, TESTBANK FOR
Maternity and Women's Health Care 13th Edition Lowdermilk
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,Chapter 01: 21st Century Maternity and Women’s Health Nursing
Lowdermilk: Maternity and Women’s Health Care, 13th Edition
MULTIPLE CHOICE
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW) infant,
which factor is the most important for the nurse to consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
ANS: A
The rise in the overall LBW rates was due to increases in LBW births to non-Hispanic black
women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are almost twice
as likely as non-Hispanic white infants to be of LBW and to die in the first year of life. Race
is a nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant
mortality rates, but it is not the most important. Additionally, smoking is a modifiable risk
factor. Poor nutrition is an important factor in potential infant mortality rates, but it is not the
most important. Additionally, nutritional status is a modifiable risk factor. Maternal education
is an important factor in potential infant mortality rates, but it is not the most important.
Additionally, maternal education is a modifiable risk factor.
DIF: Cognitive Level: Understanding TOP: Assessment
MSC: Client Needs: Health Promotion and Maintenance, Antepartum Care
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
statistics for infant mortality, which intervention is most important for the nurse to include in
the client’s plan of care?
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.
ANS: D
Consistent prenatal care is the best method of preventing or controlling risk factors associated
with infant mortality. Nutritional status is an important modifiable risk factor, but it is not the
most important action a nurse should take in this situation. The client may need assistance
from a social worker at some time during her pregnancy, but a referral to a social worker is
not the most important aspect the nurse should address at this time. If the woman has
identifiable high-risk problems, then her health care may need to be provided by a physician.
However, it cannot be assumed that all African-American women have high-risk issues. In
addition, advising the woman to see an obstetrician is not the most important aspect on which
the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage
the type of care a client is to receive.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Health Promotion and Maintenance
,3. During a prenatal intake interview, the nurse is in the process of obtaining an initial
assessment of a 21-year-old Hispanic client with limited English proficiency. Which
intervention is the most important for the nurse to implement?
a. Use maternity jargon to enable the client to become familiar with these terms.
b. Speak quickly and efficiently to expedite the visit.
c. Provide the client with handouts.
d. Assess whether the client understands the discussion.
ANS: D
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
evaluating whether the client understands the discussion. Speaking slowly and clearly and
focusing on what is important will increase understanding. Most client education materials are
written at a level too high for the average adult and may not be useful for a client with limited
English proficiency.
DIF: Cognitive Level: Applying TOP: Implementation
MSC: Client Needs: Health Promotion and Maintenance
4. The nurses working at a newly established birthing center have begun to compare their
performance in providing maternal-newborn care against clinical standards. This comparison
process is most commonly known as what?
a. Best practices network
b. Clinical benchmarking
c. Outcomes-oriented practice
d. Evidence-based practice
ANS: D
Outcomes-oriented practice measures the effectiveness of the interventions and quality of care
against benchmarks or standards. The term best practice refers to a program or service that
has been recognized for its excellence. Clinical benchmarking is a process used to compare
one’s own performance against the performance of the best in an area of service. The term
evidence-based practice refers to the provision of care based on evidence gained through
research and clinical trials.
DIF: Cognitive Level: Understanding TOP: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
5. Which statement best exemplifies contemporary maternity nursing?
a. Use of midwives for all vaginal deliveries
b. Family-centered care
c. Free-standing birth clinics
d. Physician-driven care
ANS: B
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partners,
grandparents, and siblings may be present for the birth and participate in activities such as
cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliveries.
Free-standing clinics are an example of alternative birth options. Contemporary maternity
nursing is driven by the relationship between nurses and their clients.
DIF: Cognitive Level: Understanding TOP: Planning
, MSC: Client Needs: Health Promotion and Maintenance
6. A 38-year-old woman vaginally delivered a 9-pound, 6-ounce baby girl after being in labor for
43 hours. The baby died 3 days later from sepsis. On what grounds could the woman have a
legitimate legal case for negligence?
a. Inexperienced maternity nurse was assigned to care for the client.
b. Client was past her due date by 3 days.
c. Standard of care was not met.
d. Client refused electronic fetal monitoring.
