Practices such as providing recommended immunizations, infant car seats, and school health education are part of: Secondary preventive care Primordial preventive care Primary preventive care Tertiary preventive care. A married couple lives in a single-family house with their newborn son and the husband’s daughter from a previous marriage. Based on this information, what family form best describes this family? Married-blended family Extended family Nuclear family Same-sex family. Which key factors play the most powerful role in the behaviors of individuals and families? Boundaries and channels Beliefs and values Socialization processes Rituals and customs. Using the family stress theory as an interventional approach for working with families experiencing parenting challenges, the nurse can assist the family in selecting and altering internal context factors. Which statement best describes the components of an internal context? Biologic and genetic makeup Maturation of family members Family’s perception of the event Prevailing cultural beliefs of society. The nurse is developing a plan of care for a Hispanic client who just delivered a newborn. Which cultural variation is most important to include in the care plan? Male infants are typically circumcised. Maternal grandmother participates in the care of the mother and her infant. Bathing is encouraged immediately after delivery. Breastfeeding is encouraged immediately after birth. To provide culturally competent care to an Asian-American family, which question should the nurse include during the assessment interview? “Do you have a name selected for the baby?” “Do you prefer hot or cold beverages?” “Do you want music playing while you are in labor?” “Do you want some milk to drink?”. The woman’s family members are present when the nurse arrives for a postpartum and newborn visit. What should the nurse do? Ask the woman to meet with her and the baby alone. Observe the family members’ interactions with the newborn and one another. Perform a brief assessment on all family members who are present. Reschedule the visit for another time so that the mother and infant can be privately assessed. During the childbearing experience, which behavior might the nurse expect from an African-American client? Arriving at the hospital in advanced labor Avoiding self-treatment of pregnancy-related discomfort Seeking prenatal care early in her pregnancy Requesting liver in the postpartum period to prevent anemia. Which resource best describes a health care service representing the tertiary level of prevention? Stress management seminars Childbirth education classes for single parents BSE pamphlet and teaching Premenstrual syndrome (PMS) support group. Which traditional family structure is decreasing in numbers and attributable to societal changes? Blended family Extended family Binuclear family Nuclear family. Which pictorial tool can assist the nurse in assessing the aspects of family life related to health care? Ecomap Human development wheel Life-cycle model Genogram. When weighing the advantages and disadvantages of planning home care for services, what information should the nurse use in making the decision? Home care for perinatal services allows the nurse to interact with and include family members in teaching. Home care for perinatal services is more cost-effective for the nurse than office visits Home care for perinatal services is made possible by the ready supply of nurses with expertise in maternity care. Home care for perinatal services is more dangerous for vulnerable neonates at risk of acquiring an infection from the nurse. In what form do families tend to be the most socially vulnerable? Single-parent family Married-blended family Nuclear family Extended family. Which term is an accurate description of the process by which people retain some of their own culture while adopting the practices of the dominant society? Acculturation Ethnocentrism Assimilation Cultural relativism. Which statement about the development of cultural competence is inaccurate? Nursing care is delivered in the context of the client’s culture but not in the context of the nurse’s culture. Local health care workers and community advocates can help extend health care to underserved populations. Culture’s economic, religious, and political structures influence practices that affect childbearing. Nurses must develop an awareness of and a sensitivity to various cultures. Among the legal rights of pregnant women established by the Law # 425, which of the following would you indicate? Immediate dismissal. An employer can not refuse to hire a woman because of her pregnancy status. hey can be forced to take leave when they are pregnant while they can do their jobs. Benefits related to pregnancy may be limited to employees who are married. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW) infant, which factor is the most important for the nurse to consider? Cigarette smoking Limited maternal education Poor nutritional status African-American race. What is the primary role of practicing nurses in the research process? Collecting data for other researchers Seeking funding to support research studies Identifying researchable problems Designing research studies. A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? Advise the woman to see an obstetrician, not a midwife. Refer the woman to a social worker. Perform a nutrition assessment. Explain to the woman the importance of keeping her prenatal care appointments. