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AWHONN Perinatal Nursing Item Bank QUIZ
b. 50% - ✔✔Inpatient obstetric care results in approximately what percentage of malpractice claims in obstetrics and gynecology? a. 25% b. 50% c. 70% a. American Nurses Association Code of Ethics for Nurses - ✔✔Guidance for ethical nursing care is provided by the: a. American Nurses Association Code of Ethics for Nurses b. American Academy of Pediatrics (AAP) & American College of Obstetricians and Gynecologists (ACOG) Guidelines for Perinatal Care c. American Medical Association Code of Medical Ethics a. is often directly linked to clinical practice issues - ✔✔Disruptive clinician behavior: a. is often directly linked to clinical practice issues b. rarely involves clinical practice issues c. should be handled separately from clinical practice issues a. immediate intervention - ✔✔The best approach for addressing disruptive clinician behavior is a. immediate intervention b. monitoring trends c. peer review
b. national professional standards - ✔✔Successful defense of malpractice claims is enhanced by following: a. community standards b. national professional standards c. trends in practice a. a root-cause analysis should be conducted - ✔✔When a sentinel event occurs, according to The joint Commission (TJC), a. a root-cause analysis should be conducted b. it must be reported to TJC within 60 days c. those involved should be placed on administrative leave pending an investigation c. unanticipated death of a full turn infant - ✔✔Based on TJC criteria, which of the following clinical situations is a sentinel event? a. any unexplained adverse occurrence b. birth of a baby with previously undiagnosed congenital abnormalities c. unanticipated death of a full turn infant c. review potentially contributing systems - ✔✔The purpose of the root-cause analysis process is to a. determine fault of the healthcare provider or hospital b. examine institutional liability c. review potentially contributing systems
c. rates of maternal morbidity and mortality - ✔✔Outcome measures of patient safety include a. how care is delivered b. policies and procedures c. rates of maternal morbidity and mortality c. unit protocols - ✔✔Structure measures of patient safety include a. the number of elective inductions of labor prior to 39 competed weeks gestation b. the rates of third and fourth degree laceration c. unit protocols a. how tachysystole is identified and treated Process measures of patient safety include - ✔✔a. how tachysystole is identified and treated b. number of nurses who are certified in fetal monitoring c. rate of cesarean birth for indeterminate fetal status a. focus groups - ✔✔Qualitative measures of patient safety include a. focus groups b. number of sentinel events per year c. policies and procedures consistent with national standards and guidelines c. attempting VBAC - ✔✔According to ACOG (2009) misoprostol is not recommended for women who are: a. nulliparous b. hypertensive
c. attempting VBAC a. the woman feels the urge to push; nulliparous; multiparous - ✔✔Second-state pushing should be initiated when _____________ or when more than 2 hours have passed since complete dilation for ____________ women or more than 1 hour has passed since complete dilation for ___________women a. the woman feels the urge to push; nulliparous; multiparous b. the women feels the urge to void; multiparous; nulliparous c. the woman has an epidural; nulliparous, multiparous b. EMTALA - ✔✔Triage for a pregnant women who present for care should be based on guidelines from a. AWHONN b. EMTALA C. ACOG c. the woman's request should be honored - ✔✔A 25-year-old Vietnamese woman admitted to the birthing unit requests that her husband stay in the waiting area until after she gives birth. The appropriate response is based on the nurse's knowledge that: a. all husbands should be present during labor and birth b. the husband may fear his response to his wife giving birth c. the woman's request should be honored c. the 1st month after birth being considered a time for confinement and rest - ✔✔Wang Din Wah, a Laotian mother who is 24 hours postpartum, rejects the nurse's instruction to bring the newborn back by the 7th day of life for PKU test. Wang's reasons for this refusal are most likely based on
a. Barbados b. Haiti c. West Indies b. American Indian/Alaskan native - ✔✔A major cultural group of childbearing women at increased risk for alcoholism, heart disease, cirrhosis of the liver, and diabetes mellitus is the population of woman who are: a. African American/black b. American Indian/Alaskan native c. Asian American/Pacific Islander b. hot - ✔✔According to the hot/cold theory, pregnancy is thought to be which kind of a condition? a. cold b. hot c. lukewarm c. values and practices of one's own culture are superior - ✔✔Ethnocentrism is the belief that: a. cultural values are major determiners of one's behavior b. every cultural group has a core center of common beliefs c. values and practices of one's own culture are superior a. Korean - ✔✔A woman whose discharge plan includes her mother-in-law caring for her and her newborn during the postpartum period by tradition is most likely from which of the following cultures? a. Korean
b. Laotian c. Tongan c. self-generated - ✔✔Goals each nurse can set to increase cultural competence while caring for culturally diverse childbearing women and their families are described as: a. culturally driven b. externally based c. self-generated b. 30-50% - ✔✔By 28-34 weeks' gestation in a normal pregnancy, blood volume has increased by: a. 10-20% b. 30-50% c. 60-80% a. lateral - ✔✔During pregnancy, the position for optimum maternal cardiac output is: a. lateral b. semi-Fowler's c. supine a. hypotension - ✔✔An IV fluid bolus is given before epidural anesthesia to prevent: a. hypotension b. renal hypoperfusion c. sympathetic blockade
