Chapter 01- Chapter 37: 21st
Century Maternity and Women’s
Health Nursing Lowdermilk:
Maternity & Women’s Health
Care, 11th Edition
MULTIPLE CHOICE
Chapter 1
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
For African-American births, the incidence of LBW infants is twice that of
Caucasian births. 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: Understand REF: p.
6 TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance, Antepartum Care
2. What is the primary role of practicing nurses in the research process?
a. Designing research studies
b. Collecting data for other researchers
c. Identifying researchable problems
d. Seeking funding to support research
studies
ANS: C
When problems are identified, research can be properly conducted.
Research of health care issues leads to evidence-based practice guidelines.
Designing research studies is only one factor of the research process. Data
collection is another factor of research. Financial support is necessary to
conduct research, but it is not the primary role of the nurse in the research
process.
, DIF: Cognitive Level: Understand REF: p. 14 TOP: Nursing Process:
N/A MSC: Client Needs: Safe and Effective Care Environment
3. A 23-year-old African-American woman is pregnant with her first
child. Based on the statistics for infant mortality, which plan is most
important for the nurse to implement?
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: Understand REF: p. 6 TOP: Nursing Process:
Planning MSC: Client Needs: Health Promotion and Maintenance
4. 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 action is the most important for the nurse to perform?
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: Apply REF: p. 5 TOP: Nursing Process:
Evaluation MSC: Client Needs: Health Promotion and Maintenance
5. 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: C
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: Understand REF: p. 11 TOP: Nursing Process:
Evaluation MSC: Client Needs: Safe and Effective Care Environment
6. 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: Understand REF: pp. 8-9 TOP: Nursing Process:
Planning MSC: Client Needs: Health Promotion and Maintenance
7. A 38-year-old Hispanic 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: Analyze REF: p.
13 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
8. 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. Consult the agency procedure manual, and follow the guidelines for
the procedure.
ANS: D
Century Maternity and Women’s
Health Nursing Lowdermilk:
Maternity & Women’s Health
Care, 11th Edition
MULTIPLE CHOICE
Chapter 1
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
For African-American births, the incidence of LBW infants is twice that of
Caucasian births. 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: Understand REF: p.
6 TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance, Antepartum Care
2. What is the primary role of practicing nurses in the research process?
a. Designing research studies
b. Collecting data for other researchers
c. Identifying researchable problems
d. Seeking funding to support research
studies
ANS: C
When problems are identified, research can be properly conducted.
Research of health care issues leads to evidence-based practice guidelines.
Designing research studies is only one factor of the research process. Data
collection is another factor of research. Financial support is necessary to
conduct research, but it is not the primary role of the nurse in the research
process.
, DIF: Cognitive Level: Understand REF: p. 14 TOP: Nursing Process:
N/A MSC: Client Needs: Safe and Effective Care Environment
3. A 23-year-old African-American woman is pregnant with her first
child. Based on the statistics for infant mortality, which plan is most
important for the nurse to implement?
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: Understand REF: p. 6 TOP: Nursing Process:
Planning MSC: Client Needs: Health Promotion and Maintenance
4. 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 action is the most important for the nurse to perform?
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: Apply REF: p. 5 TOP: Nursing Process:
Evaluation MSC: Client Needs: Health Promotion and Maintenance
5. 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: C
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: Understand REF: p. 11 TOP: Nursing Process:
Evaluation MSC: Client Needs: Safe and Effective Care Environment
6. 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: Understand REF: pp. 8-9 TOP: Nursing Process:
Planning MSC: Client Needs: Health Promotion and Maintenance
7. A 38-year-old Hispanic 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: Analyze REF: p.
13 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
8. 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. Consult the agency procedure manual, and follow the guidelines for
the procedure.
ANS: D