ANS: C
Not meeting the standard of care is a legitimate factor for a case of negligence. An
inexperienced maternity nurse would need to display competency before being assigned to
care for clients on his or her own. This client may have been past her due date; however, a
term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the
standard of care, the client has the right to refuse treatment. This refusal is not a case for
negligence, but informed consent should be properly obtained, and the client should have
signed an against medical advice form when refusing any treatment that is within the standard
of care.
DIF: Cognitive Level: Analyzing TOP: Implementation
MSC: Client Needs: Safe and Effective Care Environment
7. When the nurse is unsure how to perform a client care procedure that is high risk and low
volume, his or her best action in this situation would be what?
a. Ask another nurse.
b. Discuss the procedure with the client’s physician.
c. Look up the procedure in a nursing textbook.
d. First consult the agency procedure manual.
ANS: D
Following the agency’s policies and procedures manual is always best when seeking
information on correct client procedures. These policies should reflect the current standards of
care and the individual state’s guidelines. Each nurse is responsible for his or her own
practice. Relying on another nurse may not always be a safe practice. Each nurse is obligated
to follow the standards of care for safe client care delivery. Physicians are responsible for their
own client care activity. Nurses may follow safe orders from physicians, but they are also
responsible for the activities that they, as nurses, are to carry out. Information provided in a
nursing textbook is basic information for general knowledge. Furthermore, the information in
a textbook may not reflect the current standard of care or the individual state or hospital
policies.
DIF: Cognitive Level: Understanding TOP: Implementation
MSC: Client Needs: Physiological Integrity
8. A nurse caring for a pregnant client should be aware that the U.S. birth rate shows what trend?
a. Births to unmarried women are more likely to have less favorable outcomes.
b. Birth rates for women 40–44 years of age are declining.
c. Cigarette smoking among pregnant women continues to increase.
d. Rates of pregnancy and abortion among teenagers are lower in the United States
than in any other industrialized country.
, ANS: A
LBW infants and preterm births are more likely because of the large number of teenagers in
the unmarried group. Birth rates for women in their early 40s continue to increase. Fewer
pregnant women smoke. Teen pregnancy and abortion rates are higher in the United States
than in any other industrial country.
DIF: Cognitive Level: Understanding TOP: Assessment
MSC: Client Needs: Psychosocial Integrity
9. A recently graduated nurse is attempting to understand the reason for increasing health care
spending in the United States. Which information gathered from research best explains the
rationale for these higher costs compared with other developed countries?
a. Higher rate of obesity among pregnant women
b. Limited access to technology
c. Increased use of health care services along with lower prices
d. Homogeneity of the population
ANS: A
Health care is one of the fastest growing sectors of the U.S. economy. Currently, 19.7% of the
gross domestic product is spent on health care. Higher spending in the United States, as
compared with 12 other industrialized countries, is related to higher prices and readily
accessible technology along with greater obesity rates among women. Approximately 31% of
women ages 20–39 are obese. In the population in the United States, 8.5% are uninsured and
have limited access to health care. Maternal morbidity and mortality are directly related to
racial disparities.
DIF: Cognitive Level: Understanding TOP: Teaching/Learning
MSC: Client Needs: Safe and Effective Care Environment
10. Which statement best describes maternity nursing care that is based on knowledge gained
through research and clinical trials?
a. Maternity nursing care is derived from the Nursing Intervention Classification.
b. Maternity nursing care is known as evidence-based practice.
c. Maternity nursing care is at odds with the Cochrane School of traditional nursing.
d. Maternity nursing care is an outgrowth of telehealth.
ANS: B
Evidence-based practice is based on knowledge gained from research and clinical trials. The
Cochrane Collaboration oversees up-to-date systematic reviews of randomized controlled
trials and disseminates these reviews. Telehealth uses communication technologies to support
health care.
