Maternal & Child Health Nursing Care of the Childbearing & Childrearing Family 8th Edition Test Bank

Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family 8th Edition Test Bank 1. For which reasons would a nurse review infant mortality statistics in the United States? (Select all that apply.) A) Measures the quality of pregnancy care B) Reviews information on overall nutrition C) Compares health with those of other states D) Determines infant health and available care E) Provides an index of the country's general health Ans: A, B, D, E Feedback: Infant mortality statistics provide an index of a country's general health, measures the quality of pregnancy care, provides information on overall nutrition, and determines infant health and available care. Infant mortality statistics compares the health with those of other countries and not with those of other states. 2. The nurse is providing care in an organization that supports the maternal and child care continuum. Which type of patient care area is an example of this approach? A) Primary care B) Team nursing C) Case management D) Family-centered care Ans: D Feedback: Keeping the family at the center of care is important because the level of a family's functioning is important to the health status of its members. A healthy family establishes an environment conducive to growth and health-promoting behaviors to sustain family members during crises. A family-centered approach enables nurses to better understand individuals and their effect on others and, in turn, to provide more holistic care. Primary nursing, team nursing, and case management do not necessary take into consideration the maternal and child care continuum. 3. Which actions should the nurse perform when supporting the goals of maternal and child health care? (Select all that apply.) A) Advocates protecting the rights of the mother and fetus B) Teaches family members interventions to improve health C) Adheres to principles that focus on the needs of the mother D) Encourages maternal hospitalization to regain strength and stamina E) Assesses family members for strengths and specific needs or challenges Ans: A, B, E Feedback: Actions that the nurse should perform when supporting the goals of maternal and child health care include advocating the rights for the mother and fetus, teaching health promotion interventions, and assessing the family for strengths and specific needs or challenges. Adhering to principles that focus on the needs of the mother and encouraging maternal hospitalization to regain strength and stamina are not actions that support the goals of maternal and child health care. 4. The nurse is reviewing the 2020 National Health Goals and notes that which is a focus of these goals? A) Health promotion and disease prevention B) Early diagnosis of chronic health problems C) Effective use of medication to treat disease D) Reduce the cost of health care and medications Ans: A Feedback: The 2020 National Health Goals are intended to help citizens more easily understand the importance of health promotion and disease prevention and to encourage wide participation in improving health in the next decade. These goals do not focus on the early diagnosis of chronic problems, use of medications to treat disease, or reduce the cost of health care and medications. 5. The nurse has noticed a change in the type of care needed to support maternal and child health issues. What does the nurse realize as reasons for the changes in care? (Select all that apply.) A) Smaller families B) Less domestic violence C) More employed mothers D) Stable home environments E) More single-parent families Ans: A, C, E Feedback: Nursing care for maternal and child is changing because families are smaller, more mothers are employed out of the home, and there are more single-parent families. There is an increase in domestic violence, and families are less stable and more mobile, which influences homelessness. 6. During an assessment, the nurse asks a patient from a non-English-speaking culture which types of home remedies and herbs the patient uses for health care. What is the purpose of asking the patient this question? A) Analyze for herb–drug interactions B) Understand the patient's philosophy of alternative health care C) Determine the types of medications the patient will need to be prescribed D) Explain to the physician the patient's preference for nontraditional medicine approaches Ans: A Feedback: Assessing what alternative measures are being used is important because the action of an herb can interfere with prescribed medications. Assessing the use of herbal remedies is not done to understand the patient's philosophy of alternative health care, determine the types of medications the patient will need to be prescribed, or explain the patient's preferences for nontraditional medicine approaches to the physician. 7. The nurse notes that statistics on maternal mortality had improved but are again becoming elevated. What does the nurse realize as a reason for this change in maternal mortality rates? A) Earlier prenatal care B) Gestational hypertension C) Increased vaginal deliveries D) Treatment for chronic diseases Ans: B Feedback: This increasing rate in maternal mortality is associated with more cesarean births, more gestational hypertension related to preexisting hypertensive disorders, and lack of health insurance for many Americans. This increase is not because of earlier prenatal care, increased vaginal deliveries, or treatment for chronic diseases. 