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, Maternity and Women's Health Care 13th Edition Lowdermilk Test jn jn jn jn jn jn jn jn
Chapter 01: 21st Century Maternity and Women’s Health NursingL
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owdermilk: Maternity & Women’s Health Care, 13th Edition
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MULTIPLE CHOICE jn
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-
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weight (LBW)infant, which factor is the most important for the nurse to consider?
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a. African-American race jn
b. Cigarette smoking jn
c. Poor nutritional status jn jn
d. Limited maternal education jn jn
ANS: A j n
The rise in the overall LBW rates were due to increases in LBW births to non-
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Hispanic black women (13.35%) and Hispanic women (7.21%); non-
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Hispanic black infants are almost twice as likely as non- jn jn jn jn jn jn jn jn jn
Hispanic white infants to be of LBW and to die in the first year of life.. Race is a nonmodifiabl
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e risk factor. Cigarette smoking is an important factor inpotential infant mortality rates, but it i
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s not the most important. Additionally, smoking is a modifiable risk factor. Poor nutrition is a
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n important factor in potential infant mortality rates, but it is not the most important. Addition
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ally, nutritional status is a modifiable risk factor. Maternal education is an important factor in
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potential infant mortality rates, but it is not the most important. Additionally, maternal educat
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ion is a modifiable risk factor.
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PTS: 1 DIF:
Cognitive Level: UnderstandTOP: jn jn jn
Nursing Process: Assessment jn jn
MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN nTanBd.MCaO
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tenance, Antepartum Care jn jn jn jn
2. A 23-year-old African-
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American woman is pregnant with her first child. Based on currentstatistics for infant morta
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lity, which intervention is most important for the nurse to includein the client’s plan of care?
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a. Perform a nutrition assessment. jn jn jn
b. Refer the woman to a social worker. jn jn jn jn jn jn
c. Advise the woman to see an obstetrician, not a midwife. jn jn jn jn jn jn jn jn jn
d. Explain to the woman the importance of keeping her prenatal care appointments.
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ANS: D j n
Consistent prenatal care is the best method of preventing or controlling risk factors associate
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d with infant mortality. Nutritional status is an important modifiable risk factor, butit is not the
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most important action a nurse should take in this situation. The client may needassistance fro
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m a social worker at some time during her pregnancy, but a referral to a socialworker is not th
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e most important aspect the nurse should address at this time. If the woman has identifiable hi
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gh-
risk problems, then her health care may need to be provided by a physician. However, it cann
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ot be assumed that all African-American women have high-
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riskissues. In addition, advising the woman to see an obstetrician is not the most important as
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pect on which the nurse should focus at this time, and it is not appropriate for a nurse to advis
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e or manage the type of care a client is to receive.
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PTS: 1 DIF:
Cognitive Level: UnderstandTOP: jn jn jn
Nursing Process: Planning jn jn
, Maternity and Women's Health Care 13th Edition Lowdermilk Test jn jn jn jn jn jn jn jn
MSC: Client Needs: Health Promotion and Maintenance
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3. The nurses working at a newly established birthing center have begun to compare theirpe
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rformance in providing maternal- jn jn jn
newborn care against clinical standards. This comparison process is most commonly kn
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own as what? jn jn
a. Best practices network jn jn
b. Clinical benchmarking jn
c. Outcomes-oriented pracNtiUceRS jn
d. Evidence-based practice jn
ANS: C j n
Outcomes-
oriented practice measures the effectiveness of the interventions and quality of care against b
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enchmarks or standards. The term best practice refers to a program or servicethat has been reco
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gnized for its excellence. Clinical benchmarking is a process used to compare one’s own perf
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ormance against the performance of the best in an area of service. The term evidence-
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based practice refers to the provision of care based on evidence gainedthrough research and c
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linical trials. jn
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: jn jn jn
Nursing Process: Evaluation jn jn
MSC: Client Needs: Safe and Effective Care Environment
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4. During a prenatal intake interview, the nurse is in the process of obtaining an initial as
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sessment of a 21-year- jn jn jn
old Hispanic client with limited English proficiency. Whichintervention is the most i
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mportant for the nurse to implement? jn jn jn jn jn
a. Use maternity jargon to enable the client to become familiar with these terms.
