Chapter 01: The Past, Present, and Future

Chapter 01: The Past, Present, and Future

Leifer: Introduction to Maternity and Pediatric Nursing, 8th Edition

MULTIPLE CHOICE

• A patient chooses to have the certified nurse-midwife (CNM) provide care during her

pregnancy. What does the CNM’s scope of practice include?

• Practice independent from medical supervision
• Comprehensive prenatal care
• Attendance at all deliveries
• Cesarean sections

ANS: B

The CNM provides comprehensive prenatal and postnatal care, attends uncomplicated deliveries, and ensures that a backup physician is available in case of unforeseen problems.

DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5 TOP: Advance Practice Nursing Roles KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

• Which medical pioneer discovered the relationship between the incidence of puerperal

fever and unwashed hands?

• Karl Credé
• Ignaz Semmelweis
• Louis Pasteur
• Joseph Lister

ANS: B

Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by the unwashed hands of physicians and medical students.

DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1 TOP: The Past KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

• A pregnant woman who has recently immigrated to the United States comments to the

nurse, “I am afraid of childbirth. It is so dangerous. I am afraid I will die.” What is the best nursing response reflecting cultural sensitivity?

• “Maternal mortality in the United States is extremely low.”
• “Anesthesia is available to relieve pain during labor and childbirth.”
• “Tell me why you are afraid of childbirth.”
• “Your condition will be monitored during labor and delivery.”

ANS: C

Asking the patient about her concerns helps promote understanding and individualizes patient care.

DIF: Cognitive Level: Application REF: pp. 6-8 OBJ: 8 TOP: Cross-Cultural Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation

(Introduction to Maternity and Pediatric Nursing, 8th Edition Gloria Leifer) (Test Bank all Chapters) 1 / 4

• An urban area has been reported to have a high perinatal mortality rate. What information

does this provide?

• Maternal and infant deaths per 100,000 live births per year
• Deaths of fetuses weighing more than 500 g per 10,000 births per year
• Deaths of infants up to 1 year of age per 1000 live births per year
• Fetal and neonatal deaths per 1000 live births per year

ANS: D

The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.

DIF: Cognitive Level: Comprehension REF: p. 12|Box 1-6 OBJ: 9 TOP: The Present-Child Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

• What is the focus of current maternity practice?
• Hospital births for the majority of women
• The traditional family unit
• Separation of labor rooms from delivery rooms
• A quality family experience for each patient

ANS: D

Current maternity practice focuses on a high-quality family experience for all families, traditional or otherwise.

DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: 5 TOP: The Present-Maternity Care KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance

• Who advocated the establishment of the Children’s Bureau?
• Lillian Wald
• Florence Nightingale
• Florence Kelly
• Clara Barton

ANS: A

Lillian Wald is credited with suggesting the establishment of a federal Children’s Bureau.

DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 1 | 2 TOP: The Past KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

• What was the result of research done in the 1930s by the Children’s Bureau?
• Children with heart problems are now cared for by pediatric cardiologists.
• The Child Abuse and Prevention Act was passed.
• Hot lunch programs were established in many schools.
• Children’s asylums were founded.

ANS: C

School hot lunch programs were developed as a result of research by the Children’s Bureau on the effects of economic depression on children. 2 / 4

DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 2 | 3 TOP: The Past KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

• What government program was implemented to increase the educational exposure of

preschool children?

• WIC
• Title XIX of Medicaid
• The Children’s Charter
• Head Start

ANS: D

Head Start programs were established to increase educational exposure of preschool children.

DIF: Cognitive Level: Knowledge REF: p. 3 OBJ: 3 TOP: Government Influences in Maternity and Pediatric Care KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

• What guidelines define multidisciplinary patient care in terms of expected outcome and

timeframe from different areas of care provision?

• Clinical pathways
• Nursing outcome criteria
• Standards of care
• Nursing care plan

ANS: A

Clinical pathways, also known as critical pathways or care maps, are collaborative guidelines that define patient care across disciplines. Expected progress within a specified timeline is identified.

DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 10 TOP: Health Care Delivery Systems KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

• A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her

mother, and collected admission data. What is the next step the student will take to develop a nursing care plan for this child?

• Identify measurable outcomes with a timeline.
• Choose specific nursing interventions for the child.
• Determine appropriate nursing diagnoses.
• State nursing actions related to the child’s medical diagnosis.

ANS: C

The nurse uses assessment data to select appropriate nursing diagnoses from the NANDA-I list. Outcomes and interventions are then developed to address the relevant nursing diagnoses.

DIF: Cognitive Level: Application REF: p. 11 OBJ: 7 TOP: Nursing Process KEY: Nursing Process Step: Nursing Diagnosis 3 / 4

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

• A nursing student on an obstetric rotation questions the floor nurse about the definition of

the LVN/LPN scope of practice. What resource can the nurse suggest to the student?

• American Nurses Association
• State’s board of nursing
• Joint Commission
• Association of Women’s Health, Obstetric and Neonatal Nurses

ANS: B

The scope of practice of the LVN/LPN is published by the state’s board of nursing.

DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: 2 TOP: Critical Thinking KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

• What was recommended by Karl Credé in 1884?
• All women should be delivered in a hospital setting.
• Chemical means should be used to combat infection.
• Podalic version should be done on all fetuses.
• Silver nitrate should be placed in the eyes of newborns.

ANS: D

In 1884 Karl Credé recommended the use of 2% silver nitrate in the eyes of newborns to reduce the incidence of blindness.

DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1 TOP: Use of Silver Nitrate KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

• What is the purpose of the White House Conference on Children and Youth?
• Set criteria for normal growth patterns.
• Examine the number of live births in minority populations.
• Raise money to support well-child clinics in rural areas.
• Promote comprehensive child welfare.

ANS: D

White House Conferences on Children and Youth are held every 10 years to promote comprehensive child welfare.

DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: 2 TOP: White House Conferences KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

• How many hours of hospital stay does legislation currently allow for a postpartum patient

who has delivered vaginally without complications?

• 24
• 48
• 36
• 72

ANS: B

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