Chapter 12 Physical and Psychologic Changes of Pregnancy My Nursing Test Banks

Olds Maternal-Newborn Nursing and Womens Health, 10e (Davidson)

Chapter 12 Physical and Psychologic Changes of Pregnancy

1) A client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client the recommended weight gain is during pregnancy?

1. 25-35 pounds, regardless of a clients prepregnant weight

2. More than 25-35 pounds for an overweight woman

3. Up to 40 pounds for an underweight woman

4. The same for a normal weight woman as for an overweight woman

Answer: 3

Explanation: 3. Prepregnant weight determines the recommended weight gain during pregnancy. Underweight women are advised to gain 28-40 pounds.

Page Ref: 229

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, cultural, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1 Identify the anatomic and physiologic changes that occur during pregnancy.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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2) The nurse understands that a clients pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks gestation?

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

Select all that apply.

1. The joints of the pelvis have relaxed, causing a waddling gait.

2. The cervix is firm and blue-purple in color.

3. The uterus vasculature contains one sixth of the total maternal blood volume.

4. Gastric emptying time is delayed, and the client complains of constipation and bloating.

5. Supine hypotension occurs when the client lies on her back.

Answer: 1, 3, 4, 5

Explanation: 1. The sacroiliac, sacrococcygeal, and pubic joints of the pelvis relax in the later part of the pregnancy, presumably as a result of hormonal changes. This often causes a waddling gait.

3. By the end of pregnancy, one sixth of the total maternal blood volume is contained within the vascular system of the uterus.

4. Gastric emptying time and intestinal motility are delayed, leading to frequent complaints of bloating and constipation, which can be aggravated by the smooth muscle relaxation and increased electrolyte and water reabsorption in the large intestine.

5. The enlarging uterus may exert pressure on the vena cava when the woman lies supine, causing a drop in blood pressure. This is called the vena caval syndrome, or supine hypotension.

Page Ref: 225, 226, 227, 228

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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3) A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice?

1. Lightening of the nipples and areolas

2. Reddish streaks called striae on her abdomen

3. A decrease in hair thickness

4. Small purplish dots on her face and arms

Answer: 2

Explanation: 2. Striae, or stretch marks, are reddish, wavy, depressed streaks that may occur over the abdomen, breasts, and thighs as pregnancy progresses.

Page Ref: 228

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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4) The nurse is listening to the fetal heart tones of a client at 37 weeks gestation while the client is in a supine position. The client states, Im getting lightheaded and dizzy. What is the nurses best action?

1. Assist the client to sit up.

2. Remind the client that she needs to lie still to hear the baby.

3. Help the client turn onto her left side.

4. Check the clients blood pressure.

Answer: 3

Explanation: 3. During pregnancy the enlarging uterus may put pressure on the vena cava when the woman is supine, resulting in supine hypotensive syndrome. This pressure interferes with returning blood flow and produces a marked decrease in blood pressure with accompanying dizziness, pallor, and clamminess, which can be corrected by having the woman lie on her left side.

Page Ref: 226

Cognitive Level: Analyzing

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

Standards: QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

5) What is the increased vascularization causing the softening of the cervix known as?

1. Hegar sign

2. Chadwick sign

3. Goodell sign

4. McDonald sign

Answer: 3

Explanation: 3. Increased vascularization causes the softening of the cervix known as Goodell sign.

Page Ref: 231

Cognitive Level: Remembering

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

Standards: QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Identify the anatomic and physiologic changes that occur during pregnancy.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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6) It is 1 week before a pregnant clients due date. The nurse notes on the chart that the clients pulse rate was 74-80 before pregnancy. Today, the clients pulse rate at rest is 90. What action should the nurse should take?

1. Chart the findings.

2. Notify the physician of tachycardia.

3. Prepare the client for an electrocardiogram (EKG).

4. Prepare the client for transport to the hospital.

Answer: 1

Explanation: 1. The pulse rate frequently increases during pregnancy, although the amount varies from almost no increase to an increase of 10 to 15 beats per minute. This is a normal response, and does not indicate a need for emergency measures or treatment.

Page Ref: 226

Cognitive Level: Applying

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

Standards: QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

7) A client at 16 weeks gestation has a hematocrit of 35%. Her prepregnancy hematocrit was 40%. Which statement by the nurse best explains this change?

