Chapter 08 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 08 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 08_LO01_Q01

The nurse in the obstetrical clinic is setting appointments for clients seeking preconceptual care. Which client should be seen first?

1. 36-year-old, has never been pregnant, takes medication for a seizure disorder
2. 15-year-old, smokes one pack per day, had a miscarriage four months ago
3. 22-year-old, runs long distances, has been on the pill for six years
4. 29-year-old, has had two abortions, takes a multiple-vitamin supplement

Correct Answer: 1

Rationale:

1. This client is the top priority because she has multiple risk factors: She is over the age of 35 and therefore is at risk for trisomies; some medications are teratogenic, and are contraindicated during pregnancy; and pregnancy is not recommended for women with some conditions. This client needs to see the specialist who prescribes her anti-seizure medication, as well with an obstetric provider to discuss the risks her age present to a possible pregnancy.
2. Although this client has the risks of being young and a smoker, she is not the highest priority.
3. The only risk factor this client has is a need to increase folic acid intake due to being on the pill for six years.
4. This client has no risk factors for pregnancy. A history of more than three abortions increases the risks of preterm labor and infertility, but this client has only had two abortions.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 8.1 Describe the most appropriate nursing care for couples during preconception counseling to help ensure their best possible health state.

Chapter 08_LO01 _Q02

A primigravida is admitted to the labor unit with contractions every 7–8 minutes. She is 3 cm dilated, 70% effaced, and at 0 station. She is very anxious, is having difficulty coping with contractions, and states that she did not attend prenatal classes. Which of the following would be the most effective nursing intervention?

1. Instruct the client in abdominal breathing and progressive relaxation.
2. Instruct the client in patterned, paced breathing and touch relaxation.
3. Instruct the client in pelvic tilt and pelvic rock exercises.
4. Call the physician and request a sedative.

Answer: 1

Rationale:

1. Abdominal breathing and progressive relaxation assist the client in relaxing, and allow the uterine muscles to work more efficiently.
2. Patterned, paced breathing and touch relaxation are exercises that are taught in childbirth preparation classes and involve the use of a partner.
3. Pelvic tilt and rock exercises are body-conditioning exercises.
4. Providing sedatives would not allow the client to participate actively in the process.

Cognitive Need: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome 8.1 Describe the most appropriate nursing care for couples during preconception counseling to help ensure their best possible health state.

Chapter 08_LO01 _Q03

The nurse is assisting an expectant couple in developing a birth plan. Which of the following instructions would the nurse include in the teaching plan?

1. The birth plan includes only client choices, and does not take into account standard choices of the health care provider.
2. The birth plan allows the client to make choices about the birth process; however, these choices cannot be altered.
3. The birth plan is a legally binding contract between the client and the health care provider.
4. The birth plan is a communication tool between the client and the health care provider.

Answer: 4

Rationale:

1. The birth plan is used as a tool for communication among the expectant parents, the health care provider, and the health care professionals at the birth setting.
2. The written plan identifies options that are available; thus, it can be altered.
3. It is not a legal document.
4. The birth plan is used as a tool for communication among the expectant parents, the health care provider, and the health care professionals at the birth setting.

Cognitive Level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Planning

Learning Outcome 8.1 Describe the most appropriate nursing care for couples during preconception counseling to help ensure their best possible health state.

Chapter 08_LO01 _Q04

A couple would like their 5-year-old to attend the birth. Which statement by the nurse would assist in the family’s plan to include their 5-year-old in the birth?

1. “You should let your child stay home, because you will be focusing on the birth.”
2. “Children under 12 are not allowed to be present at the birth.”
3. “You should bring someone who only will tend to any specific needs of your child.”
4. “Bring some toys to keep your child occupied.”

Answer: 3

Rationale:

1. A sibling should have his own support person whose primary responsibility is to take care of the child’s needs so that the child will have support if anxiety develops over the birth process, and the mother can concentrate on the labor and birth.
2. Children are allowed to be present at births.
3. A sibling should have his own support person whose primary responsibility is to take care of the child’s needs so that the child will have support if anxiety develops over the birth process, and the mother can concentrate on the labor and birth.
4. Preparing the child on what to expect is beneficial. Toys will not sustain a 5-year-old’s attention for an extended time period.

Cognitive Level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome 8.1 Describe the most appropriate nursing care for couples during preconception counseling to help ensure their best possible health state.