Chapter 1

Question 1

1.	Which medical risk factor contributes to a higher infant mortality rate?
a.
Diabetes mellitus
b.
Mitral valve prolapse (MVP)
c.
Chronic hypertension
d.
Anemia

Answer 1

C

Question 2

2. Which woman would be most at risk for the poorest perinatal outcome?
   a.
   A 25-year-old single mother on maternity leave with two existing children
   b.
   An unemployed 32-year-old lawyer in an inner city neighbourhood
   c.
   An Inuit woman in her mid-20s with no high school education
   d.
   A 19-year-old college student who lives at home with her parents

Answer 2

C

Question 3

3. Which is the main characteristic of the evolved role of the professional perinatal nurse?
   a.
   Providing care to patients directly at the bedside
   b.
   Planning patient care to cover longer hospital stays
   c.
   Leading the activities of a team of interdisciplinary health care providers
   d.
   Managing care to cure health problems once they have occurred

Answer 3

C

Question 4

Ms. Kiyawasew, a 23-year-old First Nations woman, is pregnant with her first child. Based on the statistics for infant mortality, which intervention is most important for the nurse to implement?
a.
Perform a nutrition assessment.
b.
Refer the woman to a social worker.
c.
Advise the woman to see an obstetrician, not a midwife.
d.
Explain to the woman the importance of keeping her prenatal care appointments.

Answer 4

D

Question 5

The nurse knows that teaching to promote healthy living has been effective when the patient makes which comment?
a.
“I’ll do whatever you say; you’re the nurse.”
b.
“I don’t think I can quit smoking.”
c.
“I exercise for 30 minutes, 3 days a week.”
d.
“What do you think I should do?”

Answer 5

C

Question 6

When managing health care for pregnant women at a prenatal clinic, which barrier to access prenatal care is considered most significant?
a.
Age
b.
Minority status
c.
Educational level
d.
Geographic location

Answer 6

D

Question 7

7.	What is the primary role of practicing nurses in the research process?
a.
Designing research studies
b.
Collecting data for other researchers
c.
Identifying areas for further research
d.
Seeking funding to support research studies

Answer 7

C

Question 8

Which event shifted the focus of the Public Health Agency of Canada (PHAC) away from a population health and health promotion focus?
a.
Shift to home births
b.
Emergence of avian influenza
c.
United Nations Millennium Goals
d.
Increase in the maternal mortality rate

Answer 8

B

Question 9

From the nurse’s perspective, what measure should be the focus of the health care system to further reduce the rate of infant mortality?
a.
Implementing programs that focus on health promotion and preventive care
b.
Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days
c.
Expanding the number of neonatal intensive care units (NICUs)
d.
Mandating that all pregnant women receive care from an obstetrician

Answer 9

A

Question 10

10. Which is a characteristic of integrative healing?
    a.
    It replaces conventional Western modalities of treatment.
    b.
    It is used by only a small number of Canadian adults.
    c.
    It recognizes the value of patients’ input into their health care.
    d.
    It focuses primarily on the disease an individual is experiencing.

Answer 10

C

Question 11

11.	A 38-year-old Métis woman delivered a 4250 g baby girl vaginally after being in labour for 43 hours. The baby died 3 days later from sepsis. On what grounds would the woman potentially have a legitimate legal case for negligence?
a.
She is Métis.
b.
She delivered a girl.
c.
She refused fetal monitoring.
d.
The standards of care were not met.

Answer 11

D

Question 12

12. Which of the following have contributed to escalating maternity-related health care costs?
    a.
    Early postpartum discharges
    b.
    Explosion in perinatal care technology
    c.
    The reduction in acceptable genetic screening options
    d.
    Rural health services delivered via telemedicine networks

Answer 12

B

Question 13

13.	What is the term used to describe legal and professional responsibility for maintaining standards of practice?
a.
Collegiality
b.
Ethics
c.
Evaluation
d.
Accountability

Answer 13

D

Question 14

14. Which reflects a future goal for perinatal nursing?
    a.
    Limiting multiprofessional teams
    b.
    Maintaining existing power structures
    c.
    Advocating for an increased number of Cesarean sections
    d.
    Addressing health inequities by creating healthy public policies

Answer 14

D

Question 15

15. Which statement is true related to integrative healing?
    a.
    Its aim is to provide the same health care for all racial and ethnic groups.
    b.
    It blends complementary and alternative therapies with conventional Western treatment.
    c.
    It focuses on the disease or condition rather than the background of the patient.
    d.
    It has been mandated by Health Canada.

