London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

Chapter 1: Contemporary MaternalNewborn and Child Health Nursing Chapter 01_LO01_Q01 nurse is e!amining di""erent nursing roles# $hi%h o" the "ollowing best illustrates an ad&an%ed pra%ti%e nursing role' 1# (# +# -# registered nurse who is the manager o" a large obstetri%al unit registered nurse who is the %ir%ulating nurse at surgi%al deli&eries )%esarean se%tions* %lini%al nurse spe%ialist wor,ing as a sta"" nurse on a motherbaby unit %lini%al nurse spe%ialist with whom other nurses %onsult "or her e!pertise in %aring "or high.ris, in"ants Corre%t nswer: /ationale: 1# registered nurse who is the manager o" a large obstetri%al unit or one who is a %ir%ulating nurse at surgi%al deli&eries )%esarean se%tions* is de"ined as a pro"essional nurse0 and has graduated "rom an a%%redited program in nursing and %ompleted the li%ensure e!amination# (# registered nurse who is the manager o" a large obstetri%al unit or one who is a %ir%ulating nurse at surgi%al deli&eries )%esarean se%tions* is de"ined as a pro"essional nurse0 and has graduated "rom an a%%redited program in nursing and %ompleted the li%ensure e!amination# +# -# %lini%al nurse spe%ialist wor,ing as a sta"" nurse on a motherbaby unit might ha&e the %lini%al nurse spe%ialist with whom other nurses %onsult "or e!pertise in %aring "or high.ris, 1uali"i%ations "or an ad&an%ed pra%ti%e nursing sta"" but is not wor,ing in that %apa%ity# in"ants would illustrate an ad&an%ed pra%ti%e nursing role# 2his nurse has spe%iali3ed ,nowledge and %ompeten%e in a spe%i"i% %lini%al area0 and is master4s.prepared# Cogniti&e Le&el: 5nowledge Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: ssessment Learning Out%ome: 1#1 9denti"y the nursing roles a&ailable to maternal.newborn and pediatri% nurses# Chapter 01_LO01_Q0( 2he ma:or "o%us o" the nurse pra%titioner is on:

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

1# Leadership# (# 8hysi%al and psy%hoso%ial %lini%al assessment# +# 9ndependent %are o" the high.ris,0 pregnant %lient# -# 2ertiary pre&ention# Corre%t nswer: ( /ationale: 1# Leadership might be a 1uality o" the N80 but it is not the ma:or "o%us# (# 8hysi%al and psy%hoso%ial %lini%al assessment is the ma:or "o%us o" the nurse pra%titioner )N8*0 who pro&ides %are in many di""erent %lini%al settings# +# N8s %annot pro&ide independent %are o" the high.ris, pregnant %lient0 but must wor, under a physi%ian4s super&ision# -# 2he N8 %annot do tertiary pre&ention as a ma:or "o%us# Cogniti&e Le&el: 5nowledge;Comprehension Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: ssessment Learning Out%ome: 1#1 9denti"y the nursing roles a&ailable to maternal.newborn and pediatri% nurses# Chapter 01_LO01_Q0+ 2he role o" the %erti"ied nursemidwi"e )CNM* is to: )6ele%t all that apply#* 1# <e prepared to manage independently the %are o" women at low ris, "or %ompli%ations during pregnan%y and birth# (# =i&e primary %are "or high.ris, %lients who are in hospital settings# +# =i&e primary %are "or healthy newborns# -# Obtain a physi%ian %onsultation "or any te%hni%al pro%edures at deli&ery# ># <e edu%ated in two dis%iplines o" nursing# Corre%t nswers: 1? +? > /ationale: 1# CNM is prepared to manage independently the %are o" women at low ris, "or %ompli%ations during pregnan%y and birth and the %are o" healthy newborns# (# CNMs %annot gi&e primary %are "or high.ris, %lients who are in hospital settings# 2he

