Preview Extract
Chapter 13
1) The nurse is giving a community presentation about adolescent pregnancy. Which
presentation statement most accurately reflects a challenge of pregnancy associated with
early adolescence?
1. “Pregnancy is less likely to be related to an intimate relationship.”
2. “Girls in this stage have developed value systems that are separate and distinct from those
of their parents.”
3. “Most often, when a girl in early adolescence enters the healthcare system, she will be
accompanied by the father of the baby.”
4. "Self-consciousness about body changes related to pregnancy usually isn't an issue for
early adolescents."
Answer: 1
Rationale 1:
For early adolescents, pregnancy is probably not the result of an intimate relationship.
Rationale 2:
The early adolescent's value system still closely reflects that of parents, so she turns to her
parents for a decision or approval of a decision.
Rationale 3:
During early adolescence, a pregnant girl generally enters the healthcare system with an
adult, most likely her mother; parents are still seen as locus of control.
Rationale 4:
Along with self-consciousness about normal physiologic changes, for early adolescents, selfconsciousness and low self-esteem are likely to intensify with rapid breast enlargement and
abdominal enlargement of pregnancy.
2) The school sexual health clinic nurse has female adolescent students waiting to be seen.
Which student should be seen first?
1. 14-year-old whose 17-year-old sister is pregnant
2. 15-year-old who reports using condoms regularly
3. 16-year-old who had Chlamydia treated two weeks ago
4. 17-year-old with a history of child abuse
Answer: 3
Rationale 1:
Although this student is at risk for becoming pregnant because her sister is experiencing an
adolescent pregnancy, it is not known whether this patient is sexually active. This student is
not the top priority.
Rationale 2:
Condom use will decrease the risk of becoming pregnant. This patient is a low priority.
Rationale 3:
This patient is the top priority. Having had Chlamydia, a sexually transmitted infection,
indicates that the patient is sexually active and not using a barrier method of birth control.
This patient is at risk for pregnancy and another STI.
Rationale 4:
Although adolescents with a history of abuse are more likely to become pregnant than are
their peers who have not experienced abuse, too little information is given about this patient
to determine risk for pregnancy. This patient is not the top priority.
3) While developing a conference for adolescents, the nurse prepares a handout describing
socioeconomic and cultural factors that contribute to adolescent pregnancy. Which
information should the nurse include in the handout?
1. All cultures share an aversion to early pregnancy.
2. The younger the teen when she first gets pregnant, the less likely she is to have another
pregnancy in her teens.
3. Poverty is a major risk factor for teen pregnancy.
4. A child born to a teenage mother is at a lower risk for teen pregnancy.
Answer: 3
Rationale 1:
Early pregnancy is desirable in some cultures, such as where Islam is the predominant
religion, where large families are desired, where social change is slow in coming, and where
most childbearing occurs within marriage.
Rationale 2:
The younger the teen when she first gets pregnant, the more likely she is to have another
pregnancy in her teens.
Rationale 3:
Poverty is a major risk factor for teen pregnancy, as 85% of births to unmarried teens occur
among those adolescents from poor to low-income families.
Rationale 4:
Daughters and sisters of a woman who had a baby in her early teens tend to have intercourse
earlier and are at higher risk for teen pregnancy themselves.
4) The nurse is working with a group of pregnant teens. Which statement indicates that
teaching has been successful?
1. “Pregnant teens are more likely to quit school prior to graduation.”
2. “Because I am young, I have a low risk for pre-eclampsia.”
3. “My baby could come late because I am a teenager.”
4. “I am more likely to use birth control after I have this baby.”
Answer: 1
Rationale 1:
Patients who give birth the first time as adolescents are more likely to have lower educational
levels, including a higher rate of dropping out of high school and not attending college or
vocational training.
Rationale 2:
Pre-eclampsia is more likely to occur in teen mothers than in mothers older than age 19.
Rationale 3:
Postdates are not a risk for adolescent pregnancy; preterm birth and small-for-gestational-age
infants are risks for pregnant teens.
