Question 1

A doula is creating a teaching plan for an adolescent girl who is pregnant for the first time. The main purpose is to promote nutritional health during pregnancy. Which of the following considerations is LEAST important when creating the teaching plan?

A)The group's reactions to possible changes that concern their eating habits.
B)The involvement of the clients' families, especially the food preparers.
C)The financial status of the clients.
D)Cultural considerations.

The group's reactions to possible changes that concern their eating habits.

Accepted Answer

When teaching a group of adolescent girls who are pregnant, the doula should mainly consider the involvement of the clients' families, the financial status of the clients and the clients' cultures. Even a client who is receptive to changing her eating habits may have some difficulties if her family resists the changes. In adolescents, it is most important that the food preparers are willing to effect the change. If a client belongs to a low-income group, the client should be helped to secure financial assistance during her pregnancy. Food intake and eating habits are greatly influenced by culture.

Question 2

A doula is helping a 13-year-old client at 12 weeks' gestation consider her nutritional status. When working with an adolescent client, which of the following interventions is the most effective?&#10;A)Encourage the client to consume least 2,000 calories per day from food intake.&#10;B)Allow the client to reject traditional foods, and respect her decisions.&#10;C)Advise the client to prepare nutritious snacks for the next day before going to bed.&#10;D)Work exclusively with the client, not with her family members or guardians, during dietary planning.

Accepted Answer

The doula should allow the client to reject traditional foods and respect her decisions. This is the most effective intervention when working with an adolescent client. Adolescents are searching for their identities during this stage, and they have a tendency to reject foods that their primary caregivers or parents see as important for them. The other options would be less effective interventions. The doula should recommend that the client's diet includes adequate nutrients and advise her to consume more than 2,500 calories per day. The client can be taught to prepare her snacks early in the day because it is during this time when she has the most energy. The doula should consider the client's food preparer because adolescents are not usually in charge of cooking the food they eat.

Question 3

A client is in her 18^th week of pregnancy. Which of the following psychosocial changes is expected at this time? A)The client is ambivalent about being pregnant. B)The client begins to imagine how she will feel during the delivery. C)The client is excited to attend childbirth educational classes. D)The client engages in nest-building activities.

Accepted Answer

During the 18^th week of pregnancy, the client begins to concentrate on how it will feel to be a parent or how she will feel during the delivery. During the first trimester, the major developmental task is to accept the pregnancy. Ambivalence is a common reaction, and it can also occur in women who planned for the pregnancy. During the second trimester, an important developmental task is to accept the baby as a separate entity, and during the third trimester, the major developmental task is to prepare for the baby. Options C and D are commonly seen in clients during the third trimester.

Question 4

A doula is visiting a 25-year-old postpartum client who gave birth 18 hours ago. No complications were noted during the labor process. The newborn is brought to the client for feeding and to have the mother and child bond for the night. The client says, "I'm too tired. Please get her back to the nursery, just for tonight. I need to get some sleep." Which of the following is the most appropriate reaction from the doula?

A)Teach the mother the basics of breast feeding, focusing on how often newborns typically nurse and recognizing feeding cues.
B)Encourage the client to join a parenting skill class.
C)Accept the client's behavior as an indication that she is in the taking-in phase.
D)Accept the client's behavior as an indication that she is in the taking-hold phase.

Accepted Answer

The most appropriate action of the doula is to accept the client's behavior as an indication that she is in the taking-in phase. The taking-in phase occurs in the first 24 hours after birth. In this stage, the client is more concerned about her own needs than the baby's. The taking-hold phase is the next phase. A client in this phase demonstrates signs of readiness to learn and face responsibilities. The letting-go phase may begin weeks after the delivery. In this phase, the client incorporates the newborn into the family unit.

Question 5

A client who is due to give birth any time asks the doula what changes in the reproductive system she should expect after the delivery. Which of the following statements by the doula is the most appropriate?

A)"After birth, your uterus will weigh about 1,000 grams. By the 6^thweek after birth, it will weigh around 50 grams."
B)"Your uterus will never completely return to its pre-pregnancy state."
C)"The rate of uterine involution greatly varies from woman to woman."
D)"By the third week after birth, your uterus can no longer be detected by abdominal palpation."

