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, MaternityandWomen's Health Care 13th Edition Lowdermilk Test z zz zz zz zz zz zz zz
Chapter01:21stCenturyMaternityandWomen’sHealthNursing Lowdermilk:
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Maternity & Women’s Health Care, 12th Edition
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MULTIPLECHOICE z
1. In evaluating the levelof a pregnant woman’s risk of having a low-birth-weight (LBW)
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infant, which factor is the most important for the nurse to consider?
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a. African-Americanrace z
b. Cigarettesmoking z
c. Poor nutritional status zz zz
d. Limitedmaternal education z zz
ANS: A z z
The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic black
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women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are almost twice as
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likely as non-Hispanic white infants to be of LBW and to die in the first yearoflife..Race isa
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nonmodifiableriskfactor. Cigarettesmokingisan important factorin potential infant mortality
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rates, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor
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nutrition is an important factor in potential infant mortality rates, but it is not the most important.
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Additionally, nutritional status is a modifiable risk factor. Maternal education is an important
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factor in potential infant mortality rates, but it is not the most important. Additionally, maternal
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education is a modifiable risk factor.
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PTS: 1 DIF: CognitiveLevel:Understand z z
TOP: Nursing Process: Assessment
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MSC: Client Needs: HealtN PrRoS
hU mI ioG
otN nTanBd.MCaO
inM
tenance, Antepartum Care
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2. A 23-year-old African-American woman is pregnant with her first child. Based on current
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statisticsfor infant mortality, which intervention is most important for the nurse to include in the
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client’s plan of care?
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a. Perform anutritionassessment. zz z zz
b. Referthe woman to a social worker. zz zz zz zz zz zz
c. Advisethe woman to see an obstetrician, not a midwife. z zz zz zz zz zz zz zz zz
d. Explainto the woman theimportance of keeping her prenatal care appointments. z zz zz zz z zz zz zz zz zz zz
ANS: D z z
Consistent prenatal care is the best method of preventing or controlling risk factors associated zz zz zz zz zz zz zz zz zz zz zz zz zz
withinfantmortality. Nutritionalstatusisan importantmodifiableriskfactor,but it is not the most
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important action a nurse should take in this situation. The client may need assistance from a
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social worker at some time during her pregnancy, but a referral to a social worker is not the most
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important aspect the nurse should address at this time. If the woman has identifiable high-risk
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problems, then her health care may need to be provided by a physician. However, it cannot be
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assumed that all African-American women have high-risk issues. In addition, advising the
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woman to see an obstetrician is not the most important aspect on which the nurse should focus at
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this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to
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receive.
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PTS: 1 DIF: CognitiveLevel:Understand z z
TOP: Nursing Process: Planning
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, MaternityandWomen's Health Care 13th Edition Lowdermilk Test z zz zz zz zz zz zz zz
MSC: ClientNeeds: Health Promotionand Maintenance
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3. Thenurses workingat a newlyestablishedbirthingcenterhavebegunto comparetheir
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performance in providing maternal-newborn care against clinical standards. This
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comparison process is most commonly known as what?
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a. Bestpracticesnetwork z zz
b. Clinicalbenchmarking z
c. Outcomes-orientedp racNtiUceR S z
d. Evidence-basedpractice z
ANS: C z z
Outcomes-oriented practice measures the effectiveness of the interventions and quality of care zz zz zz zz zz zz zz zz zz zz zz
against benchmarks or standards. Theterm bestpracticereferstoaprogram orservice that has been
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recognized for its excellence. Clinical benchmarking is a process used to compare one’s own
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performance against the performance of the best in an area of service. The term evidence-based
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practice refers to the provision of care based on evidence gained through research and clinical
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trials.
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PTS: 1 DIF: CognitiveLevel:Understand z z
TOP: Nursing Process: Evaluation
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MSC: Client Needs: Safeand Effective Care Environment
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4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
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assessment of a 21-year-old Hispanic client with limited English proficiency. Which
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intervention is the most important for the nurse to implement?
