Introduction to Maternity and Pediatric Nursing 9th Edition
Gloria Leifer Test Bank Chapters 1–34
Chapter 1: The Past, Present, and Future (Questions 1–5)
1. A nurse is reviewing the history of maternity care. Which individual
introduced the concept of "trained nursing" and improved sanitation practices
during the Crimean War?
A) Clara Barton
B) Florence Nightingale
C) Lillian Wald
D) Dorothea Dix
Answer: B
Rationale: Florence Nightingale is credited with establishing trained nursing and
implementing sanitation practices that dramatically reduced mortality rates
during the Crimean War.
2. A nurse is explaining the role of the Children's Bureau to a community group.
Which accomplishment is attributed to this organization?
A) Establishment of the first neonatal intensive care unit
B) Development of the Apgar scoring system
C) Passage of the Sheppard-Towner Act of 1921 (promoting maternal and child
health)
D) Creation of the first nursing school in the United States
Answer: C
Rationale: The Children's Bureau advocated for and helped pass the Sheppard-
Towner Act (1921), which provided federal funding for maternal and child health
programs.
3. A nursing student is studying the history of pediatric nursing. Which
individual is known for establishing the Henry Street Settlement and advocating
for school nursing?
A) Florence Nightingale
B) Clara Barton
,C) Lillian Wald
D) Mary Breckinridge
Answer: C
Rationale: Lillian Wald founded the Henry Street Settlement in New York City and
established the first school nursing program.
4. A nurse is implementing family-centered care on a postpartum unit. Which
action best demonstrates this philosophy?
A) Restricting visitors to immediate family only
B) Allowing parents to be present during their infant's procedures
C) Limiting rooming-in to promote maternal rest
D) Discouraging sibling visitation to prevent infection
Answer: B
Rationale: Family-centered care encourages family involvement, including
parental presence during procedures, rooming-in, and sibling visitation.
5. A nurse is using evidence-based practice (EBP) to develop a new protocol for
newborn thermoregulation. What is the first step in the EBP process?
A) Implement the change in practice
B) Search the literature for best evidence
C) Formulate a clinical question (PICO format)
D) Evaluate the outcomes of the change
Answer: C
Rationale: The first step in evidence-based practice is formulating a clear,
answerable clinical question (often using PICO format).
Chapter 9: The Family After Birth (Questions 6–10)
6. A postpartum patient asks the nurse, "Why am I sweating so much at night?"
What is the best response?
A) "You may have an infection and need to be evaluated"
B) "Night sweats are a normal way your body gets rid of excess fluid from
pregnancy"
,C) "This is a sign of a thyroid disorder that developed during pregnancy"
D) "You should decrease your fluid intake to stop the sweating"
Answer: B
Rationale: Postpartum diaphoresis (night sweats) is a normal physiologic
response to eliminate excess fluid accumulated during pregnancy.
7. A patient who delivered 2 days ago reports that her lochia has changed from
red to pinkish-brown. The nurse documents this as:
A) Lochia rubra
B) Lochia serosa
C) Lochia alba
D) Abnormal finding indicating infection
Answer: B
Rationale: Lochia serosa (pinkish-brown) typically occurs from days 3–10
postpartum, following lochia rubra (red, days 1–3) and preceding lochia alba
(white/yellow, days 10–21).
8. A breastfeeding mother on postpartum day 2 reports that her breasts are
firm, warm, and slightly tender. What is the nurse's best action?
A) Notify the provider immediately
B) Encourage the mother to stop breastfeeding
C) Instruct the mother to apply cold packs after feeding and continue
breastfeeding
D) Administer antibiotics as ordered
Answer: C
Rationale: Breast engorgement is normal around day 2–4; treatment includes
cold packs after feeding, warm packs before feeding, and continued
breastfeeding.
9. A postpartum patient who delivered vaginally 6 hours ago has a boggy uterus
displaced to the right. What is the priority nursing action?
A) Document the finding as normal
B) Notify the provider immediately
C) Assist the patient to void, then reassess the uterus
D) Administer oxytocin (Pitocin) IV push
, Answer: C
Rationale: A displaced, boggy uterus often indicates a full bladder. The patient
should void (or be catheterized) and the uterus reassessed.
10. The nurse is teaching a postpartum patient about signs of infection. Which
statement by the patient indicates understanding?
A) "Fever is normal after delivery and I should not worry"
B) "I should call my provider if I notice foul-smelling lochia"
C) "Pain is not a sign of infection after delivery"
D) "Redness around my episiotomy means it is healing well"
Answer: B
Rationale: Foul-smelling lochia, fever, chills, and increasing perineal pain/redness
may indicate postpartum infection and should be reported.
Chapter 10: Nursing Care of Women with Complications After Birth (Questions
11–15)
11. A patient who delivered 4 hours ago has a blood pressure of 90/50 mmHg,
heart rate of 120 bpm, and a uterus that is firm but the patient has a large
amount of bright red lochia. What does the nurse suspect?
A) Uterine atony
B) Retained placental fragments
C) Vaginal or cervical laceration
D) Uterine rupture
Answer: C
Rationale: A firm uterus with heavy bright red bleeding suggests lower genital
tract trauma (laceration) rather than uterine atony.
12. A postpartum patient develops a fever of 101.5°F on day 2 with lower
abdominal tenderness and foul-smelling lochia. What condition does the nurse
suspect?
