1. Which factor significantly contributed to the shift from home births to hospital births in
zz zz zz zz zz zz zz zz zz zz zz zz zz
the early 20th century?
zz zz zz zz
a. Puerperal sepsis was identified as a risk factor in labor and delivery. zz zz zz zz zz zz zz zz zz zz zz
b. Forceps were developed to facilitate difficult births. zz zz zz zz zz zz
c. The importance of early parental-infant contact was identified.
zz zz zz zz zz zz zz
d. Technologic developments became available to physicians. zz zz zz zz zz
ANS: D zz
Technologic developments were available to physicians, not lay midwives. So in-hospital
zz zz zz zz zz zz zz zz zz zz
births increased in order to take advantage of these advancements. Puerperal sepsis has been
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
a known problem for generations. In the late 19th century, Semmelweis discovered how it
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
could be prevented with improved hygienic practices. The development of forceps is an
zz zz zz zz zz zz zz zz zz zz zz zz zz
example of a technology advance made in the early 20th century but is not the only reason
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
birthplaces moved. Unlike home births, early hospital births hindered bonding between
zz zz zz zz zz zz zz zz zz zz zz
parents and their infants.
zz zz zz zz
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
z z z zz zz
REF: p. 1
zz OBJ: Integrated Process: Teaching-Learning
z z zz z z zz zz
MSC: Client Needs: Safe and Effective Care Environment
zz z z zz zz zz zz zz zz
2. Family-centered maternity care developed in response to zz zz zz zz zz zz
a. demands by physicians for family involvement in childbirth. zz zz zz zz zz zz zz
b. the Sheppard-Towner Act of 1921.zz zz zz zz
c. parental requests that infants be allowed to remain with them rather than in
zz zz zz zz zz zz zz zz zz zz zz zz
a nursery. zz zz
d. changes in pharmacologic management of labor. zz zz zz zz zz
ANS: C zz
As research began to identify the benefits of early extended parent-infant contact, parents
zz zz zz zz zz zz zz zz zz zz zz zz
began to insist that the infant remain with them. This gradually developed into the
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
practice of rooming-in and finally to family-centered maternity care. Family-centered
zz zz zz zz zz zz zz zz zz zz
care was a request by parents, not physicians. The Sheppard-Towner Act of 1921
zz zz zz zz zz zz zz zz zz zz zz zz zz
provided funds for state-managed programs for mothers and children. The changes in
zz zz zz zz zz zz zz zz zz zz zz zz
pharmacologic management of labor were not a factor in family-centered maternity care.
zz zz zz zz zz zz zz zz zz zz zz zz
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
z z z zz zz
REF: p. 2
zz OBJ: Integrated Process: Teaching-Learning
z z zz z z zz zz
MSC: Client Needs: Psychosocial Integrity
zz z z zz zz zz
3. Which setting for childbirth allows the least amount of parent-infant contact?
zz zz zz zz zz zz zz zz zz zz
a. Labor/delivery/recovery/postpartum room z z
b. Birth center zz
c. Traditional hospital birth zz zz
d. Home birth zz
.
, ANS: C zz
In the traditional hospital setting, the mother may see the infant for only short feeding periods,
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
and the infant is cared for in a separate nursery. The labor/delivery/recovery/postpartum
zz zz zz zz zz zz zz zz zz zz zz zz
room setting allows increased parent-infant contact. Birth centers are set up to allow an
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
increase in parent-infant contact. Home births allow an increase in parent-infant contact.
zz zz zz zz zz zz zz zz zz zz zz zz
PTS: z z 1 DIF: Cognitive Level: Knowledge/Remembering zz zz
REF:
zz z z p. 2 OBJ: Nursing Process: Planning
zz z z zz zz
MSC: z z Client Needs: Health Promotion and Maintenance
zz zz zz zz zz
4. As a result of changes in health care delivery and funding, a current trend seen in the
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
pediatric setting is
zz zz zz
a. increased hospitalization of children. zz zz zz
b. decreased number of children living in poverty. zz zz zz zz zz zz
c. an increase in ambulatory care.
zz zz zz zz
d. decreased use of managed care. zz zz zz zz
ANS: C zz
One effect of managed care has been that pediatric health care delivery has shifted
zz zz zz zz zz zz zz zz zz zz zz zz zz
dramatically from the acute care setting to the ambulatory setting in order to provide
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
more cost-efficient care. The number of hospital beds being used has decreased as more
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
care is given in outpatient settings and in the home. The number of children living in
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
poverty has increased over the past decade. One of the biggest changes in health care
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
has been the growth of managed care.