Accepted Answer

The uterus never completely returns to its pre-pregnancy state. Involution is the process by which the reproductive organs return to their pre-pregnancy state. Although the uterus returns to its pre-pregnant size, its cavity becomes larger, its vessels become more convoluted, the external orifice is more marked, fissures are observed on its edges and the muscles are more defined. After birth, the uterus will weigh about 1,000 grams, but by the 6^thweek, it will weigh about 50 grams. The rate of uterine involution follows a usual pattern and rate. An hour after delivery, the fundus is palpated at the level of the umbilicus. In the next 24 hours, the fundus is expected to go down by one finger's breadth. On the second day, it is palpated two finger's breadths from the uterus. On the 10^th day the fundus is non palpable.

Question 6

A client who is pregnant for the first time asks the doula if she and her husband can still engage in sexual intercourse during her pregnancy. She is concerned that having sex may hurt the baby and cause a miscarriage. The client is at 12 weeks' gestation. The most recent physical examination reveals normal findings. The client's history is not remarkable. Which of the following statements made by the doula is the most appropriate?

A)"You need to avoid sexual intercourse during pregnancy."
B)"Yes, you may engage in sex until the first two weeks of the third trimester."
C)"You may engage in sex as far into pregnancy as you wish, as long as your doctor or midwife has not told you otherwise. You and your husband may need to adjust your positions during sexual intercourse."
D)"You may have sex during pregnancy. Your libido will most likely increase during the third trimester."

Unlock Deck

Unlock for access to all 42 flashcards in this deck.

Unlock Deck

k this deck

Accepted Answer

The doula may inform the client that she and her husband may engage in sex as far into pregnancy as they wish and that they may need to adjust their positions during sexual intercourse. A position in which partners are side-by-side or the woman is in the superior position may be more comfortable, especially during the third trimester. There is no harm in engaging in sexual intercourse during pregnancy unless the client has a history of spontaneous miscarriage or vaginal spotting, or if she is at risk for premature rupture of membranes. Sexual intercourse should also be avoided in cases of untreated sexually transmitted diseases. She should consult her doctor or midwife to be sure there is no reason to abstain. The libido is most heightened during the second trimester. Increased sexual desire during pregnancy is due to increased blood flow to the pelvic area, increasing the sensations, and increased vaginal discharges.

Question 7

This theory of pain management supposes that pain messages to the brain travel on pathways that can be interrupted, or &#34;gated-off,&#34; by other signals to the brain, such as touch, pressure, etc.&#10;A)Comfort theory&#10;B)The Bradley method&#10;C)Gate control theory&#10;D)Fear-tension-pain cycle

Accepted Answer

The gate control theory of pain management was proposed Melzack and Wall in the 1960s as a way of understanding how the body processes exposure to painful stimuli. The idea is that pain messages travel on small-fiber pathways to the brain, while other stimuli, such as touch, pressure, and even mental processing, travel on larger nerve pathways. These larger nerves can effectively "close the gate" on the noxious stimuli. Comfort theory is a nursing framework espousing meeting basic human needs. The Bradley method is a childbirth education model involving the partner as the coach. The fear-tension-pain cycle is a pain management model popularized by Grantly Dick-Read.

Question 8

Outlining the risks, benefits, and alternatives of any proposed procedure or treatment during pregnancy, labor, birth, and postpartum is known as?&#10;A)Satisficing&#10;B)Informed consent&#10;C)Problem analysis&#10;D)Cost-benefit analysis

Accepted Answer

Informed consent is the general term meaning that the healthcare provider educates the patient about the risks, benefits, and alternatives to any procedure, including doing nothing. The phrase implies that the patient will consent once all of the information is outlined for them, but the patient does have the right to informed refusal, as well. A pregnant or laboring mother may need help understanding her options to make a truly informed decision. Satisficing, problem analysis, and cost-benefit analysis are decision-making strategies.

Question 9

For pregnant couples, the benefits of attending a childbirth preparation class include:&#10;A)The chance to socialize with other pregnant couples&#10;B)The opportunity to set goals and participate in decision-making during the perinatal period&#10;C)An increase in confidence about the birth process&#10;D)All of the above

Accepted Answer

A pregnant woman and her partner should be encouraged to attend childbirth preparation classes in order to learn more about the normal course of pregnancy, labor, birth, and the postpartum period. In addition to this practical information, couples will have the opportunity to make connections with others at the same stage of development, a benefit that should not be overlooked. In addition, research shows women who attend birthing classes are more confident in the decisions they make.