8. A new mother asks the nurse if all of the new baby's injections can be given in one visit because the mother is losing income from missing work because of the office visits. What does this new mother's issue indicate to the nurse? A) The mother needs to find an alternative employer. B) The mother's income is more important that the baby's health. C) Missing work does not support the baby's health maintenance visits. D) The federal government needs to do more to support well-baby visits. Ans: C Feedback: An area that needs additional research is finding effective stimuli to encourage women to bring children for health maintenance visits. The mother losing income because of missing work for well-baby visits will deter health maintenance visits for the baby going forward. This mother's issue does not indicate that the mother needs to find another job, that the mother's income is more important that the baby's health, or that the federal government needs to do more to support well-baby visits. 9. The nurse works in a maternal and child care area that supports health promotion. Which activities will the nurse perform to support this philosophy of health care? (Select all that apply.) A) Planning care B) Patient teaching C) Family counseling D) New mother advocacy E) Identifying nursing diagnoses Ans: B, C, D Feedback: Extensive changes in the scope of maternal and child health nursing have occurred as health promotion has become a greater priority in care. The nursing activities for health promotion include teaching, counseling, and advocacy. Planning care and identifying nursing diagnoses are a part of the nursing process and not specific to health promotion. 10. During a care conference, a nurse provides everyone with a copy of the latest research on improving the success of breastfeeding for first-time mothers. Which Quality & Safety Education for Nurses competency does this nurse's action support? A) Quality improvement B) Patient-centered care C) Evidence-based practice D) Teamwork and collaboration Ans: C Feedback: Providing research material supports the Quality & Safety Education for Nurses competency of evidence-based practice because the nurse is integrating the best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. Providing research evidence does not support the Quality & Safety Education for Nurses competencies of quality improvement, patient-centered care, or teamwork and collaboration. 11. The nurse is caring for a mother who has just given birth to twins of 28 weeks gestation, each weighing 2 kg. What is the health risk for the mother and the twins? A) Child mortality B) Neonatal death C) Infant mortality D) Maternal mortality Ans: B Feedback: Neonatal death reflects the quality of care available to women during pregnancy and childbirth and the quality of care available to infants during the first month of life. The leading causes of death during this time are prematurity with associated low birth weight. Child mortality is the number of people who die during childhood years. Infant mortality is the number of infants who die before the age of 1 year. Maternal mortality is the number of women who die from activities related to childbirth. 12. The nurse is planning an educational session for community members to address the issue of school-age child mortality. Which topic should the nurse identify as the highest priority for this population? A) Cancer B) Assault C) Suicide D) Accidents Ans: D Feedback: For the school-age child between the ages of 5 and 14 years, the number one cause of mortality is from unintentional injuries or accidents. Other top five causes for child mortality include cancer, assault, and suicide. 13. While providing care to a child, the nurse informs the parents about the treatment plans and helps the parents make decisions about the child's care needs. What do this nurse's actions support? A) Autonomy B) Empowerment C) Accountability D) Informed consent Ans: B Feedback: Nurses promote empowerment of parents and children by respecting their views and concerns, regarding parents as important participants in their own or their child's health, keeping them informed, and helping and supporting them to make decisions about care. The nurse's actions are not being done to support autonomy, accountability, or informed consent. 14. The nurse has been hired to provide care to patients on a maternal and child unit. What will the nurse use to as a guide to legally provide care to this patient population? A) Code of ethics B) Nursing research C) Standards of practice D) Evidence-based guidelines Ans: C Feedback: Understanding standards of care can help nurses practice within appropriate legal parameters. The Code of Ethics will help with ethical situations. Nursing research and evidence-based guidelines will help with providing care that is based upon best practices. 