DIF: Cognitive Level: Understanding TOP: Analysis
MSC: Client Needs: Safe and Effective Care Environment
11. What is the minimum level of practice that a reasonably prudent nurse is expected to provide?
a. Standard of care
b. Risk management
c. Sentinel event
d. Failure to rescue
, ANS: A
Guidelines for standards of care are published by various professional nursing organizations.
Risk management identifies risks and establishes preventive practices, but it does not define
the standard of care. Sentinel events are unexpected negative occurrences. They do not
establish the standard of care. Failure to rescue is an evaluative process for nursing, but it does
not define the standard of care.
DIF: Cognitive Level: Remembering TOP: Implementation
MSC: Client Needs: Safe and Effective Care Environment
12. Using social media technology, nurses can link with other nurses who may share similar
interests, insights about practice, and advocate for clients. Which factor is the most concerning
pitfall for nurses using this technology?
a. Violation of client privacy and confidentiality
b. Institutions and colleagues who may be cast in an unfavorable light
c. Unintended negative consequences for using social media
d. Lack of institutional policy governing online contact
ANS: A
The most significant pitfall for nurses using this technology is the violation of client privacy
and confidentiality. Furthermore, institutions and colleagues can be cast in an unfavorable
light with negative consequences for those posting information. Nursing students have been
expelled from school and nurses have been fired or reprimanded by their Board of Nursing for
injudicious posts. The American Nurses Association has published six principles for social
networking and the nurse. All institutions should have policies guiding the use of social
media, and the nurse should be familiar with these guidelines.
DIF: Cognitive Level: Analyzing TOP: Implementation
MSC: Client Needs: Safe and Effective Care Environment
13. During a prenatal intake interview, the client informs the nurse that she would prefer a
midwife to provide both her care during pregnancy and deliver her infant. Which information
is most appropriate for the nurse to share with this client about resulting care?
a. Midwifery care is a good option for clients who are uninsured.
b. She will receive fewer interventions during the birth process.
c. She should be aware that midwives are not certified.
d. Her delivery can take place only at home or in a birth center.
ANS: B
This client will be able to participate actively in all decisions related to the birth process and is
likely to receive fewer interventions during the birth process. Midwifery services are available
to all low-risk pregnant women, regardless of the type of insurance they have. Midwifery care
in all developed countries is strictly regulated by a governing body to ensure that core
competencies are met. In the United States, this body is the American College of Nurse-
Midwives (ACNM). Midwives can provide care and delivery at home, in freestanding birth
centers, and in community and teaching hospitals.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Safe and Effective Care Environment
, 14. While obtaining a detailed history from a woman who has recently immigrated, the nurse
realizes that the client has undergone female genital mutilation (FGM). What is the nurse’s
most appropriate response in this situation?
a. “This is a very abnormal practice and rarely seen in the United States.”
b. “Are you aware of who performed this mutilation so that it can be reported to the
authorities?”
c. “We will be able to restore fully your circumcision after delivery.”
d. “The extent of your circumcision will affect the potential for complications.”
ANS: D
The extent of the circumcision is important. The client may experience pain, bleeding,
scarring, or infection and may require surgery before childbirth. Although this practice is not
prevalent in the United States, it is very common in many African and Middle Eastern
countries for religious reasons. Mentioning that the practice is abnormal and rarely seen in the
United States is culturally insensitive. The infibulation may have occurred during infancy or
childhood; consequently, the client will have little to no recollection of the event. She would
have considered this to be a normal milestone during her growth and development. The
International Council of Nurses has spoken out against this procedure as harmful to a
woman’s health.
DIF: Cognitive Level: Analyzing TOP: Assessment
MSC: Client Needs: Psychosocial Integrity
MULTIPLE RESPONSE
1. Greater than one-third of women in the United States are now obese (body mass index [BMI]
of 30 or greater). Less than one quarter of women in Canada exhibit the same BMI. Obesity in
the pregnant woman increases both maternal medical risk factors and negative outcomes for
the infant. The nurse is about to perform an assessment on a client who is 28 weeks pregnant
and has a BMI of 35. What are the most frequently reported complications for which the nurse
must be alert while assessing this client? (Select all that apply.)
a. Potential miscarriage
b. Diabetes
c. Fetal death in utero
d. Decreased fertility
e. Hypertension
ANS: B, E
The two most frequently reported maternal medical risk factors associated with obesity are
hypertension associated with pregnancy and diabetes. Decreased fertility, miscarriage, fetal
death, and congenital anomalies are also associated with obesity. These clients often
experience longer hospital stays and increased use of health services.