Question 10

Research shows that doula care during labor and birth can:&#10;A)Improve maternal satisfaction with the birth process&#10;B)Decrease the risk of Caesarean birth&#10;C)Increase the partner's feelings of inadequacy&#10;D)Only A&B

Accepted Answer

Doula care not only reduces the chance of a Caesarean birth, but also lessens the need for pain medication and assisted delivery (forceps or vacuum extraction). Mothers who have a doula during their labor and birth report fewer negative feelings about the overall experience, and have an easier time adjusting to their new parenting role. While some people may initially think the doula usurps the partner's place as the mother's support person, the doula actually supports both mom and her partner during the birth process.

Question 11

Relaxation can reduce the perception of pain, as well as increase the pain threshold. Active relaxation techniques can effectively reverse negative trends in which of the following pain management models?

A)Dissociation
B)Fear-tension-pain cycle
C)Hawthorne effect
D)Cognitive control

Accepted Answer

The answer of Relaxation can reduce the perception of pain,...

Question 12

What does the term &#34;doula&#34; mean and where did it originate?&#10;A)Doula means &#34;labor support profession&#34; in modern Portuguese&#10;B)Doula means &#34;a woman who serves&#34; in ancient Greek&#10;C)Doula means &#34;supporter&#34; in modern Greek&#10;D)Doula means &#34;natural birth&#34; in Spanish

Accepted Answer

The answer of What does the term &#34;doula&#34; mean and...

Question 13

Which of the following is NOT a principle of ethics that applies to childbirth?&#10;A)Autonomy&#10;B)Nonmaleficence&#10;C)HIPAA&#10;D)Justice

Accepted Answer

The answer of Which of the following is NOT a...

Question 14

While all doulas hope to only help couples through happy births, occasionally unexpected outcomes cause grief reactions in the couples doulas support, as well as in the doula herself. Which of the following is NOT a way to help with grieving?

A)Leave the woman or couple alone after their loss so you don't serve as a reminder.
B)Continue to support the couple through their grieving by answering questions.
C)Let the couple know a wide variety of reactions are appropriate.
D)The doula should seek support herself through colleagues or trained grief counselors.

Accepted Answer

The answer of While all doulas hope to only help...

Question 15

Why is professional labor support needed in the modern maternity care model?&#10;A)Because women have forgotten how to birth&#10;B)Because women have lost touch with their inner wisdom&#10;C)Because partners are not able to learn enough about birth&#10;D)Because continuous support by an experienced woman brings about better birth outcomes

Accepted Answer

The answer of Why is professional labor support needed in...

Question 16

Which of the following is NOT within the scope of practice for a doula?&#10;A)Vaginal exams to assess cervical dilation&#10;B)Advocating for parents' wishes&#10;C)Emotional support before, during and after birth&#10;D)Physical support with comfort measures during labor and birth

Accepted Answer

The answer of Which of the following is NOT within...

Question 17

Which of the following is a past experience that might impact a woman's ability to birth confidently?&#10;A)Level of education&#10;B)A history of infertility and miscarriage&#10;C)Growing up in a rural area&#10;D)Having no significant health challenges

Accepted Answer

The answer of Which of the following is a past...

Question 18

Which of the following BEST describes the emotional stages of pregnancy?&#10;A)Incorporation, differentiation, attachment, separation&#10;B)Denial, anger, guilt, sadness, acceptance, resolution&#10;C)First stage, second stage, third stage&#10;D)Early, active, transition

Accepted Answer

The answer of Which of the following BEST describes the...

Question 19

Which of the following is NOT a frustration doulas have to contend with?&#10;A)Always being &#34;on-call&#34;&#10;B)Adversarial relationships with maternity center staff&#10;C)Parents who act as their own advocates&#10;D)Clients who place blame rather than taking responsibility

Accepted Answer

The answer of Which of the following is NOT a...

Question 20

&#34;Women's ways of knowing&#34; is a phrase that implies women have the inherent knowledge necessary to make decisions and these decisions may stem from intuition. This is opposed to a power-based model where the keepers of knowledge know best what decisions a woman should make. The terms for these two thought processes might be viewed as:&#10;A)Embodied versus authoritative knowledge&#10;B)Expectant versus active management&#10;C)Authoritative versus embodied knowledge&#10;D)Woman-centered versus medically-managed care

Accepted Answer

The answer of &#34;Women's ways of knowing&#34; is a phrase...

