TEST BANK
Canadian Maternity and Pediatric Nursing
Jessica Webster, Caroline Sanders, Susan Ricci, Theresa Kyle & Susan Carmen
2nd Edition
,Table of Contents
Chapter 01 Perspectives on Maternal and Child Health Care 1
Chapter 02 Family-Centred Community-Based Care 9
Chapter 03 Anatomy and Physiology of the Reproductive System 22
Chapter 04 Common Reproductive Issues 32
Chapter 05 Sexually Transmitted Infections 42
Chapter 06 Disorders of the Breasts 54
Chapter 07 Benign Disorders of the Reproductive Tract 64
Chapter 08 Cancers of the Female Reproductive Tract 76
Chapter 09 Violence and Abuse 86
Chapter 10 Fetal Development and Genetics 96
Chapter 11 Adaptations During Pregnancy 105
Chapter 12 Nursing Management During Pregnancy 117
Chapter 13 Labour and Birth Process 129
Chapter 14 Nursing Management During Labour and Birth 141
Chapter 15 Postpartum Adaptations 153
Chapter 16 Nursing Management During the Postpartum Period 164
Chapter 17 Newborn Transitioning 176
Chapter 18 Nursing Management of the Newborn 189
Chapter 19 Nursing Management of Pregnancy at Risk-Pregnancy-Related Complications 201
Chapter 20 Nursing Management of the Pregnancy at Risk-Selected Health Conditions
and Vulnerable Populations 212
Chapter 21 Nursing Management of Labour and Birth at Risk 224
Chapter 22 Nursing Management of the Postpartum Client at Risk 235
Chapter 23 Nursing Care of the Newborn With Special Needs 248
Chapter 24 Nursing Management of the Newborn at Risk-Acquired and Congenital
Newborn Conditions 259
Chapter 25 Growth and Development of the Newborn and Infant 270
Chapter 26 Growth and Development of the Toddler 282
Chapter 27 Growth and Development of the Preschooler 294
Chapter 28 Growth and Development of the School-Age Child 306
Chapter 29 Growth and Development of the Adolescent 318
Chapter 30 Atraumatic Care of Children and Families 330
Chapter 31 Health Promotion in the Community With Children and Families 341
Chapter 32 Health Assessment of Children 348
Chapter 33 Caring for Children in Diverse Settings 359
Chapter 34 Caring for the Child With Special Health Care Needs (SHCN) 370
Chapter 35 Medication Administration and Provision of Nutritional Support 381
Chapter 36 Pain Management in Children 394
Chapter 37 Nursing Care of the Child With an Infectious or Communicable Disorder 406
Chapter 38 Nursing Care of the Child With a Neurologic Disorder 417
Chapter 39 Nursing Care of the Child With an Alteration in Sensory Perception-Disorder
,of the Eyes or Ears 429
Chapter 40 Nursing Care of the Child With an Alteration in Gas Exchange-Respiratory
Disorder 441
Chapter 41 Nursing Care of the Child With an Alteration in Perfusion-Cardiovascular
Disorder 450
Chapter 42 Nursing Care of the Child With an Alteration in Bowel Elimination-
Gastrointestinal Disorder 462
Chapter 43 Nursing Care of the Child With an Alteration in Urinary Elimination-
Genitourinary Disorder 473
Chapter 44 Nursing Care of the Child With an Alteration in Mobility-Neuromuscular or
Musculoskeletal Disorder 484
Chapter 45 Nursing Care of the Child With an Alteration in Tissue Integrity-
Integumentary Disorder 500
Chapter 46 Nursing Care of the Child With an Alteration in Cellular Regulation-
Hematologic or Neoplastic Disorder 511
Chapter 47 Nursing Care of the Child With an Alteration in Immunity or Immunologic
Disorder 530
Chapter 48 Nursing Care of the Child With an Alteration in Metabolism-Endocrine
Disorder 542
Chapter 49 Nursing Care of the Child With a Genetic Variation 554
Chapter 50 Nursing Care of the Child With an Alteration in Behaviour, Cognition, or
Development 564
Chapter 51 Nursing Care During a Pediatric Emergency 575
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Test Bank - Canadian Maternity and Pediatric Nursing, 2nd Edition (Webster, 2020)
Chapter 1, Perspectives on Maternal and Child Health Care
MULTIPLE CHOICE
1. When integrating the principles of family-centered care into the birthing process, the nurse
would base care upon which belief?
a. Birth is viewed as a medical event.
b. Families are unable to make informed choices due to stress.
c. Birth results in changes in relationships.
d. Families require little information to make appropriate decisions for care.
ANS: C
Rationale: Family-centered care is based on the following principles: Birth affects the entire
family, and relationships will change; birth is viewed as a normal, healthy event in the life
of the family; and families are capable of making decisions about their own care if given
adequate information and professional support.