15. The nurse is providing care to a new mother and infant according to the Quality & Safety Education for Nurses competency approach. Which action should the nurse perform to demonstrate the skill for the competency of safety? A) Assess the mother for preferences based on personal values. B) Ensure the mother and newborn have intact identification bands. C) Introduce all members of the care team to the mother and family. D) Document patient care using computerized spreadsheets and forms. Ans: B Feedback: Action to demonstrate the skill of the competency of safety is to ensure that the mother and newborn have intact identification bands. Assessing the mother for preferences based on personal values is the skill associated with patient-centered care. Introducing all members of the care team to the mother and family is the skill associated with teamwork and collaboration. Documenting patient care using computerized spreadsheets and forms is the skill associated with quality improvement. 1. A school-age child, a member of a family with a mother, father, and toddler, is hospitalized. The father is employed outside of the home, and the mother stays at home with the other child. The mother is challenged with supporting both children at this time. What should the nurse suggest to the mother? A) Place the toddler in day care. B) Suggest the father take time off to help. C) Ask extended family members to help out during this time. D) Visit with the patient after the father comes home from work. Ans: C Feedback: In a time of crisis, the nuclear family is challenged because there are few family members to share the burden or look at a problem objectively. The nurse should suggest that the family locate and reach out to support people in their extended family during a crisis. Placing the toddler in day care and suggesting the father take time off to help might negatively impact the family's financial situation and would be inappropriate for the nurse to suggest these options. The option of visiting the school-age child after the father comes home from work may not support the child adequately during the hospitalization. 2. A preadolescent patient, a member of a single-parent family, has abdominal pain and the health care provider suspects that an appendectomy might need to be performed. The patient's father is asking for a second opinion, whereas the mother tells the nurse to do whatever needs to be done to help the patient. What does the nurse need to assess before moving forward with planning care for this patient? A) Permission to miss school B) Identify the custodial parent C) The type of health insurance D) Plans for help upon discharge Ans: B Feedback: The nurse needs to identify who is the custodial parent. This is especially important when consent forms for care need to be signed. Once this information is obtained, the nurse needs to clearly document it in the patient's medical record. Permission to miss school, health insurance, and needs after discharge do not necessarily need to be assessed prior to planning care for the patient. 3. During a family assessment, the nurse learns that the male parent smokes. What should the nurse do with this information to support the 2020 National Health Goals? A) Document the information in the medical record. B) Explain that smoking can cause long-term health problems. C) Ask if the male parent has made any efforts towards smoking cessation. D) Suggest that smoking be done away from other family members because of health concerns. Ans: C Feedback: One of the 2020 National Health Goals is to increase the percentage of adult smokers aged 18 years and older attempting to stop smoking from 48.3% to 80%. To support this goal, the nurse should ask the parent if any efforts toward smoking cessation have been taken. The nurse needs to do more than just document the information. Explaining that smoking can cause long-term health problems may not be an effective strategy to encourage the parent to stop smoking. Suggesting that smoking be done away from other family members is assuming that the parent is smoking with the family members present. 4. During a family assessment, it is identified that the mother is unemployed but stays at home to prepare meals, monitor medication doses, and comfort the children with emotional issues. The father works outside of the home and pays the bills. Which terms should the nurse use to document the role of the father in this family? (Select all that apply.) A) Provider B) Nurturer C) Culture bearer D) Health manager E) Financial manager Ans: A, E Feedback: The provider is considered the person who brings home the money, which would be the father because he works outside of the home. The person who pays the bills is considered the financial manager. The nurturer would be the one who makes the meals or the mother in this situation. The health manager is also the mother because she is the person who monitors medication doses. There is no evidence to support that either the mother or father function in the role as culture bearer. 5. The nurse is completing an assessment of a family with a preschool-age child. Which areas should the nurse focus when instructing the parents on tasks needed during this stage of family development? (Select all that apply.) A) Prevention of accidental injuries B) Importance of child's socialization C) Promoting health through immunizations D) Socialization through sporting events E) Need for dental care and health assessments Ans: A, B Feedback: In the stage of family development with a preschool-age child, the parent's tasks are to prevent accidental injuries and begin the child's socialization. Socialization through sporting events, promoting health through immunizations, and the need for dental care and health assessments are family responsibilities for the family with a school-age child. 