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

physi%ian pro&ides the primary %are# +# CNM is prepared to manage independently the %are o" women at low ris, "or %ompli%ations during pregnan%y and birth and the %are o" healthy newborns# -# 2he CNM does not need to obtain a physi%ian %onsultation "or any te%hni%al pro%edures at deli&ery# ># 2he CNM is edu%ated in the dis%iplines o" nursing and midwi"ery# Cogniti&e Le&el: 5nowledge;Comprehension Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: 8lanning Learning Out%ome: 1#1 9denti"y the nursing roles a&ailable to maternal.newborn and pediatri% nurses# Chapter 01_LO0(_Q0@uring the hospital admission pro%ess0 the %hild4s parent re%ei&es in"ormation about the pediatri% unit4s goals0 in%luding the statement that the unit pra%ti%es A"amily.%entered %are#B 2he parent as,s why that should be important# 2he nurse would respond that in the A"amily.%entered %areB paradigm0 the: 1# Mother is the prin%ipal %aregi&er in ea%h "amily# (# Child4s physi%ian is the ,ey person in assuring the health o" a %hild is maintained# +# Camily ser&es as the %onstant in"luen%e and %ontinuing support in the %hild4s li"e# -# Cather is the leader in ea%h home? thus0 all %ommuni%ations should in%lude him# nswer: + /ationale: 1# Culturally %ompetent %are re%ogni3es that both matriar%hal and patriar%hal households e!ist# (# 2he physi%ian is not present during the day.to.day routines in a %hild4s li"e +# 2he "oundation "or the de&elopment o" trusting relationships and partnerships with "amilies is the re%ognition that the "amily is the prin%ipal %aregi&er0 ,nows the uni1ue nature o" ea%h indi&idual %hild best0 plays the &ital role o" meeting the %hild4s needs0 and is responsible "or ensuring ea%h %hild4s health# -# Culturally %ompetent %are re%ogni3es that both matriar%hal and patriar%hal households e!ist# Cogniti&e Le&el: 5nowledge;Comprehension

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

Category o" Client Need: Health 8romotion and Maintenan%e Nursing 8ro%ess: 8lanning Learning Out%ome: 1#( 6ummari3e the use o" %ommunity.based nursing %are in meeting the needs o" %hildbearing and %hildrearing "amilies

Chapter 01_LO0+_Q0> @espite the a&ailability o" 6tate Children4s Health 9nsuran%e 8rograms )6CH98s*0 many eligible %hildren are not enrolled# 2he nursing inter&ention that %an best help eligible %hildren be%ome enrolled is: 1# +# ssessment o" the details o" the "amily4s in%ome and e!penditures# d&o%a%y "or the %hild by en%ouraging the "amily to in&estigate its 6CH98 eligibility# (# Case management to limit %ostly0 unne%essary dupli%ation o" ser&i%es# -# 7du%ation o" the "amily about the need "or ,eeping regular well.%hild &isit appointments# nswer: + /ationale: 1# Cinan%ial assessment is more %ommonly the "un%tion o" a so%ial wor,er# (# 2he %ase management a%ti&ity mentioned will not pro&ide a sour%e o" "unding0 and neither will the edu%ational e""ort des%ribed# +# 9n the role o" an ad&o%ate0 a nurse will ad&an%e the interests o" another by suggesting the "amily in&estigate its 6CH98 eligibility# -# 2he %ase management a%ti&ity mentioned will not pro&ide a sour%e o" "unding0 and neither will the edu%ational e""ort des%ribed# Health 8romotion and Maintenan%e Cogniti&e Le&el: ppli%ation Category o" Client Need: Health 8romotion and Maintenan%e Nursing 8ro%ess: 9mplementation Learning Out%ome: 1#+ 6ummari3e the %urrent status o" "a%tors related to health insuran%e and a%%ess to health %are# Chapter 01_LO0-_Q0D

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

2he telephone triage nurse at a pediatri% %lini% ,nows ea%h %all is important# Howe&er0 re%ogni3ing that in"ant deaths are most "re1uent in the "ollowing %ategories0 the nurse must be e!tra attenti&e during %alls "rom parents o" in"ants who are: )6ele%t all that apply#* 1# Less than + wee,s old# (# O" an meri%an 9ndian "amily# +# O" a non.Hispani% bla%, "amily# -# <etween D and E months old# ># <orn to an unmarried mother# nswer: 1? +? > /ationale: 1# lmost two.thirds o" all in"ant deaths o%%ur during the "irst (E days a"ter birth# 2his %ategory has a higher ris, o" death than some o" the other %ategories listed ) meri%an 9ndian "amily and in"ants age between D and E months old*# (# lmost two.thirds o" all in"ant deaths o%%ur during the "irst (E days a"ter birth# 2his %ategory has a higher ris, o" death than some o" the other %ategories listed ) meri%an 9ndian "amily and in"ants age between D and E months old*# +# 9n"ant mortality rates are highest among non.Hispani% bla%, women )1+#D per 10000 li&e births*# -# lmost two.thirds o" all in"ant deaths o%%ur during the "irst (E days a"ter birth# ># 9n"ant mortality rates are higher among in"ants born to unmarried mothers# lmost two.thirds o" all in"ant deaths o%%ur during the "irst (E days a"ter birth# Cogniti&e Le&el: ppli%ation Category o" Client Need: Health 8romotion and Maintenan%e Nursing 8ro%ess: nalysis Learning Out%ome: 1#- /elate the a&ailability o" statisti%al data to the "ormulation o" "urther resear%h 1uestions#

