Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig)

Chapter 1 Contemporary Maternal-Newborn Nursing

1. The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect?
2. Shortens newborn length of stay
3. Decreases use of home health agencies
4. Decreases healthcare costs
5. Decreases the number of emergency department visits

Page Ref: 3

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Self-Care

Standards: Q S E N Competencies: Ⅰ.A.2. Describe strategies to empower patients or families in all aspects of the healthcare process. | A A C N Essentials Competencies: Ⅸ.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 1 Discuss the impact of the self-care movement on contemporary childbirth.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following?
   1. There is less trauma to the mother.
   2. More childbirth education classes are available.
   3. They are instrumental in providing change in the birth environment at work.
   4. They advocate for more home healthcare agencies.

Page Ref: 3

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅲ.A.6. Describe how the strength and relevance of available evidence influences the choice of interventions in provision of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is telling a new client how advanced technology has permitted the physician to do which of the following?
   1. Treat the fetus and monitor fetal development.
   2. Deliver at home with a nurse-midwife and doula.
   3. Have the father act as the coach and cut the umbilical cord.
   4. Breastfeed a new baby on the delivery table.

Page Ref: 2—3

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅰ.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 6 Evaluate the potential impact of some of the special situations in contemporary maternity care.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role?
   1. A registered nurse who is the manager of a large obstetrical unit
   2. A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections)
   3. A clinical nurse specialist working as a staff nurse on a mother-baby unit
   4. A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants

Page Ref: 5

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | A A C N Essentials Competencies: Ⅵ. 6. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | N L N Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. A nursing student investigating potential career goals is strongly considering becoming a nurse practitioner (N P). The major focus of the N P is on which of the following?
   1. Leadership
   2. Physical and psychosocial clinical assessment
   3. Independent care of the high-risk pregnant client
   4. Tertiary prevention

Page Ref: 5

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | A A C N Essentials Competencies: Ⅵ. 2. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | N L N Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse manager is consulting with a certified nurse-midwife about a client. What is the role of the C N M?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth.
2. Give primary care for high-risk clients who are in hospital settings.
3. Give primary care for healthy newborns.
4. Obtain a physician consultation for any technical procedures at delivery.
5. Be educated in two disciplines of nursing.

Page Ref: 5

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | A A C N Essentials Competencies: Ⅵ. 1. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | N L N Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The registered nurse who has completed a master’s degree program and passed a national certification exam has clinic appointments with clients who are pregnant or seeking well-woman care. What is the role of this nurse considered to be?
   1. Professional nurse
   2. Certified registered nurse (R N C)
   3. Clinical nurse specialist
   4. Nurse practitioner

Page Ref: 5

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | A A C N Essentials Competencies: Ⅵ. 6. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | N L N Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. While a child is being admitting to the hospital, the parent receives information about the pediatric unit’s goals, including the statement that the unit practices family-centered care. The parent asks why that is important. The nurse responds that what communication dynamic is characteristic of the family-centered care paradigm?
   1. The mother is the principal caregiver in each family.
   2. The child’s physician is the key person in ensuring that the health of a child is maintained.
   3. The family serves as the constant influence and continuing support in the child’s life.
   4. The father is the leader in each home; thus, all communications should include him.

Page Ref: 2

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅸ. 6. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Relationship-Centered Care: Promote and accept the patient’s emotions; accept and respond to distress in the patient and self; facilitate hope, trust and faith. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Identify specific factors that contribute to a family’s value system.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The current emphasis on federal healthcare reform has yielded what unexpected benefit?
   1. Assessment of the details of the family’s income and expenditures
   2. Case management to limit costly, unnecessary duplication of services
   3. Many healthcare providers and consumers are becoming more aware of the vitally important role nurses play in providing excellent care to clients and families
   4. Education of the family about the need for keeping regular well-child visit appointments