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a. Usematernityjargon to enable theclientto become familiarwith these terms.
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b. Speak quickly and efficientlyto expeditethe visit. zz zz zz zz zz zz zz
c. Providetheclient withhandouts. z zz zz zz
d. Assesswhetherthe client understands the discussion. z z zz zz zz zz
ANS: D z z
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
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evaluating whether the client understands the discussion. Speaking slowly and clearly and
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focusing on what is important will increase understanding. Most client education materials are
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written at a level too high for the average adult and may not be useful for a client with limited
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English proficiency.
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PTS: 1 DIF: CognitiveLevel:Apply z z
TOP: Nursing Process: Implementation
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MSC: ClientNeeds: Health Promotionand Maintenance
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5. Whichstatementbest exemplifies contemporarymaternitynursing?
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a. Useof midwives for all vaginal deliveries
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b. Family-centeredcare z
c. Free-standingbirthclinics z z
d. Physician-drivencare z
zz ANS: B z z
, MaternityandWomen's Health Care 13th Edition Lowdermilk Test z zz zz zz zz zz zz zz
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partners, zz zz zz zz zz zz zz zz zz zz zz
grandparents, and siblings maybe present forthebirthand participate inactivities such as cutting
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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. Contemporary maternity nursing is
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driven by the relationship between nurses and their clients.
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PTS: 1 DIF: CognitiveLevel:Understand z z
TOP: Nursing Process: Planning
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MSC: ClientNeeds: Health Promotionand Maintenance z z z zz zz zz zz
6. A38-year-old Hispanic woman vaginallydelivereda9-pound,6-ounce babygirlafter being in
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labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could the woman
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have a legitimate legal case for negligence?
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a. Inexperiencedmaternitynursewas assigned to careforthe client. zz zz z zz zz zz zz z zz
b. Clientwas past her duedate by3 days. zz zz zz zz zz zz z zz
c. Standard ofcare was not met. zz z zz zz zz
d. Clientrefusedelectronicfetal monitoring. z zz z zz
ANS: C z z
Not meeting the standard of care is a legitimate factor for a case of negligence. An inexperienced
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maternitynurse wouldneed todisplaycompetencybefore beingassigned to care for clients on his
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or her own. This client may have been past her due date; however, a term pregnancy often goes
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beyond 40 weeks of gestation. Although fetal monitoring isthe standard of care, the client has the
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right to refuse treatment. This refusal is not a case for negligence, but informed consent should be
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properly obtained, and the client should have signed an against medical advice form when
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refusing any treatment that is within the standard of care.
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PTS: 1 DIF: CognitiveLevel:Analyze z z
TOP: Nursing Process: Implementation
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MSC: Client Needs: Safeand Effective Care Environment
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7. Whenthe nurseisunsure howto perform a client careprocedurethat ishigh risk and low volume,
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his or her best action in this situation would be what?
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a. Ask another nurse. zz zz
b. Discuss theprocedure withtheclient’sphysician. zz z zz zz z zz
c. Look up the procedure in a nursing textbook. zz zz zz zz zz zz zz
d. First consult the agency proceduremanual zz zz zz zz zz
ANS: D z z
Following the agency’s policies and procedures manual is always best when seeking zz zz zz zz zz zz zz zz zz zz zz
informationon correct clientprocedures. These policies should reflect thecurrent standards of
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care and the individual state’s guidelines. Each nurse is responsible for his or her own practice.
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Relying on another nurse may not always be a safe practice. Each nurse is obligated to follow the
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standards of care for safe client care delivery. Physicians are responsible for their own client care
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activity. Nurses may follow safe orders from physicians, but they are also responsible for the
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activities that they, as nurses, are to carry out. Information providedina nursingtextbookisbasic
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informationforgeneralknowledge. Furthermore, the information in a textbook may not reflect
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the current standard of care or the individual state or hospital policies.
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