Rationale 4:
Patients who give birth the first time as adolescents are more likely to have their next child
during adolescence as well. Birth control use is not higher among teen parents.
5) A 20-weeks’-gestation adolescent patient states that it is important not to have a baby that
weighs too much. She states this has been her rationale for limiting calories. Her weight has
decreased from 110 pounds to 106 pounds. What would be the best nursing response?
1. “You are causing harm to your baby.”
2. “It’s okay to want a small baby when you’re a teen.”
3. “You shouldn’t be worrying about your figure.”
4. “Your baby needs adequate nutrition to develop.”
Answer: 4
Rationale 1:
The first role of the nurse is to explain why food is important to the growing fetus, specifying
how each food group will help the fetus develop. Next, the nurse must assist the pregnant
adolescent to plan foods that she likes to eat from each food group.
Rationale 2:
Anticipatory guidance in the body changes of pregnancy will assist the adolescent’s
adjustment to them. Although many teens are anxious, this teen is expressing a direct
nutritional deficit.
Rationale 3:
Pregnant adolescents are just adapting to a new body image created by the changes of puberty
when the pregnancy produces rapid and substantial body changes. The desire to maintain a
socially desirable figure can lead to nutritional deficits.
Rationale 4:
Teens might not understand the physiology behind the profound body changes of pregnancy.
6) Which of the following statements, if made by the pregnant adolescent, indicates that she
understands her increased risk of physiologic complications during pregnancy?
1. “It’s no big deal that I started prenatal care in my seventh month.”
2. “My anemia and eating mostly fast food are not important.”
3. “I need to take good care of myself so my baby doesn’t come early.”
4. “Smoking and using crack cocaine won’t harm my baby.”
Answer: 3
Rationale 1:
Early and regular prenatal care is the best intervention to prevent complications or to detect
them early, to minimize the harm to both the teen and her fetus.
Rationale 2:
Pregnant adolescents are at great risk for complications such as anemia.
Rationale 3:
Early and regular prenatal care is the best intervention to prevent complications or to detect
them early, to minimize the harm to both the teen and her fetus.
Rationale 4:
Pregnant adolescents are at great risk for complications such as pregnancy-induced
hypertension, anemia, preterm birth, low-birth-weight infants, fetal harm from cigarette
smoking, alcohol consumption, or the use of street drugs.
7) The nurse is working with male teens whose partners are pregnant. What situation requires
that the nurse intervene? The father-to-be states that:
1. He is the only other person who will be present, although his girlfriend wants her mother to
be with her during the birth.
2. He is not convinced that he is the father of the baby and doesn’t want his name on the birth
certificate.
3. The pregnancy doesn’t seem real to him, and he’s not sure what he should do to plan for
the future.
4. Because his father was not involved in his life, he wants to be actively involved in the life
of his child.
Answer: 1
Rationale 1:
It is common for pregnant adolescents to want their mothers to accompany them for the labor
and birth. Overriding his girlfriend’s expressed desire could be an indication that their
relationship is abusive. Because studies indicate 16–37% of pregnant teens experience abuse
from their partners, this statement requires follow-up by the nurse to assess for abuse.
Rationale 2:
Many young fathers are not sure if they are the father of the baby and do not want to be listed
on the birth certificate if they are not sure. Often these young men will request paternity
testing to either verify or discount their parentage.
Rationale 3:
An early pregnancy is often an abstract concept to fathers. It is normal for a teen to be unsure
about the future.
Rationale 4:
This might be the case when a young father was raised without his own father, or a lack of
involvement with the child might be seen as the norm and desired.
8) The nurse seeks to involve the adolescent father in the prenatal care of his girlfriend. The
rationale for this nursing strategy includes:
1. Increasing the self-care behaviors of the pregnant teen.
2. Avoiding conflict between the adolescent father and pregnant teen.
3. Improving the long-term outcome of the relationship.
4. Avoiding legal action by the adolescent father’s family.
Answer: 1
Rationale 1:
Involving the partner of a pregnant adolescent helps the mother-to-be feel more confident in
her decision making and improves her self-confidence and self-esteem, which in turn will
improve positive self-care behaviors.