1. Because of your pregnancy, youre not making enough red blood cells.

2. Because your blood volume has increased, your hematocrit count is lower.

3. This change could indicate a serious problem that might harm your baby.

4. Youre not eating enough iron-rich foods like meat.

Answer: 2

Explanation: 2. Hemoglobin and hematocrit levels drop in early to mid-pregnancy as a result of pregnancy-associated hemodilution. Because the plasma volume increase (50%) is greater than the erythrocyte increase (25%), the hematocrit decreases slightly.

Page Ref: 226

Cognitive Level: Applying

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

Standards: QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination and his or her own power and self-healing processes. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

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Learning Outcome: 1 Identify the anatomic and physiologic changes that occur during pregnancy.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

8) During her first months of pregnancy, a client tells the nurse, It seems like I have to go to the bathroom every 5 minutes. The nurse explains to the client that this is because of which of the following?

1. The client probably has a urinary tract infection.

2. Bladder capacity increases throughout pregnancy.

3. The growing uterus puts pressure on the bladder.

4. Some women are very sensitive to body function changes.

Answer: 3

Explanation: 3. During the first trimester, the growing uterus puts pressure on the bladder, producing urinary frequency until the second trimester, when the uterus becomes an abdominal organ. Near term, when the presenting part engages in the pelvis, pressure is again exerted on the bladder.

Page Ref: 227

Cognitive Level: Applying

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

Standards: QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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9) The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected?

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

Select all that apply.

1. The clients chest circumference has increased by 6 cm during the pregnancy.

2. The client has a narrowed subcostal angle.

3. The client is using thoracic breathing.

4. The client may have epistaxis.

5. The client has a productive cough.

Answer: 1, 3, 4

Explanation: 1. The chest increase compensates for the elevated diaphragm.

3. Breathing changes from abdominal to thoracic as pregnancy progresses.

4. Epistaxis (nosebleeds) may occur and are primarily the result of estrogen-induced edema and vascular congestion of the nasal mucosa.

Page Ref: 225, 226

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. BB. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally, and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing processes. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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10) The nurse is examining a pregnant woman in the third trimester. What skin changes should the nurse highlight as an alteration for the womans healthcare provider?

1. Linea nigra

2. Melasma gravidarum

3. Petechiae

4. Vascular spider nevi

Answer: 3

Explanation: 3. Petechiae are pinpoint red or purple spots on the skin. They are seen in hemorrhagic conditions.

Page Ref: 227, 228

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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11) The nurse in the prenatal clinic will tell the client at 38-weeks gestation to lie on her left side when the client complains of which of the following?

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

Select all that apply.

1. Nausea

2. Pallor

3. Clamminess

4. Constipation

5. Dizziness

Answer: 2, 3, 5

Explanation: 2. Vena caval syndrome can cause pallor, which is relieved when the client turns to lie on her left side.

3. Vena caval syndrome can cause clamminess, which is relieved when the client turns to lie on her left side.

5. Vena caval syndrome can cause dizziness, which is relieved when the client turns to lie on her left side.

Page Ref: 226

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally, and culturally appropriate approaches. | NLN Competencies: Personal and Professional Development: Identify problems. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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12) A client at 32 weeks gestation comes to the clinic with urinary burning and frequency. The nurse explains that urinary tract infections are common in pregnancy due to which of the following?

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

Select all that apply.

1. Ureteral atonia

2. Stasis of urine

3. Increased glomerular filtration rate

4. Increased renal plasma flow

5. Increased clearance of urea

Answer: 1, 2

Explanation: 1. The presence of amino acids and glucose in the urine in conjunction with the tendency toward ureteral atonia and stasis of urine in the ureters may increase the risk of urinary tract infection.

2. The presence of amino acids and glucose in the urine in conjunction with the tendency toward ureteral atonia and stasis of urine in the ureters may increase the risk of urinary tract infection.

Page Ref: 227

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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13) The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take?

1. Reassure the client that this is a normal finding in multigravidas.

2. Suggest that she should feel for movement with her fingertips.

3. Schedule an appointment for her with her physician for that same day.

4. Tell her gently that her fetus is probably dead.

Answer: 3

Explanation: 3. Quickening, or the mothers perception of fetal movement, occurs about 18 to 20 weeks after the LMP in a primigravida (a woman who is pregnant for the first time) but may occur as early as 16 weeks in a multigravida (a woman who has been pregnant more than once).

Page Ref: 231

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care. | AACN Essentials Competencies: I. 3. Use skills of inquiry, analysis, and information literacy to address practice issues. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

14) The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she has not had a menstrual cycle for 3 months, and her breasts are getting bigger. What response by the nurse is best?

