A nurse educator is teaching a group of nursing students about the history of family-centered maternity care. Which statement should the nurse include in the teaching session?
Parental requests that infants be allowed to remain with them rather than in a nursery initiated the practice of family-centered
Expectant parents ask a prenatal nurse educator, “Which setting for childbirth limits the amount of parent–infant interaction?” Which provides for these parents in order to assist them in choosing an appropriate birth setting
Traditional hospital birth
Which statement best describes the advantage of a labor, birth, recovery, and postpartum (LDRP) room?
The woman’s support system is encouraged to stay until discharge.
Which nursing intervention is an independent function of the professional nurse?
Teaching the patient perineal care
Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to have a cesarean birth”
What concerns you most about a cesarean birth
In which step of the nursing process does the nurse determine the appropriate interventions for the identified nursing diagnosis?
Planning
Which goal is most appropriate for the collaborative problem of wound infection?
Monitor the patient to detect therapeutic response to antibiotic therapy.
Which nursing intervention is written correctly?
Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6PM
The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which response by the nurse would be the most therapeutic?
You’re afraid to take the baby home?”
The nurse is writing an expected outcome for the nursing diagnosis—acute pain related to tissue trauma, secondary to vaginal birth, as evidenced by the patient stating pain of 8 on a scale of 10 which expected outcome is correctly stated for this problem
The patient will state that pain is a 2 on a scale of 10,1 hour after the administration of the prescribed analgesic.
Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?
Risk for injury (maternal) related to altered sensations and positional or physical changes
Regarding advanced roles of nursing, which statement related to clinical practice is the most accurate?
Neonatal nurse practitioners provide emergency care in the postbirth setting to high risk infants
Which statement is true regarding the shortage of nurses in the United States?
Nursing programs are turning away qualified applicants.
A hospital has achieved Magnet status. Which indicators would be consistent with this type of certification?
There is increased job satisfaction of nurses, with a lower staff turnover rate.
Which of the following statements highlights the nurse’s role as a researcher?
Reading peer-reviewed journal articles
Which patient could safely be cared for by a certified nurse-midwife?
Gravida 3, para 2, with no complications
A primipara patient asks about possible support options for her during the labor process she is apprehensive that her family members will not be prepared to assist her during this time
Provide information to the patient about obtaining a doula during the labor process.
The nurse states to the newly pregnant patient, “Tell me how you feel about being pregnant.” Which communication technique is the nurse using with this patient?
Clarifying
When reviewing a new patient’s birth plan, the nurse notices that the patient will be bringing a doula to the hospital during labor what does the nurse think that this means
The patient will bring a paid, trained labor support person with her during labor
In consideration of the historic evolution of maternity care, which treatment options were used over the past century (SATA)
Granny midwives received their training through a period of apprenticeship.
The recognition of improved obstetric outcomes was related to increased usage of hygienic practices.
A shift to hospital-based births occurred as a result of medical equipment designed to facilitate birth
Many communities now offer the availability of free-standing birth centers to provide care for low-risk women during pregnancy, birth, and postpartum. When counseling the newly pregnant patient regarding this option, the nurse should be aware that this type of care setting includes which advantages? (SATA.)
Less expensive than acute care hospitals
Safe, homelike births in a familiar setting
Access to follow-up care for 6 weeks postpartum
The nurse is assessing a patient’s use of complementary and alternative therapies. Which should the nurse document as an alternative or complementary therapy practice?
Practicing yoga daily
Drinking green tea in the morning
Using aromatherapy during a relaxing bath
The nurse is formulating a nursing care plan for a postpartum patient. Which actions by the nurse indicate use of critical thinking skills when formulating the care plan (SATA)
Determining priorities for each diagnosis written
Reflecting and suspending judgment when writing the care plan
Clustering data during the assessment process versus abnormal
The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the nurse delegate? (SATA)
Vital signs on a postpartum patient who delivered the night before
Assisting a postpartum patient to take a shower on the second postpartum day
During which phase of the cycle of violence does the batterer become contrite and remorseful
Honeymoon
The United States ranks poorly in terms of worldwide infant mortality rates. Which factor has the greatest impact on decreasing the mortality rate of infants?
Ensuring early and adequate prenatal care
he nurse is planning a teaching session for staff on ethical theories. Which situation best reflects the Deontologic theory
Initiating resuscitative measures on a 90-year-old patient with terminal cancer
Which step of the nursing process is being used when the nurse decides whether an ethical dilemma exists?
Analysis
The nurse is interviewing a patient who is 6-weeks pregnant. The patient asks the nurse why is elective abortion considered such as an ethical issue which response by the nurse is most appropriate
There is a conflict between the rights of the woman and the rights of the fetus.