Rationale 2:
If the patient desires the participation of her partner, the nurse should provide education and
support appropriate to the age, knowledge, and developmental level of the adolescent father.
Rationale 3:
Involving the patient’s partner in prenatal care will not decrease the likelihood that this
relationship will be short-term.
Rationale 4:
The nurse first must explore what the relationship is between the pregnant teen and the father.
Relationships between adolescents tend to be short-lived, and pregnancy is an added stressor
for the couple.
9) Which statement by a parent of a pregnant, unmarried 15-year-old is expected?
1. “We’re very happy for her. It will be easier to focus on education with a new baby.”
2. “I’m not going to get involved. She understands how her health insurance works.”
3. “Her father told her to stop dating that boy. Now look at the trouble she’s gotten into.”
4. “An abortion is the best choice for her. She can deal with our Catholic priest later.”
Answer: 3
Rationale 1:
Most parents accept the pregnancy but are not excited when their 15-year-old is pregnant.
And education is harder when child care is involved. Teens that give birth are less likely to
complete their education.
Rationale 2:
The parent of a pregnant teen is usually the support person and helps the teen understand how
to access prenatal care. It is unlikely that a 15-year-old would understand health insurance.
Rationale 3:
This statement indicates anger and dismay, which are expected when a parent finds out about
a teen daughter’s pregnancy.
Rationale 4:
This statement indicates that the parent is not going to discuss the pregnancy with the teen but
might be forcing the teen into abortion. Because religious tradition impacts views on
abortion, and Catholicism disapproves of abortion, the teen might not accept abortion as an
option.
10) Which of the following statements from the mother of a pregnant 13-year-old would be
an expected response?
1. “We had such high hopes for you.”
2. “But she was always an easygoing child.”
3. “I told you that boy was up to no good.”
4. “This is just one of those things that happen.”
Answer: 1
Rationale 1:
When an adolescent pregnancy is first revealed to the teen’s mother, the result is often anger,
shame, or disappointment. The degree of negative response will be determined by the age of
the teen, the family expectations for the teen, and the presence or absence of other teen
pregnancies in the family or support network. In early adolescents, the teen’s mother
frequently accompanies her daughter to prenatal examinations. The role of the nurse is to
facilitate communication between mother and daughter and provide education for both.
Rationale 2:
When an adolescent pregnancy is first revealed to the teen’s mother, the result is often anger,
shame, or disappointment.
Rationale 3:
When an adolescent pregnancy is first revealed to the teen’s mother, the result is often anger,
shame, or disappointment.
Rationale 4:
When an adolescent pregnancy is first revealed to the teen’s mother, the result is often anger,
shame, or disappointment.
11) Which approach to planning educational activities is best suited to a group of pregnant
adolescents?
1. Primarily using audio-based presentations during teaching
2. Avoiding the inclusion of handouts with bulleted items and white space as part of the
teaching
3. Combining teaching for adolescent mothers of all ages as one group
4. Respecting confidentiality and building trust by avoiding the topics of drug and alcohol
abuse
Answer: 1
Rationale 1:
Many teens prefer teaching aids that are visual and that they can handle, such as realistic fetal
models.
Rationale 2:
Some pregnant teens have low reading levels and tend to prefer handouts and posters that
have visual interest, short sentences, bulleted items, and white space.
Rationale 3:
Teaching adolescents in groups according to their ages may be more effective for learning
because younger adolescent mothers' parenting skills and emotional needs may differ from
those of older adolescent mothers.
Rationale 4:
The nurse should review the risks associated with the use of tobacco, caffeine, drugs, and
alcohol, as well as discussing the fetal effects of these substances.
