Chapter 01 The Past Present and Future
MULTIPLE CHOICE
1. A patient chooses to have the certified nurse midwife (CNM) provide care during her pregnancy What
doesthe CNMs scope of practice include?
a. Practice independent from medical supervision
b. Comprehensive prenatal care
c. Attendance at all deliveries
d. Cesarean sections
ANS B
The CNM provides comprehensive prenatal and postnatal care attends uncomplicated deliveries and ensures
that a backup physician is available in case of unforeseen problems
DIF Cognitive Level Comprehension REF Page 6
TOP Advance Practice Nursing Roles KEY Nursing Process Step Implementation
MSC NCLEX Health Promotion and Maintenance Prevention and Early Detection of Disease
2. Which medical pioneer discovered the relationship between the incidence of puerperal fever and unwashed
hands?
a. Karl Cred
b. Ignaz Semmelweis
c. Louis Pasteur
d. Joseph Lister
ANS B
Ignaz Semmelweis deduced that puerperal fever was septic contagious and transmitted by the unwashed
hands of physicians and medical students
NURSINGTB COM
DIF Cognitive Level Knowledge REF Page
2TOP The Past KEY Nursing Process Step
N/A
MSC NCLEX Safe Effective Care Environment Safety and Infection Control
3. A pregnant woman who has recently immigrated to the United States comments to the nurse I am afraid
ofchildbirth It is so dangerous I am afraid I will die What is the best nursing response reflecting
cultural sensitivity?
a. Maternal mortality in the United States is extremely low
b. Anesthesia is available to relieve pain during labor and childbirth
c. Tell me why you are afraid of childbirth
d. Your condition will be monitored during labor and delivery
ANS C
Asking the patient about her concerns helps promote understanding and individualizes patient care
DIF Cognitive Level Application REF Page 7
TOP Cross-Cultural Care KEY Nursing Process Step
Implementation MSC NCLEX Psychosocial Integrity Psychological
Adaptation
4. An urban area has been reported to have a high perinatal mortality rate What information does this provide?
a. Maternal and infant deaths per 100 000 live births per year
b. Deaths of fetuses weighing more than 500 g per 10 000 births per year
c. Deaths of infants up to 1 year of age per 1000 live births per year
d. Fetal and neonatal deaths per 1000 live births per year
ANS D
The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year
DIF Cognitive Level Comprehension REF Page 12
pg. 2
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OBJ 9 TOP The Present-Child Care
KEY Nursing Process Step Implementation
MSC NCLEX Safe Effective Care Environment Coordinated Care
5. What is the focus of current maternity practice?
a. Hospital births for the majority of women
b. The traditional family unit
c. Separation of labor rooms from delivery rooms
d. A quality family experience for each patient
ANS D
Current maternity practice focuses on a high-quality family experience for all families traditional or otherwise
DIF Cognitive Level Comprehension REF Page 6
TOP The Present-Maternity Care KEY Nursing Process Step N/A
MSC NCLEX Health Promotion and Maintenance
6. Who advocated the establishment of the Childrens Bureau?
a. Lillian Wald
b. Florence Nightingale
c. Florence Kelly
d. Clara Barton
ANS A
Lillian Wald is credited with suggesting the establishment of a federal Childrens Bureau
DIF Cognitive Level Knowledge REF Page 4
TOP The Past KEY Nursing Process Step Implementation
MSC NCLEX Health Promotion and Maintenance Growth and Development
7. What was the result of research done in the 1930s by the Childrens Bureau?
a. Children with heart problems are now cared for by pediatric cardiologists
b. The Child Abuse and Prevention Act was passed
c. Hot lunch programs were established in many schools
d. Childrens asylums were founded
ANS C
School hot lunch programs were developed as a result of research by the Childrens Bureau on the effects of
economic depression on children
DIF Cognitive Level Knowledge REF Page
4TOP The Past KEY Nursing Process Step
N/A
MSC NCLEX Health Promotion and Maintenance Coordinated Care
8. What government program was implemented to increase the educational exposure of preschool children?
a. WIC
b. Title XIX of Medicaid
c. The Childrens Charter
d. Head Start
ANS D
Head Start programs were established to increase educational exposure of preschool children
DIF Cognitive Level Knowledge REF Page 3
TOP Government Influences in Maternity and Pediatric Care KEY Nursing Process Step
N/A MSC NCLEX Health Promotion and Maintenance Growth and Development
9. What guidelines define multidisciplinary patient care in terms of expected outcome and timeframe from
different areas of care provision?
