Deck 24: The Childbearing Family with Special Needs

Question 1

In planning sex education classes for the 12- to 15-year-old age group, more emphasis should be placed on which?

A) How to set limits for sexual behavior
B) The inaccuracy of information from peers
C) The use of oral contraceptives to prevent unwanted pregnancy
D) The use of condoms to prevent sexually transmitted diseases as well as pregnancy

Answer 1

How to set limits for sexual behavior

Question 2

Which complication of adolescent pregnancy should the nurse plan to monitor?

A) Anemia
B) Placenta previa
C) Abruptio placenta
D) Incompetent cervix

Answer 2

Anemia

Question 3

Which antidepressant is no longer recommended for use during pregnancy?

A) Sertraline (Zoloft)
B) Paroxetine (Paxil)
C) Fluoxetine (Prozac)
D) Citalopram (Celexa)

Answer 3

Paroxetine (Paxil)

Question 4

A pregnant client who abuses cocaine admits to exchanging sex for her drug habit. This behavior puts her at a greater risk for:

A) postmature birth.
B) Sexually transmitted diseases.
C) Hypotension and vasodilation.
D) Depression of the central nervous system.

Question 5

Which statement correctly describes the incidence of intimate partner violence (IPV) in the United States?

A) Intimate partner violence seldom occurs during pregnancy.
B) Each year about 42.4 million women experience intimate partner violence.
C) The largest number of intimate partner violence is in the lower socioeconomic classes.
D) Intimate partner violence is second only to automobile accidents as the most frequent cause of injury to women.

Question 6

When the nurse is alone with a battered client, the client seems extremely anxious and says, "It was all my fault. The house was so messy when he got home and I know he hates that." Which is the best response by the nurse?

A) "No one deserves to be hurt. It's not your fault. How can I help you?"
B) "What else do you do that makes him angry enough to hurt you?"
C) "He will never find out what we talk about. Don't worry. We're here to help you."
D) "You have to remember that he is frustrated and angry, so he takes it out on you."

Question 7

A client who is older than 35 years may have difficulty achieving pregnancy because:

A) prepregnancy medical attention is lacking.
B) personal risk behaviors influence fertility.
C) she has used contraceptives for an extended time.
D) her ovaries may be affected by the aging process.

Question 8

Which is an example of healthy grieving?

A) The mother exhibits an absence of crying or expression of feelings.
B) The parents do not mention the baby in conversation with family members.
C) The mother asks that the baby be taken away from the delivery area quickly.
D) While holding the baby, the mother says to her husband, "He has your eyes and nose."

Question 9

A client who is 6 months pregnant has sought medical attention, saying she fell down the stairs. Which scenario would cause an emergency department nurse to suspect that the woman has been battered?

A) She avoids making eye contact and is hesitant to answer questions.
B) The woman and her partner are having an argument that is loud and hostile.
C) The woman has injuries on various parts of her body that are in different stages of healing.
D) Examination reveals a fractured arm and fresh bruises. Her husband asks her about her pain.

Question 10

A pregnant client tells you during a clinic visit that she is concerned about her significant other's change in behavior during the course of the pregnancy. She relates feelings of being afraid but emphatically denies any physical or verbal threats. She confides in you that she has been using her mobile phone to find out more information about this subject. What is the most appropriate nursing response?

A) Tell her that all relationships change during pregnancy and give herself and her significant other some time to adapt to this situation by spending quality time with one another.
B) Tell the client that you are concerned for her and the baby; provide her with a phone number for a safe house just in case she needs to act quickly and leave the home situation.
C) Explore in more detail the client's feelings but tell her that you are concerned about searching information on the Internet as a stimulus trigger for potential abuse.
D) Do not let the client leave the clinic office and call the domestic abuse hotline number to report the incident.

Question 11

Which is an appropriate nursing measure when a baby has an unexpected defect?

A) Remove the baby from the delivery area immediately.
B) Inform the parents immediately that something is wrong.
C) Tell the parents that the baby has to go to the nursery immediately.
D) Explain the defect and show the baby to the parents as soon as possible.

Question 12

Which is the most dangerous effect on the fetus of a client who smokes cigarettes while pregnant?

A) Intrauterine growth restriction
B) Genetic changes and anomalies
C) Extensive central nervous system damage
D) Fetal addiction to the substance inhaled

Question 13

A client at 24 weeks of gestation says she has a glass of wine with dinner every evening. Which is the reason the nurse should give to counsel her to eliminate all alcohol intake?

A) The fetus is placed at risk for altered brain growth.
B) The fetus is at risk for severe nervous system injury.
C) The client will be at risk for abusing other substances as well.
D) A daily consumption of alcohol indicates a risk for alcoholism.

