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Chapter 01: Contemporary Perinatal and Pediatric Nursing in Canada
Keenan-Lindsay: Perry’s Maternal Child Nursing Care in Canada, 3rd Edition
MULTIPLE CHOICE
1. Which is true regarding perinatal nurses?
a. They provide care for only childbearing persons and babies.
b. They require advanced practice education beyond an entry to practice degree.
c. They work with patients and families
from preconception throughout the child-
bearing year.
d. They provide care for families with children up to age 18 years.
ANS: C
Perinatal nurses are those nurses who work collaboratively with patients
and families from the preconception period throughout the child-bearing
year. Pediatric nurses care for children from birth up to age 18 years.
Perinatal or pediatric nurses also provide care for the family. Perinatal
nurses often do have advanced education, but this is not a requirement.
DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: N/A
2. Which is true regarding pediatric nurses?
a. They provide care for children up to and including 13 years of age.
b. They require advanced practice education beyond an entry to practice degree.
c. They work with patients and families throughout the child-bearing year.
d. They provide care for children and families up to age 18 years.
ANS: D
Pediatric nurses care for children from birth up to age 18 years. Perinatal
nurses are those nurses who work collaboratively with patients and
families from the preconception period throughout the child-bearing year.
Perinatal and pediatric nurses also provide care for the family. Pediatric
nurses often do have advanced education, but this is not a requirement.
DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: N/A
3. Which of the following would not be included in a discussion of the social
determinants of health (SDOH)?
a. Racism
b. Daily exercise
c. Chronic illness
d. Presence of playgrounds
ANS: C
Chronic illness is not considered a SDOH. Racism, healthy behaviours (exercise)
and healthy outdoor spaces (playgrounds) can all
impact a person’s health.
DIF: Cognitive Level:
Application
OBJ
: 3 KEY: Nursing Process:
Assessment
4. An Indigenous patient is pregnant with their first child. Which evidence-
informed intervention is most important for the nurse to implement?
a. Perform a nutrition assessment.
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, b. Refer the patient to a social worker.
c. Advise the patient to see an obstetrician, not a midwife.
d. Explain to the patient the importance of keeping their prenatal care
appointments.
ANS: D
Consistent prenatal care is associated with healthier infants. Nutritional
status is an important modifiable risk factor, but it is not the most
important action a nurse should take in this situation. The patient may
need assistance from a social worker at some time during the pregnancy,
but a referral to a social worker is not the most important aspect the nurse
should address at this time. If the patient has identifiable high-risk
problems, their health care may need to be provided by a physician.
However, it cannot be assumed that all Indigenous patients have high-risk
issues. In addition, advising the patient to see an obstetrician is not the
most important aspect on which the nurse should focus at this time.
DIF: Cognitive Level: Application OBJ: 1 KEY: Nursing Process: Planning
5. Which social determinant of health has the greatest influence on health status
and behaviours?
a. Education and literacy
b. Income and social status
c. Employment and working conditions
d. Biology and genetic endowment
ANS: B
Income and social status has the greatest influence on health status and
behaviours and use of health care services. Lower-income Canadians have
poorer health, with more chronic illness and earlier death, than that of
higher-income Canadians, regardless of age, gender, culture, race, or
residence.
DIF: Cognitive Level:
Application
OBJ
: 3 KEY: Nursing Process:
Assessment
6. Which is an example of invisible poverty?
a. Insufficient clothing
b. Limited employment opportunities
c. Poor sanitation
d. Deteriorating housing
ANS: B
Invisible poverty refers to social and cultural deprivation, such as limited
employment opportunities, inferior educational opportunities, lack of or
inferior medical services and health care facilities, and an absence of public
services. Visible poverty refers to lack of money or material resources,
which includes insufficient clothing, poor sanitation, and deteriorating
housing.
DIF: Cognitive Level:
Knowledge
OBJ
: 3 KEY: Nursing Process:
Assessment
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,7. What is the primary role of practicing nurses in the research process?
a. Designing research studies
b. Collecting data for other researchers
c. Identifying areas for further research
d. Seeking funding to support research studies
ANS: C
The primary role of the practicing nurse is to identify areas for further
research in the health and health care of women, children, and families.
When problems are identified, research can be conducted properly.
