Chapter 19 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Chapter 19 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nurse is orienting a new graduate nurse to the labor and birth unit. Which statement indicates that teaching has been effective? “When a patient 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.

Rationale 2: Supine position predisposes the patient to supine hypotension syndrome; side-lying is preferred.

Rationale 3: Domestic abuse is not the sole reason the prenatal record is examined; any complications of pregnancy are noted.

Rationale 4: Unless delivery seems imminent because the patient is bearing down or contractions are very close and strong, the vaginal exam is performed after the vital signs are obtained.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO01 – Identify admission data for a woman admitted to the birthing area.

 

Question 2

Type: MCMA

The patient presents to labor and delivery stating that her water broke two hours ago. Indicators of normal labor include:

Standard Text: 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.

Correct Answer: 1,2,5

Rationale 1: FHR 120–160 with variability is a normal indication.

Rationale 2: Maternal vital sign of blood pressure below 140/70 is a normal indication.

Rationale 3: A pulse of 60–100 is a normal indication.

Rationale 4: Proteinuria of +1 or more could be a sign of pre-eclampsia.

Rationale 5: Fluid clear and without odor is a normal indication.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO01 – Identify admission data for a woman admitted to the birthing area.

 

Question 3

Type: MCSA

The laboring patient 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.

Rationale 2: Establishing rapport will decrease anxiety of the couple and facilitate a more pleasant birth experience.

Rationale 3: Welcoming the couple is more important upon arrival.

Rationale 4: Although assessing for intact or ruptured membranes is a part of the admission assessment, welcoming the couple is more important upon arrival.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO02 – Describe the nursing care of a woman and her partner/family upon admission to the birthing area.

 

Question 4

Type: MCSA

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 patient’s mother might be of more help.

Correct Answer: 3

Rationale 1: Insisting that the father leave does not reassure him about the care the woman will receive in his absence.

Rationale 2: Telling him that he is ineffective does not reassure him about the care the woman will receive in his absence.

Rationale 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.

Rationale 4: Suggesting that the patient’s mother take his place does not reassure him about the care the woman will receive in his absence.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO02 – Describe the nursing care of a woman and her partner/family upon admission to the birthing area.