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Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank Copyright 2014 by Pearson Education, Inc.
Chapter 01 Question 1
Type: MCSA
During a prenatal visit, a patient 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?
- "Most healthcare services provided to childbearing women and their families take place in a hospital setting."
- "Community-based care can provide a patient with certain primary care services."
- "Nurses are the sole providers of services related to home care."
- "Due to lack of support from third-party payers, community-based care has decreased."
Correct Answer: 2
Rationale 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.Rationale 2: Primary care includes health promotion and illness prevention, and it features services that are best provided in community-based settings.Rationale 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.Rationale 4: As third-party payers begin to recognize the importance of primary care in containing costs and maintaining health, community-based care has increased.
Global Rationale:
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO01 - Describe the use of community-based nursing care in meeting the needs of childbearing families.
Question 2
Type: MCSA
The labor and delivery nurse and a nurse new to the labor and delivery unit are admitting a laboring patient. The patient is making groaning guttural sounds during contractions and answering questions with one-word answers.(Contemporary Maternal Newborn Nursing 8e Patricia Ladewig, Marcia London, Michele) (Test Bank all Chapters) 1 / 4
Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank Copyright 2014 by Pearson Education, Inc.The labor and delivery nurse simultaneously is quickly setting up the instruments and sterile field for this delivery while asking the admission questions between contractions. The experienced labor and delivery nurse has not yet completed a pelvic exam. The nurse new to labor and delivery understands that this is an example of:
- An expert nurse assessing advanced labor and imminent delivery in the patient.
- The correct order of steps when admitting a laboring patient.
- Inconsistencies in an individual nurse’s approach to patient care.
- Advanced nurse practice.
Correct Answer: 1
Rationale 1: An expert nurse utilizes multiple aspects of a patient’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 laboring patient. The expert nurse has identified that the grunting and guttural sounds during contractions are involuntary pushing and that the patient is very close to delivery.Rationale 2: Although most nurses have a routine when admitting a patient, the order of the steps will vary according to the situation at hand.Rationale 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 patient at that point in time.Rationale 4: Advanced nurse practice describes educational and certification achievement and is not used to describe the continuum from novice to expert.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO02 - Distinguish among the education, qualifications, and scopes of practice in nurses caring for childbearing families.
Question 3
Type: MCSA
Currently, one-third of children under 20 years old come from families of minority populations. The new nurse is observing her preceptor assess the patient’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: 2 / 4
Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank Copyright 2014 by Pearson Education, Inc.
- Patient’s cooperation with the plan of care.
- Hospital’s compliance with the Joint Commission on Accreditation of Healthcare Organizations JCAHO
- Nurse’s knowledge of cultural beliefs.
- Patient’s satisfaction with her care.
standards.
Correct Answer: 1
Rationale 1: Gaining cooperation with the plan of care increases the outcome desired at discharge. When a patient’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.Rationale 2: Although compliance with JCAHO standards is very important, it is more important to gain patient cooperation with the plan of care.Rationale 3: The nurse’s knowledge of cultural beliefs increases the ability to care for the patient, but without patient cooperation with the plan of care, the nurse’s knowledge is lost.Rationale 4: Patient 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.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO02 - Distinguish among the education, qualifications, and scopes of practice in nurses caring for childbearing families.
Question 4
Type: MCSA
The patient 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 patient's perinatal care and delivery, the nurse is recognizing principles related to:
- Standards of care.
- Scope of practice.
- Right to privacy.
- Informed consent. 3 / 4
Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank Copyright 2014 by Pearson Education, Inc.
Correct Answer: 2
Rationale 1: Standards of care pertain to established minimum criteria for competent, proficient actions related to delivery of nursing care.Rationale 2: Scope of practice is defined as the limits of nursing practice set forth in state statutes.Rationale 3: Right to privacy involves the legal right of a person to keep her or his person and property free from public scrutiny.Rationale 4: Informed consent is a legal concept that protects a patient’s right to autonomy and self-determination in terms of his or her care.
Global Rationale:
Cognitive Level: Understanding
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO02 - Distinguish among the education, qualifications, and scopes of practice in nurses caring for childbearing families
Question 5
Type: MCMA
The certified nurse–midwife (CNM) role includes which of the following?
Standard Text: Select all that apply.
- Is prepared to manage independently the care of women at low risk for complications during pregnancy and
- Gives primary care for high-risk patients who are in hospital settings
- Gives primary care for healthy newborns
- Obtains a physician consultation for any technical procedures at delivery
- Is educated in two disciplines of nursing
birth
Correct Answer: 1,3,5
Rationale 1: A CNM is prepared to manage independently the care of women at low risk for complications during pregnancy and birth.Rationale 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.
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