Research of health care issues leads to
evidence-informed practice guidelines. Designing research studies is only
one factor of the research process. Data collection is one factor of research.
Financial support is necessary to conduct research, but it is not the
primary role of the nurse in the research process.
DIF: Cognitive Level:
Comprehension
OBJ
: 6 KEY: Nursing Process:
Implementation
8. Which event shifted the focus of the Public Health Agency of Canada
(PHAC) away from a population health and health promotion focus?
a. Shift to home births
b. Emergence of avian influenza
c. United Nations Sustainable Goals
d. Increase in the maternal mortality rate
ANS: B
The emergence of the avian influenza shifted the focus of the PHAC from
population health and a health promotion focus to a focus on planning for
a pandemic. There has been no shift to home births from hospital births in
Canada. The United Nations Millennium Goals did not cause a focal shift
for the PHAC. There has not been an increase in the maternal mortality
rate.
DIF: Cognitive Level: Comprehension OBJ: 2 KEY: Nursing Process: N/A
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, 9. The World Health Organization has identified which period as the most important
for overall development throughout a person’s
lifetime?
a. Preconception
b. Early childhood
c. Young adult
d. Adolescence
ANS: B
The period from prenatal development to eight years of age is critical for
cognitive, social, emotional and physical development of the child. It is
important to identify where children are most at risk for adversity and to
intervene accordingly.
DIF: Cognitive Level:
Knowledge OBJ:
N/A KEY: Nursing Process:
Assessment
10. Which is a characteristic of integrative healing?
a. It replaces conventional Western modalities of treatment.
b. It is used by only a small number of Canadian adults.
c. It recognizes the value of patients’ input into their health care.
d. It focuses primarily on the disease an individual is experiencing.
ANS: C
Integrative healing encompasses complementary and alternative therapies
and healing modalities that offer human-centred care based on
philosophies that recognize the value of the patient’s input and honour
the individual’s beliefs, values, and desires.
Alternative and complementary therapies are part of an integrative approach to
health care.
DIF: Cognitive Level: Comprehension OBJ: 1 KEY: Nursing Process:
Planning
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,11.t WhichtoftthetfollowingtwasthighlightedtintthetTruthtandtReconciliationtReportt(2015)?
a. IncreasedttransportationtfortIndigenoustpe
oplettottravelttottertiarytcaretcentrestfortheal
thtcare.
b. RecognizetthetvaluetoftIndigenousthealingtp
racticestandttheirtusetintthethealthtcaretsyst
em.
c. TreatthealthtconcernstoftIndigenoustpeopletwithtWesterntwaystofthealing.
d. EducatethealthtcaretproviderstabouttIndigeno
usthealingtpracticesttoteliminatetthetroletoftthet
Elder.
ANS:tB
ThetTRCt(2015)tfinaltreporttcallstonthealthtcaretprovidersttotrecognizetthetvaluet
oftIndigenousthealingtpracticestandttotusetthemtintthettreatmenttoftIndigenoust
patientstintcollaborationtwithtIndigenousthealerstandtElderstwheretrequestedtb
ytIndigenoustpatients.tIttistimperativetthatthealthtcaretproviderstbecometknowl
edgeabletintIndigenousthealingtpractices,tnotttoteliminatetthetrolet oftthetEldert
butttotworktcollaborativelytwithtElders.
HealthtcaretservicestneedttotbetavailabletwheretIndigenoustpeopletworktandtli
vetandtnottrequiretincreasedttransportationttottertiarytcaretcentrestforthealtht
care.
DIF: CognitivetLevel:tComprehension OBJ:t 5
KEY:tNursingtProcess:tPlanning
12.t Whichthastdirectlytincreasedtthetlifetexpectancytoftchildrentexperiencingtatchroni
ctdisease?
a. Earlyt postpartumt discharges
b. Enhancedt technology
c. Thetreductiont int acceptablet genetict screeningt options
d. Ruralthealthtservicestdeliveredtviattelehealth
ANS:tB
Enhancedttechnologythastincreasedtthetlifetexpectancytoftmanytchildrentwithtc
hronictdiseases.tEarlytpostpartumtdischargestandtgenetictscreeningtoptionstha
vetnottincreasedtthetlifetexpectancytoftchildrentwithtchronictdisease.tRuraltheal
thtservicestdeliveredtviattelehealthtaretalteringthowtservicestaretdeliveredtandt
maytindirectlytincreasetlifetexpectancy,tbuttittistnottatdirecttcontributingtfactor.