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic client with limited English proficiency. Which action is the most important for the nurse to perform? Speak quickly and efficiently to expedite the visit. Use maternity jargon to enable the client to become familiar with these terms. Assess whether the client understands the discussion. Provide the client with handouts. Which statement best exemplifies contemporary maternity nursing? vaginal deliveries Family-centered care Free-standing birth clinics Physician-driven care. The National Quality Forum has issued a list of “never events” specifically pertaining to maternal and child health. These include all of the following except: artificial insemination with the wrong donor sperm or egg. infant discharged to the wrong person. foreign object retained after surgery kernicterus associated with the failure to identify and treat hyperbilirubinemia. A recently graduated nurse is attempting to understand the reason for increasing health care spending in the United States. Which information gathered from her research best explains the rationale for these higher costs compared with other developed countries? Increased use of health care services along with lower prices Homogeneity of the population Higher rate of obesity among pregnant women Limited access to technology. Through the use of social media technology, nurses can link with other nurses who may share similar interests, insights about practice, and advocate for clients. Which factor is the most concerning pitfall for nurses using this technology? Lack of institutional policy governing online contact Violation of client privacy and confidentiality Institutions and colleagues who may be cast in an unfavorable light Unintended negative consequences for using social media. Maternity nurses can enhance communication among health care providers by using the SBAR technique. The acronym SBAR stands for what? Situation, baseline, assessment, recommendation Situation, background, assessment, recommendation Subjective, background, analysis, recommendation Subjective, background, analysis, review. Healthy People 2020 has established national health priorities that focus on a number of maternal-child health indicators. Nurses are assuming greater roles in assessing family health and are providing care across the perinatal continuum. Which of these priorities has made the most significant progress? Infant mortality and the prevention of birth defects Elimination of health disparities based on race LBW infants and preterm births Reduction of fetal deaths and use of prenatal care. Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast self-examination (BSE)? Any time during a shower or bath Day 1 of the endometrial cycle Between 5 and 7 days after menses ceases Midmenstrual cycle. Which action would be inappropriate for the nurse to perform before beginning the health history interview? Speak in a relaxed manner with an even, nonjudgmental tone. Make the client comfortable Smile and ask the client whether she has any special concerns. Tell the client her questions are irrelevant. Preconception and prenatal care have become important components of women’s health. What is the guiding principal of preconception care? Encourage healthy lifestyles for families desiring pregnancy. Identify the woman who should not become pregnant. Ensure that women know about prenatal care. Ensure that pregnancy complications do not occur. Ovarian function and hormone production decline during which transitional phase? Climacteric Menopause Puberty Menarche. A blind woman has arrived for an examination. Her guide dog assists her to the examination room. She appears nervous and says, “I’ve never had a pelvic examination.” What response from the nurse would be most appropriate? “Don’t worry. It will be over before you know it.” “Try to relax. I’ll be very gentle, and I won’t hurt you.” “Your anxiety is common. I was anxious when I first had a pelvic examination.” “I’ll let you touch each instrument that I’ll use during the examination as I tell you how it will be used.”. Which female reproductive organ(s) is(are) responsible for cyclic menstruation? Vaginal vestibule Ovaries Uterus Urethra. Which body part both protects the pelvic structures and accommodates the growing fetus during pregnancy? Fourchette Perineum Vaginal vestibule Bony pelvis. What fatty acids (classified as hormones) are found in many body tissues with complex roles in many reproductive functions? Luteinizing hormone (LH) GnRH FSH Prostaglandins (PGs). As part of their participation in the gynecologic portion of the physical examination, which approach should the nurse take? Take a firm approach that encourages the client to facilitate the examination by following the physician’s instructions exactly. Help the woman relax through the proper placement of her hands and proper breathing during the examination. Explain the procedure as it unfolds, and continue