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Contemporary Maternal Newborn Nursing, 9th ed By Ladewig
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,Contemporary Maternal-Newborn Nursing, 9e (Ladewig et al.)Chapter 1 Contemporary Maternal-Newborn Care
1) During a prenatal visit, a client expresses interest in accessing community-based care and
services. Which response allows the registered nurse to best describe services that are offered by
way of community-based care?
1. "Most healthcare services provided to childbearing women and their families take place in a
hospital setting."
2. "Community-based care can provide a client with certain primary care services."
3. "Nurses are the sole providers of services related to home care."
4. "Due to lack of support from third-party payers, community-based care has decreased."
Answer: 2
Explanation: 1. The majority of health care provided to childbearing women and their families
takes place outside of hospital in clinics, offices, community-based organizations, and private
homes.
2. Primary care includes health promotion and illness prevention, and it features services that are
best provided in community-based settings.
3. While nurses are the major providers of home care services, healthcare providers in various
other fields, such as physical therapy, also offer home care services.
4. As third-party payers begin to recognize the importance of primary care in containing costs
and maintaining health, community-based care has increased.
Page Ref: 3
Cognitive Level: Application
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies:
Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing
| Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health
promotion
Learning Outcome: LO 1.2-Describe the use of community-based nursing care in meeting the
needs of childbearing families.
MNL LO: Overview of maternal-newborn nursing.
1
Copyright © 2017 Pearson Education, Inc.
,2) The labor and delivery nurse and a novice nurse are admitting a client who is in labor. The
client is making groaning guttural sounds during contractions and answers questions with one-
word answers. The labor and delivery nurse is quickly setting up the instruments and sterile field
for this delivery while asking admission questions between contractions. The labor and delivery
nurse has not completed a pelvic exam. The novice nurse understands that this is an example of:
1. An expert nurse assessing advanced labor and imminent delivery in the client.
2. The correct order of steps when admitting a who is in labor.
3. Inconsistencies in an individual nurse's approach to client care.
4. Advanced nurse practice.
Answer: 1
Explanation: 1. An expert nurse utilizes multiple aspects of a client's behavior (including the
length of each response to a question and sounds the patient produces during contractions) in
addition to the more objective findings of the pelvic exam (including dilation of the cervix) in the
assessment of a who is in labor. The expert nurse has identified that the grunting and guttural
sounds during contractions are involuntary pushing and that the client is very close to delivery.
2. Although most nurses have a routine when admitting a client, the order of the steps will vary
according to the situation at hand.
3. Changing the order of the steps of admission is not being inconsistent; changing the order of
the steps of admission is responsive to the needs of the client at that point in time.
4. Advanced nurse practice describes educational and certification achievement and is not used
to describe the continuum from novice to expert.
Page Ref: 4, 5
Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies:
Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing
| Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care
Learning Outcome: LO 1.3-Identify the nursing roles available to the maternal-newborn and
women's healthcare nurses.
MNL LO: Overview of maternal-newborn nursing.
2
Copyright © 2017 Pearson Education, Inc.
, 3) Currently, one-third of children under 20 years old come from families of minority
populations. The new nurse is observing her preceptor assess the client's communication pattern,
religious beliefs, level of education, and support system. The new nurse understands that the best
reason for her preceptor to assess these areas is to increase the:
1. Client's cooperation with the plan of care.
2. Hospitals compliance with the Joint Commission on Accreditation of Healthcare
Organizations JCAHO standards.
3. Nurse's knowledge of cultural beliefs.
4. Client's satisfaction with her care.
Answer: 1
Explanation: 1. Gaining cooperation with the plan of care increases the outcome desired at
discharge. When a client's value system is not included in the plan of care, it will decrease
compliance with the treatment plan and possibly increase the length of stay and decrease the
desired outcome at discharge.
2. Although compliance with JCAHO standards is very important, it is more important to gain
client cooperation with the plan of care.
3. The nurse's knowledge of cultural beliefs increases the ability to care for the client, but
without the client's cooperation with the plan of care, the nurse's knowledge is lost.
4. Client satisfaction with care is important, but the prime reason for the satisfaction is the
nurse's taking time to gain patient cooperation with the plan of care.
Page Ref: 4, 5
Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies:
Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Professional
identity | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health
promotion
Learning Outcome: LO 1.3-Identify the nursing roles available to the maternal-newborn and
women's healthcare nurses.
MNL LO: Overview of maternal-newborn nursing.
3
Copyright © 2017 Pearson Education, Inc.
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