Olds' Maternal-Newborn Nursing and Women's Health Across the Lifespan 8th Edition Test Bank

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Chapter 1Current Issues in Maternal-Newborn NursingMULTIPLE CHOICE.Choose the one alternative that best completes the statement or answers the question.1)An experienced nurse is working with a new graduate. The experienced nurse suspects that the multiparousclient is going to deliver precipitously, while the new graduate is unaware that the labor is proceedingrapidly. One reason for this difference in interpretation of the client situation is because experienced nursesare able to view situations more holistically because they:A)Know more about the pathophysiology of diseases.B)Need less supervision in managing complex clinical situations.C)Spend less time providing direct client care.D)Are more aware of subtle cues that indicate client changes.Answer:D2)Self-care has gained wide acceptance with clients, the healthcare community, and third-party payors due toresearch findings that suggest that it has:A)Reduced health care costs.B)Decreased the number of emergency room visits.C)Decreased use of home health agencies.D)Shortened newborn length of stay.Answer:A3)The new graduate is learning about advanced practice nursing. Which of the following situations bestillustrates an advanced practice nursing role? (Select all that apply.)A)An experienced registered nurse who is the manager of a large obstetrical unitB)A nurse-midwife attending vaginal deliveries of uncomplicated pregnancies.C)A registered nurse who is the circulating nurse at surgical (cesarean) deliveriesD)A clinical nurse specialist who is working as a staff nurse on a mother-baby unitE)A nurse practitioner who is consulting with a physician in the newborn nurseryAnswer:B, E4)The nurse at an elementary school is performing TB screenings on all of the students. Permission slips werereturned for all children except for the Nguyen children. When the nurse phones to obtain permission, themother states in clearly-understandable English that she is unable to give permission at this time because hergrandmother is out of town for two more weeks. Which of the following elements of culture is contributingto the dilemma that faces the nurse?A)Belief and understanding about the concepts of health and illnessB)Permissible physical contact with strangersC)Presence and influence of the extended familyD)Religion and social beliefsAnswer:C5)The insurance company is demanding that a client who is experiencing complications be discharged in twodays, because her benefits will run out. The physician and nurses who are involved in this client's care allfeel that, because there is no one at home to provide assistance, it is an ethical breach of duty to send thisclient home when she cannot care for herself. Which of the six components of ethical decision making is thenurse considering when evaluating the driving and restraining forces and assessing the likelihood of asuccessful outcome?A)Action and implementationB)Conflict resolution

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C)Data gatheringD)Plan formulationAnswer:B6)The nurse is reviewing care of clients on a mother-baby unit. Which of the following situations should bereported to the supervisor?A)The client who delivered by cesarean delivery yesterday received oral narcotics.B)An infant was placed in the wrong crib after examination by the physician.C)A 2-day-old infant has breastfed every three hours and voided four times.D)A primiparous client who delivered today is requesting discharge within 24 hours.Answer:B7)The nurse manager is planning a presentation on ethical issues in caring for the childbearing families. Whichof the following should the nurse manager include as an example of maternal-fetal conflict?A)A 39-year-old nulliparous client undergoes therapeutic insemination.B)A cesarean delivery of a breech fetus is court-ordered after the client refuses.C)A family of a child with leukemia requests cord blood banking at this birth.D)A client chooses an abortion after her fetus is diagnosed with a genetic anomaly.Answer:B8)The nurse is working at a community clinic. For which of the following clients must the nurse seek parentalpermission to obtain informed consent?A)A 16-year-old who is seeking information on contraceptive useB)An emancipated minor who is requesting treatment for a urinary tract infectionC)A 12-year-old with an ectopic (tubal) pregnancy who requires surgeryD)A married 17-year-old who is recommended for a planned cesarean birthAnswer:C9)In explaining descriptive statistics to the student nurse, the experienced nurse should include which of thefollowing examples?A)Comparison of maternal mortality rates across racial groupsB)Understanding the behavioral variations within a cultural groupC)Determining why the infant mortality is declining in the United StatesD)Assessment of maternal nutrition with age and birth weightAnswer:A10)The nurse knows the birth rate by age group in the state. Which research question could be developed forfurther study from this data?A)What is the average number of children per family in the United States?B)Which high schools provide day care for student parents?C)How does educational level affect the incidence of unplanned pregnancy?D)What is the overall nutritional status of adolescents?Answer:C11)The nurse manager is leading an in-service educational session about evidence-based nursing practice.Which participant statement indicates the need for additional information? "Evidence-based nursing