1. Lack of menses and breast enlargement are presumptive signs of pregnancy.

2. The changes you are describing are definitely indicators that you are pregnant.

3. Lack of menses can be caused by many things. We need to do a pregnancy test.

4. Youre probably not pregnant, but we can check it out if you like.

Answer: 3

Explanation: 3. This is a true statement, and addresses that these changes could be caused by conditions other than pregnancy.

Page Ref: 233

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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15) The nurse has completed a community presentation about the changes of pregnancy, and knows that the lesson was successful when a community member states that which of the following is one probable or objective change of pregnancy?

1. Enlargement of the uterus

2. Hearing the babys heart rate

3. Increased urinary frequency

4. Nausea and vomiting

Answer: 1

Explanation: 1. An examiner can perceive the objective (probable) changes that occur in pregnancy. Enlargement of the uterus is a probable change.

Page Ref: 231

Cognitive Level: Remembering

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

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, cultural, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3 Compare subjective (presumptive), objective (probable), and diagnostic (positive) changes of pregnancy.

MNL LO: 2.1.3 Differentiate between subjective, objective, and diagnostic indicators of pregnancy.

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16) A client who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the client needs additional information?

1. Because we heard the babys heartbeat, I am undoubtedly pregnant.

2. Because I havent felt the baby move yet, we dont know whether Im pregnant.

3. My last period was 2 months ago, which means Im 2 months along.

4. The increased size of my uterus means that I am finally pregnant.

Answer: 2

Explanation: 2. Fetal movement is a subjective, or presumptive, change of pregnancy, and is not a reliable indicator in the early months of pregnancy.

Page Ref: 231

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations that foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3 Compare subjective (presumptive), objective (probable), and diagnostic (positive) changes of pregnancy.

MNL LO: 2.1.3 Differentiate between subjective, objective, and diagnostic indicators of pregnancy.

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17) The nurse is assessing a new client in the clinic. The nurse knows that the subjective (presumptive) signs and symptoms of pregnancy include which of the following?

1. Positive urine pregnancy test, enlarged abdomen, and Braxton Hicks contractions

2. Positive urine pregnancy test, amenorrhea, changes in pigmentation of the skin, and softening of the cervix

3. Increase in urination, amenorrhea, fatigue, breast tenderness, and quickening

4. Enlarged abdomen and fetal heartbeat

Answer: 3

Explanation: 3. An increase in urination, amenorrhea, fatigue, breast tenderness, and quickening are all subjective (presumptive) changes of pregnancy.

Page Ref: 230, 231

Cognitive Level: Remembering

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

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN 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. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 3 Compare subjective (presumptive), objective (probable), and diagnostic (positive) changes of pregnancy.

MNL LO: 2.1.3 Differentiate between subjective, objective, and diagnostic indicators of pregnancy.

18) On examination of the prenatal client, the nurse is aware that she will assess for a bluish pigmentation of the vagina. What is this objective (probable) sign of pregnancy also known as?

1. Hegar sign

2. Chadwick sign

3. Nightingale sign

4. Goodell sign

Answer: 2

Explanation: 2. The blue-purple discoloration of the cervix is Chadwick sign.

Page Ref: 231

Cognitive Level: Remembering

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

Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care. | AACN Essentials Competencies: I. 3. Use skills of inquiry, analysis, and information literacy to address practice issues. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and (a) quality and safe patient care, (b) excellence in nursing, and (c) advancement of the profession. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Identify the anatomic and physiologic changes that occur during pregnancy.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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19) The nurse notes the following findings in a client at 12-weeks gestation. Which of the findings would enable the nurse to tell the client that she is diagnostically pregnant?

1. Fetal heart rate by Doppler

2. Positive pregnancy test

3. Positive Chadwicks sign

4. Montgomery gland enlargement

Answer: 1

Explanation: 1. A fetal heart rate by Doppler is a diagnostic (positive) change of pregnancy.

Page Ref: 233

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care. | AACN Essentials Competencies: I. 3. Use skills of inquiry, analysis, and information literacy to address practice issues. | NLN Competencies: Knowledge and Science: Relationship between knowledge/science and (a) quality and safe patient care, (b) excellence in nursing, and (c) advancement of the profession. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 3 Compare subjective (presumptive), objective (probable), and diagnostic (positive) changes of pregnancy.

MNL LO: 2.1.3 Differentiate between subjective, objective, and diagnostic indicators of pregnancy.