Page Ref: 4

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ.A.4. Examine how the safety, quality and cost effectiveness of health care can be improved through the active involvement of patients and families. | A A C N Essentials Competencies: Ⅵ. 1. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | N L N Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. For prenatal care, the client is attending a clinic held in a church basement. The client’s care is provided by registered nurses and a certified nurse-midwife. What is this type of prenatal care?
   1. Secondary care
   2. Tertiary care
   3. Community care
   4. Unnecessarily costly care

Page Ref: 3

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ.A.1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅵ. 1. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | N L N Competencies: Context and Environment: Environmental health; health promotion/disease prevention (e.g. transmission of disease, disease patterns, epidemiological principles); chronic disease management; health care systems; transcultural approaches to health; family dynamics. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 3 Describe the use of community-based nursing care in meeting the needs of childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse at an elementary school is performing T B screenings on all of the students. Permission slips were returned for all but the children of one family. When the nurse phones to obtain permission, the parent states in clearly understandable English that permission cannot be given because the grandmother is out of town for 2 more weeks. Which cultural element is contributing to the dilemma that faces the nurse?
   1. Permissible physical contact with strangers
   2. Beliefs about the concepts of health and illness
   3. Religion and social beliefs
   4. Presence and influence of the extended family

Page Ref: 4

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Screening

Standards: Q S E N Competencies: Ⅰ.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Analyze ethical challenges presented by ambiguous and uncertain clinical situations; self-assess one’s own tolerance for ambiguity and uncertainty; accept the possibility of multiple "right" answers (rather than one right answer thinking) in patient care and other professional situations. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Identify specific factors that contribute to a family’s value system.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. A maternity client is in need of surgery. Which healthcare member is legally responsible for obtaining informed consent for an invasive procedure?
   1. The nurse
   2. The physician
   3. The unit secretary
   4. The social worker

Page Ref: 7—8

Cognitive Level: Remembering

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: I.B.12. Facilitate informed patient consent for care. | A A C N Essentials Competencies: Ⅷ. 1. Demonstrate the professional standards of moral, ethical, and legal conduct. | N L N Competencies: Context and Environment: Code of ethics (e.g. American Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional standards (A N A Social Policy Statement [A N A, 2003]; H I P A A [Health Insurance Portability and Accountability Act]); ethical decision making modes; scope of practice considerations; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. A nurse who tells family members the sex of a newborn baby without first consulting the parents would have committed which of the following?
   1. A breach of privacy
   2. Negligence
   3. Malpractice
   4. A breach of ethics

Page Ref: 8

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Ethical Practice

Standards: Q S E N Competencies: Ⅰ.B.13. Assess own level of communication skill in encounters with patient and families. | A A C N Essentials Competencies: Ⅳ. 8. Uphold ethical standards related to data security, regulatory requirements, confidentiality and clients’ right to privacy. | N L N Competencies: Context and Environment: Code of ethics (e.g. American Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional standards (A N A Social Policy Statement [A N A, 2003]; H I P A A [Health Insurance Portability and Accountability Act]); ethical decision making modes; scope of practice considerations; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nursing instructor explains to the class that according to the 1973 Supreme Court decision in Roe v. Wade, abortion is legal if induced:
   1. Before the 30th week of pregnancy.
   2. Before the period of viability.
   3. To provide tissue for therapeutic research.
   4. Can be done any time if mother, doctor, and hospital all agree.

Page Ref: 9

Cognitive Level: Remembering

Client Need/Sub: Safe and Effective Care Environment: Ethical Practice

Standards: Q S E N Competencies: Ⅰ.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅳ. 8. Uphold ethical standards related to data security, regulatory requirements, confidentiality and client’s right to privacy. | N L N Competencies: Context and Environment: Code of ethics (e.g. American Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional standards (A N A Social Policy Statement [A N A, 2003]; H I P A A [Health Insurance Portability and Accountability Act]); ethical decision making modes; scope of practice considerations; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse reviewing charts for quality improvement notes that a client experienced a complication during labor. The nurse is uncertain whether the labor nurse took the appropriate action during the situation. What is the best way for the nurse to determine what the appropriate action should have been?
   1. Call the nurse manager of the labor and delivery unit and ask what the nurse should have done.
   2. Ask the departmental chair of the obstetrical physicians what the best nursing action would have been.
   3. Examine other charts to find cases of the same complication, and determine how it was handled in those situations.
   4. Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization.