Question 21

In addition to providing physical and emotional support during labor, the doula also acts as a patient advocate for her clients. This role is BEST defined as:&#10;A)Creating dependency in the couple due to their lack of knowledge of the maternity care system&#10;B)Supporting the woman and her partner in seeking individual solutions to problems within a maternity care system that is sometimes rigid&#10;C)Using her power over others within the maternity care system to support a laboring couple's wishes&#10;D)Forming antagonistic relationships with the healthcare staff

Accepted Answer

The answer of In addition to providing physical and emotional...

Question 22

With the ease of medicated birth and modern technological interventions, natural birth may seem like a lesser alternative. Which of the following is NOT an advantage of natural birth?&#10;A)All interventions are without risk, making a medicated birth and natural birth equal as far as risk.&#10;B)A woman who gives birth naturally maintains her locus of control.&#10;C)Natural birth encourages a woman to trust her body, improving her body image and self esteem for the rest of her life.&#10;D)A woman who learns to advocate for herself in birth will be better able to advocate for her family.

Accepted Answer

The answer of With the ease of medicated birth and...

Question 23

In order to help mothers have the births they want, it is necessary for the doula to enlist the support and trust of the entire healthcare team. Ways to do this include all of the following EXCEPT:&#10;A)Keep all your thoughts about the staff to yourself, and only share them with your colleagues.&#10;B)Help the staff understand their importance in the mother's memory of this birth.&#10;C)Recognize you are all part of the same team helping the mother achieve the birth she wants.&#10;D)Help the staff see the benefits of natural birth, and the challenge and excitement of working with these mothers.

Accepted Answer

The answer of In order to help mothers have the...

Question 24

Which of the following does NOT factor into how the continuity of care by a doula contributes the psychological well-being of a laboring mother?&#10;A)A physician other than the mother's primary caregiver may need to deliver the baby.&#10;B)The labor nurse may meet the end of her work shift mid-labor.&#10;C)The doula is present before, during, and after the birth.&#10;D)The doula is the only support needed so that the partner does not need to be involved.

Accepted Answer

The answer of Which of the following does NOT factor...

Question 25

Three components of relaxation include cognitive, affective. and psychomotor processes. Which of the following does NOT describe how these categories can inform relaxation training?&#10;A)Parents can be taught how stress can physically changes the body.&#10;B)The emotional environment is more important than the physical environment for relaxation to occur.&#10;C)Assessing fears is an integral part of the affective component of relaxation training.&#10;D)A partner's assistance in relaxation training can give the mother a sense of trust and confidence in his or her ability to support the mother when she is vulnerable.

Accepted Answer

The answer of Three components of relaxation include cognitive, affective....

Question 26

Which of the following is the most important aspect of the doula - client relationship?&#10;A)Power dynamics&#10;B)Trust&#10;C)Locus of control&#10;D)Gratitude

Accepted Answer

The answer of Which of the following is the most...

Question 27

The mother, and the doula, can use positive affirmations to form an optimistic attitude during birth. Which of the following is NOT a positive affirmation that would helpful in labor?&#10;A)I must try harder to relax.&#10;B)I trust my body to give birth.&#10;C)I am strong and capable.&#10;D)Each contraction is my body hugging my baby.

Accepted Answer

The answer of The mother, and the doula, can use...

Question 28

Partners experience childbirth in ways different than mothers, because it is not an embodied experience for them. Which of the following is NOT true of the partner's role in birth?&#10;A)Partners are displaced by doulas&#10;B)Partners may be too close emotionally to provide objective judgment.&#10;C)Partners can provide more intimate support when the couple is assisted by a doula.&#10;D)Partners may feel decreased self-esteem and guilt if they are not able to help the laboring woman have the birth she imagined.

Accepted Answer

The answer of Partners experience childbirth in ways different than...

Question 29

The state of mental focus on the baby that begins in late pregnancy and continues for the first few weeks postpartum is called:&#10;A)Mothering the mother&#10;B)Role attainment theory&#10;C)Primary maternal preoccupation&#10;D)Attachment theory

Accepted Answer

The answer of The state of mental focus on the...

Question 30

Which of the following BEST describes evidence-based maternity care?&#10;A)Any research can be used to support any viewpoint on maternity care.&#10;B)Current research evidence supports the practice as beneficial to the mother and/or baby.&#10;C)Conducting research about birth&#10;D)Only a select group of statistics should be used to inform maternity care.

Accepted Answer

The answer of Which of the following BEST describes evidence-based...