6. The nurse is caring for a school-age child whose mother works two jobs, father is away from the home during the week truck driving, and older brother has a part-time after school job. The child will be hospitalized for several weeks for chemotherapy treatments. Which nursing diagnosis should the nurse identify as being appropriate for this family? A) Impaired parenting B) Parental role conflict C) Health-seeking behaviors D) Readiness for enhanced family coping Ans: B Feedback: The diagnosis parental role conflict would address the parents' work responsibilities and schedules and the relationship of work to the child's extended hospitalization. There is no evidence to suggest that there is impaired parenting, health-seeking behaviors, or readiness for enhanced family coping. 7. The nurse is evaluating outcomes about a family's ability to care for an adolescent child that is recovering from a spinal cord injury. Which statements indicate that this family is transitioning in a healthy manner? A) The patient states the injuries “messed up” the rest of his life. B) The mother states the need to have a break at least once per week. C) The patient states fewer episodes of nausea with changing position. D) The father states the child's accident has brought the family closer together. E) The mother states the ability to provide care for the child is becoming easier. Ans: D, E Feedback: The statements that indicate that the family is able to care for an adolescent child that is recovering from a spinal cord injury include the father's statement about the family being brought closer together and the mother's statement about the care being easier to provide. The patient's two statements do not address the family's ability to care for the patient. The mother's statement about needing a break does not measure if the family is able to care for the adolescent patient. 8. The nurse is planning outcomes of care for a family whose infant was born with a birth defect. Which outcome statement would be the most appropriate for this family? A) The parents will seek information regarding the birth defect. B) The parents will limit involvement with extended family members. C) The mother will return to work after 6 weeks as planned before the delivery. D) The father will learn to care for the infant so that the mother can return to work. Ans: A Feedback: The family has a new member that has a birth defect. The outcome statement that would be most appropriate for the family would be for the parents to seek out information about the birth defect. The parents limiting involvement with extended family members may indicate that the family will be isolated. The father learning to care for the infant so that the mother can return to work does not take into consideration if the father is employed. The mother planning to return to work after 6 weeks as planned before the delivery does not take into consideration the newborn's health care needs. 9. The nurse is visiting a family with a toddler and school-age child. Which teaching should the nurse provide to the parents that would be appropriate for both children? A) Increased freedom B) Actions to ensure safety C) Encourage independent thinking D) Importance of school experiences Ans: B Feedback: The teaching that would support both of the children's needs would be to focus on actions to ensure safety. Increased freedom would be appropriate for the adolescent. Encourage independent thinking would be appropriate for the young adult. Importance of school experiences would be appropriate for the school-age child but not for the toddler. 10. A recently separated mother is overwhelmed with caring for three children under the age of 5 years. The oldest child has been recently diagnosed with muscular dystrophy. Which health care providers should the nurse consult to help the mother? (Select all that apply.) A) Dietician B) Physician C) Pharmacist D) Social worker E) Physical therapist Ans: D, E Feedback: The mother is recently separated and is raising three children independently. The older child is diagnosed with a chronic illness. The nurse should consult a social worker to help identify resources that the mother and family need. The nurse should consult with a physical therapist to help the oldest child attain or maintain the maximum level of physical functioning. A dietician, physician, and pharmacist will not necessarily be of assistance to the family at this time. 11. A family of dual-parent employment with two school-age children has moved into a community. During the home visit, the nurse overhears the children talking about something on the Internet being more interesting than school work. What type of information would be beneficial for the nurse to share with the parents at this time? A) School clubs that meet on the weekends B) Community activities planned specifically for after school C) Names of the Internet providers that service the community