Page Ref: 7

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅳ.A.4. Explain the importance of variation and measurement in assessing quality of care. | A A C N Essentials Competencies: Ⅴ. 1. Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments; including local, state, national, and global healthcare trends. | N L N Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is reviewing care of clients on a mother-baby unit. Which situation should be reported to the supervisor?
   1. A 2-day-old infant has breastfed every 2-3 hours and voided four times.
   2. An infant was placed in the wrong crib after examination by the physician.
   3. The client who delivered by cesarean birth yesterday received oral narcotics.
   4. A primiparous client who delivered today is requesting discharge within 24 hours.

Page Ref: 7

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: Q S E N Competencies: Ⅴ.B.1. Demonstrate effective use of strategies to reduce risk of harm to self or others. | A A C N Essentials Competencies: Ⅷ. 1. Demonstrate the professional standards of moral, ethical, and legal conduct. | N L N Competencies: Quality and Safety: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse manager is planning a presentation on ethical issues in caring for childbearing families. Which example should the nurse manager include to illustrate maternal-fetal conflict?
   1. A client chooses an abortion after her fetus is diagnosed with a genetic anomaly.
   2. A 39-year-old nulliparous client undergoes therapeutic insemination.
   3. A family of a child with leukemia requests cord-blood banking at a sibling’s birth.
   4. A cesarean delivery of a breech fetus is court ordered after the client refuses.

Page Ref: 9

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: I.B.9. Assess level of patient’s decisional conflict and provide access to resources. | A A C N Essentials Competencies: Ⅷ. 1. Demonstrate the professional standards of moral, ethical, and legal conduct. | N L N Competencies: Context and Environment: Show respect for others’ values; appreciate diversity; be civil during relationships and work; value community empowerment and social justice; work to improve social conditions affecting health; adopt inclusive language. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. Client safety goals, which are evaluated and updated regularly, are requirements for what?
   1. Clinical practice guidelines
   2. Scope of practice
   3. Accreditation
   4. Standards of care

Page Ref: 7

Cognitive Level: Remembering

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅴ.A.7. Discuss potential and actual impact of national patient safety resources, initiatives, and regulations. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high quality patient outcomes. | N L N Competencies: Quality and Safety: Value and encourage nurses’ involvement in the design, selection, implementation, and evaluation of information technologies to support patient care (e.g. as recommended by Q S E N ). | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. A fetus has been diagnosed with myelomeningocele. Which of the following surgeries would be performed to correct this condition?
   1. Tubal ligation
   2. Intrauterine fetal surgery
   3. Cesarean section
   4. Sterilization

Page Ref: 9

Cognitive Level: Remembering

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅱ.B.8. Integrate the contributions of others who play a role in helping the patient/family achieve health goals. | A A C N Essentials Competencies: Ⅵ. 1. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | N L N Competencies: Teamwork: Function competently within one’s own scope of practice as leader or member of the health care team and manage delegation effectively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. A nurse is providing guidance to a group of parents of children in the infant-to-preschool age group. After reviewing statistics on the most common cause of death in this age group, the nurse includes information about prevention of which of the following?
   1. Cancer by reducing the use of pesticides in the home
   2. Accidental injury by reducing the risk of pool and traffic accidents
   3. Heart disease by incorporating heart-healthy foods into the child’s diet
   4. Pneumonia by providing a diet high in vitamin C from fruits and vegetables

