneous abortions in drug-abusing women as compared with non-drug-abusing women

Question 28

Nursing research is vital to do which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Expand the science of nursing.
B) Foster evidence-based practice.
C) Improve client care.
D) Visually depict nursing management.
E) Plan and organize care.

Question 29

The nurse is preparing a presentation for new labor and delivery nurses. Which cultural group should the nurse identify as having the lowest birth rate for the 20 to 24 age range?
Table 1-2 Birth Rate by Age and Race of Mother, 2011

Source: Martin, J.A., Hamilton, B.E., Ventura, S.J., Osterman, M.J.K., & Matthews, T.J. (2013). Births: Final data 2011. National Vital Statistics Reports, 62(1), 1-70.

A) Asian
B) White
C) Black
D) American Indian

Question 30

The nurse manager is examining the descriptive statistics of increasing teen pregnancy rates in the community. Which inferential statistical research question 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 31

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). What is this an example of?

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