Chapter 1 Contemporary Maternal-Newborn Care

Chapter 1   Contemporary Maternal-Newborn Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) During a prenatal visit, a client expresses interest in accessing community-based care and services. Which response allows the registered nurse to best describe services that are offered by way of community-based care?

1. “Most healthcare services provided to childbearing women and their families take place in a hospital setting.”
2. “Community-based care can provide a client with certain primary care services.”
3. “Nurses are the sole providers of services related to home care.”
4. “Due to lack of support from third-party payers, community-based care has decreased.”

Answer:  2

Explanation:  1. The majority of health care provided to childbearing women and their families takes place outside of hospital in clinics, offices, community-based organizations, and private homes.

2. Primary care includes health promotion and illness prevention, and it features services that are best provided in community-based settings.
3. While nurses are the major providers of home care services, healthcare providers in various other fields, such as physical therapy, also offer home care services.
4. As third-party payers begin to recognize the importance of primary care in containing costs and maintaining health, community-based care has increased.

Page Ref: 3

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 1.2-Describe the use of community-based nursing care in meeting the needs of childbearing families.

MNL LO:  Overview of maternal-newborn nursing.

 

2) The labor and delivery nurse and a novice nurse are admitting a client who is in labor. The client is making groaning guttural sounds during contractions and answers questions with one-word answers. The labor and delivery nurse is quickly setting up the instruments and sterile field for this delivery while asking admission questions between contractions. The labor and delivery nurse has not completed a pelvic exam. The novice nurse understands that this is an example of:

1. An expert nurse assessing advanced labor and imminent delivery in the client.
2. The correct order of steps when admitting a who is in labor.
3. Inconsistencies in an individual nurse’s approach to client care.
4. Advanced nurse practice.

Answer:  1

Explanation:  1. An expert nurse utilizes multiple aspects of a client’s behavior (including the length of each response to a question and sounds the patient produces during contractions) in addition to the more objective findings of the pelvic exam (including dilation of the cervix) in the assessment of a who is in labor. The expert nurse has identified that the grunting and guttural sounds during contractions are involuntary pushing and that the client is very close to delivery.

2. Although most nurses have a routine when admitting a client, the order of the steps will vary according to the situation at hand.
3. Changing the order of the steps of admission is not being inconsistent; changing the order of the steps of admission is responsive to the needs of the client at that point in time.
4. Advanced nurse practice describes educational and certification achievement and is not used to describe the continuum from novice to expert.

Page Ref: 4, 5

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 1.3-Identify the nursing roles available to the maternal-newborn and women’s healthcare nurses.

MNL LO:  Overview of maternal-newborn nursing.

 

3) Currently, one-third of children under 20 years old come from families of minority populations. The new nurse is observing her preceptor assess the client’s communication pattern, religious beliefs, level of education, and support system. The new nurse understands that the best reason for her preceptor to assess these areas is to increase the:

1. Client’s cooperation with the plan of care.
2. Hospitals compliance with the Joint Commission on Accreditation of Healthcare Organizations JCAHO standards.
3. Nurse’s knowledge of cultural beliefs.
4. Client’s satisfaction with her care.

Answer:  1

Explanation:  1. Gaining cooperation with the plan of care increases the outcome desired at discharge. When a client’s value system is not included in the plan of care, it will decrease compliance with the treatment plan and possibly increase the length of stay and decrease the desired outcome at discharge.

2. Although compliance with JCAHO standards is very important, it is more important to gain client cooperation with the plan of care.
3. The nurse’s knowledge of cultural beliefs increases the ability to care for the client, but without the client’s cooperation with the plan of care, the nurse’s knowledge is lost.
4. Client satisfaction with care is important, but the prime reason for the satisfaction is the nurse’s taking time to gain patient cooperation with the plan of care.

Page Ref: 4, 5

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 1.3-Identify the nursing roles available to the maternal-newborn and women’s healthcare nurses.

MNL LO:  Overview of maternal-newborn nursing.

 

4) The client at 30 weeks’ gestation expresses a desire for the registered nurse to independently manage her perinatal care and the birth of her baby. When the nurse explains she is not credentialed to independently manage the client’s perinatal care and delivery, the nurse is recognizing principles related to:

1. Standards of care.
2. Scope of practice.
3. Right to privacy.
4. Informed consent.

Answer:  2

Explanation:  1. Standards of care pertain to established minimum criteria for competent, proficient actions related to delivery of nursing care.

2. Scope of practice is defined as the limits of nursing practice set forth in state statutes.
3. Right to privacy involves the legal right of a person to keep her or his person and property free from public scrutiny.
4. Informed consent is a legal concept that protects a client’s right to autonomy and self-determination.

Page Ref: 4, 5

Cognitive Level:  Understanding

Client Need&Sub:  Safe and Effective Care Environment | Management of Care

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Coordination of care

Learning Outcome:  LO 1.3-Identify the nursing roles available to the maternal-newborn and women’s healthcare nurses.

MNL LO:  Overview of maternal-newborn nursing.

 

5) The certified nurse-midwife (CNM) role includes which of the following? Select all that apply.

1. Prepared to independently the care of women that are at low risk for complications during pregnancy and birth
2. Provides primary care for high-risk patients who are in hospital settings
3. Provides primary care for healthy newborns
4. Obtains a physician consultation for any technical procedures at delivery
5. Formal educated in two disciplines of nursing

Answer:  1, 3, 5

Explanation:  1. A CNM is prepared to independently manage the care of women at low risk for complications during pregnancy and birth.

2. CNMs cannot give primary care for high-risk patients who are in hospital settings. The physician provides the primary care for high-risk patients who are in hospital settings.
3. A CNM is prepared to manage independently the care of healthy newborns.
4. The CNM does not need to obtain a physician consultation for any technical procedures at delivery.
5. The CNM is educated in the disciplines of nursing and midwifery.

Page Ref: 4, 5

Cognitive Level:  Understanding

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VI: Interprofessional communication and collaboration for improving patient health outcomes | NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 1.3-Identify the nursing roles available to the maternal-newborn and women’s healthcare nurses.

MNL LO:  Overview of maternal-newborn nursing.