Chapter 01_LO0>_Q0F 2he maternity nurse4s best de"ense against an a%%usation o" malpra%ti%e or negligen%e is that the nurse:

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

1# Collowed the physi%ian4s written orders# (# Met the sso%iation o" $omen4s Health0 Obstetri% and Neonatal Nurses ) $HONN* standards o" pra%ti%e# +# 9s a %erti"ied nursemidwi"e or nurse pra%titioner# -# $as a%ting on the ad&i%e o" the nurse manager# Corre%t nswer: ( /ationale: 1# Collowing the physi%ian4s written orders is not enough to de"end the nurse "rom a%%usations be%ause the orders and;or ad&i%e might be wrong or unethi%al# (# Meeting the $HONN standards o" pra%ti%e would %o&er the maternity nurse against an a%%usation o" malpra%ti%e or negligen%e be%ause the standards are rigorous and %o&er all bases o" e!%ellent nursing pra%ti%e# +# <eing a %erti"ied nursemidwi"e or nurse pra%titioner does not de"end the nurse against these a%%usations i" she does not "ollow the $HONN standards o" pra%ti%e# -# %ting on the ad&i%e o" the nurse manager is not enough to de"end the nurse "rom a%%usations be%ause the orders and;or ad&i%e might be wrong or unethi%al# Cogniti&e Le&el: ppli%ation Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: 8lanning Learning Out%ome: 1#> @elineate signi"i%ant legal and ethi%al issues that in"luen%e the pra%ti%e o" maternal.%hild nursing# Chapter 01_LO0>_Q0E nurse is wor,ing with pediatri% %lients in a resear%h "a%ility# 2he nurse re%ogni3es that "ederal guidelines delineate that pediatri% %lients must gi&e %onsent "or parti%ipation in resear%h trials# <ased on the %lient4s age0 the nurse would see, assent "rom whi%h %hild' 6ele%t all that apply# 1# (# +# -# pre%o%ious -.year.old starting as a %ysti% "ibrosis resear%h study parti%ipant F.year.old leu,emia %lient ele%ting to re%ei&e a newly de&eloped trial medi%ation 10.year.old starting in an in&estigati&e study "or %lients with pre%o%ious puberty 1+.year.old %lient beginning parti%ipation in a resear%h program "or @H@ treatments

Corre%t nswers: (? +? -

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

/ationale: 1# Cederal guidelines mandate that resear%h parti%ipants F years old and older must re%ei&e de&elopmentally appropriate in"ormation about health %are pro%edures and treatments0 and gi&e assent# (# Cederal guidelines mandate that resear%h parti%ipants F years old and older must re%ei&e de&elopmentally appropriate in"ormation about health %are pro%edures and treatments0 and gi&e assent# +# Cederal guidelines mandate that resear%h parti%ipants F years old and older must re%ei&e de&elopmentally appropriate in"ormation about health %are pro%edures and treatments0 and gi&e assent# -# Cederal guidelines mandate that resear%h parti%ipants F years old and older must re%ei&e de&elopmentally appropriate in"ormation about health %are pro%edures and treatments0 and gi&e assent# Cogniti&e Le&el: ppli%ation Category o" Client Need: 8sy%hoso%ial 9ntegrity Nursing 8ro%ess: 8lanning Learning Out%ome: 1#> @elineate signi"i%ant legal and ethi%al issues that in"luen%e the pra%ti%e o" maternal.%hild nursing# Chapter 01_LO0>_Q0G 1(.year.old pediatri% %lient is in need o" surgery# 2he health %are member who is legally responsible "or obtaining in"ormed %onsent "or an in&asi&e pro%edure is: 1# 2he nurse# (# 2he physi%ian# +# 2he unit se%retary# -# 2he so%ial wor,er# Corre%t nswer: ( /ationale:

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

1# 9n"ormed %onsent is legal preauthori3ation "or an in&asi&e pro%edure# 9t is the physi%ian4s legal responsibility to obtain this be%ause it %onsists o" an e!planation about the medi%al %ondition0 a detailed des%ription o" treatment plans0 the e!pe%ted bene"its and ris,s related to the proposed treatment plan0 alternati&e treatment options0 the %lient4s 1uestions0 and the guardian4s right to re"use treatment# (# 9n"ormed %onsent is legal preauthori3ation "or an in&asi&e pro%edure# 9t is the physi%ian4s legal responsibility to obtain this be%ause it %onsists o" an e!planation about the medi%al %ondition0 a detailed des%ription o" treatment plans0 the e!pe%ted bene"its and ris,s related to the proposed treatment plan0 alternati&e treatment options0 the %lient4s 1uestions0 and the guardian4s right to re"use treatment# +# 9n"ormed %onsent is legal preauthori3ation "or an in&asi&e pro%edure# 9t is the physi%ian4s legal responsibility to obtain this be%ause it %onsists o" an e!planation about the medi%al %ondition0 a detailed des%ription o" treatment plans0 the e!pe%ted bene"its and ris,s related to the proposed treatment plan0 alternati&e treatment options0 the %lient4s 1uestions0 and the guardian4s right to re"use treatment# -# 9n"ormed %onsent is legal preauthori3ation "or an in&asi&e pro%edure# 9t is the physi%ian4s legal responsibility to obtain this be%ause it %onsists o" an e!planation about the medi%al %ondition0 a detailed des%ription o" treatment plans0 the e!pe%ted bene"its and ris,s related to the proposed treatment plan0 alternati&e treatment options0 the %lient4s 1uestions0 and the guardian4s right to re"use treatment# Cogniti&e Le&el: Comprehension Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: 8lanning Learning Out%ome: 1#> @elineate signi"i%ant legal and ethi%al issues that in"luen%e the pra%ti%e o" maternal.%hild nursing# Chapter 01_LO0>_Q10 nurse who tells "amily members the se! o" a newborn baby without "irst %onsulting the parents would be %onsidered ha&ing %ommitted: 1# <rea%h o" pri&a%y# (# Negligen%e#

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

+# Malpra%ti%e# -# brea%h o" ethi%s# Corre%t nswer: 1 /ationale: 1# brea%h o" pri&a%y would ha&e been %ommitted in this situation0 be%ause it &iolates the right to pri&a%y o" this "amily# 2he right to pri&a%y is the right o" a person to ,eep his person and property "ree "rom publi% s%rutiny )o" e&en other "amily members*# (# Negligen%e and malpra%ti%e are punishable legal o""enses0 and are more serious# +# Negligen%e and malpra%ti%e are punishable legal o""enses0 and are more serious# -# brea%h o" ethi%s would not apply to this situation# Cogniti&e Le&el: ppli%ation Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: 9mplementation Learning Out%ome: 1#> @elineate signi"i%ant legal and ethi%al issues that in"luen%e the pra%ti%e o" maternal.%hild nursing# Chapter 01_LO0>_Q11 %%ording to the 1GF+ 6upreme Court de%ision in Roe v. Wade, abortion is legal i" indu%ed: 1# t a "ederally "unded %lini%# (# <e"ore the period o" &iability# +# 2o pro&ide tissue "or therapeuti% resear%h# -# t a military hospital o&erseas# Corre%t nswer: ( /ationale: 1# $hether at a "ederally "unded %lini% or at a military hospital o&erseas0 abortion %an be pro&ided legally i" under H#6# laws# (# bortion %an be per"ormed legally until the period o" &iability? a"ter &iability0 the rights o" the "etus ta,e pre%eden%e# +# bortion %annot be used to pro&ide tissue "or therapeuti% resear%h# -# $hether at a "ederally "unded %lini% or at a military hospital o&erseas0 abortion %an be pro&ided legally i" under H#6# laws#

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

Cogniti&e Le&el: ppli%ation Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: 8lanning Learning Out%ome: 1#> @elineate signi"i%ant legal and ethi%al issues that in"luen%e the pra%ti%e o" maternal.%hild nursing#

Chapter 01_LO0>_Q1( $hi%h o" the "ollowing "amilies might "ind %ord blood ban,ing to be espe%ially use"ul' 1# (# +# -# "amily with a history o" leu,emia "amily with a history o" in"ertility "amily that wishes to sele%t the se! o" a "uture %hild "amily that wishes to a&oid a "uture intrauterine "etal surgery