A) Mastitis
B) Endometritis
C) Urinary tract infection
D) Wound infection
Gloria Leifer Test Bank Chapters 1–34
Chapter 1: The Past, Present, and Future (Questions 1–5)
1. A nurse is reviewing the history of maternity care. Which individual
introduced the concept of "trained nursing" and improved sanitation practices
during the Crimean War?
A) Clara Barton
B) Florence Nightingale
C) Lillian Wald
D) Dorothea Dix
Answer: B
Rationale: Florence Nightingale is credited with establishing trained nursing and
implementing sanitation practices that dramatically reduced mortality rates
during the Crimean War.
2. A nurse is explaining the role of the Children's Bureau to a community group.
Which accomplishment is attributed to this organization?
A) Establishment of the first neonatal intensive care unit
B) Development of the Apgar scoring system
C) Passage of the Sheppard-Towner Act of 1921 (promoting maternal and child
health)
D) Creation of the first nursing school in the United States
Answer: C
Rationale: The Children's Bureau advocated for and helped pass the Sheppard-
Towner Act (1921), which provided federal funding for maternal and child health
programs.
3. A nursing student is studying the history of pediatric nursing. Which
individual is known for establishing the Henry Street Settlement and advocating
for school nursing?
A) Florence Nightingale
B) Clara Barton
,C) Lillian Wald
D) Mary Breckinridge
Answer: C
Rationale: Lillian Wald founded the Henry Street Settlement in New York City and
established the first school nursing program.
4. A nurse is implementing family-centered care on a postpartum unit. Which
action best demonstrates this philosophy?
A) Restricting visitors to immediate family only
B) Allowing parents to be present during their infant's procedures
C) Limiting rooming-in to promote maternal rest
D) Discouraging sibling visitation to prevent infection
Answer: B
Rationale: Family-centered care encourages family involvement, including
parental presence during procedures, rooming-in, and sibling visitation.
5. A nurse is using evidence-based practice (EBP) to develop a new protocol for
newborn thermoregulation. What is the first step in the EBP process?
A) Implement the change in practice
B) Search the literature for best evidence
C) Formulate a clinical question (PICO format)
D) Evaluate the outcomes of the change
Answer: C
Rationale: The first step in evidence-based practice is formulating a clear,
answerable clinical question (often using PICO format).
Chapter 9: The Family After Birth (Questions 6–10)
6. A postpartum patient asks the nurse, "Why am I sweating so much at night?"
What is the best response?
A) "You may have an infection and need to be evaluated"
B) "Night sweats are a normal way your body gets rid of excess fluid from
pregnancy"
,C) "This is a sign of a thyroid disorder that developed during pregnancy"
D) "You should decrease your fluid intake to stop the sweating"
Answer: B
Rationale: Postpartum diaphoresis (night sweats) is a normal physiologic
response to eliminate excess fluid accumulated during pregnancy.
7. A patient who delivered 2 days ago reports that her lochia has changed from
red to pinkish-brown. The nurse documents this as:
A) Lochia rubra
B) Lochia serosa
C) Lochia alba
D) Abnormal finding indicating infection
Answer: B
Rationale: Lochia serosa (pinkish-brown) typically occurs from days 3–10
postpartum, following lochia rubra (red, days 1–3) and preceding lochia alba
(white/yellow, days 10–21).
8. A breastfeeding mother on postpartum day 2 reports that her breasts are
firm, warm, and slightly tender. What is the nurse's best action?
A) Notify the provider immediately
B) Encourage the mother to stop breastfeeding
C) Instruct the mother to apply cold packs after feeding and continue
breastfeeding
D) Administer antibiotics as ordered
Answer: C
Rationale: Breast engorgement is normal around day 2–4; treatment includes
cold packs after feeding, warm packs before feeding, and continued
breastfeeding.
9. A postpartum patient who delivered vaginally 6 hours ago has a boggy uterus
displaced to the right. What is the priority nursing action?
A) Document the finding as normal
B) Notify the provider immediately
C) Assist the patient to void, then reassess the uterus
D) Administer oxytocin (Pitocin) IV push
, Answer: C
Rationale: A displaced, boggy uterus often indicates a full bladder. The patient
should void (or be catheterized) and the uterus reassessed.
10. The nurse is teaching a postpartum patient about signs of infection. Which
statement by the patient indicates understanding?
A) "Fever is normal after delivery and I should not worry"
B) "I should call my provider if I notice foul-smelling lochia"
C) "Pain is not a sign of infection after delivery"
D) "Redness around my episiotomy means it is healing well"
Answer: B
Rationale: Foul-smelling lochia, fever, chills, and increasing perineal pain/redness
may indicate postpartum infection and should be reported.
Chapter 10: Nursing Care of Women with Complications After Birth (Questions
11–15)
11. A patient who delivered 4 hours ago has a blood pressure of 90/50 mmHg,
heart rate of 120 bpm, and a uterus that is firm but the patient has a large
amount of bright red lochia. What does the nurse suspect?
A) Uterine atony
B) Retained placental fragments
C) Vaginal or cervical laceration
D) Uterine rupture
Answer: C
Rationale: A firm uterus with heavy bright red bleeding suggests lower genital
tract trauma (laceration) rather than uterine atony.
12. A postpartum patient develops a fever of 101.5°F on day 2 with lower
abdominal tenderness and foul-smelling lochia. What condition does the nurse
suspect?
A) Mastitis
B) Endometritis
C) Urinary tract infection
D) Wound infection