Question 14

Which is a major barrier to health care for teen mothers?

A) Health care workers have a positive attitude.
B) The hospital or clinic is within walking distance of the girl's home.
C) Seeing a different nurse and/or health care provider at every visit.
D) The institution is open days, evenings, and Saturday by special arrangement.

Question 15

Women who become pregnant after the age of 35 are more likely to:

A) have multiple births because of increased fertility rates.
B) be hypotensive during the pregnancy.
C) have fewer obstetric complications due to stronger pelvic structure.
D) have a child who has a trisomy 21 abnormality.

Question 16

Which environment can assist a pregnant teen to achieve the task of establishing a stable identity?

A) Home schooling
B) Alternative education program
C) School-based mothers' program
D) Continuing mainstream high school classes

Question 17

Which should the nurse do when counseling a teenage client who has decided to relinquish her baby for adoption?

A) Question her about her feelings regarding adoption.
B) Tell her she can always change her mind about adoption.
C) Affirm her decision while acknowledging her maturity in making it.
D) Ask her if anyone is coercing her into the decision to relinquish her baby.

Question 18

A client has delivered twins. The first twin was stillborn, and the second is in the intensive care nursery, recovering quickly from respiratory distress. The client is crying softly and says, "I wish my baby could have lived." Which is the most therapeutic response?

A) "How soon do you plan to have another baby?"
B) "Don't be sad. At least you have one healthy baby."
C) "I have a friend who lost a twin and she's doing just fine now."
D) "I am so sorry about your loss. Would you like to talk about it?"

Question 19

What is most likely to be a concern for an older mother?

A) Nutrition and diet planning
B) Exercise and fitness
C) Having enough rest and sleep
D) Effective contraceptive methods

Question 20

During which phase of the cycle of violence does the batterer become contrite and remorseful?

A) Battering
B) Honeymoon
C) Tension-building
D) Increased drug taking

Question 21

Match each term with the correct definition.

Opiates

A)A powerful short-acting CNS stimulant
B)CNS depressants that produce a feeling of mental dullness, drowsiness, and finally stupor
C)Active constituent is tetrahydrocannabinol, which crosses the placenta and accumulates in the fetus

Question 22

Many teens wait until the second or even third trimester to seek prenatal care. The nurse should understand that the reasons behind this delay include which of the following? (Select all that apply.)

A) Continuing to deny the pregnancy
B) Uncertainty about where to go for care
C) Lack of realization that they are pregnant
D) A desire to gain control over their situation
E) Wanting to hide the pregnancy as long as possible

Question 23

Which nursing diagnoses may apply to the childbearing family with special needs? (Select all that apply.)

A) Risk for spiritual distress
B) Risk for injury
C) Readiness for enhanced nutrition
D) Ineffective breathing pattern
E) Situational low self-esteem

Question 24

Match each term with the correct definition.

Cocaine

A)A powerful short-acting CNS stimulant
B)CNS depressants that produce a feeling of mental dullness, drowsiness, and finally stupor
C)Active constituent is tetrahydrocannabinol, which crosses the placenta and accumulates in the fetus

Question 25

Match each term with the correct definition.

Marijuana

A)Bleeding between the periosteum and the skull
B)An area of localized edema that appears over the vertex of the newborn's head
C)Changes in the shape of the head that allow it to pass through the birth canal

Question 26

The nurse is seeing a 17-year-old female in the clinic for complaints of acne. The nurse plans on taking advantage of this teachable moment with the teen. What topics will the nurse include in the teen's teaching plan?

A) Smoking habits, folic acid intake, and heart disease
B) Hyperlipidemia, distracted driving, and menstrual history
C) Sexual activity, contraception, and screening for violence
D) Optimum weight, hypothyroidism, and sexually transmitted diseases

Question 27

A patient has just acknowledged that she is 20 weeks pregnant and confides to the nurse that she has a daily heroin habit. The nurse discusses treatment options for the patient. Which patient statement requires follow-up?

A) "My plan is to visit the outpatient clinic daily for treatment."
B) "I will see my health care provider at least every 2 weeks."
C) "My baby will not have to go through withdrawal when I take methadone."
D) "With oral methadone, my baby and I are at decreased risk of infection."

Question 28

Which characteristics of fetal alcohol syndrome (FAS) should the nurse expect to assess in affected neonates? (Select all that apply.)

A) Hydrocephaly
B) Low activity
C) Epicanthal folds
D) Short palpebral fissures
E) Flat midface, with a low nasal bridge

Question 29

Which congenital defects in a newborn are associated with long-term parenting problems? (Select all that apply.)

A) Polydactyl
B) Cleft lip and palate
C) Ventral septal defect
D) Ambiguous genitalia