Page Ref: 13

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: Q S E N Competencies: Ⅴ.A.1. Examine human factors and other basic safety design principles as well as commonly used unsafe practices (such as work-arounds and dangerous abbreviations) | A A C N Essentials Competencies: Ⅱ. 7. Promote factors that create a culture of safety and caring. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Contrast descriptive and inferential statistics.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is preparing a report on the number of births by three service providers at the facility (certified nurse-midwives, family practitioners, and obstetricians). What is this an example of?
   1. Inferential statistics
   2. Descriptive statistics
   3. Evidence-based practice
   4. Secondary use of data

Page Ref: 11

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅲ.A.2. Describe E B P to include the components of research evidence, clinical expertise and patient/family values. | A A C N Essentials Competencies: Ⅲ. 2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice. | N L N Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Contrast descriptive and inferential statistics.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is explaining the difference between descriptive statistics and inferential statistics to a group of student nurses. To illustrate descriptive statistics, what would the nurse use as an example?
   1. A positive correlation between breastfeeding and infant weight gain
   2. The infant mortality rate in the state of Oklahoma
   3. A causal relationship between the number of sexual partners and sexually transmitted infections
   4. The total number of spontaneous abortions in drug-abusing women as compared with non-drug-abusing women

Page Ref: 11

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅲ.A.2. Describe E B P to include the components of research evidence, clinical expertise, and patient/family values. | A A C N Essentials Competencies: Ⅲ. 2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice. | N L N Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 7 Contrast descriptive and inferential statistics.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse manager is examining the descriptive statistics of increasing teen pregnancy rates in the community. Which inferential statistical research question would the nurse manager find most useful in investigating the reasons for increased frequency of teen pregnancy?
   1. What providers do pregnant teens see for prenatal care?
   2. What are the ages of the parents of pregnant teens in the community?
   3. Do pregnant teens drink caffeinated beverages?
   4. What do pregnant teens do for recreation?

Page Ref: 11

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅲ.A.2. Describe E B P to include the components of research evidence, clinical expertise, and patient/family values. | A A C N Essentials Competencies: Ⅲ. 2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice. | N L N Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 7 Contrast descriptive and inferential statistics.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The Quality and Safety Education for Nurses (Q S E N) project focused on competencies in which areas?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Client-centered care
2. Teamwork and collaboration
3. Evidence-based practice
4. Family planning
5. Injury and violence prevention

Page Ref: 7

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: V.B.8. Use national patient safety resources for own professional development and to focus attention on safety in care settings. | A A C N Essentials Competencies: Ⅷ. 12. Act to prevent unsafe, illegal, or unethical care practices. | N L N Competencies: Quality and Safety: Value and encourage nurses’ involvement in the design, selection, implementation, and evaluation of information technologies to support patient care (e.g., as recommended by Q S E N ). | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is serving on a panel to evaluate the hospital staff’s reliance on evidence-based practice in their decision-making processes. Which practices characterize the basic competencies related to evidence-based practice?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Recognizing which clinical practices are supported by good evidence
2. Recognizing and including clinical practice supported by intuitive evidence
3. Using data in clinical work to evaluate outcomes of care
4. Including quality-improvement measures in clinical practice
5. Appraising and integrating scientific bases into practice

Page Ref: 7

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅲ.A.2. Describe E B P to include the components of research evidence, clinical expertise and patient/family values. | A A C N Essentials Competencies: Ⅱ. 5. Participate in quality and patient safety initiatives, recognizing that these are complex system issues, which involve individuals, families, groups, communities, populations and other members of the healthcare team. | N L N Competencies: Knowledge and Science: Translate research into practice in order to promote quality and improve practices. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 8 Identify the impact of evidence-based practice in improving the quality of nursing care for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. Nursing research is vital to do which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Expand the science of nursing.
2. Foster evidence-based practice.
3. Improve client care.
4. Visually depict nursing management.
5. Plan and organize care.

