Chapter 27 Maternal and Child Health Nursing 7th Edition

Chapter 27  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse is caring for an infant born with a myelomeningocele. Which should the nurse assess in this patient?
A)
Vision
B)
Level of pain
C)
Voiding pattern
D)
Tonic neck reflex
Ans:
C

Feedback:

: A myelomeningocele is the defect that is equated with “spina bifida” and is the most common birth defect affecting the central nervous system. In a meningomyelocele, the meninges protrude through the vertebrae and the spinal cord usually ends at the point of protrusion. Motor and sensory function will be decreased or absent beyond this point. The child will have loss of bowel and bladder control and urine, and stools will continually dribble because of lack of sphincter control. This defect is not known to affect vision. Assessing for pain is not a priority with this defect. This defect does not affect the neck region of the spinal cord.

2.
A newborn with esophageal atresia has just returned from surgery to place a gastrostomy tube. Which nursing diagnosis will the nurse use to plan the care for this patient?
A)
Risk for imbalanced nutrition
B)
Risk for deficient fluid volume
C)
Risk for impaired skin integrity
D)
Risk for ineffective gas exchange
Ans:
C

Feedback:

: The patient is at risk for impaired skin integrity related to gastrostomy tube insertion site. Acidic gastric secretions can leak onto the skin from the gastrostomy site, leading to skin irritation. The nurse should plan interventions to protect the skin by using a cream or commercial skin protection system or consult with a wound, ostomy, and continence therapy nurse to reduce the possibility of skin irritation and infection. With the placement of the gastrostomy tube, the patient is at less risk for imbalanced nutrition and deficient fluid volume. The gastrostomy tube will not affect the patient’s gas exchange.

3.
The nurse manager at a family clinic is identifying ways to address the 2020 National Health Goals for the prevention of birth defects. Which action should the manager encourage all staff to perform when caring for pregnant patients?
A)
Avoid extreme physical activity and exercise.
B)
Monitor daily intake of calcium and dairy products.
C)
Stress the importance of taking prenatal folic acid as prescribed.
D)
Ensure adequate hydration by drinking eight glasses of water each day.
Ans:
C

Feedback:

: Nurses can help the nation achieve the 2020 National Health Goals by urging patients to enter pregnancy with an adequate folic acid level. Extreme physical activity, exercise, calcium, and water are not identified interventions to prevent birth defects in the developing fetus.

4.
The nurse is evaluating the outcome of teaching for a baby born with torticollis. Which observation indicates that teaching has been successful?
A)
The child looks in the direction of the affected muscle.
B)
The child’s shoulder of the affected muscle is elevated.
C)
The child looks in the direction opposite of the affected muscle.
D)
The child rolls onto the side to look from the direction opposite of the affected muscle.
Ans:
A

Feedback:

: To relieve torticollis, parents need to begin a program of passive stretching exercises, laying the infant on a flat surface and rotating the head through a full range of motion. Parents should always encourage the infant to look in the direction of the affected muscle. They can encourage this by holding the child to feed in such a position the child must look in the desired direction. If manual stretching is begun early and performed consistently by parents, further treatment usually is not necessary. If extreme injury to the muscle occurred, torticollis can lead to the continued elevation of one shoulder. Any observations where the child is looking in the direction opposite of the affected muscle indicates that teaching has not been successful.

5.
A newborn is diagnosed with a meconium plug. Which interventions should the nurse prepare to provide to help resolve this health problem? (Select all that apply.)
A)
Administration of a barium enema
B)
Administration of a gastrografin enema
C)
Administration of 5 ml of saline enema
D)
Administration of 10 ml of tap water enema
E)
Rectal instillation of acetylcysteine (Mucomyst)
Ans:
A, B, C, E

Feedback:

: Treatment for a meconium plug includes the administration of 5 ml saline enema, rectal instillation of acetylcysteine (Mucomyst), a gastrografin enema, and a barium enema used to diagnose the disorder. A tap water enema should never be used in newborns because it can cause water intoxication.