to question the client to get information in a timely manner. Take the opportunity to explain that the trendy vulvar self-examination is only for women at risk for developing cancer. Which statement best describes Kegel exercises? Kegel exercises are the best exercises for a pregnant woman because they are so pleasurable. Kegel exercises help manage stress. Kegel exercises are ineffective without sufficient calcium in the diet. Kegel exercises were developed to control or reduce incontinent urine loss. The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called what? Four As procedure Papanicolaou (Pap) test Rectovaginal palpation Bimanual palpation. Which hormone is responsible for the maturation of mammary gland tissue? Progesterone Prolactin Estrogen Testosterone. A 62-year-old woman has not been to the clinic for an annual examination for 5 years. The recent death of her husband reminded her that she should come for a visit. Her family physician has retired, and she is going to see the women’s health nurse practitioner for her visit. What should the nurse do to facilitate a positive health care experience for this client? Reassure the woman that a nurse practitioner is just as good as her old physician. Carefully listen, and allow extra time for this woman’s health history interview. Encourage the woman to talk about the death of her husband and her fears about her own death Remind the woman that she is long overdue for her examination and that she should come in annually. During a health history interview, a woman states that she thinks that she has “bumps” on her labia. She also states that she is not sure how to check herself. The correct response by the nurse would be what? Reassure her that most women have “bumps” on their labia. Explain the process of vulvar self-examination, and reassure the woman that she should become familiar with normal and abnormal findings during the examination Reassure the woman that the examination will reveal any problems. Reassure the woman that “bumps” can be treated. A man smokes two packs of cigarettes a day. He wants to know if smoking is contributing to the difficulty he and his wife are having getting pregnant. Which guidance should the nurse provide? Your sperm count seems to be okay in the first semen analysis.” Although smoking has no effect on sperm count, it can give you lung cancer.” “Only marijuana cigarettes affect sperm count.” "Smoking can reduce the quality of your sperm.”. A couple comes in for an infertility workup, having attempted to achieve pregnancy for 2 years. The woman, 37 years of age, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional testing is needed? Testicular biopsy Examination for testicular infection FSH level Antisperm antibodies. A couple is attempting to cope with an infertility problem. They want to know what they can do to preserve their emotional equilibrium. What is the nurse’s most appropriate response? “Talk only to other friends who are infertile, because only they can help.” “Tell your friends and family so that they can help you.” “Get involved with a support group. I’ll give you some names.” “Start adoption proceedings immediately, because adopting an infant can be very difficult.”. Which condition would be inappropriate to treat with exogenous progesterone (human chorionic gonadotropin)? Oocyte retrieval Thyroid dysfunction Recent miscarriage PCOD. In vitro fertilization–embryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or with unexplained infertility and for men with very low sperm “The procedure begins with collecting eggs from your wife’s ovaries.” “A donor embryo will be transferred into your wife’s uterus.” “Donor sperm will be used to inseminate your wife.” “Don’t worry about the technical stuff; that’s what we are here for.”. With regard to the assessment of female, male, or couple infertility, the nurse should be aware of which important information? The investigation will take several months and can be very costly. The couple’s religious, cultural, and ethnic backgrounds provide emotional clutter that does not affect the clinical scientific diagnosis. The woman is assessed first; if she is not the problem, then the male partner is analyzed Semen analysis is for men; the postcoital test is for women. The nurse is having her first meeting with a couple experiencing infertility. The nurse has formulated the nursing diagnosis, “Deficient knowledge, related to lack of understanding of the reproductive process with regard to conception.” Which nursing intervention does not apply to this diagnosis? Evaluate the couple’s support system. Assess the current level of factors promoting conception. Identify and describe the basic infertility tests. Provide information regarding conception in a supportive manner. To provide adequate care, the nurse should be cognitive of which important information regarding infertility? Is more likely the result of a physical flaw in the woman than in her male partner. Is the same thing as sterility. Is perceived differently by women and men. Has a relatively stable prevalence among the overall population and throughout a woman’s potential reproductive years. Male fertility declines slowly after age 40 years; however, no