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practice:A)Incorporates research findings into clinical practice."B)Is a lifelong learning approach to client care."C)Is supported by current, valid research."D)Is unnecessary on a unit with established policies."Answer:D12)State nurse practice acts define the legal scope of nursing practice. How can the policies of an institution ororganization such as a hospital influence nursing practice? The institution: (Select all that apply.)A)Cannot redefine in any way the limits set by the practice act.B)Can permit nurses to do some things that are forbidden by the state practice act.C)Should remain aware of changes or updates as they are enacted.D)Can either restrict or expand the limits of the practice act.E)Can restrict nurses from doing some things that are allowed by the state nurse practice act.Answer:C, E13)The maternity nurse has been named in a negligence malpractice suit. The best defense against theaccusation of negligence is if the nurse:A)Was acting on the advice of the nurse manager.B)Followed the physician's written orders.C)Met the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) standards ofpractice.D)Is a certified nurse midwife or nurse practitioner.Answer:C14)The nurse is planning care in a labor and delivery unit. Which of the following families is most likely torequest cord blood banking?A)A family with a history of leukemiaB)A family who wishes to avoid a future intrauterine fetal surgeryC)A family who wishes to select the sex of a future childD)A family with a history of infertilityAnswer:A15)A nurse has attended a cesarean birth. Without first consulting the parents the nurse goes to the waitingroom and tells family members the sex of a newborn baby. In this situation, the nurse would be consideredto have committed:A)A breach of ethics.B)Malpractice.C)A breach of privacy.D)Negligence.Answer:C

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1)D2)A3)B, E4)C5)B6)B7)B8)C9)A10)C11)D12)C, E13)C14)A15)C

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Chapter 2Care of the Family in a Culturally Diverse SocietyMULTIPLE CHOICE.Choose the one alternative that best completes the statement or answers the question.1)Which examples of a pregnant client's culture may influence her decision making? (Select all that apply.)A)The client follows the nutrition advice of the certified nurse-midwife.B)The client's husband comes to a prenatal visit to hear the fetal heartbeat.C)The client plans to return to work full-time at six weeks postpartum.D)The client's grandfather makes the family's major health care decisions.E)The client includes specific foods in her diet every day during pregnancy.Answer:D, E2)At 38 weeks gestation, the client reports to the nurse that she will return to work when her child is twoweeks old, and her grandmother will care for the infant. This is an example of:A)A family development stage.B)A spiritual belief.C)A developmental task.D)An economic employment trend.Answer:D3)The public health nurse is working with a student nurse. The student nurse asks which of the six groups ofpeople seen today are families. How should the nurse respond? "The clients we visited today that arefamilies are the: (Select all that apply.)A)Married heterosexual couple with three children, living with grandparents."B)Unmarried heterosexual couple with two biological children."C)Gay couple with two adopted children."D)The married heterosexual couple without children."E)Lesbian couple not living together that have no children"Answer:A, B, C, D4)The nurse is preparing a community presentation on family development. Which of the following statementsshould the nurse include?A)A family does not experience overlapping of stages.B)The stages describe the family's progression over time.C)The youngest child's age determines the family's current stage.D)Family development ends when the youngest child leaves home.Answer:B5)The family the nurse is caring for in the community has a two-month-old child. The infant is breastfed, andthe father helps care for the child by changing diapers, and dressing and bathing the baby. The mother willbe returning to work when the baby is three months old, and a day care provider has been arranged.Although the mother occasionally feels fatigued, the couple has resumed having sexual relations, althoughnot as frequently as before the pregnancy. Which family model best describes this family?A)Model of the Breastfeeding MotherB)Model of the Childbearing FamilyC)Model Incorporating the Unattached Young AdultD)Model of the Nuclear FamilyAnswer:B