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a. Clinical pathways
b. Nursing outcome criteria
c. Standards of care
d. Nursing care plan
ANS A
Clinical pathways also known as critical pathways or care maps are collaborative guidelines that define
patient care across disciplines Expected progress within a specified timeline is identified
DIF Cognitive Level Knowledge REF Page 12
TOP Health Care Delivery Systems KEY Nursing Process Step
N/A MSC NCLEX Safe Effective Care Environment Coordinated
Care
10. A nursing student has reviewed a hospitalized pediatric patient chart interviewed her mother and
collected admission data What is the next step the student will take to develop a nursing care plan for this
child?
a. Identify measurable outcomes with a timeline
b. Choose specific nursing interventions for the child
c. Determine appropriate nursing diagnoses
d. State nursing actions related to the childs medical diagnosis
ANS C
The nurse uses assessment data to select appropriate nursing diagnoses from the NANDA-I list Outcomes and
interventions are then developed to address the relevant nursing diagnoses
DIF Cognitive Level Application REF Page 11
TOP Nursing Process KEY Nursing Process Step Nursing
Diagnosis MSC NCLEX Safe Effective Care Environment
Coordinated Care
11. A nursing student on an obstetric rotation questions the floor nurse about the definition of the LVN/LPN
scope of practice What resource can the nurseNsUuRgS
geIN
stGtoTBth C
eOstM
udent?
a. American Nurses Association
b. States board of nursing
c. Joint Commission
d. Association of Womens Health Obstetric and Neonatal Nurses
ANS B
The scope of practice of the LVN/LPN is published by the states board of nursing
DIF Cognitive Level Comprehension REF Page
3 OBJ 18 TOP Critical Thinking
KEY Nursing Process Step Implementation
MSC NCLEX Safe Effective Care Environment Coordinated Care
12. What was recommended by Karl Cred in 1884?
a. All women should be delivered in a hospital setting
b. Chemical means should be used to combat infection
c. Podalic version should be done on all fetuses
d. Silver nitrate should be placed in the eyes of newborns
ANS D
In 1884 Karl Cred recommended the use of 2% silver nitrate in the eyes of newborns to reduce the incidence of
blindness
DIF Cognitive Level Knowledge REF Page 2
TOP Use of Silver Nitrate KEY Nursing Process Step N/A
MSC NCLEX Health Promotion and Maintenance Prevention and Early Detection of Disease
13. What is the purpose of the White House Conference on Children and Youth?
a. Set criteria for normal growth patterns
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b. Examine the number of live births in minority populations
c. Raise money to support well-child clinics in rural areas
d. Promote comprehensive child welfare
ANS D
White House Conferences on Children and Youth are held every 10 years to promote comprehensive child
welfare
DIF Cognitive Level Knowledge REF Page 4
TOP White House Conferences KEY Nursing Process Step N/A
MSC NCLEX Health Promotion and Maintenance Prevention and Early Detection of Disease
14. How many hours of hospital stay does legislation currently allow for a postpartum patient who has
delivered vaginally without complications?
a. 24
b. 48
c. 36
d. 72
ANS B
Postpartum patients who deliver vaginally stay in the hospital for an average of 48 hours; patients who have
had a cesarean delivery usually stay 4 days
DIF Cognitive Level Knowledge REF Page
6 TOP Hospital Terms for Postpartum
Patients KEY Nursing Process Step
Planning
MSC NCLEX Health Promotion and Maintenance Prevention and Early Detection of Disease
15. How does the clinical pathway or critical pathway improve quality of care?
a. Lists diagnosis-specific implementations NURSINGTB COM
b. Outlines expected progress with stated timelines
c. Prioritizes effective nursing diagnoses
d. Describes common complications
ANS B
Critical pathways outline expected progress with stated timelines Any deviation from those timelines is called
a variance
DIF Cognitive Level Comprehension REF Page 12
TOP Critical Pathway KEY Nursing Process Step
Implementation MSC NCLEX Safe Effective Care Environment
Coordinated Care
16. A patient asks the nurse to explain what is meant by gene therapy What is the nurses best response?
a. Gene therapy can replace missing genes
b. Gene therapy evaluates the parents genes
c. Gene therapy can change the sex of the fetus
d. Gene therapy supports the regeneration of defective genes
ANS A
Gene therapy can replace missing or defective genes
DIF Cognitive Level Knowledge REF Page 8
TOP Gene Therapy KEY Nursing Process Step Implementation
MSC NCLEX Health Promotion and Maintenance Prevention and Early Detection of Disease
17. The nurse is clarifying information to a patient regarding diagnosis-related groups (DRGs) What is
the nurses best response when the patient asks how DRGs reduce medical care costs?
a. By determining payment based on diagnosis
b. By requiring two medical opinions to confirm a diagnosis
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