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 c. “Tell me why you are afraid of childbirth.”
d. “Your condition will be monitored during labor and delivery.”
ANS: C
Asking the patient about her concerns helps promote understanding and individualizes
patient care.

DIF: Cognitive Level: Application REF: 7 OBJ: 5

TOP: Cross-Cultural Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation

4. An urban area has been reported to have a high perinatal mortality rate. The nurse explains
that this statistic refers to:
a. Maternal and infant deaths per 100,000 live births per year
b. Deaths of fetuses weighing more than 500 g per 10,000 births per year
c. Deaths of infants up to 1 year of age per 1,000 live births per year
d. Fetal and neonatal deaths per 1,000 live births per year
ANS: D
The perinatal mortality rate includes both fetal and neonatal deaths per 1,000 live births per
year.

DIF: Cognitive Level: Comprehension REF: 9 OBJ: 13

TOP: The Present-Child Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

5. Current maternity practices focus on:

a. Hospital births for the majority of women
b. The traditional family unit
c. Teaching the proper attitudes toward childbearing
d. A quality family experience for each patient
ANS: D
Current maternity practice focuses on a high-quality family experience.

DIF: Cognitive Level: Comprehension REF: 6 OBJ: 2

TOP: The Present-Maternity Care KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance

6. The nurse explains that the individual who advocated the establishment of the Children’s
Bureau was:
a. Lillian Wald
b. Florence Nightingale
c. Florence Kelly
d. Clara Barton
ANS: A
Lillian Wald is credited with suggesting the establishment of a federal Children’s Bureau.

DIF: Cognitive Level: Knowledge REF: 3 OBJ: 7

TOP: The Past KEY: Nursing Process Step: Implementation
 MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. As a result of research done in the 1930s by the Children’s Bureau:

a. Children with heart problems are now cared for by pediatric cardiologists
b. The Child Abuse and Prevention Act was passed
c. Hot lunch programs were established in many schools
d. Children’s asylums were founded
ANS: C
School hot lunch programs were developed as a result of research by the Children’s Bureau
on the effects of economic depression on children.

DIF: Cognitive Level: Knowledge REF: 3 OBJ: 7

TOP: The Past KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

8. The government program that was implemented to increase the educational exposure of
preschool children is:
a. WIC program
b. Title XIX of the Medicaid program
c. The Children’s Charter
d. Head Start
ANS: D
Head Start programs were established to increase educational exposure of preschool
children.

DIF: Cognitive Level: Knowledge REF: 3 OBJ: 9

TOP: Government Influences in Maternity and Pediatric Care
KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. The nurse explains that guidelines that define multidisciplinary patient care in terms of
expected outcome and timeframe are known as:
a. Clinical pathways
b. Nursing outcome criteria
c. Standards of care
d. Nursing care plan
ANS: A
Clinical pathways, also known as critical pathways or care maps, are collaborative
guidelines that define patient care across disciplines. Expected progress within a specified
time line is identified.

DIF: Cognitive Level: Knowledge REF: 6 OBJ: 14

TOP: Health Care Delivery Systems KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
10. A nursing student has reviewed a hospitalized child’s chart, interviewed her mother, and
performed a physical assessment. The next step in developing a nursing care plan for this
child is to:
a. Identify measurable outcomes with a time line
b. Identify specific nursing implementations for the child
c. Determine appropriate nursing diagnoses
d. State nursing actions related to the child’s medical diagnosis
ANS: C
The nurse uses assessment data to select appropriate nursing diagnoses from the NANDA
list. Outcomes and Implementations are then developed to address the relevant nursing
diagnoses.

DIF: Cognitive Level: Application REF: 15 OBJ: 6

TOP: Nursing Process
KEY: Nursing Process Step: Nursing Diagnosis
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

11. A nursing student on an obstetrical rotation questions the floor nurse where the LVN/LPN
scope of practice is defined. The nurse directs the student to contact the:
a. American Nurses Association
b. State Board of Nursing
c. Joint Commission on Accreditation of Healthcare Organizations
d. Association of Women’s Obstetric and Neonatal Nurses
ANS: B
The scope of practice of the LVN/LPN is published by the State Board of Nursing.

DIF: Cognitive Level: Application REF: 16 OBJ: 11

TOP: Critical Thinking KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

12. The delivery room nurse remarks that in 1884 Karl Credé recommended that:
a. All women should be delivered in a hospital setting
b. Chemical means should be used to combat infection
c. Podalic version be done on all fetuses
d. Silver nitrate be placed in the eyes of newborns
ANS: D
In 1884 Karl Credé recommended the use of 2% silver nitrate to be placed in the eyes of
newborns to reduce the incidence of blindness. The practice is still current, but uses 1%
silver nitrate.

DIF: Cognitive Level: Comprehension REF: 2 OBJ: 7

TOP: Use of Silver Nitrate KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease

13. White House Conferences on Children and Youth are held every _____ years.
a. 2
 b. 3
c. 5
d. 10
ANS: D
White House Conferences are held every 10 years.