DIF:t CognitivetLevel:tAnalysis
OBJ
:t1t KEY:tNursingtProcess:
Implementation
13.t WhichtistthetfocustoftthetCodetoftEthicstfortRegisteredtNurses?
a. Collegiality
b. Dependenttrole
c. Evaluation
d. Accountability
ANS:tD
ThetCodetoftEthicstfortRegisteredtNurses,tbytthetCanadiantNursestAssociationt(
CNA),tprovidestthetframeworktandtcoretresponsibilitiestfortnursingtpractice.tTh
etCodetoftEthicstfocusestontthetnurse'staccountabilitytandtresponsibilityttotthetp
atientt(CNA,t2017)tandtemphasizestthetnursing
, roletastantindependenttprofessional,tonetthattupholdstitstowntlegaltliability.
Collegialitytrefersttotatworkingtrelationshiptwithtone’stcolleagues.tEvaluationtr
efersttotexaminationtofttheteffectivenesstoftinterventionstintrelationttotexpecte
dtoutcomes.
DIF: CognitivetLevel:tEvaluation OBJ:t 9t KEY:tNursingtProcess:tN/A
14.t Whichtreflectstatfuturetgoaltfortperinataltandtpediatrictnursing?
a. Limitingt interprofessionalt teams
b. Maintainingtexistingt powertstructures
c. AdvocatingtfortantincreasedtnumbertoftCaesareantbirths
d. Addressingthealthtinequitiestbytengagingtintpolicytanalysistandtadvocacy
ANS:tD
Addressingthealthtinequitiestbytcreatingthealthtpolicytandtservicestthattfocust
ontbothtresourcestneededtforthealthtandtaccessttothealthtservicestistatfuturetg
oaltoftperinataltnurses.tNursestshouldtbetexpandingtinterprofessionaltteamstr
athertthantlimitingttheirtexistence.tExistingtpowertstructurestandtpracticestne
edttotbetdisruptedtrathertthantmaintained.
AdvocatingtfortantincreasedtnumbertoftCaesareantbirthstistnottatfuturetgoaltfo
rtperinataltnursing.
DIF: CognitivetLevel:tKnowledge OBJ:t 1t KEY:tNursingtProcess:tN/A
Whattistthetmosttimportanttaspecttofttrauma-informedtcare?
15.t
a. Providingtcounsellingttotpatientstwhothavetbettraumatized
b. Minimizetthetpotentialtfortharmtandtre-traumatization
c. Askingtalltpatientstabouttpreviousttraumatinttheirtlife
d. Totprovidetatcontrollingtenvironmenttfortthetpatient
ANS:tB
Thetfocustofttraumatandtviolence-
informedtapproachestarettotminimizetthetpotentialtfortharmtandtre-
traumatization,tandttotenhancetsafety,tcontroltandtresiliencetfortalltclients.t
Whiletpatientstshouldtbetaskedtaboutttraumatinttheirtlifetthististnottthetmostti
mportanttpointtastnottalltpatientstwilltdisclosetthettrauma.tIttistalsotimportant
ttotenhancettheirtowntcontroltovertthetsituationtandtnottforthealthtcaretprovid
ersttotcontroltthetsituation.tProvidingtcounsellingtmaytbetappropriatetfortsom
etpatientstbuttittistnottthetfocustofttrauma-informedtcare.
DIF:t CognitivetLevel:tApplicat
ion
OBJ
:t4t KEY:tNursingtProcess:tImp
lementation
3
,
, 16.tWhichtistantaccuratetstatistictrelatedttotIndigenoustpeopletintCanada?
a. TheretaretapproximatelythalftatmilliontIndigenoustpeopletintCanada.
b. Indigenoustpeopletcomprisetapproximatelyt2%toftthettotaltCanadiantpo
pulation.
c. ThetIndigenoustpopulationtistincreasingtattatsl
owertratetthantnon-Indigenoustpopulations.
d. Childrent14tyearstandtundertcompriseta
pproximatelytone-
thirdtoftthettotaltIndigenoustpopulation
.