Question 31

Research has shown that a woman's satisfaction with birth has less to do with __________ and more to do with _____________.&#10;A)Nurses/the doctor&#10;B)Pain/active participation&#10;C)Participation/pain&#10;D)Support/medication

Accepted Answer

The answer of Research has shown that a woman's satisfaction...

Question 32

The Bradley method of childbirth education is also known as:&#10;A)Husband-coached childbirth&#10;B)Midwifery model of care&#10;C)Medicalized birth&#10;D)Psychoprophylaxis

Accepted Answer

The answer of The Bradley method of childbirth education is...

Question 33

The Lamaze method of childbirth education focuses on which of the following:&#10;A)Breathing&#10;B)Partner support&#10;C)Increasing a mother's confidence&#10;D)All of the above

Accepted Answer

The answer of The Lamaze method of childbirth education focuses...

Question 34

Though birth is universal, the context given to the event by the culture in which a woman births, as well as the culture in which she was raised, can have a profound effect on birth. In order to function within this framework, a doula should:

A)Only judge situations by her own cultural standards since she is the caregiver.
B)Learn as much as she can about a client's cultural beliefs about pregnancy, birth, and parenting.
C)Assume the client will conform to the dominant cultural beliefs in the doula's own culture.
D)Use stereotypes and generalizations to come up with a care model.

Accepted Answer

The answer of Though birth is universal, the context given...

Question 35

Researchers have found that the childbirth experience has the potential to be pleasurable. Enjoyment of childbirth is most likely in women with which of the following characteristics?&#10;A)A history of dealing with menstrual problems&#10;B)A traditional view of gender roles&#10;C)A close marital relationship and the partner present at the birth&#10;D)A decision not to attend childbirth classes

Accepted Answer

The answer of Researchers have found that the childbirth experience...

Question 36

All of the following are ways in which the doula can enhance the early parenting experience EXCEPT:&#10;A)Help parents explore what support they have and what they might need&#10;B)Help parents forget the birth experience&#10;C)Help parents plan for the changes and difficulties associated with caring for a newborn&#10;D)Help the parents set realistic goals for meeting their own needs after birth

Accepted Answer

The answer of All of the following are ways in...

Question 37

Biofeedback is technically defined as the use of technology to provide information about bodily reactions so that a person can learn to control those responses. Which of the following is NOT another method for biofeedback?

A)Breathing awareness
B)Temperature feedback
C)Auditory/verbal feedback
D)Aromatherapy

Accepted Answer

The answer of Biofeedback is technically defined as the use...

Question 38

Imagery as a technique for relaxation in childbirth can BEST be described as:&#10;A)Daydreaming&#10;B)An attention focusing technique&#10;C)A cognitive tool involving all the senses&#10;D)An ineffective coping strategy

Accepted Answer

The answer of Imagery as a technique for relaxation in...

Question 39

Paced or patterned breathing can have all of the following effects EXCEPT:&#10;A)Decreased pain&#10;B)Energy conservation&#10;C)Hyperventilation&#10;D)Improved oxygenation to all muscles, including the uterus

Accepted Answer

The answer of Paced or patterned breathing can have all...

Question 40

Holism - the belief that body, mind and spirit are interconnected - along with the view of health as a balance of energy in the life forces, informs which of the following techniques for childbirth?&#10;A)Hypnosis&#10;B)Yoga&#10;C)Accupressure&#10;D)Feng shui

Accepted Answer

The answer of Holism - the belief that body, mind...

Question 41

Encouraging couples to examine their own philosophy of birth early before they write their birth plan can help with decision-making. Which of the following BEST describes a philosophy of birth:&#10;A)It is a new-age way of thinking about the world, especially childbirth.&#10;B)It provides a framework for understanding birth options and making personal choices.&#10;C)It discounts personal values and helps couples focus on information only to inform their actions.&#10;D)It leads to acquiring skills that will only be used during birth.

Accepted Answer

The answer of Encouraging couples to examine their own philosophy...

Question 42

A pregnant client asks the doula about non-pharmacologic methods for managing labor pains. The doula informs her about a method that is based on the idea that childbirth is a natural and joyful process. This method stresses the importance of having the husband's support during the pregnancy, labor, and early postpartum period. It also encourages walking during labor. The doula is describing which method to the client?

A)Lamaze method
B)Bradley method
C)Psychosexual method
D)Dick-Read method

Accepted Answer

The answer of A pregnant client asks the doula about...

Deck 6: Psychology Philosophy