Page Ref: 11

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅲ.A.7. Discriminate between valid and invalid reasons for modifying evidence-based clinical practice based on clinical expertise or patient/family preferences. | A A C N Essentials Competencies: Ⅲ. 5. Participate in the process of retrieval, appraisal and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes. | N L N Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 8 Identify the impact of evidence-based practice in improving the quality of nursing care for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. A group of nurses are meeting as identified in the image below. Which behavior are the nurses demonstrating during this meeting?

• 1. Privacy
  2. Advocacy
  3. Collaboration
  4. Informed consent

Page Ref: 7

Cognitive Level: Analyzing

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅱ.B.9.9. Communicate with team members, adapting own style of communicating to needs of the team and situation. | A A C N Essentials Competencies: Ⅵ.5. 5. Demonstrate appropriate teambuilding and collaborative strategies when working with interprofessional teams. | N L N Competencies: Relationship Centered Care; Practice; Share responsibility responsibly; collaborate and work cooperatively with others. | Nursing/Integrated Concepts: Assessment; Communication and Documentation.

Learning Outcome: 3 Describe the use of community-based nursing care in meeting the needs of childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is reviewing the Quality and Safety Education for Nurses (Q S E N) competencies while preparing an in-service program to address safety in the neonatal intensive care unit. In which order should the nurse present these competencies?
2. Safety
3. Informatics
4. Patient-centered care
5. Quality improvement
6. Evidence-based practice
7. Teamwork and collaboration

Page Ref: 7

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: Q S E N Competencies: Ⅰ.A.1.1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅱ. 7. Promote factors that create a culture of safety and caring. | N L N Competencies: Quality and Safety; Ethical Comportment; Commit to a generative safety culture. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is ensuring that a patient has provided informed consent before agreeing to an amniocentesis. In which order should the nurse validate that informed consent was provided by the patient?
   1. Information provides risk and benefits
   2. Information provided clearly and concisely
   3. Information included treatment alternatives
   4. Information explaining the right to refuse treatment
   5. Information reviews consequences if no treatment provided

Page Ref: 7

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅰ.B.12. Facilitate informed patient consent for care. | A A C N Essentials Competencies: Ⅱ. 7. Promote factors that create a culture of safety and caring. | N L N Competencies: Context and Environment; Knowledge; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Evaluation; Nursing Process.

Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The nurse is preparing a presentation for new labor and delivery nurses. Which cultural group should the nurse identify as having the lowest birth rate for the 20 to 24 age range?

Table 1-2 Birth Rate by Age and Race of Mother, 2011

Source: Martin, J.A., Hamilton, B.E., Ventura, S.J., Osterman, M.J.K., & Matthews, T.J. (2013). Births: Final data 2011. National Vital Statistics Reports, 62(1), 1-70.

• 1. Asian
  2. White
  3. Black
  4. American Indian

Page Ref: 11-12

Cognitive Level: Analyzing

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅰ.A.1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅴ. 6. Explore the impact of socio-cultural, economic, legal and political factors influencing healthcare delivery and practice. | N L N Competencies: Relationship Centered Care; Knowledge; The role of family, culture, and community in a person’s development. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 6 Evaluate the potential impact of some of the special situations in contemporary maternity care.

M N L L O: Recognize contemporary issues related to care of the childbearing family.

1. The manager of a maternal-child care area is preparing information to share with nursing staff regarding the leading causes of infant death in the United States. In which order, from most to least frequent, should the manager provide this information?
   1. S I D S
   2. Low birth weight
   3. Unintentional injuries
   4. Maternal complications
   5. Congenital malformation

Page Ref: 13

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅰ.A.1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅴ. 6. Explore the impact of socio-cultural, economic, legal and political factors influencing healthcare delivery and practice. | N L N Competencies: Relationship Centered Care; Knowledge; The role of family, culture, and community in a person’s development. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 6 Evaluate the potential impact of some of the special situations in contemporary maternity care.

M N L L O: Recognize contemporary issues related to care of the childbearing family.