cessation of sperm production analogous to menopause in women occurs in men. What condition is not associated with advanced paternal age? Down syndrome Autosomal dominant disorder Schizophrenia Autism spectrum disorder. An infertile woman is about to begin pharmacologic treatment. As part of the regimen, she will take purified FSH (Metrodin). The nurse instructs her that this medication is administered in the form of what? Intranasal spray Tablet Vaginal suppository Intramuscular (IM) injection. A couple arrives for their first appointment at an infertility center. Which of the following is a noninvasive test performed during the initial diagnostic phase of testing? Laparoscopy Sperm analysis Hysterosalpingogram Endometrial biopsy. What kind of fetal anomalies are most often associated with oligohydramnios? Renal Cardiac Neurologic Gastrointestinal. A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? “That must have been a coincidence; babies can’t respond like that.” "Let me know if it happens again; we need to report that to your midwife.” "The fetus is demonstrating the aural reflex.” "Babies respond to sound starting at approximately 24 weeks of gestation.”. At a routine prenatal visit, the nurse explains the development of the fetus to her client. At approximately ____ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and 24 28 30 20. Which statement regarding the structure and function of the placenta is correct? Secretes both estrogen and progesterone Forms a protective, impenetrable barrier to microorganisms such as bacteria and viruses Excretes prolactin and insulin Produces nutrients for fetal nutrition. A woman in labor passes some thick meconium as her amniotic fluid ruptures. The client asks the nurse where the baby makes the meconium. What is the correct response by the nurse? Fetal intestines Fetal kidneys Amniotic fluid Placenta. Which structure is responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream? Decidua basalis Chorionic villi Blastocyst Germ layer. A woman who is 8 months pregnant asks the nurse, “Does my baby have any antibodies to fight infection?” What is the most appropriate response by the nurse? “Your baby won’t receive any antibodies until he is born and you breastfeed him.” “Your baby has IgG and IgM.” “Your baby does not have any antibodies to fight infection.” "Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA).”. What is the most basic information that a nurse should be able to share with a client who asks about the process of conception? Implantation in the endometrium occurs 6 to 10 days after conception. Ova are considered fertile 48 to 72 hours after ovulation. Sperm remain viable in the woman’s reproductive system for an average of 12 to 24 hours. Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum. Which statement regarding the development of the respiratory system is a high priority for the nurse to understand? The infant’s lungs are considered mature when the L/S ratio is 1:1, at approximately 32 weeks of gestation. Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks of gestation. The respiratory system does not begin developing until after the embryonic stage. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. The various systems and organs of the fetus develop at different stages. Which statement ismost accurate? Gastrointestinal system is mature at 32 weeks of gestation. Hematopoiesis originating in the yolk sac begins in the liver at 10 weeks of gestation. Cardiovascular system is the first organ system to function in the developing human. Body changes from straight to C-shape occurs at 8 weeks of gestation. Which statement concerning neurologic and sensory development in the fetus is correct? Brain waves have been recorded on an electroencephalogram as early as the end of the first trimester (12 weeks of gestation). Fetuses respond to sound by 24 weeks of gestation and can be soothed by the sound of the mother’s voice. At term, the fetal brain is at least one third the size of an adult brain. Eyes are first receptive to light at 34 to 36 weeks of gestation. The nurse caring for a pregnant client is evaluating his or her health teaching regarding fetal circulation. Which statement from the client reassures the nurse that his or her teaching has been effective? “Optimal fetal circulation is achieved when the head of the bed is elevated.” “Optimal fetal circulation is achieved when I am on my back with a pillow under my knees.” “Optimal fetal circulation is achieved when I am in the side-lying position.” “Optimal fetal circulation is achieved when I am on my abdomen.”. A woman is 15 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. What is the nurse’s best answer? “You should have felt the baby move by now.” “The baby is moving; however, you can’t feel it yet.” “Within the next month, you should start to feel fluttering sensations.” “Some babies are quiet, and you don’t feel them move.”. Which development related to the integumentary system is correct? By 32 weeks, scalp hair becomes apparent. Eyelashes, eyebrows, and scalp hair appear at 28 weeks of gestation. Very fine hairs called lanugo appear at 12 weeks of gestation. Fingernails and toenails develop at 28 weeks of gestation.