12) The nurse is working in a teen pregnancy clinic. In order to give the pregnant adolescent
a role in her prenatal care, the nurse should allow the teen to:
1. Choose the type of prenatal vitamin she takes.
2. Measure and record her weight at each visit.
3. Choose the schedule of her prenatal visits.
4. Decide if she wants her labor to be induced.
Answer: 2
Rationale 1:
Prenatal vitamins are prescribed by the certified nurse–midwife or the physician. Many
formulations exist, and some might not be indicated for this patient due to her nutritional
practices and lab results. In addition, if the patient is a member of a health maintenance
organization, only certain medications (including prenatal vitamins) are accepted for
coverage.
Rationale 2:
Having the patient weigh herself and record her weight provides her with information that
indicates she is growing a healthy fetus.
Rationale 3:
Prenatal visit schedules are set to detect developing complications of pregnancy.
Rationale 4:
Induction of labor is a medical decision and should not be taken lightly.
13) A 16-year-old is making her first prenatal visit to the clinic in her fourth month of
pregnancy. The nurse’s first responsibility would be to:
1. Contact the social worker.
2. Develop a trusting relationship.
3. Schedule the patient for prenatal classes.
4. Teach the patient about proper nutrition.
Answer: 2
Rationale 1:
A social worker might be able to provide assistance with financial program eligibility,
support groups, or obtaining baby items such as furniture and car seats.
Rationale 2:
The most important goal for the nurse caring for a pregnant adolescent is to be open-minded
and nonjudgmental in order to foster trust between the adolescent and the nurse. Through a
trusting relationship, the nurse can provide counseling and education to the mother-to-be,
both about her body and the fetus.
Rationale 3:
Prenatal classes specifically designed for teen moms and attended by only teen moms
facilitate both learning and support for the teens.
Rationale 4:
Although nutrition is an important physiologic need, without a trusting relationship, little
teaching will occur because the teen will often “tune out” adults that she does not trust.
14) The nurse has been asked by a community organization to give a presentation on
prevention of teen pregnancy. Which statement indicates appropriate steps toward reduction
of the local teen pregnancy rate?
1. Abstinence-only education will be offered in the school and clinics.
2. Classes on how to parent will be mandatory in high school.
3. Plans are made to create a low-cost reproductive health clinic.
4. Parents will be encouraged to avoid discussing sexual activity.
Answer: 3
Rationale 1:
Abstinence first with information on contraception is most effective in reducing teen
pregnancy rates.
Rationale 2:
Parenting classes for teens who are neither pregnant nor parents do not address reducing teen
pregnancy.
Rationale 3:
Confidential, low cost contraceptive education and services are most likely to increase
contraceptive use by teens that are sexually active and therefore decrease teen pregnancy
rates.
Rationale 4:
Parents are the biggest influence on teens’ decisions to begin or avoid sexual activity. Parents
should be encouraged to talk openly and frankly with their teens about their views on sex,
contraception, and abstinence.
15) The nurse is planning a community adolescent pregnancy prevention program aimed
toward parents. Which of the following recommendations should be included in the program
include in order to be effective?
1. Instead of bringing up the topic of sex, parents should allow their children to reach a point
where the child initiates the discussion.
2. Parents should encourage steady dating.
3. Rather than embarrassing an adolescent by addressing specific topics related to sex,
parents should speak in broad, general terms.
4. Parents should not allow their son to develop an intense relationship with a girl who is
much younger.
Answer: 4
Rationale 1:
Parents need to talk with their children about sex early and often and be specific in the
discussions.
Rationale 2:
Parents need to clearly discourage early dating as well as frequent and steady dating.
Rationale 3:
Parents should be specific in their discussions about sex.
Rationale 4:
Parents should take a strong stand against allowing a daughter to date a much older boy; nor
should they allow a son to develop an intense relationship with a much younger girl.
Test Bank for Contemporary Maternal-Newborn Nursing
Patricia W Ladewig, Marcia L London, Michele Davidson
9780133429862, 9780134257020
