Contemporary Maternal Newborn Nursing 9th ed By Ladewig - Test Bank

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.

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.