zz zz zz zz zz zz zz
PTS: z z 1 DIF: Cognitive Level: Knowledge/Remembering zz zz
REF:
zz z z p. 5 OBJ: Nursing Process: Planning
zz z z zz zz
MSC: z z Client Needs: Safe and Effective Care Environment
zz zz zz zz zz zz
5. The Women, Infants, and Children (WIC) program provides
zz zz zz zz zz zz zz
a. well-child examinations for infants and children living at the poverty level. zz zz zz zz zz zz zz zz zz zz
b. immunizations for high-risk infants and children. zz zz zz zz zz
c. screening for infants with developmental disorders. zz zz zz zz zz
d. supplemental food supplies to low-income pregnant or breastfeeding women. zz zz zz zz zz zz zz zz
ANS: D zz
WIC is a federal program that provides supplemental food supplies to low-income women
zz zz zz zz zz zz zz zz zz zz zz zz
who are pregnant or breastfeeding and to their children until age 5 years. Medicaid‘s Early
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
and Periodic Screening, Diagnosis, and Treatment Program provides for well-child
zz zz zz zz zz zz zz zz zz zz
examinations and for treatment of any medical problems diagnosed during such checkups.
zz zz zz zz zz zz zz zz zz zz zz zz
Children in the WIC program are often referred for immunizations, but that is not the
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
primary focus of the program. Public Law 99-457 is part of the Individuals with
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
Disabilities Education Act that provides financial incentives to states to establish
zz zz zz zz zz zz zz zz zz zz zz
comprehensive early intervention services for infants and toddlers with, or at risk for,
zz zz zz zz zz zz zz zz zz zz zz zz zz
developmental disabilities.
zz zz
PTS: 1 DIF: Cognitive Level: Comprehension
z z zz zz REF: z z p. 8 zz
OBJ: Integrated Process: Teaching-Learning
zz z z zz zz
MSC: Client Needs: Health Promotion and Maintenance
zz zz zz zz zz zz
6. In most states, adolescents who are not emancipated minors must have the permission of
zz zz zz zz zz zz zz zz zz zz zz zz zz
zz their parents before zz zz
.
, a. treatment for drug abuse. zz zz zz
b. treatment for sexually transmitted diseases (STDs). zz zz zz zz zz
c. accessing birth control. zz zz
d. surgery.
ANS: D zz
Minors are not considered capable of giving informed consent, so a surgical procedure
zz zz zz zz zz zz zz zz zz zz zz zz
would require consent of the parent or guardian. Exceptions exist for obtaining treatment for
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
drug abuse or STDs or for getting birth control in most states.
zz zz zz zz zz zz zz zz zz zz zz zz
PTS: z z 1 DIF: Cognitive Level: Knowledge/Remembering zz zz
REF:
zz z zp. 17 OBJ: Nursing Process: Planning
zz z z zz zz
MSC: z z Client Needs: Safe and Effective Care Environment
zz zz zz zz zz zz
7. The maternity nurse should have a clear understanding of the correct use of a
zz zz zz zz zz zz zz zz zz zz zz zz zz
zz clinical pathway. One characteristic of clinical pathways is that they
zz zz zz zz zz zz zz zz zz
a. are developed and implemented by nurses.
zz zz zz zz zz
b. are used primarily in the pediatric setting.
zz zz zz zz zz zz
c. set specific time lines for sequencing interventions.
zz zz zz zz zz zz
d. are part of the nursing process.
zz zz zz zz zz
ANS: C zz
Clinical pathways are standardized, interdisciplinary plans of care devised for patients with
zz zz zz zz zz zz zz zz zz zz zz
a particular health problem. They are used to identify patient outcomes, specify time lines
zz zz zz zz zz zz zz zz zz zz zz zz zz zz
to achieve those outcomes, direct appropriate interventions and sequencing of
zz zz zz zz zz zz zz zz zz zz
interventions, include interventions from a variety of disciplines, promote collaboration,
zz zz zz zz zz zz zz zz zz zz
and involve a comprehensive approach to care. They are developed by multiple health
zz zz zz zz zz zz zz zz zz zz zz zz zz
care professionals and reflect interdisciplinary care. They can be used in multiple settings
zz zz zz zz zz zz zz zz zz zz zz zz zz
and for patients throughout the life span. They are not part of the nursing process but can
zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz zz
be used in conjunction with the nursing process to provide care to patients.
zz zz zz zz zz zz zz zz zz zz zz zz zz
PTS: z z 1 DIF: Cognitive Level: Knowledge/Remembering zz zz
REF:
zz z zp. 7 OBJ: Nursing Process: Planning
zz z z zz zz
MSC: z z Client Needs: Safe and Effective Care Environment
zz zz zz zz zz zz
8. The fastest growing group of homeless people is
zz zz zz zz zz zz zz
a. men and women preparing for retirement. zz zz zz zz zz
b. migrant workers. zz
c. single women and their children. zz zz zz zz
d. intravenous (IV) substance abusers. zz zz zz
ANS: C zz
Pregnancy and birth, especially for a teenager, are important contributing factors for
zz zz zz zz zz zz zz zz zz zz zz
becoming homeless. People preparing for retirement, migrant workers, and IV substance
z z zz zz zz zz zz zz zz zz zz zz
abusers are not among the fastest growing groups of homeless people.
zz zz zz zz zz zz zz zz zz zz zz
PTS: z z 1 DIF: Cognitive Level: Knowledge/Remembering zz zz
REF:
zz z zp. 14 OBJ:
zz Nursing Process: Assessment z z zz zz
MSC: z z Client Needs: Physiologic Integrity zz zz zz
.
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