Chapter 19 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 19 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 19_LO01_Q01

The nurse is orienting a new graduate nurse to the Labor and Birth unit. Which statement indicates that teaching has been effective? “When a client arrives in labor:

1. “A urine specimen is obtained by catheter to check for protein and ketones.”
2. “She will be positioned supine to facilitate a normal blood pressure.”
3. “Her prenatal record is reviewed for indications of domestic abuse.”
4. “A vaginal exam is performed if delivery appears to be imminent.”

Correct Answer: 4

Rationale:

1. A midstream clean-catch specimen is obtained to assess for proteinuria and ketonuria.
2. Supine position predisposes the client to supine hypotension syndrome; side-lying is preferred.
3. Domestic abuse is not the sole reason the prenatal record is examined; any complications of pregnancy are noted.
4. Unless delivery seems imminent because the client is bearing down or contractions are very close and strong, the vaginal exam is performed after the vital signs are obtained.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Evaluation

Learning Outcome: 19.1 Identify admission data of a woman admitted to the birthing area.

Chapter 19_LO01_Q02

The client presents to Labor and Delivery stating that her water broke two hours ago. Indicators of normal labor include: (Select all that apply.)

1. Fetal heart rate of 130 with average variability.
2. Blood pressure of 130/80.
3. Maternal pulse of 160.
4. Protein of +1 in urine.
5. Odorless, clear fluid on underwear.

Answer: 1, 2, 5

Rationale:

1. FHR 120–160 with variability is a normal indication.
2. Maternal vital sign of blood pressure below 140/70 is a normal indication.
3. A pulse of 60–100 is a normal indication.
4. Proteinuria of +1 or more could be a sign of pre-eclampsia.
5. Fluid clear and without odor is a normal indication.

Cognitive Level: Application

Category of Client Need: Health Promotion and Maintenance: Prevention and Early Detection

Nursing Process: Assessment

Learning Outcome: 19.1 Identify admission data of a woman admitted to the birthing area.

Chapter 19_LO02 _Q03

The laboring client and her partner have arrived at the birthing unit. Which step of the admission process should be undertaken first?

1. The sterile vaginal exam
2. Welcoming the couple
3. Auscultation of the fetal heart rate
4. Checking for ruptured membranes

Correct Answer: 2

Rationale:

1. The sterile vaginal exam should be performed after rapport has been established and maternal vital signs have been assessed.
2. Establishing rapport will decrease anxiety of the couple and facilitate a more pleasant birth experience.
3. Welcoming the couple is more important upon arrival.
4. Although assessing for intact or ruptured membranes is a part of the admission assessment, welcoming the couple is more important upon arrival.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 19.2 Describe the nursing care of a woman and her partner/family upon admission to the birthing area.

Chapter 19_LO02 _Q04

An expectant father has been at the bedside of his laboring partner for more than 12 hours. An appropriate nursing intervention would be to:

1. Insist that he leave the room for at least the next hour.
2. Tell him he is not being as effective as he was, and that he needs to let someone else take over.
3. Offer to remain with his partner while he takes a break.
4. Suggest that the client’s mother might be of more help.

Answer: 3

Rationale:

1. Insisting that the father leave does not reassure him about the care the woman will receive in his absence.
2. Telling him that he is ineffective does not reassure him about the care the woman will receive in his absence.
3. Support persons frequently are reluctant to leave the laboring woman to take care of their own needs. Offering to stay with the woman so that he can take a break reassures the support person that the woman will be well cared-for in his absence.
4. Suggesting that the client’s mother take his place does not reassure him about the care the woman will receive in his absence.

Cognitive Level: Analysis

Category of Client Need: Health Promotion and Maintenance: Prevention and Early Detection

Nursing Process: Implementation

Learning Outcome: 19.2 Describe the nursing care of a woman and her partner/family upon admission to the birthing area.