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Introduction to Maternity & Pediatric Nursing Leifer 5th
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MULTIPLE CHOICE
1. The certified nurse-midwife (CNM) clarifies to the pregnant patient that the CNM’s scope
of practice includes:
a. Practice independent from medical supervision
b. Comprehensive prenatal care
c. Attendance at all deliveries
d. Simple surgical techniques
ANS: B
The CMN provides comprehensive prenatal and postnatal care and attends uncomplicated
deliveries and assures a back-up physician in case of unforeseen problems.
2. The medical pioneer who discovered the relationship between the incidence of puerperal
fever and unwashed hands was:
a. Karl Credé
b. Ignaz Semmelweis
c. Louis Pasteur
d. Joseph Lister
ANS: B
Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by
the unwashed hands of physicians and medical students.
3. A pregnant woman who has recently immigrated to the United States comments to the
nurse, “I am afraid of childbirth. It is so dangerous. I am afraid I will die.” A nursing
response reflecting cultural sensitivity would be:
a. “Maternal mortality in the United States is extremely low.”
b. “Anesthesia is available to relieve pain during labor and childbirth.”
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
COMPLETION
1. The nurse who is very conscientious about handwashing is following the concepts set out by
____________________ and ____________________.
2. The first White House Conference on Children and Youth was called by
______________________________.
In weaving, the weavers should be kept wet, but not the spokes.
Do not put the reed in water and leave it for any length of time, as it
will become discolored. About 15 minutes will be sufficient to make
the reed pliable, then it is best to have a sponge and bucket of water
at hand, to dampen long weavers frequently by drawing the reed
across the wet sponge. Besides being more workable, the wet reed,
held in place until dry, stays curved in the form woven much better.
Some workmen leave the reed in water for a long time and depend
on bleaching to whiten it, but so much of the bleached work looks
like a poor job of painting that it is much better to keep it white from
the start. In case bleaching is found necessary, a little chloride of
lime in water makes a good bleacher. Avoid making the solution too
strong. It should be put on with a brush, so as to get it into the
interstices of the weaving, whereupon the work is placed in the
sunshine to dry.
Any kind of reed used will have some of the small hairlike fibers
sticking out after the weaving is complete, and this should be singed
off with a gas flame. A blowtorch is good for this purpose. Be careful
not to scorch the weaving.
A Homemade Ellipsograph
By J. A. SHELLY
To operate the ellipsograph lay out the length of the major axis on
a center line, then bisect the distance between these points and
erect a perpendicular. On this line lay off half the minor axis,
measuring from the center line; then from this point locate the foci by
setting the dividers to half the major axis and scribing arcs of circles
to cut the center line. Set the heads of the instrument so that the
projecting needle ends will be the same distance apart as the foci,
and clamp the sliding head with the wedge. Set the instrument so
that the needle eyes will be exactly over the points where the foci are
on the center line. A pencil, with a little groove filed ¹⁄₈ in. from the
point, for the thread to run in, is set to half the minor axis and the
thread is pulled taut and secured by the thumb tack. The pencil
should be held perfectly perpendicular while scribing the line. The
instrument must be reversed to draw the other half of the ellipse.
To draw an ellipse that will be an exact projection of a circle at any
given angle it is necessary to determine the length of the major axis.
This may be done by laying out the circle, either full size or to scale,
and projecting two parallel lines equal to the diameter of the circle, or
its scale, and connecting these lines with a line drawn to the required
angle. The length of this line is the major axis.
¶Never run a glass cutter over the same line twice, as this will ruin
the cutter. Alcohol rubbed along the line to be cut aids in the
process.
Ship’s-Wheel Device for a Radiator Valve
Leaving one’s comfortable bed to open the valve of a radiator in a
cold room is an unpleasant task. The device shown in the sketch
obviates the necessity for leaving the bed, yet gives as positive
control over the valve as if the hand were on the valve wheel.
The wires which lead from the propeller are run under the hood,
and attached to the socket for the trouble lamp. They are taped to
the rod that braces the radiator, to avoid a short circuit, and then out
from under the hood at the radiator cap, and connected to the
brushes A and B. The incandescent electric-light bulbs are attached
to the ends of the propeller blades and connected in series. The wire
is run from one side of the socket E to the collar C, and soldered to
the latter. The wire from the other side of the socket is connected to
the other lamp F. The other wire from this lamp socket at F is
soldered to the other collar D. The brushes are made by bending a
strip of copper into the shape shown in the detail, and fastening it to
the wooden block by means of screw binding posts, soldered to the
strips.—F. Lloyd Adams, Jersey City, N. J.
A Fifty-Cent Electric Stove
Few persons realize what an intense heat may be developed
when the globe of an ordinary incandescent lamp is tightly inclosed,
largely eliminating the loss of heat. When the lamp is inclosed, the
temperature will increase until the rate of radiation is equal to that at
which the heat is generated. A good reflector is a poor radiator,
hence, when the metal wall surrounding the lamp is bright and shiny,
both inside and out, the heat is reflected inward.
To make a small stove that will keep liquids warm, melt paraffin,
dissolve glue, etc., procure an ordinary 16-cp. carbon lamp, a
porcelain receptacle, and a bright, clean tin can, about 4 in. in
diameter and 7 in. long. Thoroughly blacken the bottom on the
inside, and then solder on four small brackets, cut from sheet brass
or copper, so that the can may be held down firmly, when inverted on
the base. The latter should preferably be made of hard wood, with
the upper edges beveled, as shown. Next bore the hole for the wire
or flexible cord. Fasten down the porcelain receptacle, connect the
wiring, screw in the globe, and screw down the tin can; the stove is
then ready for operation.—John D. Adams, Phoenix, Ariz.
Woven Reed Furniture
By CHARLES M. MILLER
A Variety of Small Stools and
Foot Rests