D) Local businesses seeking workers for part-time employment Ans: B Feedback: The children of a dual-parent employment family might spend significant amounts of time on the Internet. The parents may not be aware of what Internet sites the children are frequenting. To reduce the amount of time spent alone on the Internet, the nurse should provide the parents with information about community activities planned specifically for after school. This could reduce the amount of time the children spend in the Internet while waiting for parents to return home from work. School clubs that meet on weekends will not help with the children spending time on the Internet during the week. Providing the names of Internet service providers does not address the issue. Local businesses seeking workers for part-time employment is inappropriate because the children are of school age. 12. The nurse is visiting a family new to a community. The mother has a disability, and the adolescent child is being treated for anorexia. What will the nurse do first when assessing this family? A) Construct an ecomap. B) Complete a genogram. C) Assess the home for safety. D) Discuss the daughter's anorexia. Ans: A Feedback: An ecomap documents the “fit” of a family into their community by diagramming the family and community relationships. Because this family is new to the community, this would be the best thing for the nurse to do first. A mark of families who are new to a community is they have few community contacts because they have not formed these as yet. A family with few connecting lines between its members and the community may need increased nursing contact and support to remain a well family. A genogram is a diagram that details family structure and provides information about the family's health history and the roles of various family members across several generations. This might be appropriate for the nurse to complete at a later time. Assessing the home for safety and discussing the daughter's anorexia could also be done at a later time. 13. The nurse has been working with a family on actions that strengthen loyalty between all members. Which healthy family behavior has been the focus of the nurse's interventions? A) Division of labor B) Physical maintenance C) Socialization of family members D) Maintenance of motivation and morale Ans: D Feedback: In maintenance of motivation and morale, healthy families have pride in their family and allow them to support each other during a crisis. Assessing for loyalty is one way to measure this behavior. Division of labor focuses on family members dividing the workload among family members and adjusting workloads as necessary. Physical maintenance focuses on food, shelter, clothing, and health care. Socialization of family members focuses on every family member feeling as a part of the family and interacting with people outside of the family. 14. The nurse determines that a small nuclear family has achieved the family task of division of labor. What did the nurse assess in this family to come to this conclusion? A) Parents take the children out to meet the new neighbors. B) Parents and children attend religious services every week. C) Older children finish homework before watching television. D) Mother cares for children while father works outside of the home. Ans: D Feedback: The task of division of labor is when the workload is divided evenly between family members. Parents taking children to meet the neighbors fulfill the task of family member socialization. The family attending religious services every week fulfills the task of member placement in society. Older children finishing homework before watching television fulfills the task of maintenance of order. 15. An extended family is experiencing a crisis. Excessive work demands have caused the primary parents to work longer hours, but the grandmother who usually watches the children after school is recovering from hip replacement surgery. What can the nurse suggest to help this family through this period of time? A) One parent reduces work hours. B) Children go to the grandmother's house after school. C) Identify another extended family member to assist while the grandmother recovers. D) Recommend the children learn independence and stay at home alone until a parent arrives. Ans: C Feedback: A positive aspect of the extended family is the availability of many people for child care and support. The family needs to call on this strength and ask another family member to help with the child support until the grandmother recovers. One negative aspect of the extended family is reduced resources because of fewer wage earners. This is not the case because both primary parents are working. Asking for one parent to reduce work hours would be a negative suggestion. Having the children go to the grandmother's home after school would negatively impact the grandmother's healing and is an inappropriate suggestion to make at this time. Recommending the children learn independence and stay at home alone could be a safety issue and would be an inappropriate suggestion at this time. 1. Which question should the nurse ask when assessing the sociocultural aspects of a patient's family? A) Citizenship B) Occupation C) Education level D) Family structure Ans: D Feedback: Family st