Chapter 01: 21st Century Maternity and Women’s Health Nursing
Lowdermilk: Maternity & Women’s Health Care, 12th Edition
MULTIPLE CHOICE
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW) infant, which
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 were due to increases in LBW births to non-Hispanic black women
women (7.21%); non-Hispanic black infants are almost twice as likely as non-Hispanic white infants
the first year of life.. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in
rates, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor nutritio
potential infant mortality rates, but it is not the most important. Additionally, nutritional status is a m
Maternal education is an important factor in potential infant mortality rates, but it is not the most imp
maternal education is a modifiable risk factor.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: 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 f
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 in
status is an important modifiable risk factor, but it is not the most important action a nurse should tak
may need assistance from a social worker at some time during her pregnancy, but a referral to a socia
important aspect the nurse should address at this time. If the woman has identifiable high-risk proble
need to be provided by a physician. However, it cannot be assumed that all African-American wome
addition, advising the woman to see an obstetrician is not the most important aspect on which the nur
and it is not appropriate for a nurse to advise or manage the type of care a client is to receive.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: 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 2
with limited English proficiency. Which intervention is the most important for the nurse to implemen
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
understands the discussion. Speaking slowly and clearly and focusing on what is important will incre
client education materials are written at a level too high for the average adult and may not be useful f
English proficiency.
, 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, grandp
present for the birth and participate in activities such as cutting the baby’s umbilical cord. Both midw
vaginal deliveries. Free-standing clinics are an example of alternative birth options. Contemporary m
the relationship between nurses and their clients.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after being in labor
3 days later from sepsis. On what grounds could the woman have a legitimate legal case for negligen
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 ma
display competency before being assigned to care for clients on his or her own. This client may have
however, a term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is th
has the right to refuse treatment. This refusal is not a case for negligence, but informed consent shoul
the client should have signed an against medical advice form when refusing any treatment that is wit
PTS: 1 DIF: Cognitive Level: Analyze
TOP: Nursing Process: 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, hi
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
These policies should reflect the current standards of care and the individual state’s guidelines. Each
or her own practice. Relying on another nurse may not always be a safe practice. Each nurse is obliga
of care for safe client care delivery. Physicians are responsible for their own client care activity. Nurs
from physicians, but they are also responsible for the activities that they, as nurses, are to carry out. I
nursing textbook is basic information for general knowledge. Furthermore, the information in a textb
current standard of care or the individual state or hospital policies.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic 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 to 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
Lowdermilk: Maternity & Women’s Health Care, 12th Edition
MULTIPLE CHOICE
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW) infant, which
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 were due to increases in LBW births to non-Hispanic black women
women (7.21%); non-Hispanic black infants are almost twice as likely as non-Hispanic white infants
the first year of life.. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in
rates, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor nutritio
potential infant mortality rates, but it is not the most important. Additionally, nutritional status is a m
Maternal education is an important factor in potential infant mortality rates, but it is not the most imp
maternal education is a modifiable risk factor.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: 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 f
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 in
status is an important modifiable risk factor, but it is not the most important action a nurse should tak
may need assistance from a social worker at some time during her pregnancy, but a referral to a socia
important aspect the nurse should address at this time. If the woman has identifiable high-risk proble
need to be provided by a physician. However, it cannot be assumed that all African-American wome
addition, advising the woman to see an obstetrician is not the most important aspect on which the nur
and it is not appropriate for a nurse to advise or manage the type of care a client is to receive.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: 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 2
with limited English proficiency. Which intervention is the most important for the nurse to implemen
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
understands the discussion. Speaking slowly and clearly and focusing on what is important will incre
client education materials are written at a level too high for the average adult and may not be useful f
English proficiency.
, 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, grandp
present for the birth and participate in activities such as cutting the baby’s umbilical cord. Both midw
vaginal deliveries. Free-standing clinics are an example of alternative birth options. Contemporary m
the relationship between nurses and their clients.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after being in labor
3 days later from sepsis. On what grounds could the woman have a legitimate legal case for negligen
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 ma
display competency before being assigned to care for clients on his or her own. This client may have
however, a term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is th
has the right to refuse treatment. This refusal is not a case for negligence, but informed consent shoul
the client should have signed an against medical advice form when refusing any treatment that is wit
PTS: 1 DIF: Cognitive Level: Analyze
TOP: Nursing Process: 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, hi
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
These policies should reflect the current standards of care and the individual state’s guidelines. Each
or her own practice. Relying on another nurse may not always be a safe practice. Each nurse is obliga
of care for safe client care delivery. Physicians are responsible for their own client care activity. Nurs
from physicians, but they are also responsible for the activities that they, as nurses, are to carry out. I
nursing textbook is basic information for general knowledge. Furthermore, the information in a textb
current standard of care or the individual state or hospital policies.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic 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 to 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