DIF: Cognitive Level: Applying TOP: Assessment
MSC: Client Needs: Physiological Integrity
2. Which statements indicate that the nurse is practicing appropriate family-centered care
techniques? (Select all that apply.)
a. The nurse commands the pregnant woman to do as she is told.
b. The nurse allows time for the partner to ask questions.
, c. The nurse allows the mother and father to make choices when possible.
d. The nurse informs the family about what is going to happen.
e. The nurse tells the client’s sister, who is a nurse, that she cannot be in the room
during the delivery.
ANS: B, C
Including the partner in the care process and allowing the couple to make choices are
important elements of family-centered care. The nurse should never tell the client what to do.
Family-centered care involves collaboration between the health care team and the client.
Unless an institutional policy limits the number of attendants at a delivery, the client should be
allowed to have whomever she wants present (except when the situation is an emergency and
guests are asked to leave).
DIF: Cognitive Level: Analyzing TOP: Implementation
MSC: Client Needs: Psychosocial Integrity
3. Which methods help alleviate the problems associated with access to health care for the
maternity client? (Select all that apply.)
a. Provide transportation to prenatal visits.
b. Provide child care to enable a pregnant woman to keep prenatal visits.
c. Increase the number of providers that will care for Medicaid clients.
d. Provide low-cost or no-cost health care insurance.
e. Provide job training.
ANS: A, B, C, D
Lack of transportation to prenatal visits, child care, access to skilled obstetric providers, and
affordable health insurance are prohibitive factors associated with the lack of prenatal care.
Although job training may result in employment and income, the likelihood of significant
changes during the time frame of the pregnancy is remote.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Health Promotion and Maintenance
, Chapter 02: Community Care: The Family and Culture
Lowdermilk: Maternity and Women’s Health Care, 13th Edition
MULTIPLE CHOICE
1. A married couple lives in a single-family house with their newborn son and the husband’s
daughter from a previous marriage. Based on this information, what family form best
describes this family?
a. Married-blended family
b. Extended family
c. Nuclear family
d. Same-sex family
ANS: A
Married-blended families are formed as the result of divorce and remarriage. Unrelated family
members join to create a new household. Members of an extended family are kin or family
members related by blood, such as grandparents, aunts, and uncles. A nuclear family is a
traditional family with male and female partners along with the children resulting from that
union. A same-sex family is a family with homosexual partners who cohabit with or without
children.
DIF: Cognitive Level: Remembering TOP: Assessment
MSC: Client Needs: Psychosocial Integrity
2. Which key factors play the most powerful role in the behaviors of individuals and families?
a. Rituals and customs
b. Beliefs and values, or culture
c. Boundaries and channels
d. Socialization processes
ANS: B
Beliefs and values (culture) are the most prevalent factors in the decision-making and
problem-solving behaviors of individuals and families. This prevalence is particularly true
during times of stress and illness. Boundaries and channels affect the relationship between the
family members and the health care team, not the decisions within the family. Socialization
processes may help families with interactions within the community, but they are not the
criteria used for decision-making within the family.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Psychosocial Integrity
3. What is the primary difference between hospital care and home health care?
a. Home care is routinely and continuously delivered by professional staff.
b. Home care is delivered on an intermittent basis by professional staff.
c. Home care is delivered for emergency conditions.
d. Home care is not available 24 hours a day.
ANS: B
Maternity and Women's Health Care 13th Edition Lowdermilk
Important Notes
The file includes the complete test bank, organized chapter by chapter.
A sample of selected pages has been provided for preview.
All available appendices and Excel files (if included in the original resources) are
provided.