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6)The pregnant client reports to the nurse that she is eating dirt on a weekly basis, and was told to do this byher grandmother to have a healthy pregnancy. How should the nurse respond?A)"There is no problem with this practice. Feel free to continue."B)"Your grandmother gave you bad advice. Stop at once."C)"This practice is completely unhealthy and should be stopped."D)"The soil may contain contaminants that could harm your baby."Answer:D7)The nurse is performing a cultural assessment using the Transcultural Assessment Model. What aspect ofcommunication should the nurse keep in mind when planning the assessment?A)Personal space does not vary from one culture to another.B)The use of silence may differ among different groups.C)Non-verbal communication is consistent across cultures.D)Cultural groups living in America are future-oriented.Answer:B8)A family is said to be acculturating to United States norms when the parent makes which of the followingstatements?A)"Our diet now includes hamburgers and French fries."B)"We celebrate the same holidays that we used to at home."C)"The children are much less well-behaved than they used to be."D)"When the children leave the house, I worry about them."Answer:A9)The nurse is working with an immigrant group in the community that has been in the state for several years.Which of the following findings would indicate that the immigrant group is acculturating?A)Fewer screening mammogramsB)Lowered cholesterol levels and insulin resistanceC)Decreased incidence of obesity in adults and childrenD)Increased rates of cervical cancer screening examsAnswer:D10)The nurse manager in a hospital with a large immigrant population is planning an inservice. The nursemanager is aware of how ethnocentrism affects nursing care. Which statement should the nurse managerinclude? "The belief that one's own values and beliefs are the only or the best:A)Can create barriers to communication through misunderstanding."B)Leads to an expectation that all clients will exhibit pain the same way."C)Improves the quality of care provided to culturally diverse clients."D)Means that newcomers to the United States should adopt United States norms and values."Answer:A11)When planning care of childbearing families, the nurse encounters different spiritual and religious beliefsand practices. Which of the following is a spiritual practice that could impact the nurse's care of thechildbearing family?A)A strong belief in reincarnation, and thus refusal of an autopsyB)Refusing consent for a blood transfusion by a Jehovah's WitnessC)Request by the family to speak to a Roman Catholic priest

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D)The desire to light candles at home during a naming ceremonyAnswer:A12)When preparing to teach a group of culturally diverse childbearing families about hospital birthing options,in order to be culturally competent, the nurse should:A)Understand that the family has the same values as the nurse.B)Teach the family how childbearing takes place in the United States.C)Learn about the cultural groups that are likely to attend the class.D)Insist that the client answer questions instead of her husband.Answer:C13)The laboring client is being tended by her mother, older sisters, and aunts. The husband of the client is not atthe hospital. The most likely explanation for this, based on an understanding of the client's culture, is:A)Labor support is to be provided by adult women, not men.B)The client and her husband are not legally married.C)This is the indirect communication of this culture.D)The husband is angry at his wife.Answer:A14)The nurse in the community should use a family assessment tool to obtain what type of information?A)How they meet their nutritional needs and obtain foodB)What other health insurance the family has had in the pastC)How long the family has lived at their current addressD)What eye color they desire in their unborn childAnswer:A15)The laboring client the nurse is caring for speaks English well, and has identified her race as Asian. She hasrequested only warm water to drink, and has refused ice chips and cold liquids throughout the labor. Thenurse understands that this is most likely related to:A)Folklore concerning the desired sex of the unborn child.B)A desire to have complete control of the environment.C)The client's belief in the role of hot and cold in health.D)The fact that the client has not yet become thirsty.Answer:C

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1)D, E2)D3)A, B, C, D4)B5)B6)D7)B8)A9)D10)A11)A12)C13)A14)A15)C

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Chapter 3Complementary and Alternative TherapiesMULTIPLE CHOICE.Choose the one alternative that best completes the statement or answers the question.1)The client states "I am using homeopathic remedies to help with my morning sickness." The nurseunderstands that the client is utilizing:A)Traditional Chinese medicine.B)A complementary therapy.C)Naturopathy.D)An alternative therapy.Answer:B2)Complementary and alternative therapies are becoming more commonly used in the U.S. Based on anunderstanding of how clients learn about these therapies, which client is most likely to use either acomplementary or an alternative therapy?A)A middle-aged woman who travels internationally for her jobB)An adolescent male who plays many sports through schoolC)An elderly couple on a fixed income without a computer at homeD)A young mother of three preschoolers who works part-timeAnswer:A3)The National Center for Complementary and Alternative Medicine (NCCAM) is responsible for:A)Ensuring the safety of complementary and alternative therapies.B)Disseminating information to consumers.C)Performing testing on new therapies and products.D)Endorsing products for further approval by the FDA.Answer:B4)The nurse is planning a community education program on the role of complementary and alternativetherapies during pregnancy. Which statement should the nurse include? "Alternative and complementarytherapies:A)Bring about cures for illnesses and diseases."B)Prevent pregnancy complications."C)Emphasize prevention and wellness."D)Are invasive but effective for achieving health."Answer:C5)The pregnant client asks the nurse about the safety and risks of using complementary and alternativetherapies. How should the nurse respond? "The use of complementary and alternative therapies is:A)Not regulated by the FDA and little has been proven about some methods."B)Safe as long as you see a certified and registered practitioner of the therapy."C)Completely safe and therefore not a problem during pregnancy."D)Very inexpensive and can easily be tried to see if they help your health."Answer:A6)The nurse is teaching a community education class on complementary and alternative therapies. To assesslearning, the nurse asks this question about traditional Chinese medicine: "What is the invisible flow ofenergy in the body that maintains health and assures physiologic functioning?" Which answer indicatesteaching was successful?