ANS:tD
Indigenoustchildrentagedt14tandtundertmadetuptone-
thirdtoftthettotaltIndigenoustpopulation.tTheretaretapproximatelyt1.7tmilliontIn
digenoustpeopletintCanadatandttheytcompriset4.9%toftthettotaltCanadiantpop
ulation.
DIF:t CognitivetLevel:tKnowle
dge
OBJ
:t5t KEY:tNursingtProcess:
Assessment
17.t Approximatelytwhattpercentagetofthospitalizedtpatientstexperiencetantadverseteve
nt?
a. 2.5%
b. 5%
c. 7.5%
d. 10%
ANS:t C
AccordingttotthetCanadiantAdversetEventstStudyt(Bakertettal.,t2004),tthetmostt
quotedtstudytintCanadatregardingtmedicalterrors,t7.5%tofthospitalizedtpatien
tsthadtantadversetevent,tandtoftthese,t16%tdiedtastatresult.
DIF: CognitivetLevel:tKnowledge OBJ:t N/A KEY:tNursingtProcess:tN/A
18.t Whichtorganizationtofferstcertificationtfortperinatal,tgeneraltpediatrics,tandtpediatr
ictintensivetcaretnurses?
a. SOGC
b. CNA
c. RNAO
d. CAPWHN
ANS:tB
ThetCanadiantNursestAssociationt(CNA)tofferstspecialtytcertificationtintmanyt
areastoftnursing,tincludingtperinatal,tgeneraltpediatrics,tpediatrictintensivetca
re,tandtneonataltintensivetcare.tThetSOGC,tRNAO,tandtCAPWHNtdeveloptguid
elinestthatthelptguidetnurses’tpractice.
DIF: CognitivetLevel:tKnowledge OBJ:t 1t KEY:tNursingtProcess:tN/A
19.t Whichtist atUnitedtNationstSustainablet DevelopmenttGoal?
a. Safe,t compassionate,t andt competentt care
b. Improvet familyt health
c. Reducetchildtmorbidity
d. Promotetgoodt healthtandt well-being
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, ANS:tD
Onetoftthet17tUnitedtNationstSustainabletDevelopmenttGoalstisttotpromotetg
oodthealthtandtwell-
being.tSafe,tcompassionatetcaretistincludedtintthetCodetoftEthicstfortRNs.
DIF: CognitivetLevel:tKnowledge OBJ:t 8t KEY:tNursingtProcess:tN/A
20.t Whichtstatementtisttruetoftnursingtcaretthattistbasedtontknowledgetgainedtthrou
ghtvarioustformstandtsourcestoftinformation?
a. Antoutgrowthtofttelemedicine
b. Knownt astevidence-informedt practice
c. Exclusivet tot maternitytnursingt practice
d. Attoddst witht thetCochranetPregnancytandtChildbirtht Database
ANS:tB
Evidence-
informedtpracticet(EIP)tistthetcollection,tinterpretation,tandtintegrationtoftvalid,timportan
t,tandtapplicable
patient-reported,tnurse-observed,tandtresearch-
derivedtinformation.tEvidence-
informedtpracticetistpractisedtwithintalltdisciplinestoftnursingtandtistnottexclusi
vettotmaternitytnursingtpractice.tThetCochranetPregnancytandtChildbirthtDat
abasetistbasedtontsystematicallytreviewedtresearchttrialstandtistparttoftthetevi
dence-informedtpracticetmovement.
Telemedicinetusestcommunicationttechnologiesttotsupportthealthtcare.
DIF:t CognitivetLevel:tCompre
hension
OBJ
:t6t KEY:tNursingtProcess:
Assessment
21.t WhichtistatprincipletoftthetCanadatHealthtAct?
a. Justice
b. Universality
c. Healthtandt well-being
d. Informedt decisiont making
ANS:tB
UniversalitytistonetoftthetfivetprinciplestoftthetCanadatHealthtAct.tJusticetistatgu
idingtprincipletfortperinataltandtpediatrictnursingtintCanada.tInformedtdecisio
ntmakingtistatguidingtprincipletfortperinataltandtpediatrictnursingtintCanada.tH
ealthtandtwell-
beingtistatguidingtprincipletfortperinataltandtpediatrictnursingtintCanada.
DIF:t CognitivetLevel:tKnowle
dge
OBJ
:t2t KEY:tNursingtProcess:tAss
essment
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