PTS: 1
REF: Page and Header: 6, The History of Maternal and Newborn Health and Health Care
NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1
BLM: Cognitive Level: Understand
2. The nurse is working with a group of community health members to develop a plan to
address the special health needs of women. The group would design educational programs
to address which condition as the priority?
a. Smoking
b. Heart disease
c. Diabetes
d. Cancer
ANS: B
Rationale: The group needs to address cardiovascular disease, the number one cause of
death in women regardless of racial or ethnic group. Smoking is related to heart disease and
the development of cancer. However, heart disease and cancer can occur in any woman
regardless of her smoking history. Cancer is the second leading cause of death, with women
having a one in three lifetime risk of developing cancer. Diabetes is another important
health condition that can affect women. However, it is not the major health problem that
heart disease is.
PTS: 1 REF: Page and Header: 13, Women’s Health Indicators
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter: 1 BLM: Cognitive Level: Apply
3. A nurse is conducting an orientation program for a group of newly hired nurses. As part of
the program, the nurse is reviewing the issue of informed consent. The nurse determines that
the teaching was effective when the group identifies which situation as a violation of
informed consent?
a. Performing a procedure on a 12-year-old cognitively challenged client without
parental consent
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Test Bank - Canadian Maternity and Pediatric Nursing, 2nd Edition (Webster, 2020)
b. Serving as a witness to the signature process on an operative consent form
c. Asking whether the client understands what she is signing following receiving
education
d. Getting verbal consent over the phone for an emergency procedure from the
spouse of a unconscious woman
ANS: A
Rationale: In some provinces and territories, mature minors (usually over the age of 14) can
give consent, pending their level of maturity and intelligence to make decisions about
treatment. In some provinces/territories there are no laws related to consent. Children 12
years old are likely not sufficiently mature to understand teaching and consent related to
medical procedures. Serving as a witness to the signature process, asking whether the client
understands what she is signing, and getting verbal consent over the phone for emergency
procedures are all key to informed consent and are not violations.
PTS: 1
REF: Page and Header: 43, Exceptions to Parental Consent Requirement
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 BLM: Cognitive Level: Analyze
4. The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis.
His parents are out of town on vacation, and the child is staying with a neighbor. Which
action would be the priority?
a. Getting telephone consent with two people listening to the verbal consent
b. Providing emergency care without parental consent
c. Contacting the child's aunt or uncle to obtain their consent
d. Asking the courts to grant permission on the child's behalf
ANS: A
Rationale: The priority action would be to contact the neighbor for an emergency number to
reach the parents and get their verbal consent with two witnesses listening simultaneously. If
the nurse cannot reach the parents, and there is no relative or other person with written
authorization to act on the parent's behalf, then the primary care provider may initiate
emergency care without the parents' consent. Involving the court would take too much time.
The child needs immediate treatment.
PTS: 1
REF: Page and Header: 43, Exceptions to Parental Consent Requirement
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 BLM: Cognitive Level: Apply
5. Which statement made by a nursing student would best indicate that their education on
family-centered care was fully understood?
a. “Childbirth affects the entire family, and relationships will change.”
b. “Families are challenged to make health care decisions for themselves in stressful
situations.”
c. “Mothers are the primary family member affected by childbirth.”
d. “Since childbirth is a medical procedure, it may affect everyone.”
ANS: A
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Test Bank - Canadian Maternity and Pediatric Nursing, 2nd Edition (Webster, 2020)
Rationale: Childbirth affects the entire family, and relationships will change. Childbirth is
viewed as a normal life event, not a medical procedure. Families are very capable of making
health care decisions about their own care with proper information and support.
PTS: 1
REF: Page and Header: 9, Evolution of Maternal and Newborn Nursing
NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1
BLM: Cognitive Level: Apply
6. Which aspect of client wellness has been less of a focus of health during the 21st century in
developed countries?
a. Disease prevention
b. Health promotion
c. Wellness
d. Analysis of morbidity and mortality
ANS: D
Rationale: The focus on health has shifted to disease prevention, health promotion, and
wellness. In the last century, much of the focus was on analyzing morbidity and mortality
rates.
PTS: 1 REF: Page and Header: 13, Morbidity
NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1
BLM: Cognitive Level: Understand
7. A nurse is conducting an in-service program for a group of nurses on the health of women
and their families. The nurse determines that additional discussion and clarification is
needed when the group makes which statement?
a. “Obesity, drug use, and smoking are major problems.”
b. “Maintaining a physically active lifestyle is strongly encouraged”
c. “Immunizations may be the cause of some illnesses.”
d. “Environmental quality is directly related to health care.”