At the present time, which agency governs surrogate parenting?
Individual court decision
Which patient will most likely seek prenatal care?
A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic
A medical-surgical nurse is asked to float to a women’s health unit to care for patients who are scheduled for therapeutic abortions. The nurse refuses to accept this assignment and expresses her personal beliefs as being incongruent with this medical practice. The nursing supervisor states that the unit is short-staffed and the nurse is familiar with caring for postoperative patients. In consideration of legal and ethical practices, can the nursing supervisor enforce this assignment?
The staff nurse has expressed a legitimate concern based on his or her feelings; the nursing supervisor does not have the authority to enforce this assignment.
With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?
The nurse did not document fetal heart tones (FHR) during the second stage of labor.
A nurse is working with an active labor patient who is in preterm labor and has been designated as high risk. The patient is very apprehensive and asks the nurse, “Is everything going to be all right?” The nurse replies, “Yes, everything will be okay.” Following delivery via an emergency cesarean birth, the newborn undergoes resuscitation and does not survive. The patient is distraught over the outcome and blames the nurse for telling her that everything would be okay. Which ethical principle did the nurse violate?
Fidelity
A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 woman who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, –1 station, and vertex with membranes intact. The patient asks the nurse if she can break her water so that her labor can go faster. The nurse’s response, based on the ethical principle of nonmaleficence, is which of the following?
Instruct the patient that only a physician or certified midwife can perform this procedure
A nurse working in a labor and birth unit is asked to take care of two high-risk patients in the labor and birth suite: a 34 weeks’ gestation 28-year-old gravida 3, para 2 in preterm labor and a 40-year-old gravida 1, para 0 who is severely preeclamptic. The nurse refuses this assignment telling the charge nurse that based on individual patient acuity, each patient should have one-on-one care. Which ethical principle is the nurse advocating?
Beneficence
A charge nurse is working on a postpartum unit and discovers that one of the patients did not receive AM care during her shift assessment. The charge nurse questions the nurse assigned to provide care and finds out that the nurse thought “the patient should just do it by herself because she will have to do this at home.” On further questioning of the nurse, it is determined that the rest of her assigned patients were provided AM care. The assigned nurse has violated which ethical principle?
Justice
A nurse is entering information on the patient’s electronic health record (EHR) and is called to assist in an emergency situation with regard to another patient in labor and birth suite. The nurse rushes to the scene to assist; however, she leaves the chart open on the computer screen.The emergent patient situation is resolved satisfactorily, and the nurse comes back to the computer entry screen to complete charting. At the end of the shift, the nurse manager asks to speak with the nurse and tells her that she is concerned with what happened today on the unit because there was a breach in confidentiality. Which response by the nurse indicates that sheunderstands the nurse manager’s concerns?
The nurse states that she should have logged out of the EHR prior to attending to the emergency.
A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues areadbisircbe.rcnoemd /ftreosmt the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?
No action is indicated because the nurse is acting within the scope of practice.
A nurse who works in the emergency department (EDa)is assigned to a patient who is experiencing heavy vaginal bleeding at 12 weeks’ gestation. An ultrasound has confirmed the absence of a fetal heart rate, and the patient is scheduled for a dilation and evacuation of the pregnancy. The nurse refuses to provide any further care for this patient based on moral principles. What is the nurse manager’s initial response to the nurse?
“I recall you sharing that information in your interview. I will arrange for another nurse to take report on this patient.
The nurse is providing care to a patient who was just admitted to the labor and birth unit in active labor at term. The patient informed the nurse, “I have not received any prenatal care because I cannot afford to go to the doctor. And, this is my third baby, so I know what to expect.” What is the nurse’s primary concern when developing the plan of care?
Low birth weight
A nurse is reviewing evidence-based teaching and learning principles. Which situation is most conducive to learning with patients of other cultures?
An Asian nurse provides nutritional information to a group Asian women.
The nurse is teaching a parenting class to new parents. Which statement should the nurse include in the teaching session about the characteristics of a healthy family?
Adults agree on the majority of basic parenting principles.
A patient who is 6 months pregnant has sought medical attention, saying she fell down the stairs. Which scenario would cause an emergency department nurse to suspect that the woman has been battered?
The woman has injuries on various parts of her body that are in different stages of healing.
Which situation is most representative of an extended family?
It is composed of children, parents, and grandparents living in the same house.
The nurse is reviewing the principles of family-centered care with a primiparous patient. Which patient statement will the nurse need to correct?
Because childbirth is normal, after my baby’s birth our family dynamics will not change
Which issue is a major concern among members of lower socioeconomic groups?