20) A 16-year-old pregnant client is seen at her 10-weeks-gestation visit. She tells the nurse that she felt the baby move that morning. What response by the nurse is appropriate?

1. That is very exciting. The baby must be very healthy.

2. Would you please describe what you felt for me?

3. That is impossible. The baby is not big enough yet.

4. Would you please let me see whether I can feel the baby?

Answer: 2

Explanation: 2. The nurse should ask the client to describe what she felt, as 10 weeks gestation is too early to feel fetal movement.

Page Ref: 239

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered care, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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21) The nurse is assessing a client who is at 35 weeks gestation. What does the nurse expect the client to report at this phase of pregnancy?

1. Nausea and vomiting

2. Maternal ambivalence

3. Emotional shifts from highs to lows

4. Stretch marks on the abdomen

Answer: 4

Explanation: 4. Striae are purplish stretch marks that may develop as the pregnancy progresses.

Page Ref: 225

Cognitive Level: Understanding

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

Standards: QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2 Relate the physiologic and anatomic changes that occur in the body systems during pregnancy to the signs and symptoms that develop in the woman.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

22) The nurse recognizes that subjective pregnancy changes such as amenorrhea can be caused by which conditions?

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

Select all that apply.

1. Goodell sign

2. Anemia

3. Pseudocyesis

4. Thyroid dysfunction

5. Fetal heartbeat

Answer: 2, 3, 4

Explanation: 2. Anemia can cause amenorrhea, and is a subjective sign of pregnancy.

3. Pseudocyesis (intense desire for pregnancy) can cause amenorrhea.

4. Thyroid dysfunction can cause amenorrhea, and is a subjective sign of pregnancy.

Page Ref: 231

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Compare subjective (presumptive), objective (probable), and diagnostic (positive) changes of pregnancy.

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MNL LO: 2.1.3 Differentiate between subjective, objective, and diagnostic indicators of pregnancy.

23) The adolescent client reports to the clinic nurse that her period is late, but that her home pregnancy test is negative. What should the nurse explain that these findings most likely indicate?

1. This means you are not pregnant.

2. You might be pregnant, but it might be too early for your home test to be accurate.

3. We dont trust home tests. Come to the clinic for a blood test.

4. Most people dont use the tests correctly. Did you read the instructions?

Answer: 2

Explanation: 2. This is a true statement. Most home pregnancy tests have low false-positive rates, but the false-negative rate is slightly higher. Repeating the test in a week is recommended.

Page Ref: 233

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. A. 1. Integrate multiple dimensions of patient centered care. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4 Contrast the various types of pregnancy tests.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

24) The client is at 6 weeks gestation, and is spotting. The client had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order which intervention?

1. A urine pregnancy test

2. The client to be seen next week for a full examination

3. An antiserumpregnancy test

4. An ultrasound to be done

Answer: 3

Explanation: 3. A -Subunit radioimmunoassay (RIA) uses an antiserum with specificity for the -subunit of hCG in blood plasma. This test may not only detect pregnancy but also detect an ectopic pregnancy or trophoblastic disease.

Page Ref: 233

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Contrast the various types of pregnancy tests.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

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25) A woman calls the clinic and tells a nurse that she thinks she might be pregnant. She wants to use a home pregnancy test before going to the clinic, and asks the nurse how to use it correctly. What information should the nurse give?

1. The false-positive rate of these tests is quite high.

2. If the results are negative, the woman should repeat the test in 2 weeks if she has not started her menstrual period.

3. A negative result merely indicates growing trophoblastic tissue and not necessarily a uterine pregnancy.

4. The client should follow up with a healthcare provider after taking the home pregnancy test.

Answer: 4

Explanation: 4. It is important that clients remember that the tests are not always accurate and they should follow up with a healthcare provider.

Page Ref: 233

Cognitive Level: Applying

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

Standards: QSEN Competencies: III. B. 3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and effectively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 4 Contrast the various types of pregnancy tests.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

26) To answer a clients question about home pregnancy tests and their accuracy, the nurse must know that accuracy is affected by which of the following?

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

Select all that apply.

1. Unclear directions

2. Unable to comprehend the directions

3. Blood in the specimen giving a false reading

4. Completing the test too late

5. Tagged antibodies becoming outdated

Answer: 1, 4

Explanation: 1. Women may not comprehend the HPT instructions, which can affect the accuracy results.

4. False-negative results typically occur when the test is completed too early or too late.

Page Ref: 233

Cognitive Level: Applying

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

Standards: QSEN Competencies: III. B. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. |

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Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Contrast the various types of pregnancy tests.