Answer 15

B

Question 16

16. Which recent trend in childbirth practices in Canada is accurate?
    a.
    More than 15% of mothers had late or no prenatal care.
    b.
    The percentage of Aboriginal and White women who received prenatal care was essentially the same.
    c.
    Ninety-eight percent of births occurred in the hospital.
    d.
    Less than 50% of pregnant women take folic acid supplements.

Answer 16

C

Question 17

17. Which trend has a positive impact on the infant mortality rate?
    a.
    Delayed second-stage pushing is now discouraged in labour.
    b.
    Episiotomy rates are increasing.
    c.
    Midwives perform more episiotomies than physicians.
    d.
    Newborn infants remain with the mother and are encouraged to breastfeed.

Answer 17

D

Question 18

18. Which of the following best describes a doula?
    a.
    Advanced practice labour and delivery nurse
    b.
    A trained and experienced female labour attendant
    c.
    Clinical nurse specialist in neonatal and postpartum care
    d.
    Leader of a multidisciplinary, intrapartum health care team

Answer 18

B

Question 19

19. Which is the correct definition of the perinatal mortality rate?
    a.
    Number of live births in one year per 1000 population
    b.
    Number of deaths of infants under one year of age per 1000 live births
    c.
    Number of deaths of infants under 28 days of age per 1000 live births
    d.
    Number of stillbirths and neonatal deaths per 1000 live births

Answer 19

D

Question 20

20.	Which statement is true of maternity nursing care that is based on knowledge gained through various forms of research?
a.
An outgrowth of telemedicine
b.
Known as evidence-informed practice
c.
Exclusive to maternity nursing practice
d.
At odds with the Cochrane Pregnancy and Childbirth Database

Answer 20

B

Question 21

21.	Which of the following is a principle of the Canada Health Act?
a.
Justice
b.
Universality
c.
Health and well-being
d.
Informed decision making

Answer 21

B

Question 22

22. During an initial prenatal interview, the patient informs the nurse that she would prefer a midwife to both provide her care during pregnancy and deliver her infant. What information would be most appropriate for the nurse to share with this patient?
    a.
    Midwifery care is not a choice for women in Canada.
    b.
    Usually two midwives attend the birth and share perinatal care.
    c.
    She should be aware of poor outcomes associated with midwifery care.
    d.
    Her delivery can take place only at home or in a birth centre.

Answer 22

B

Question 23

23. While obtaining a detailed history from a woman who has recently emigrated from Somalia, the nurse realizes that the patient has undergone female genital mutilation (FGM). Which is the nurse’s best response?
    a.
    “This is a very abnormal practice and rarely seen in Canada.”
    b.
    “Do you know who performed this so that it can be reported to the authorities?”
    c.
    “We will be able to fully restore your circumcision after delivery.”
    d.
    “The extent of your circumcision will affect the potential for complications.”

Answer 23

D

Question 24

24.	According to the Canadian Maternity Experiences Survey, what was the most frequent pain medication used during labour and delivery?
a.
Nitrous oxide
b.
Demerol (meperidine)
c.
Epidural anaesthesia
d.
Local infiltration anaesthesia

Answer 24

C

Question 25

25. Which of the following is a strategic direction for nursing and midwifery services as identified by the World Health Organization?
    a.
    Culturally appropriate prenatal care
    b.
    Health and human resource planning
    c.
    Consent and allocation of scarce resources
    d.
    Collaborating with stakeholders in an ongoing dialogue

Answer 25

B