We continuously update our files to ensure you receive the latest and most accurate
editions.
New editions are added regularly – stay connected for updates!
Purchase Guarantee
If you believe you have purchased the wrong file, don’t worry. Contact us anytime and we
will gladly replace it with the correct version.
Contact Email:
,Chapter 01: 21st Century Maternity and Women’s Health Nursing
Lowdermilk: Maternity and Women’s Health Care, 13th Edition
MULTIPLE CHOICE
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW) infant,
which factor is the most important for the nurse to consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
ANS: A
The rise in the overall LBW rates was due to increases in LBW births to non-Hispanic black
women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are almost twice
as likely as non-Hispanic white infants to be of LBW and to die in the first year of life. Race
is a nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant
mortality rates, but it is not the most important. Additionally, smoking is a modifiable risk
factor. Poor nutrition is an important factor in potential infant mortality rates, but it is not the
most important. Additionally, nutritional status is a modifiable risk factor. Maternal education
is an important factor in potential infant mortality rates, but it is not the most important.
Additionally, maternal education is a modifiable risk factor.
DIF: Cognitive Level: Understanding TOP: Assessment
MSC: Client Needs: Health Promotion and Maintenance, Antepartum Care
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
statistics for infant mortality, which intervention is most important for the nurse to include in
the client’s plan of care?
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.
ANS: D
Consistent prenatal care is the best method of preventing or controlling risk factors associated
with infant mortality. Nutritional status is an important modifiable risk factor, but it is not the
most important action a nurse should take in this situation. The client may need assistance
from a social worker at some time during her pregnancy, but a referral to a social worker is
not the most important aspect the nurse should address at this time. If the woman has
identifiable high-risk problems, then her health care may need to be provided by a physician.
However, it cannot be assumed that all African-American women have high-risk issues. In
addition, advising the woman to see an obstetrician is not the most important aspect on which
the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage
the type of care a client is to receive.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Health Promotion and Maintenance
,3. During a prenatal intake interview, the nurse is in the process of obtaining an initial
assessment of a 21-year-old Hispanic client with limited English proficiency. Which
intervention is the most important for the nurse to implement?
a. Use maternity jargon to enable the client to become familiar with these terms.
b. Speak quickly and efficiently to expedite the visit.
c. Provide the client with handouts.
d. Assess whether the client understands the discussion.
ANS: D
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
evaluating whether the client understands the discussion. Speaking slowly and clearly and
focusing on what is important will increase understanding. Most client education materials are
written at a level too high for the average adult and may not be useful for a client with limited
English proficiency.
DIF: Cognitive Level: Applying TOP: Implementation
MSC: Client Needs: Health Promotion and Maintenance
4. The nurses working at a newly established birthing center have begun to compare their
performance in providing maternal-newborn care against clinical standards. This comparison
process is most commonly known as what?
a. Best practices network
b. Clinical benchmarking
c. Outcomes-oriented practice
d. Evidence-based practice
ANS: D
Outcomes-oriented practice measures the effectiveness of the interventions and quality of care
against benchmarks or standards. The term best practice refers to a program or service that
has been recognized for its excellence. Clinical benchmarking is a process used to compare
one’s own performance against the performance of the best in an area of service. The term
evidence-based practice refers to the provision of care based on evidence gained through
research and clinical trials.
DIF: Cognitive Level: Understanding TOP: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
5. Which statement best exemplifies contemporary maternity nursing?
a. Use of midwives for all vaginal deliveries
b. Family-centered care
c. Free-standing birth clinics
d. Physician-driven care
ANS: B
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partners,
grandparents, and siblings may be present for the birth and participate in activities such as
cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliveries.
Free-standing clinics are an example of alternative birth options. Contemporary maternity
nursing is driven by the relationship between nurses and their clients.
DIF: Cognitive Level: Understanding TOP: Planning
, MSC: Client Needs: Health Promotion and Maintenance
6. A 38-year-old woman vaginally delivered a 9-pound, 6-ounce baby girl after being in labor for
43 hours. The baby died 3 days later from sepsis. On what grounds could the woman have a
legitimate legal case for negligence?
a. Inexperienced maternity nurse was assigned to care for the client.
b. Client was past her due date by 3 days.
c. Standard of care was not met.
d. Client refused electronic fetal monitoring.