MNL LO: 2.1.2 Explain the expected maternal physiologic adaptations to pregnancy.

27) A prenatal educator is asking a partner about normal psychological adjustment of an expectant mother during the second trimester of pregnancy. Which answer by the partner would indicate a typical expectant mothers response to pregnancy?

1. She is very body-conscious, and hates every little change.

2. She daydreams about what kind of parent she is going to be.

3. I havent noticed anything. I just found out she was pregnant.

4. She has been having dreams at night about misplacing the baby.

Answer: 2

Explanation: 2. The second trimester brings increased introspection and consideration of how she will parent. She might begin to get furniture and clothing as concrete preparation, and feels movement and is aware of the fetus and incorporates it into herself.

Page Ref: 235

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preference and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

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28) The partner of a client at 16 weeks gestation accompanies her to the clinic. The partner tells the nurse that the baby just doesnt seem real to him, and he is having a hard time relating to his partners fatigue and food aversions. Which statement would be best for the nurse to make?

1. If you would concentrate harder, youd be aware of the reality of this pregnancy.

2. My husband had no problem with this. What was your childhood like?

3. You might need professional psychological counseling. Ask your physician.

4. Many men feel this way. Feeling the baby move in a few weeks will help make it real to you.

Answer: 4

Explanation: 4. Initially, expectant fathers may have ambivalent feelings.The extent of ambivalence depends on many factors, including the fathers relationship with his partner, his previous experience with pregnancy, his age, his economic stability, and whether the pregnancy was planned. The expectant father must first deal with the reality of the pregnancy and then struggle to gain recognition as a parent from his partner, family, friends, coworkers, societyand from his baby as well.

Page Ref: 237

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preference, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

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29) The client at 30 weeks gestation with her first child is upset. She tells the prenatal clinic nurse that she is excited to become a mother, and has been thinking about what kind of parent she will be. But her mother has told her that she doesnt want to be a grandmother because she doesnt feel old enough, while her husband has said that the pregnancy doesnt feel real to him yet, and he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family?

1. Her husband will not attach with this child and will not be a good father.

2. Her mother is rejecting the role of grandparent, and will not help out.

3. The client is not progressing through the developmental tasks of pregnancy.

4. The family members are adjusting to the role change at their own paces.

Answer: 4

Explanation: 4. This is a true statement. With each pregnancy, routines and family dynamics are altered, requiring readjustment and realignment.

Page Ref: 234

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. C. 10. Value active partnership with patients or designated surrogates in planning implementation, and evaluation of care. | AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

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30) The pregnant client at 14 weeks gestation is in the clinic for a regular prenatal visit. Her mother also is present. The grandmother-to-be states that she is quite uncertain about how she can be a good grandmother to this baby because she works full-time. Her own grandmother was retired, and was always available when needed by a grandchild. What is the nurses best response to this concern?

1. Dont worry. Youll be a wonderful grandmother. It will all work out fine.

2. What are your thoughts on what your role as grandmother will include?

3. As long as there is another grandmother available, you dont have to worry.

4. Grandmothers are supposed to be available. You should retire from your job.

Answer: 2

Explanation: 2. Although relationships with parents can be very complex, the expectant grandparents often become increasingly supportive of the expectant couple, even if conflicts previously existed. But it can be difficult for even sensitive grandparents to know how deeply to become involved in the childrearing process. In some areas, classes for grandparents provide information about changes in birthing and parenting practices.

Page Ref: 240, 241

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. C. 10. Value active partnership with patients or designated surrogates in planning, implementation and evaluation of care. | AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

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31) The nurse asks a woman how her husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which statement?

1. My husband is ready for the pregnancy to end so that we can have sex again.

2. My husband is much more attentive to me now that I am pregnant.

3. My husband seems more worried about our finances now than he was before the pregnancy.

4. My husband plays his favorite music for my belly so the baby will learn to like it.

Answer: 1

Explanation: 1. This is implying that the woman and her husband are not having sex, which indicates the need for counseling. Sex is fine with a normal pregnancy.

Page Ref: 235

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. C. 10. Value active partnerships with patients or designated surrogates in planning, implementation, and evaluation of care. | AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

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32) The clinic nurse is assessing how the prenatal client is meeting developmental tasks using Rubins tasks, including which of the following?

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

Select all that apply.