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b. Speak quickly and efficiently to expedite the visit. jn jn jn jn jn jn jn
c. Provide the client with handouts. jn jn jn jn
d. Assess whether the client understands the discussion. jn jn jn jn jn jn
ANS: D j n
Nurses contribute to health literacy by using simple, common words, avoiding jargon, ande
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valuating whether the client understands the discussion. Speaking slowly and clearly andfo
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cusing on what is important will increase understanding. Most client education materialsare
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written at a level too high for the average adult and may not be useful for a client withlimite
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d English proficiency.
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PTS: 1 DIF:
Cognitive Level: ApplyTOP: jn jn jn
Nursing Process: Implementation jn jn
MSC: Client Needs: Health Promotion and Maintenance
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5. Which statement best exemplifies contemporary maternity nursing?
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a. Use of midwives for all vaginal deliveries
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b. Family-centered care jn
c. Free-standing birth clinics jn jn
d. Physician-
driven careANS: B jn jn j n
, Maternity and Women's Health Care 13th Edition Lowdermilk Test jn jn jn jn jn jn jn jn
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partners, jn jn jn jn jn jn jn jn jn jn jn
grandparents, and siblings may be present for the birth and participate in activitiessuch as cutti
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ng the baby’s umbilical cord. Both midwives and physicians perform vaginal deliveries. Free
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-
standing clinics are an example of alternative birth options. Contemporarymaternity nursing i
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s driven by the relationship between nurses and their clients.
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PTS: 1 DIF:
Cognitive Level: UnderstandTOP: jn jn jn
Nursing Process: Planning jn jn
MSC: Client Needs: Health Promotion and Maintenance
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6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-
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ounce baby girl after beingin labor for 43 hours. The baby died 3 days later from sepsis. On w
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hat grounds could the woman have a legitimate legal case for negligence?
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a. Inexperienced maternity nurse was assigned to care for the client. jn jn jn jn jn jn jn jn jn
b. Client was past her due date by 3 days. jn jn jn jn jn jn jn jn
c. Standard of care was not met. jn jn jn jn jn
d. Client refused electronic fetal monitoring. jn jn jn jn
ANS: C j n
Not meeting the standard of care is a legitimate factor for a case of negligence. An inexperie
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nced maternity nurse would need to display competency before being assigned tocare for cli
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ents on his or her own. This client may have been past her due date; however, aterm pregnan
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cy often goes beyond 40 weeks of gestation. Although fetal monitoring is thestandard of car
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e, the client has the right to refuse treatment. This refusal is not a case for negligence, but inf
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ormed consent should be properly obtained, and the client should have signed an against me
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dical advice form when refusing any treatment that is within the standard of care.
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PTS: 1 DIF:
Cognitive Level: AnalyzeTOP: jn jn jn
Nursing Process: Implementation jn jn
MSC: Client Needs: Safe and Effective Care Environment
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7. When the nurse is unsure how to perform a client care procedure that is high risk and lowvol
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ume, his or her best action in this situation would be what?
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a. Ask another nurse. jn jn
b. Discuss the procedure with the client’s physician. jn jn jn jn jn jn
c. Look up the procedure in a nursing textbook. jn jn jn jn jn jn jn
d. First consult the agency procedure manual jn jn jn jn jn
ANS: D j n
Following the agency’s policies and procedures manual is always best when seeking informa
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tion on correct client procedures. These policies should reflect the current standardsof care an
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d the individual state’s guidelines. Each nurse is responsible for his or her own practice. Relyi
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ng on another nurse may not always be a safe practice. Each nurse is obligated to follow the st
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andards of care for safe client care delivery. Physicians are responsible for their own client ca
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re activity. Nurses may follow safe orders from physicians, but they are also responsible for t
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he activities that they, as nurses, are to carry out. Information provided in a nursing textbook is
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basic information for general knowledge.Furthermore, the information in a textbook may not
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reflect the current standard of care or the individual state or hospital policies.
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