DIF: Cognitive Level: Knowledge REF: 5 OBJ: 9

TOP: White House Conferences KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease

14. The nurse takes into consideration in designing the nursing care plan for a vaginally
delivered postpartum patient that the patient will be hospitalized a minimum of ____ hours.
a. 24
b. 48
c. 36
d. 72
ANS: B
Postpartum patients who deliver vaginally stay in the hospital for an average of 48 hours,
patients who have had a cesarean delivery usually stay 4 days.

DIF: Cognitive Level: Application REF: 6 OBJ: 12

TOP: Hospital Terms for Postpartum Patients
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease

15. The nurse explains that the clinical pathway or critical pathway improves quality of care by:
a. Listing diagnosis specific implementations
b. Outlining expected progress with stated time lines
c. Prioritizing effective nursing diagnoses
d. Describing common complications
ANS: B
Critical pathways outline expected progress with stated time lines. Any deviation from those
time lines is called a variance.

DIF: Cognitive Level: Comprehension REF: 6 OBJ: 14

TOP: Critical Pathway KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

16. When the patient asks the nurse to explain what is meant by “gene therapy,” the nurse’s best
response would be that gene therapy:
a. Can replace missing genes
b. Evaluates parent’s genes
c. Can change the sex of the fetus
d. Supports the regeneration of defective genes
ANS: A
 Gene Therapy can replace missing or defective genes.

DIF: Cognitive Level: Analysis REF: 10 OBJ: 2

TOP: Gene Therapy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease

17. The nurse clarifies to a patient that diagnosis related groups (DRGs) are designed to contain
medical care costs by:
a. Determining payment based on diagnosis
b. Requiring two medical opinions to confirm a diagnosis
c. Organizing HMOs
d. Defining a person who will require hospitalization
ANS: A
DRGs determine the amount of payment and length of hospital stay based on the diagnosis.

DIF: Cognitive Level: Comprehension REF: 11 OBJ: 12

TOP: DRGs KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

18. An example of an NIC is:

a. Patient will ambulate in the hall independently for 10 minutes three times a day.
b. The nurse will report temperature elevations to the charge nurse.
c. The nurse will offer extra liquids at all meals.
d. Patient will express pain relief after massage.
ANS: C
NICs (Nursing Implementations Classifications) are guides to nursing actions.

DIF: Cognitive Level: Application REF: 15 OBJ: 15

TOP: NICs KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

19. The nurse clarifies to the patient that computer charting supports accurate and
comprehensive documentation by requiring:
a. A uniform style of chart
b. Certain responses before allowing the user to progress
c. Documentation reflective of the Nursing Care Plan
d. A daily audit by the charge nurse
ANS: B
Comprehensive charting by computer is ensured by requiring specific input in designated
categories before the user can progress through the system.

DIF: Cognitive Level: Application REF: 16 OBJ: 2

TOP: Computer Charting KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

MULTIPLE RESPONSE
1. The nurse clarifies that family-centered care focuses on:
Select all that apply.
a. Family integrity
b. Family as caregivers
c. Family as decision makers
d. Empowerment of the family
e. Cultural values of the family
ANS: A, B, C, D, E
Family-centered care empowers the family to exercise its own integrity to give care and
make medical decisions that are culturally consistent.

DIF: Cognitive Level: Analysis REF: 2 OBJ: 2

TOP: Family Centered Care KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

2. The nurse explains that the developments in the early 20th century that focused on
hospitalization for childbirth were:
Select all that apply.
a. Use of specialized obstetrical instruments
b. Use of anesthesia
c. Physicians’ closer relationships with hospitals
d. Focus on family-centered care
e. Insurance coverage
ANS: A, B, C
In the early 1900s the development of specialized obstetrical instruments, better modes of
anesthesia, and the physician’s reliance on hospital services were instrumental in bringing
childbirth to the hospital rather than at home.

DIF: Cognitive Level: Analysis REF: 2 OBJ: 2

TOP: Hospitalization for Childbirth KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

3. The nurse points out that some non-family-centered policies of hospital in the 1960s were:
Select all that apply.
a. Waiting room for fathers
b. Sedation of mother during labor
c. Delay of reunion of mother and baby
d. Stringent visiting hours
e. Restrictions of visitations by minor children
ANS: A, B, C, D, E
Hospital policies in the 1960s provided a separate waiting room for fathers while the mother
went through labor in a sedated state. The reunion of mother and baby was delayed for
several hours due to the sedation. Visiting hours were rigid and disallowed the visitation of
minor children.

DIF: Cognitive Level: Comprehension REF: 3 OBJ: 2

 TOP: Non-Family-Centered Practices KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

COMPLETION

1. The nurse who is very conscientious about handwashing is following the concepts set out by
____________________ and ____________________.

ANS: Lister and Pasteur

DIF: Cognitive Level: Application REF: 2 OBJ: 7

TOP: Handwashing KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Safety and Infection Control
NOT: Rationale: Both Lister and Pasteur set out that handwashing could reduce incidence
of infection by cross-contamination.

2. The first White House Conference on Children and Youth was called by
______________________________.

ANS: Theodore Roosevelt

DIF: Cognitive Level: Knowledge REF: 5 OBJ: 7

TOP: White House Conferences KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease
NOT: Rationale: Theodore Roosevelt called the first White House Conference in 1909.
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