1. Ensuring safe passage through pregnancy, labor, and birth.

2. Turning in on oneself to focus on the child.

3. Seeking commitment and acceptance of self as mother to the infant.

4. Completing the tasks of nesting at the appropriate time.

5. Seeking acceptance of the child by others.

Answer: 1, 3, 5

Explanation: 1. The tasks Rubin identified form the basis for a mutually gratifying relationship with the baby, and include ensuring safe passage through pregnancy, labor, and birth.

3. The tasks Rubin identified form the basis for a mutually gratifying relationship with the baby, and include seeking commitment and acceptance of self as mother.

5. The tasks Rubin identified form the basis for a mutually gratifying relationship with the baby, and include seeking acceptance of the child by others.

Page Ref: 237

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct a comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

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33) The partner of a pregnant client comes to the clinic with her. He complains to the nurse that he is experiencing different physical changes. The nurse determines he is experiencing couvade when he describes which symptoms?

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

Select all that apply.

1. Fatigue

2. Increased appetite

3. Headache

4. Backache

5. High anxiety level

Answer: 1, 2, 3, 4

Explanation: 1. Couvade is demonstrated by increased fatigue in the partner.

2. Couvade is demonstrated by an increased appetite in the partner.

3. Couvade is demonstrated by the partners having headaches.

4. Couvade is demonstrated by the partners experiencing backache.

Page Ref: 239

Cognitive Level: Understanding

Client Need/Sub: Psychosocial Integrity: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. C. 10. Value active partnership with patients or designated surrogates in planning, implementation, and evaluation of care. | AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

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34) Nurses who are interacting with expectant families from a different culture or ethnic group can provide more effective, culturally sensitive nursing care by doing what?

1. Recognizing that ultimately it is the familys right to make a womans healthcare choices.

2. Obtaining a medical interpreter of the language the client speaks.

3. Evaluating whether the clients healthcare beliefs have any positive consequences for her health.

4. Accepting personal biases, attitudes, stereotypes, and prejudices.

Answer: 2

Explanation: 2. The nurse should provide for the services of an interpreter if language barriers exist.

Page Ref: 241

Cognitive Level: Applying

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

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Affirm and value diversity. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6 Summarize cultural factors that may influence a familys response to pregnancy.

MNL LO: 2.2.3 Recognize maternal cultural and spirituality factors that affect pregnancy.

35) Which of the following is common in many non-Western cultures and is on the increase in the United States?

1. Ceremonial rituals and rites

2. Cultural assessment

3. Cultural values

4. Cosleeping

Answer: 4

Explanation: 4. Some parents advocate cosleeping or bed sharing (one or both parents sleeping with their baby or young child). Cosleeping, which is common in many non-Western cultures, is on the increase in the United States.

Page Ref: 240

Cognitive Level: Understanding

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

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship. | NLN Competencies: Relationship-Centered Care: Affirm and value diversity. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6 Summarize cultural factors that may influence a familys response to pregnancy.

MNL LO: 2.2.3 Recognize maternal cultural and spirituality factors that affect pregnancy.

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36) The introduction of a new baby into the family is often the beginning of which of the following?

1. Sibling rivalry

2. Inconsistent childrearing

3. Toilet training

4. Weaning

Answer: 1

Explanation: 1. Sibling rivalry results from childrens fear of change in the security of their relationships with their parents.

Page Ref: 239

Cognitive Level: Remembering

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

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship. | NLN Competencies: Relationship-Centered Care: Affirm and value diversity. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Discuss the emotional and psychologic changes that commonly occur in a woman, her partner, and her family during pregnancy.

MNL LO: 2.1.4 Assess the childbearing familys psychosocial adaptation to pregnancy.

37) The clinic nurse is culturally sensitive when, while assessing the pregnant client, he asks about which of the following?

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

Select all that apply.

1. The familys expectations of the healthcare system

2. Which cultural practices should be incorporated into care

3. Any alternative healer who should be consulted

4. Positive consequences of the clients healthcare beliefs

5. The clients giving up her practices and adopting the practices of the dominant culture

Answer: 1, 2, 3

Explanation: 1. The nurse needs to ask about the clients expectations of the healthcare system.

2. The nurse should ask about any cultural or spiritual practices that should be incorporated into care.

3. The culturally sensitive nurse will ask whether any alternative healer should be consulted about care.

Page Ref: 241

Cognitive Level: Analyzing

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

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship. | NLN Competencies: Relationship-Centered Care: Affirm and value diversity. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6 Summarize cultural factors that may influence a familys response to pregnancy.

MNL LO: 2.2.3 Recognize maternal cultural and spirituality factors that affect pregnancy.

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