ESSENTIALS OF MATERNITY, NEWBORN & WOMEN’S
HEALTH NURSING
6TH EDITION
CHAPTER No. 01: PERSPECTIVES ON MATERNAL, NEWBORN,
AND
WOMEN’S HEALTH CARE
ANSWERS TO WORKSHEET QUESTIONS
ANSWERS TO DEVELOPING CLINICAL JUDGMENT
PRACTICING FOR NCLEX
1. The correct response is D. The leading cause of mortality in female patients is heart disease,
accounting for about 310,600 deaths per year. Cancer is the second leading cause of death in female
patients. Deaths occur secondary to childbirth complications but the numbers are much lower than
cardiovascular disease. Statistics for injury resulting from violence would be much less than when
compared to the number of female patients who die annually from heart disease.
2. The correct response is C. Lack of adequate health insurance is a major barrier to receiving adequate
prenatal care. Access to health care is affected negatively by lack of health insurance. Without health
insurance, many have limited options to procure prenatal care. Statistics will demonstrate the better
outcomes with prenatal care and most pregnant patients would want to have medical supervision for a
,better outcome. Most patients seek care early in the pregnancy, except for adolescents who hide or are
unaware of their pregnancy. The majority of pregnant patients receive quality prenatal care and the
outcome is positive. The mistrust of traditional medical practices may play a role in some pregnant
patients from different cultures since they differ in their own cultural health practices.
3. The correct responses are b, c, and e, because all three items make up case management. Case
management is a collaborative interdisciplinary process of assessment, planning, application,
coordination of care, follow-up, and evaluation of the options and services required to meet an
individual’s health needs through communication and available resources to promote improved health
outcomes and quality cost-effective results. Primary care does focus on the patient, but is not a case
management concept.
4. The correct response is C, because every culture has numerous differences, values, traditions, and
ways they wish to receive health care. Nurses working with diverse populations must have knowledge
of these variations to meet the needs of each patient. People are individuals within each culture, thus
they are not all the same even within the same culture; human physiology is not based on culture, but
rather genetics and environment; and is an incorrect response because minority cultures in the United
States are not all new immigrants, as many have been born in the United States and lived here all of
their lives.
,5. The correct responses are b, c, and d. Factors contributing to homelessness include economic factors
such as the increase in poverty, lack of affordable housing, decreases in availability of rent subsidies,
unemployment, and cutbacks in public welfare programs. Personal crises such as divorce, domestic
violence, and substance misuse also are factors. Deinstitutionalization of people with a mental disorder
has played a major role, especially without the development of community centers and homes to assist
these individuals during times of crisis.
CRITICAL THINKING EXERCISE
1.
a. Many of the patients may have employment based on an hourly wage. If they don’t work, they
don’t get paid, and therefore can’t attend the clinic during their normal work hours. Offer
evening and Saturday hours to improve their attendance at clinic appointments.
b. Acceptance and a supportive tone are frequently set at the initial meeting, and one may need to
examine how this is communicated to patients at their first encounter with the clinic staff. Offer
suggestions of how the staff can set a positive, welcoming tone so patients will return for
additional care.
c. Have a staff person call each patient to remind them of their appointment the next day and offer
any needed assistance to get them there. Assign a staff member to be an “outreach” person to
make home visits to follow-up on patients who habitually miss appointments.
d. Educate staff concerning cultural norms regarding the patients served. Based on the culture
served, devise culturally appropriate policies and procedures.
, STUDY ACTIVITIES
1. Answers will vary depending on your location and time period when researched.
2. Depending on the students’ frames of reference, some will think it is a right and the government
should provide it for all citizens. Others will think it should be a privilege and should be paid for by the
person and not the government. There is no right or wrong answer, but this topic can provide for a
lively classroom discussion.
3. Female patients lack insurance to pay for services, no transportation available to get to services,
language or cultural barriers, health care agency hours are in conflict with their work hours, and
negative health staff attitudes.