ANS: C
Rationale: Obesity, drug use, and smoking are major concerns. Physical activity and
environmental quality are also on the list of leading health indicators in the Healthy People
2020 Report. The students that understood that immunizations are the causes of diseases
need clarification since maintenance of immunizations is one of the health indicators listed
in the report.
PTS: 1 REF: Page and Header: 14, Childhood Morbidity
NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1
BLM: Cognitive Level: Analyze
8. A nurse is planning a continuum of care for a client during pregnancy, labor, and childbirth.
What is the most important factor in enhancing the birthing experience?
a. Adhering to strict specific routines
b. Involving a pediatrician
c. Educating the client about the importance of a support person
d. Assigning several nurses as a support team
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Test Bank - Canadian Maternity and Pediatric Nursing, 2nd Edition (Webster, 2020)
ANS: C
Rationale: Educating the client about the importance of a support person during labor and
delivery has been shown to improve and enhance the birthing experience.
PTS: 1 REF: Page and Header: 7, EVIDENCE-BASED PRACTICE 1.1
NAT: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
TOP: Chapter: 1 BLM: Cognitive Level: Apply
9. Parents who recently experienced the death of their unborn child ask the nurse, "What is a
fetal death?" What is the nurse's best response?
a. "Fetal deaths occur later in pregnancy after 20 weeks' gestation."
b. "It refers to the intrauterine fetal death at any time during pregnancy."
c. "Fetal deaths occur earlier in pregnancy before 20 weeks' gestation."
d. "Fetal death occurs only at the birth of the newborn."
ANS: B
Rationale: Fetal death refers to the spontaneous intrauterine death of a fetus at any time
during pregnancy. Fetal deaths later in pregnancy (>20 weeks of gestation) are referred to as
stillbirths, and deaths earlier than 20 weeks are referred to as a miscarriage.
PTS: 1 REF: Page and Header: 11, Fetal Mortality
NAT: Client Needs: Psychosocial Integrity TOP: Chapter: 1
BLM: Cognitive Level: Apply
10. When teaching a parenting class on childhood discipline, the nurse is asked by a parent,
"How long do I place my child in time-out?" How should the nurse best respond?
a. "Use the amount of time it takes to elicit a behavior change."
b. "Use 1 minute per year of age, but do not exceed 5 minutes."
c. "Use as much time as is needed to control the behavior."
d. "Use 1 minute per year of the child's age as needed."
ANS: B
Rationale: Another form of discipline is extinction, which focuses on reducing or
eliminating the positive reinforcement for inappropriate behavior. Examples are "time-out."
When using time-out, use 1 minute per year of the child's age (a 3- year-old would have
time-out for 3 minutes). Do not exceed 5 minutes.
PTS: 1 REF: Page and Header: 22, DISCIPLINE
NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1
BLM: Cognitive Level: Apply
11. A public health nurse visits the home of a young toddler. What aspect of the home
environment would the nurse expect to address with the parents?
a. The presence of power cords plugged into capped outlets
b. Cartoons playing on a television in the child's room
c. The family dog is present in the house during the visit
d. The presence of pots on the stove with handles pointing toward back
ANS: B
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Test Bank - Canadian Maternity and Pediatric Nursing, 2nd Edition (Webster, 2020)
Rationale: The nurse is encouraged to ask questions regarding the amount of recreational
screen time and if the child has a television or Internet-connected device in his or her
bedroom. The American Academy of Pediatrics discourages any screen media before the
age of 2. The nurse would question why the TV is being used in the child's room. The
family dog may be a threat to observe during the visit, but having a TV in the child's room
indicates that it is being exposed to earlier than advised screen time. Pot handles are in the
appropriate position. Cords are plugged into capped outlets, which is safe.
PTS: 1 REF: Page and Header:22, DISCIPLINE
NAT: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
TOP: Chapter: 1 BLM: Cognitive Level: Apply
12. The nurse working in a maternity clinic suspects that a client and her children are in an
abusive relationship. While waiting for test results, the nurse decides to teach the client
about partner abuse. What would be the best rationale for the nurse's decision?
a. The nurse knows that the woman may be weak and controlled by her partner.
b. The nurse has a legal responsibility to protect clients.
c. The nurse understands there is an ethical responsibility to protect clients.
d. The nurse knows that children exposed to family violence are likely to be abused.
ANS: D
Rationale: Children exposed to family violence are more likely to be physically, sexually, or
emotionally abused themselves. Children have died from abuse and neglect when no one has
intervened on their behalf. Children who are exposed to stressors such as domestic violence
or who are victims of childhood abuse or neglect are at high risk for short- and long-term
problems. Witnessing and being exposed to violence in childhood results in a higher
tolerance, and greater use, of violence as an adult. The nurse may feel an ethical
responsibility towards clients, but the nurse does not have a legal responsibility to protect
clients. Women being the weaker sex is a myth.