a. decrease - ✔✔During pregnancy, serum urea and creatine levels a. decrease b. increase c. remain constant c. relaxation of the lower esophageal sphincter - ✔✔Heartburn is common during pregnancy due primarily to: a. decreased gastric motility b. increased secretion of hydrochloric acid c. relaxation of the lower esophageal sphincter b. dependent edema - ✔✔A physical finding that may occur during pregnancy in response to normal cardiovascular changes is: a. decreased heart rate b. dependent edema c. elevated blood pressure b. 500 mL - ✔✔The average blood loss during vaginal birth is less than: a. 300 mL b. 500 mL c. 700 mL c. 1,000 mL - ✔✔The average blood loss during a cesarean birth is less than:
a. 600 mL b. 800 mL c. 1,000 mL b. 30-50% - ✔✔During pregnancy, cardiac output increases approximately: a. 10-25% b. 30-50% c. 60-75% b. immediately after birth - ✔✔Cardiac output is greatest during which period of the birth process? a. first stage, active phase b. immediately after birth c. second stage c. systemic vascular resistance - ✔✔A cardiovascular parameter which normally decreases during pregnancy is? a. heart rate b. stroke volume c. systemic vascular resistance c. 20,000-22,000 - ✔✔An expected WBC count during labor and the early postpartum is: a. 8,000-10,
a. oxygen consumption increases - ✔✔Which of the following is a change occurring in the respiratory system during pregnancy? a. oxygen consumption increases b. respiratory rate decreases c. tidal volume decreases a. glycosuria - ✔✔A normal finding during pregnancy is a. glycosuria b. hematuria c. proteinuria a. functional residual capacity - ✔✔The respiratory system parameter that decreases during pregnancy is the: a. functional residual capacity b. minute ventilation c. vital capacity b. insulin sensitivity - ✔✔A metabolic change characteristic of late pregnancy is decreased: a. blood free fatty acid levels b. insulin sensitivity c. serum glucose levels after meals b. hemodilution - ✔✔The greater increase in plasma volume than in red blood cell volume results in
a. hemoconcentration b. hemodilution c. hemostasis a. anabolism; catabolism - ✔✔Metabolic changes are characterized by ________ during the first half of pregnancy and __________ during the second half: a. anabolism; catabolism b. metabolism; anabolism c. metabolism; catabolism c. mother - ✔✔Maternal weight gain during the first half of the pregnancy is primarily due to changes in the weight of the: a. father b. infant c. mother c. increase - ✔✔Both maternal metabolic rate and thyroid hormone levels _______ during pregnancy. a. decrease b. stay the same c. increase c. 30 lb - ✔✔An appropriate recommendation for weight gain for an underweight pregnant woman would be:
c. 10 c. 5 g/L - ✔✔A diagnosis of severe preeclampsia is consistent with a 24-hour urine showing protein excretion of: a. 1 g/L b. 3 g/L c. 5 g/L a. deep tendon reflexes - ✔✔An indication of impending magnesium sulfate toxicity in the patient being treated for preeclampsia is the absence of: a. deep tendon reflexes b. fetal movement c. urine output b. 5-8 mg/dL - ✔✔The therapeutic range of serum magnesium during magnesium sulfate therapy to prevent eclamptic seizures is: a. 1-4 mg/dL b. 5-8 mg/dL c. 9-12 mg/dL b. ensure a patent airway - ✔✔The first priority in the care of a patient during an eclamptic seizure is to: a. administer an anticonvulsant agent b. ensure a patent airway c. establish IV access
c. proteinuria - ✔✔Diagnosis of preeclampsia requires the presence of hypertension and a. edema b. headaches c. proteinuria b. serial diastolic BP of at least 110 mm Hg - ✔✔Severe preeclampsia can be diagnosed in the presence of: a. excretion of 4,500 g protein in a 24-hour urine collection b. serial diastolic BP of at least 110 mm Hg c. serum blood urea nitrogen of 10 mg/dL with a serum creatine of 1 mg/dL b. increta - ✔✔Invasion of the trophoblastic cells into the uterine myometrium is termed placenta
a. accreta b. increta c. percreta b. increased rate of cesarean birth - ✔✔The incidence of placenta previa is increasing likely due to: a. better diagnostic tools such as transvaginal ultrasound b. increased rate of cesarean birth c. more women delaying childbirth until they are older b. placenta previa - ✔✔Painless, bright red vaginal bleeding at 28 weeks' gestation is most likely due to:
a. prior uterine scar b. suprapubic pressure c. traction applied to the cord c. the uterus is well contracted but frank bleeding continues - ✔✔Cervical lacerations after birth should be suspected if: a. estimated blood loss exceeds 500 mL b. the mother reports severe cramping pain c. the uterus is well contracted but frank bleeding continues a. velamentous insertion - ✔✔Vasa previa is a result of a ____________ of the cord: a. velamentous insertion b. stricture c. central insertion c. hypotension - ✔✔______________________ is a late sign of hypovolemia in the woman experience bleeding during pregnancy: a. shortness of breath b. elevated pulse c. hypotension a. headache - ✔✔Which of the following is not a common symptom of preterm labor? a. headache
b. menstrual-like cramps c. pelvic pressure c. history of preterm birth - ✔✔Once of the three most common risk factors predictive of preterm birth is: a. low pregnancy weight b. smoking during pregnancy c. history of preterm birth a. maternal transport to a high-4risk center has improved outcome over neonatal transport to a special care nursery - ✔✔When considering nursing care of the woman in preterm labor, which of the following is true? a. maternal transport to a high-4risk center has improved outcome over neonatal transport to a special care nursery b. the effect of antenatal glucocortoid treatment is immediate c. tocolycsis has great effective ness in delaying preterm birth by 7 days a. Procardia - ✔✔A drug that is used for tocolysis but is not classified as a beta-mimetic is: a. Procardia b. ritodrine c. terbutaline a. born at gestational age <37 - ✔✔To accurately be considered preterm, an infant must be: a. born at gestational age < b. <10th percentile in weight