ANS: C
Not meeting the standard of care is a legitimate factor for a case of negligence. An
inexperienced maternity nurse would need to display competency before being assigned to
care for clients on his or her own. This client may have been past her due date; however, a
term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the
standard of care, the client has the right to refuse treatment. This refusal is not a case for
negligence, but informed consent should be properly obtained, and the client should have
signed an against medical advice form when refusing any treatment that is within the standard
of care.
DIF: Cognitive Level: Analyzing TOP: Implementation
MSC: Client Needs: Safe and Effective Care Environment
7. When the nurse is unsure how to perform a client care procedure that is high risk and low
volume, his or her best action in this situation would be what?
a. Ask another nurse.
b. Discuss the procedure with the client’s physician.
c. Look up the procedure in a nursing textbook.
d. First consult the agency procedure manual.
ANS: D
Following the agency’s policies and procedures manual is always best when seeking
information on correct client procedures. These policies should reflect the current standards of
care and the individual state’s guidelines. Each nurse is responsible for his or her own
practice. Relying on another nurse may not always be a safe practice. Each nurse is obligated
to follow the standards of care for safe client care delivery. Physicians are responsible for their
own client care activity. Nurses may follow safe orders from physicians, but they are also
responsible for the activities that they, as nurses, are to carry out. Information provided in a
nursing textbook is basic information for general knowledge. Furthermore, the information in
a textbook may not reflect the current standard of care or the individual state or hospital
policies.
DIF: Cognitive Level: Understanding TOP: Implementation
MSC: Client Needs: Physiological Integrity
8. A nurse caring for a pregnant client should be aware that the U.S. birth rate shows what trend?
a. Births to unmarried women are more likely to have less favorable outcomes.
b. Birth rates for women 40–44 years of age are declining.
c. Cigarette smoking among pregnant women continues to increase.
d. Rates of pregnancy and abortion among teenagers are lower in the United States
than in any other industrialized country.
, ANS: A
LBW infants and preterm births are more likely because of the large number of teenagers in
the unmarried group. Birth rates for women in their early 40s continue to increase. Fewer
pregnant women smoke. Teen pregnancy and abortion rates are higher in the United States
than in any other industrial country.
DIF: Cognitive Level: Understanding TOP: Assessment
MSC: Client Needs: Psychosocial Integrity
9. A recently graduated nurse is attempting to understand the reason for increasing health care
spending in the United States. Which information gathered from research best explains the
rationale for these higher costs compared with other developed countries?
a. Higher rate of obesity among pregnant women
b. Limited access to technology
c. Increased use of health care services along with lower prices
d. Homogeneity of the population
ANS: A
Health care is one of the fastest growing sectors of the U.S. economy. Currently, 19.7% of the
gross domestic product is spent on health care. Higher spending in the United States, as
compared with 12 other industrialized countries, is related to higher prices and readily
accessible technology along with greater obesity rates among women. Approximately 31% of
women ages 20–39 are obese. In the population in the United States, 8.5% are uninsured and
have limited access to health care. Maternal morbidity and mortality are directly related to
racial disparities.
DIF: Cognitive Level: Understanding TOP: Teaching/Learning
MSC: Client Needs: Safe and Effective Care Environment
10. Which statement best describes maternity nursing care that is based on knowledge gained
through research and clinical trials?
a. Maternity nursing care is derived from the Nursing Intervention Classification.
b. Maternity nursing care is known as evidence-based practice.
c. Maternity nursing care is at odds with the Cochrane School of traditional nursing.
d. Maternity nursing care is an outgrowth of telehealth.
ANS: B
Evidence-based practice is based on knowledge gained from research and clinical trials. The
Cochrane Collaboration oversees up-to-date systematic reviews of randomized controlled
trials and disseminates these reviews. Telehealth uses communication technologies to support
health care.