PTS: 1 REF: Page and Header: 28, Violence
NAT: Client Needs: Psychosocial Integrity TOP: Chapter: 1
BLM: Cognitive Level: Understand
MULTIPLE RESPONSE
13. A nurse educator is teaching a group of students about what made cities during the late 19th
and early 20th century healthier to live in than they previously were. The nurse determines
that the teaching is effective when the students make which statements? Select all that
apply.
a. Cities were healthier due to the enforcement of an immunization process.
b. The pasteurization of milk assisted in making cities healthier.
c. The cities were much healthier with treated municipal water.
d. Improved sanitation services made the cities healthier.
e. Hygienic practices improved living conditions of the cities.
ANS: C, D, E
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Test Bank - Canadian Maternity and Pediatric Nursing, 2nd Edition (Webster, 2020)
Rationale: In the late 19th and early 20th centuries, cities became healthier places to live due
to urban public health improvements such as sanitation services, treated municipal water,
and improvements in hygiene. Pasteurization of milk and immunization made people
healthier.
PTS: 1
REF: Page and Header: 9, The History of Child Health and Child Health Care
NAT: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
TOP: Chapter: 1 BLM: Cognitive Level: Analyze
14. A public health nurse is developing programs to assist in improving infant mortality rates.
Which factors would need to be addressed because they would have the greatest impact?
Select all that apply.
a. Congenital anomalies
b. Low birth weights
c. Prematurity
d. Sudden infant death syndrome
e. Infectious diseases
ANS: A, B, C
Rationale: Congenital anomalies remain the leading cause of infant mortality. In addition,
low birth weight and prematurity are major indicators of infant health and predictors of
infant mortality. There is a high rate of preterm low birth weight infants born, and this rate
is a significant reason why infant mortality is higher than in many other countries. SIDS and
infant infections are not included in this issue.
PTS: 1 REF: Page and Header: 12, Neonatal and Infant Mortality
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter: 1 BLM: Cognitive Level: Apply
15. A nurse is preparing a class discussion on cardiovascular disease in women. When
discussing the priority risk factors for this disease, which should the nurse include? Select
all that apply.
a. Menopause
b. Diabetes diagnosis
c. Weight cycling
d. Gender
e. Age
ANS: A, B, C
Rationale: CVD is the leading cause of death in women. Risk factors of CVD differ between
men and women with menopause, diabetes, and repeated weight losses and gains increasing
the risk for coronary morbidity and mortality in women. Yo-yo dieting or yo-yo effect, also
known as weight cycling is a major risk factor. Gender and age are not major risk factors
and should not be considered in this list.
PTS: 1 REF: Page and Header: 13, Women’s Health Indicators
NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1
BLM: Cognitive Level: Analyze
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Test Bank - Canadian Maternity and Pediatric Nursing, 2nd Edition (Webster, 2020)
16. A nurse is preparing a class discussion on the clinical manifestations of a heart attack
observed in women. Which symptoms would the nurse include as key assessment data?
Select all that apply.
a. Syncope
b. Unusual fatigue
c. Sleep disturbances
d. Arm pain
e. Extreme hunger
ANS: B, C, D
Rationale: Nurses need to go beyond the obvious crushing chest pain textbook symptom that
indicates heart attack in men. Clinical manifestations of a heart attack observed in women
include nausea, dizziness, irregular heartbeat, unusual fatigue, sleep disturbances,
indigestion, anxiety, shortness of breath, pain or discomfort in one or both arms, and
weakness.
PTS: 1 REF: Page and Header: 13, Women’s Health Indicators
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter: 1 BLM: Cognitive Level: Analyze
17. Which factors are main causes of the high infant mortality rate? Select all that apply.
a. Postmaturity
b. Low birth weight
c. Sudden infant death syndrome
d. Cardiac complications
e. Viral infections
f. Necrotizing enterocolitis
ANS: B, C, F
Rationale: The main causes of early infant death in the United States include problems
occurring at birth or shortly thereafter, such as prematurity, low birth weight, congenital and
chromosomal anomalies, sudden infant death syndrome, respiratory distress syndrome,
unintentional injuries, bacterial sepsis, and necrotizing enterocolitis.
PTS: 1 REF: Page and Header: 12, Neonatal and Infant Mortality
NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1
BLM: Cognitive Level: Apply
18. A nurse is preparing for a health promotion presentation for new mothers. Which topics
would be appropriate for the nurse to include in the presentation? Select all that apply.
a. Breastfeeding encouragement
b. Proper infant sleep position
c. Infants in smoke-free environments
d. How to swaddle their infants
e. How to bed share with their infants
ANS: A, B, C
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