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A)YinB)ChiC)YangD)MeridiansAnswer:B7)The client reports to the nurse that she is utilizing Ayurvedic medicine. Which statements would the nurseexpect this client to make? "Aryurvedic medicine (Select all that apply.)A)Uses both traditional means with current modern medicine."B)Cures an illness with a like substance."C)Combines heat and cold with spinal manipulation."D)Seeks balance to achieve harmony in my life."E)Is knowledge of how to live a vital, healthful life."Answer:D, E8)The nurse is seeing clients at the wellness clinic. Which client is most likely to be using a form ofchromotherapy?A)A client with severe burnsB)A client with cancerC)A baby with spina bifidaD)A client with a seasonal mood disorderAnswer:D9)The nurse is teaching a class to the community on mind-body therapies. A class participant gives an exampleof a friend with leukemia who was taught by her complementary therapist to concentrate on makingantibodies that will fight and kill the cancer cells in the blood stream. The nurse would describe thistechnique as:A)Homeopathy.B)Biofeedback.C)Qigong.D)Guided imagery.Answer:D10)The client reports using an alternative therapy that involves the manipulation of soft tissues. This therapyhas reduced the client's stress, diminished pain, and increased circulation. This therapy is most likely:A)Homeopathy.B)Guided imagery.C)Massage therapy.D)Reflexology.Answer:C11)The client asks why she should not use a sauna or sweat bath in the first trimester of pregnancy. The bestexplanation by the nurse is that saunas and sweat baths have been associated with fetal:A)Neural tube defects.B)Craniofacial defects.C)Patent ductus arteriosus.D)Gastroschisis.

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Answer:A12)The client reports relief from headaches when she rubs the temples on each side of the head. The nurseunderstands that this is a form of:A)The Alexander technique.B)The Feldenkrais method.C)Acupressure.D)Acupuncture.Answer:C13)The nurse is reviewing charts. A client seen in the clinic yesterday reported seeing a practitioner that placedhis hands above a painful abdomen in order to transfer energy. This resulted in a decrease in painsimultaneously with an improved overall sense of well-being. The nurse understands this therapy to be:A)Therapeutic touch.B)Chiropractic.C)Reiki.D)Homeopathy.Answer:C14)The nurse is preparing a class on complementary and alternative medicine (CAM). One fact that could beincluded in this presentation is:A)Men are more likely to use CAM than women.B)People of lower educational levels use more CAM.C)36% of Americans use some form of CAM.D)Prayer and megavitamin therapy are not considered CAMAnswer:C15)The pregnant client has brought an herbal remedy to the clinic to learn about the safety of the remedy. Thenurse should include which statements about herbal therapies? "Herbal remedies: (Select all that apply.)A)Are not subject to safety and effectiveness testing."B)Are used to eliminate certain diseases."C)Are subject to FDA approval."D)Cannot be sold over the counter."E)Are different from homeopathic remedies."Answer:A, E

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1)B2)A3)B4)C5)A6)B7)D, E8)D9)D10)C11)A12)C13)C14)C15)A, E

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Chapter 4Women’s Health Across the LifespanMULTIPLE CHOICE.Choose the one alternative that best completes the statement or answers the question.1)A client asks her nurse "Is it okay for me to take a tub bath during the heavy part of my menstruation?" Thebest response by the nurse is:A)"Either a bath or a shower is fine at that time."B)"You should bathe and use a feminine deodorant spray during menstruation."C)"Tub baths are contraindicated during menstruation."D)"You should shower and douche daily instead."Answer:A2)An adolescent client is asking the nurse about using tampons during heavy menstrual flow. Which answer isbest for the nurse to provide?A)Tampons are recommended for use at the end of the menstrual period rather than at the beginning.B)Tampons should be avoided when the menstrual flow is heavy.C)Super tampons with added deodorants are recommended for the day, while regular tampons may beworn at night.D)Tampons should be used during the day; change to napkins at night when flow is lighter to decreasethe risk of toxic shock syndrome.Answer:DSHORT ANSWER.Write the word or phrase that best completes each statement or answers the question.3)The nurse is beginning to take a sexual history from the client. List the answer choices in chronological orderof how the nurse should proceed. Your answer should be a four digit number.1.Ask specific questions about the client's current sexual practices.2.Ask the client mostly open-ended questions.3.Have the client fill out a comprehensive questionnaire.4.Explain that the history is obtained from all clients and will be confidential.Answer:4321MULTIPLE CHOICE.Choose the one alternative that best completes the statement or answers the question.4)The nurse has successfully completed a client's sexual and gynecologic history. Which of the followingquestions is the nurse most likely to have included?A)When was the last time you had intercourse?B)Have you had a sexually-transmitted infection?C)Have you ever had any type of surgery?D)Have you had any elective abortions?Answer:C5)A 19-year-old woman comes to the gynecologist's office. When the nurse asks the reason for this visit, thewoman explains that she has never had a menstrual period and that she is concerned there may besomething wrong. The diagnosis that the physician is most likely to make based on this information is:A)Primary amenorrhea.B)Secondary amenorrhea.C)Secondary infertility.D)Primary dysmenorrhea.Answer:A