Corre%t nswer: 1 /ationale: 1# Camilies with a history o" leu,emia might "ind %ord blood ban,ing use"ul be%ause %ord blood0 li,e bone marrow and embryoni% tissue0 %ontains regenerati&e stem %ells0 whi%h %an repla%e diseased %ells in the a""e%ted indi&idual# (# +# -# "amily with a history o" in"ertility0 or one that wishes to sele%t the se! o" a "uture %hild or "amily with a history o" in"ertility0 or one that wishes to sele%t the se! o" a "uture %hild or "amily with a history o" in"ertility0 or one that wishes to sele%t the se! o" a "uture %hild or a&oid a "uture intrauterine surgery0 would not be helped by %ord blood ban,ing# a&oid a "uture intrauterine surgery0 would not be helped by %ord blood ban,ing# a&oid a "uture intrauterine surgery0 would not be helped by %ord blood ban,ing# Cogniti&e Le&el: nalysis Category o" Client Need: 8hysiologi%al 9ntegrity Nursing 8ro%ess: 8lanning Learning Out%ome: 1#> @elineate signi"i%ant legal and ethi%al issues that in"luen%e the pra%ti%e o" maternal.%hild nursing# Chapter 01_LO0D_Q1+

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

nurse is pro&iding guidan%e to a group o" parents o" %hildren in the in"ant.to.pres%hool age group# "ter re&iewing statisti%s on the most %ommon %ause o" death in this age group0 the nurse would in%lude in"ormation about pre&ention o": 1# Can%er by redu%ing the use o" pesti%ides in the home# (# %%idental in:ury0 in%luding pool and tra""i% a%%idents# +# Heart disease by in%orporating heart.healthy "oods into the %hild4s diet# -# 8neumonia by pro&iding a diet high in &itamin C "rom "ruits and &egetables# Corre%t nswer: ( /ationale: 1# Hnintentional in:uries are the most %ommon %ause o" death "or %hildren between 1 and 1G years old# 9n %hildren 1-0 this is "ollowed by drowning? "ire and burns? su""o%ation? and pedestrian.related in:uries# (# Hnintentional in:uries are the most %ommon %ause o" death "or %hildren between 1 and 1G years old# 9n %hildren 1-0 this is "ollowed by drowning? "ire and burns? su""o%ation? and pedestrian.related in:uries# +# Hnintentional in:uries are the most %ommon %ause o" death "or %hildren between 1 and 1G years old# 9n %hildren 1-0 this is "ollowed by drowning? "ire and burns? su""o%ation? and pedestrian.related in:uries# -# Hnintentional in:uries are the most %ommon %ause o" death "or %hildren between 1 and 1G years old# 9n %hildren 1-0 this is "ollowed by drowning? "ire and burns? su""o%ation? and pedestrian.related in:uries# Cogniti&e Le&el: Comprehension Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: 9mplementation Learning Out%ome: 1#D @is%uss the role o" e&iden%e.based pra%ti%e in impro&ing the 1uality o" nursing %are "or %hildbearing "amilies# Chapter 01_LO0D_Q1$hi%h o" the "ollowing pra%ti%es %hara%teri3e the basi% %ompeten%ies related to e&iden%e.based pra%ti%e' 6ele%t all that apply# 1# Clini%al pra%ti%e supported by good e&iden%e

London et al., Maternal & Child Nursing Care, 3e 2011 by Pearson Education, Inc.

(# Clini%al pra%ti%e supported by intuiti&e e&iden%e +# Clini%al pra%ti%e supported by data -# Clini%al pra%ti%e that promotes 1uality ># Clini%al pra%ti%e that pro&ides a use"ul approa%h to problem sol&ing D# Corre%t nswers: 1? +? -? > /ationale: 1# 6upported by good e&iden%e and data0 promotes 1uality0 and pro&ides a use"ul approa%h to problem sol&ing are the hallmar, %hara%teristi%s o" the basi% %ompeten%ies related to e&iden%e. based pra%ti%e# (# Clini%al pra%ti%e supported by intuiti&e e&iden%e does not pro&ide &alid e&iden%e and data "or the proper a%tions# +# 6upported by good e&iden%e and data0 promotes 1uality0 and pro&ides a use"ul approa%h to problem sol&ing are the hallmar, %hara%teristi%s o" the basi% %ompeten%ies related to e&iden%e. based pra%ti%e# -# 6upported by good e&iden%e and data0 promotes 1uality0 and pro&ides a use"ul approa%h to problem sol&ing are the hallmar, %hara%teristi%s o" the basi% %ompeten%ies related to e&iden%e. based pra%ti%e# ># 6upported by good e&iden%e and data0 promotes 1uality0 and pro&ides a use"ul approa%h to problem sol&ing are the hallmar, %hara%teristi%s o" the basi% %ompeten%ies related to e&iden%e. based pra%ti%e# Cogniti&e Le&el: ssessment Category o" Client Need: 6a"e0 7""e%ti&e Care 7n&ironment Nursing 8ro%ess: nalysis Learning Out%ome: 1#D @is%uss the role o" e&iden%e.based pra%ti%e in impro&ing the 1uality o" nursing %are "or %hildbearing "amilies#