DIF: Cognitive Level: Understanding TOP: Analysis
MSC: Client Needs: Safe and Effective Care Environment
11. What is the minimum level of practice that a reasonably prudent nurse is expected to provide?
a. Standard of care
b. Risk management
c. Sentinel event
d. Failure to rescue
, ANS: A
Guidelines for standards of care are published by various professional nursing organizations.
Risk management identifies risks and establishes preventive practices, but it does not define
the standard of care. Sentinel events are unexpected negative occurrences. They do not
establish the standard of care. Failure to rescue is an evaluative process for nursing, but it does
not define the standard of care.
DIF: Cognitive Level: Remembering TOP: Implementation
MSC: Client Needs: Safe and Effective Care Environment
12. Using social media technology, nurses can link with other nurses who may share similar
interests, insights about practice, and advocate for clients. Which factor is the most concerning
pitfall for nurses using this technology?
a. Violation of client privacy and confidentiality
b. Institutions and colleagues who may be cast in an unfavorable light
c. Unintended negative consequences for using social media
d. Lack of institutional policy governing online contact
ANS: A
The most significant pitfall for nurses using this technology is the violation of client privacy
and confidentiality. Furthermore, institutions and colleagues can be cast in an unfavorable
light with negative consequences for those posting information. Nursing students have been
expelled from school and nurses have been fired or reprimanded by their Board of Nursing for
injudicious posts. The American Nurses Association has published six principles for social
networking and the nurse. All institutions should have policies guiding the use of social
media, and the nurse should be familiar with these guidelines.
DIF: Cognitive Level: Analyzing TOP: Implementation
MSC: Client Needs: Safe and Effective Care Environment
13. During a prenatal intake interview, the client informs the nurse that she would prefer a
midwife to provide both her care during pregnancy and deliver her infant. Which information
is most appropriate for the nurse to share with this client about resulting care?
a. Midwifery care is a good option for clients who are uninsured.
b. She will receive fewer interventions during the birth process.
c. She should be aware that midwives are not certified.
d. Her delivery can take place only at home or in a birth center.
ANS: B
This client will be able to participate actively in all decisions related to the birth process and is
likely to receive fewer interventions during the birth process. Midwifery services are available
to all low-risk pregnant women, regardless of the type of insurance they have. Midwifery care
in all developed countries is strictly regulated by a governing body to ensure that core
competencies are met. In the United States, this body is the American College of Nurse-
Midwives (ACNM). Midwives can provide care and delivery at home, in freestanding birth
centers, and in community and teaching hospitals.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Safe and Effective Care Environment
, 14. While obtaining a detailed history from a woman who has recently immigrated, the nurse
realizes that the client has undergone female genital mutilation (FGM). What is the nurse’s
most appropriate response in this situation?
a. “This is a very abnormal practice and rarely seen in the United States.”
b. “Are you aware of who performed this mutilation so that it can be reported to the
authorities?”
c. “We will be able to restore fully your circumcision after delivery.”
d. “The extent of your circumcision will affect the potential for complications.”
ANS: D
The extent of the circumcision is important. The client may experience pain, bleeding,
scarring, or infection and may require surgery before childbirth. Although this practice is not
prevalent in the United States, it is very common in many African and Middle Eastern
countries for religious reasons. Mentioning that the practice is abnormal and rarely seen in the
United States is culturally insensitive. The infibulation may have occurred during infancy or
childhood; consequently, the client will have little to no recollection of the event. She would
have considered this to be a normal milestone during her growth and development. The
International Council of Nurses has spoken out against this procedure as harmful to a
woman’s health.