Meeting health needs as they occur
While teaching an Asian patient regarding prenatal care, the nurse notes that the patient refuses to make eye contact. Which is the most likely cause for this behavior?
Cultural beliefs about eye contact
The nurse in labor and birth is caring for a Muslim patient during the active phase of labor. The nurse notes that the patient quickly draws away when touched. Which intervention should the nurse implement
Limit touching to a minimum because physical contact may not be acceptable in her culture.
Which patient may require more help and understanding when integrating the newborn into the family?
A multipara (gravida 6) who has two children younger than 3 years old
A patient arrives to the clinic 2 hours late for her prenatal appointment. This is the third she has been late what is the nurse's best action in response to this patient's tardiness
Determine if the patient arrives after the start time for other types of appointments.
The clinic nurse often cares for patients who are considering an abortion. Which responsibilities does this nurse have in regard to this issue?
Being informed about abortion from a legal standpoint
Being informed about abortion from an ethical standpoint
Recognizing that this issue may result in confusion for the patient
A couple asks the nurse about the procedure for surrogate parenting. Which correct responses should the nurse provide for this couple?(SATA)
Donated embryos can be implanted into the surrogate mother.
Conception can take place outside the surrogate mother’s body and then implanted.
The surrogate mother can be inseminated artificially with sperm intended father
Which actions by the nurse indicate compliance with the Health Insurance Portability and Accountability Act (HIPAA)?
The nurse gives the report to the oncoming nurse in a private area.
The nurse logs off any computer screen showing patient data before leaving the computer unattended.
The nurse puts any documentation with the patient’s information in the shred bin at
the hospital before leaving for the day.
In some Middle Eastern and African cultures, female genital mutilation (female cutting) is a prerequisite for marriage. Women who now live in North America need care from nurses who are knowledgeable about the procedure and comfortable with the abnormal of their genitalia. When caring for this patient, the nurse can formulate a diagnosis with the understanding that the patient may be at risk for which of the following?
Infection
Laceration
Hemorrhage
Obstructed labor
A Vietnamese patient who speaks little English is admitted to the labor and birth unit in early labor. The nurse plans to use an interpreter during an initial assessment. Which should the nurse plan to implement with regard to using an interpreter?
Listen carefully to what the patient says.
Speak slowly and smile when appropriate
Ask the interpreter to explain exactly what is said as much as possible, instead of parapharsing
A postpartum patient who has had a vaginal birth asks the nurse, “I was wondering if my cervix will return to its previous shape before I had the baby?” Which is the best response by the nurse?
The cervix will now have a slit-like shape.
The school nurse is conducting health education classes for a group of adolescents. Which statement best describes a secondary sexual characteristic?
Female breast development
Which 16-year-old female patient is most likely to experience secondary amenorrhea?
5 ft 7 in, 96 lb
Which characteristic best describes the levator ani?
Collection of three pairs of muscles
The nurse is describing the size and shape of the nonpregnant uterus to a patient. Which is an accurate description?
The nonpregnant uterus is the size and shape of a pear
f a woman’s menstrual cycle began on June 2, on which date should ovulation mostly likely have occurred?
June 16
A patient states, “My breasts are so small. I don’t think I will be able to breastfeed my baby.” Which is the nurse’s best response?
All women have about the same amount of glandular tissue necessary to secrete milk
The nurse is explaining the function of the male’s cremaster muscle to a group of nursing students. Which statement accurately describes the function of the cremaster muscle?
Aids in temperature control of the testicles
A newly pregnant patient asks the nurse, “What is a false pelvis?” Which statement by the nurse will best explain this anatomy to the patient?
It provides support for the internal organs and the upper part of the body
The clinic nurse is reviewing breastfeeding with a pregnant patient. Which hormone will the nurse explain is responsible for milk production after the birth of the placenta?
Prolactin
Which hormonal effect is noted during the menstrual cycle?
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion rise during the ovulatory phase.
A female patient who has gone through puberty and started menstruating without any problems has developed cessation of periods after 2 years of normal cycles. Which finding would indicate a possible cause for this occurrence
Overproduction of androgenic hormones
On speculum examination of the cervix, it is found to be rounded and smooth these findings suggest that the patient
is nulliparous.
Which statement with regard to reproductive anatomy and physiology is inaccurate?
Puberty symptoms are more prominent in males than females
The nurse is reviewing normal female development with a mother of a 10-year-old daughter. The mother states, “I noticed that my daughter developed breast buds about a year ago. When do you think she will start her menstrual cycle?” What is the nurse’s best response?
In about a year.”
The middle school nurse is reviewing the phases of the endometrial cycle with a group of female students. Which statement by a student will the nurse need to correct?