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6)The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last fourmonths, and reports running at least five miles per day. The client asserts that her menarche was five yearsago. Her menses are usually every 28 days, but her last menstrual period was four months ago. The clientdenies any sexual activity. Which of the following statements is best for the nurse to make?A)"Adolescents rarely have regular menses, even if they used to be regular."B)"Your lack of menses may be related to your rapid weight loss."C)"Increase your intake of iron-rich foods to reestablish menses."D)"It is common and normal for runners to stop having any menses."Answer:B7)A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has beendiagnosed with ovarian cysts, and has had an intrauterine device (IUD) for two years. The most likely causefor the client's complaint is:A)Primary dysmenorrhea.B)Menorrhagia.C)Secondary dysmenorrhea.D)Hypermenorrhea.Answer:C8)A teaching plan for a client with premenstrual syndrome (PMS) should include a recommendation to restricther intake of:A)Chicken, eggs, and fish.B)Coffee, colas, and chocolate cake.C)Whole grain breads and cereals, and beans.D)High-starch foods such as potatoes and spaghetti.Answer:B9)A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hotflashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combinationhormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must takeboth hormones, the best reply is:A)"There is an increased risk of tissue abnormality inside the uterus if only one is given."B)"Your blood pressure may become elevated if only one hormone is used."C)"Hot flashes respond better when replacement includes both hormones."D)"You are having very severe symptoms, so you need more hormones replaced."Answer:A10)The nurse is answering the perimenopausal client's questions about hormone replacement therapy. Whichclient statement indicates a need for additional teaching? "The Women's Health Initiative of 2002 reportedthat long-term hormone replacement therapy caused decreased:A)Risk of heart attack."B)Hip fractures."C)Risk of blood clots to the lungs."D)Risk of gallbladder disease."Answer:BSHORT ANSWER.Write the word or phrase that best completes each statement or answers the question.

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11)Rank the following clients in order from highest to lowest risk for developing osteoporosis. Your answershould be a four-digit number.1.Small-boned, underweight 40-year-old woman2.Overweight 55-year-old with type II diabetes3.60-year-old African American woman who smokes.4.75-year-old male who plays tennis three times per weekAnswer:3124MULTIPLE CHOICE.Choose the one alternative that best completes the statement or answers the question.12)The client is given a prescription for hormone replacement therapy (HRT). She asks the nurse, "What type ofside effects or consequences should I expect from taking this medicine?" The nurse's best response would be:"You mayA)Experience irregular, heavy menstrual bleeding."B)Notice chest pains initially that will subside."C)Notice some intermittent abdominal cramping."D)Have a decrease in vaginal dryness."Answer:D13)A menopausal woman tells her nurse that she experiences discomfort from vaginal dryness during sexualintercourse and asks, "What should I use as a lubricant?" The nurse should recommend:A)Less frequent intercourse.B)Petroleum jelly.C)Body cream or body lotion.D)A water-soluble lubricant.Answer:D14)The client is experiencing symptoms of menopause, and states that she would prefer to use herbs rather thanmedication. Which statement indicates that no further teaching is indicated?A)"Soy protein may be helpful, but should not be taken over a long time period."B)"Studies have shown significant improvement of menopausal symptoms."C)"Dong quai decreases hot flashes, and does not interfere with medications."D)"Black cohosh will reduce the frequency of my hot flashes and mood swings."Answer:A15)The nurse is conducting health screening at a community clinic. The client has asked if there are any riskswith body piercing and tattooing, or if these activities would impact sexual activity. How should the nurserespond?A)"Both piercing and tattooing carry risks of infection, including hepatitis."B)"The benefit of body art outweighs any risk of infection of a tattoo or piercing."C)"There are no problems that occur with either body piercing or tattooing."D)"You should avoid piercing your genitalia and your nipples."Answer:A

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