DIF: Cognitive Level: Analyzing TOP: Assessment
MSC: Client Needs: Psychosocial Integrity
MULTIPLE RESPONSE
1. Greater than one-third of women in the United States are now obese (body mass index [BMI]
of 30 or greater). Less than one quarter of women in Canada exhibit the same BMI. Obesity in
the pregnant woman increases both maternal medical risk factors and negative outcomes for
the infant. The nurse is about to perform an assessment on a client who is 28 weeks pregnant
and has a BMI of 35. What are the most frequently reported complications for which the nurse
must be alert while assessing this client? (Select all that apply.)
a. Potential miscarriage
b. Diabetes
c. Fetal death in utero
d. Decreased fertility
e. Hypertension
ANS: B, E
The two most frequently reported maternal medical risk factors associated with obesity are
hypertension associated with pregnancy and diabetes. Decreased fertility, miscarriage, fetal
death, and congenital anomalies are also associated with obesity. These clients often
experience longer hospital stays and increased use of health services.
DIF: Cognitive Level: Applying TOP: Assessment
MSC: Client Needs: Physiological Integrity
2. Which statements indicate that the nurse is practicing appropriate family-centered care
techniques? (Select all that apply.)
a. The nurse commands the pregnant woman to do as she is told.
b. The nurse allows time for the partner to ask questions.
, c. The nurse allows the mother and father to make choices when possible.
d. The nurse informs the family about what is going to happen.
e. The nurse tells the client’s sister, who is a nurse, that she cannot be in the room
during the delivery.
ANS: B, C
Including the partner in the care process and allowing the couple to make choices are
important elements of family-centered care. The nurse should never tell the client what to do.
Family-centered care involves collaboration between the health care team and the client.
Unless an institutional policy limits the number of attendants at a delivery, the client should be
allowed to have whomever she wants present (except when the situation is an emergency and
guests are asked to leave).
DIF: Cognitive Level: Analyzing TOP: Implementation
MSC: Client Needs: Psychosocial Integrity
3. Which methods help alleviate the problems associated with access to health care for the
maternity client? (Select all that apply.)
a. Provide transportation to prenatal visits.
b. Provide child care to enable a pregnant woman to keep prenatal visits.
c. Increase the number of providers that will care for Medicaid clients.
d. Provide low-cost or no-cost health care insurance.
e. Provide job training.
ANS: A, B, C, D
Lack of transportation to prenatal visits, child care, access to skilled obstetric providers, and
affordable health insurance are prohibitive factors associated with the lack of prenatal care.
Although job training may result in employment and income, the likelihood of significant
changes during the time frame of the pregnancy is remote.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Health Promotion and Maintenance
, Chapter 02: Community Care: The Family and Culture
Lowdermilk: Maternity and Women’s Health Care, 13th Edition
MULTIPLE CHOICE
1. A married couple lives in a single-family house with their newborn son and the husband’s
daughter from a previous marriage. Based on this information, what family form best
describes this family?
a. Married-blended family
b. Extended family
c. Nuclear family
d. Same-sex family
ANS: A
Married-blended families are formed as the result of divorce and remarriage. Unrelated family
members join to create a new household. Members of an extended family are kin or family
members related by blood, such as grandparents, aunts, and uncles. A nuclear family is a
traditional family with male and female partners along with the children resulting from that
union. A same-sex family is a family with homosexual partners who cohabit with or without
children.
DIF: Cognitive Level: Remembering TOP: Assessment
MSC: Client Needs: Psychosocial Integrity
2. Which key factors play the most powerful role in the behaviors of individuals and families?
a. Rituals and customs
b. Beliefs and values, or culture
c. Boundaries and channels
d. Socialization processes
ANS: B
Beliefs and values (culture) are the most prevalent factors in the decision-making and
problem-solving behaviors of individuals and families. This prevalence is particularly true
during times of stress and illness. Boundaries and channels affect the relationship between the
family members and the health care team, not the decisions within the family. Socialization
processes may help families with interactions within the community, but they are not the
criteria used for decision-making within the family.
DIF: Cognitive Level: Understanding TOP: Planning
MSC: Client Needs: Psychosocial Integrity
3. What is the primary difference between hospital care and home health care?
a. Home care is routinely and continuously delivered by professional staff.
b. Home care is delivered on an intermittent basis by professional staff.
c. Home care is delivered for emergency conditions.
d. Home care is not available 24 hours a day.
ANS: B
