During a prenatal visit, a patient 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 patient 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."
Correct Answer: 2
Rationale 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.
Rationale 2: Primary care includes health promotion and illness prevention, and it features services that are best
provided in community-based settings.
Rationale 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.
Rationale 4: As third-party payers begin to recognize the importance of primary care in containing costs and
maintaining health, community-based care has increased.
Global Rationale:
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO01 - Describe the use of community-based nursing care in meeting the needs of
childbearing families.
Question 2
Type: MCSA
The labor and delivery nurse and a nurse new to the labor and delivery unit are admitting a laboring patient. The
patient is making groaning guttural sounds during contractions and answering questions with one-word answers.
The labor and delivery nurse simultaneously is quickly setting up the instruments and sterile field for this delivery
Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank
Copyright 2014 by Pearson Education, Inc.
,while asking the admission questions between contractions. The experienced labor and delivery nurse has not yet
completed a pelvic exam. The nurse new to labor and delivery understands that this is an example of:
1. An expert nurse assessing advanced labor and imminent delivery in the patient.
2. The correct order of steps when admitting a laboring patient.
3. Inconsistencies in an individual nurse’s approach to patient care.
4. Advanced nurse practice.
Correct Answer: 1
Rationale 1: An expert nurse utilizes multiple aspects of a patient’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 laboring patient. The expert
nurse has identified that the grunting and guttural sounds during contractions are involuntary pushing and that the
patient is very close to delivery.
Rationale 2: Although most nurses have a routine when admitting a patient, the order of the steps will vary
according to the situation at hand.
Rationale 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 patient at that point in time.
Rationale 4: Advanced nurse practice describes educational and certification achievement and is not used to
describe the continuum from novice to expert.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: LO02 - Distinguish among the education, qualifications, and scopes of practice in nurses
caring for childbearing families.
Question 3
Type: MCSA
Currently, one-third of children under 20 years old come from families of minority populations. The new nurse is
observing her preceptor assess the patient’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. Patient’s cooperation with the plan of care.
Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank
Copyright 2014 by Pearson Education, Inc.
, 2. Hospital’s compliance with the Joint Commission on Accreditation of Healthcare Organizations JCAHO
standards.
3. Nurse’s knowledge of cultural beliefs.
4. Patient’s satisfaction with her care.
Correct Answer: 1
Rationale 1: Gaining cooperation with the plan of care increases the outcome desired at discharge. When a
patient’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.
Rationale 2: Although compliance with JCAHO standards is very important, it is more important to gain patient
cooperation with the plan of care.
Rationale 3: The nurse’s knowledge of cultural beliefs increases the ability to care for the patient, but without
patient cooperation with the plan of care, the nurse’s knowledge is lost.
Rationale 4: Patient 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.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: LO02 - Distinguish among the education, qualifications, and scopes of practice in nurses
caring for childbearing families.
Question 4
Type: MCSA
The patient at 30 weeks’ gestation expresses a desire for the registered nurse to independently manage her
perinatal care and the birth of her baby. When the nurse explains she is not credentialed to independently manage
the patient's perinatal care and delivery, the nurse is recognizing principles related to:
1. Standards of care.
2. Scope of practice.
3. Right to privacy.
4. Informed consent.
Correct Answer: 2
Ladewig, Contemporary Maternal-Newborn Nursing, 8/E Test Bank
Copyright 2014 by Pearson Education, Inc.
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