The expulsion phase occurs when the ovum is discharged from the ovary.
A young female patient comes to the health unit at school to discuss her irregular periods. In providing education regarding the female reproductive cycle, the nurse describes the regular and recurrent changes related to the ovaries and the uterine endometrium. Although this is generally referred to as the menstrual cycle, the ovarian cycle includes which phases?
Follicular
Ovulatory
Luteal
The school nurse is conducting health education classes for a group of adolescent girls. Select the actions of the estrogen hormone that the nurse should include in the lessons
Relaxes pelvic ligaments during pregnancy
Stimulates the endometrium before ovulation
Stimulates growth of uterus during pregnancy
A clinic nurse is planning a teaching session for childbearing-age female patients. Which information should the nurse include in the teaching session with regard to avoiding exposing a fetus to teratogens?
Eliminate use of acne medications.
The parents of a child with a karyotype of 47,XY,+21 ask the nurse what this means. Which is the most accurate response by the nurse?
This karyotype is for a male with Down syndrome
People who have two copies of the same abnormal autosomal dominant gene are generally
more severely affected by the disorder than people with one copy of the gene
An infant is born with blood type AB. The father is type A and the mother is type B. The father asks why the baby has a blood type different from that of the parents. The nurse’s answer should be based on the knowledge that
both A and B blood types are dominant.
Which statement regarding multifactorial disorders is correct?
They are usually present and detectable at birth.
Which information should the nurse include when discussing the prenatal diagnosis of genetic disorders with an expectant couple?
The diagnosis may be slow and could be inconclusive.
A patient tells the nurse at a prenatal interview that she has quit smoking, and only has one glass of wine with dinner. Which response by the nurse will be most helpful in promoting a lifestyle change?
You have made some good progress toward having a healthy baby Let’s talk about the changes you have made.
A 35-year-old patient has an amniocentesis performed to identify whether her baby has a chromosomal defect. Which statement indicates that the patient understands the situation?
When all the lab results come back, my husband and I will make a decision about the pregnancy.”
Which characteristic is related to Down syndrome?
Up-slanting eyes
Which question posed by the nurse will most likely promote the sharing of sensitive information during a genetic counseling interview?
Are there any members of your family who have learning or developmental problems?”
Testing for the cause of anomalies in a stillborn infant is underway. The mother angrily asks the nurse how long these tests are going to take. The nurse should understand that this mother is
exhibiting normal grief behavior.
While obtaining a genetic history from a female patient, you note that there is a family history of a genetic disease on the maternal side; however, no evidence of symptomatology in the patient or the patient’s children, two girls. Which observation can you make related to genetic expression?
More information is needed to determine the answer.
A couple is undergoing genetic counseling and are very concerned about the possibility of having a child with a birth defect as a result of a strong family history on both sides of the family. Which statement made by the nurse is evidence of therapeutic communication?
It is important to ask other members of your family for any information they can provide that will help obtain more insight into the health history
A patient presents with curly hair and blue eyes. These findings are consistent with
phenotype.
The nurse is working with a patient to obtain information necessary for genetic counseling. Which tool will be used to obtain this information?
Genogram
The nurse receives report on an infant whose analysis indicates 47 total chromosomes, with the abnormality noted at chromosome 21. Which additional assessments will the nurse include when evaluating the infant?
Protruding tongue
The patient indicates to the clinic nurse that she is trying to become pregnant. The clinic nurse and developmentally delayed, but two characteristics will become more noticeable as the child gets older. Cleft palate and polydactyly are more common with trisomy 13. reviews the patient’s chart and notes the following laboratory values: Blood type O−, RPR nonreactive, rubella non-immune, HCT 35%. Which laboratory value is most concerning to the nurse?
Rubella non-immune
The clinic nurse is reviewing charts on prenatal patients. Which patient histories indicate that a referral to a genetic counselor is warranted?(SATA)
A family history of unexplained stillbirths
A patient with a family history of birth defects
A patient who is a carrier of an X-linked disorder
The nurse is teaching prenatal patients about avoiding substances or conditions that can harm the fetus. Which should the nurse include in the teaching session?
Elimination of use of alcohol
Stabilization of blood glucose levels in a diabetic patient with insulin
Avoidance of nonurgent radiologic procedures during the pregnancy
Avoidance of maternal hyperthermia to temperatures of 37.8°C (100°F) or higher
The nurse is explaining genetics to a group of nursing students. Which are autosomal recessive disorders that the nurse should discuss during the teaching session?(SATA)
Cystic fibrosis
Sickle cell disease
Phenylketonuria (PKU) disease