In the traditional hospital setting, the mother may see the infant for only short feeding periods,
and the infant is cared for in a separate nursery. The labor/delivery/recovery/postpartum room
setting allows increased parent-infant contact. Birth centers are set up to allow an increase in
parent-infant contact. Home births allow an increase in parent-infant contact.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 2 OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
As a result of changes in health care delivery and funding, a current trend seen in the pediatric
setting is
a. increased hospitalization of children.
b. decreased number of children living in poverty.
c. an increase in ambulatory care.
d. decreased use of managed care.
ANS: C
One effect of managed care has been that pediatric health care delivery has shifted
dramatically from the acute care setting to the ambulatory setting in order to provide more
cost-efficient care. The number of hospital beds being used has decreased as more care is
given in outpatient settings and in the home. The number of children living in poverty has
increased over the past decade. One of the biggest changes in health care has been the growth
of managed care.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 5 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
1. The Women, Infants, and Children (WIC) program provides
a. well-child examinations for infants and children living at the poverty level.
b. immunizations for high-risk infants and children.
c. screening for infants with developmental disorders.
d. supplemental food supplies to low-income pregnant or breastfeeding women.
ANS: D
WIC is a federal program that provides supplemental food supplies to low-income women
who are pregnant or breastfeeding and to their children until age 5 years. Medicaid’s Early
and Periodic Screening, Diagnosis, and Treatment Program provides for well-child
examinations and for treatment of any medical problems diagnosed during such checkups.
Children in the WIC program are often referred for immunizations, but that is not the primary
focus of the program. Public Law 99-457 is part of the Individuals with Disabilities Education
Act that provides financial incentives to states to establish comprehensive early intervention
services for infants and toddlers with, or at risk for, developmental disabilities.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 8
OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance
2. In most states, adolescents who are not emancipated minors must have the permission of their
parents before
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, a. treatment for drug abuse.
b. treatment for sexually transmitted diseases (STDs).
c. accessing birth control.
d. surgery.
ANS: D
Minors are not considered capable of giving informed consent, so a surgical procedure would
require consent of the parent or guardian. Exceptions exist for obtaining treatment for drug
abuse or STDs or for getting birth control in most states.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 17 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
3. The maternity nurse should have a clear understanding of the correct use of a clinical
pathway. One characteristic of clinical pathways is that they
a. are developed and implemented by nurses.
b. are used primarily in the pediatric setting.
c. set specific time lines for sequencing interventions.
d. are part of the nursing process.
ANS: C
Clinical pathways are standardized, interdisciplinary plans of care devised for patients with a
particular health problem. They are used to identify patient outcomes, specify time lines to
achieve those outcomes, direct appropriate interventions and sequencing of interventions,
include interventions from a variety of disciplines, promote collaboration, and involve a
comprehensive approach to care. They are developed by multiple health care professionals
and reflect interdisciplinary care. They can be used in multiple settings and for patients
throughout the life span. They are not part of the nursing process but can be used in
conjunction with the nursing process to provide care to patients.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 7 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
4. The fastest growing group of homeless people is
a. men and women preparing for retirement.
b. migrant workers.
c. single women and their children.
d. intravenous (IV) substance abusers.
ANS: C
Pregnancy and birth, especially for a teenager, are important contributing factors for becoming
homeless. People preparing for retirement, migrant workers, and IV substance abusers are not
among the fastest growing groups of homeless people.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 14 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity
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, 5. A nurse wishes to work to reduce infant mortality in the United States. Which activity would
this nurse most likely participate in?
a. Creating pamphlets in several different languages using an interpreter.
b. Assisting women to enroll in Medicaid by their third trimester.
c. Volunteering to provide prenatal care at community centers.
d. Working as an intake counselor at a women’s shelter.
ANS: C
Prenatal care is vital to reducing infant mortality and medical costs. This nurse would most
likely participate in community service providing prenatal care outreach activities in
community centers, particularly in low-income areas. Pamphlets in other languages, enrolling
in Medicaid, and working at a women’s shelter all might impact infant mortality, but the
greatest effect would be from assisting women to get consistent prenatal care.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 14 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
6. The intrapartum woman sees no need for a routine admission fetal monitoring strip. If she
continues to refuse, what is the first action the nurse should take?
a. Consult the family of the woman.
b. Notify the provider of the situation.
c. Document the woman’s refusal in the nurse’s notes.
d. Make a referral to the hospital ethics committee.
ANS: B
Patients must be allowed to make choices voluntarily without undue influence or coercion
from others. The physician, especially if unaware of the patient’s decision, should be notified
immediately. Both professionals can work to ensure the mother understands the rationale for
the action and the possible consequences of refusal. The woman herself is the decision maker,
unless incapacitated. Documentation should occur but is not the first action. This situation
does not rise to the level of an ethical issue so there is no reason to call the ethics committee.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 18 OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
7. Which statement is true regarding the “quality assurance” or “incident” report?
a. The report assures the legal department that no problem exists.
b. Reports are a permanent part of the patient’s chart.
c. The nurse’s notes should contain, “Incident report filed, and copy placed in chart.”
d. This report is a form of documentation of an event that may result in legal action.
ANS: D
An incident report is used when something occurs that might result in legal action, such as a
patient fall or medication error. It warns the legal department that there may be a problem in a
particular patient’s care. Incident reports are not part of the patient’s chart; thus the nurses’
notes should not contain any reference to them.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 18 OBJ: Integrated Process: Communication and Documentation
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