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b b b b
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,Chapter 01: 21st Century Maternity and Women’s Health Nursing
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Lowdermilk: Maternity & Women’s Health Care, 11th Edition
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MULTIPLE CHOICE b
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW) infant,
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b which factor is the most important for the nurse to consider?
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a. African-American race b
b. Cigarette smoking b
c. Poor nutritional status b b
d. Limited maternal education b b
ANS: A b
For African-American births, the incidence of LBW infants is twice that of Caucasian births.
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Race is a non-modifiable risk factor. Cigarette smoking is an important factor in potential infant
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mortality rates, but it is not the most important. Additionally, smoking is a modifiable risk factor.
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Poor nutrition is an important factor in potential infant mortality rates, but it is not the most
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important. Additionally, nutritional status is a modifiable risk factor. Maternal education is an
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important factor in potential infant mortality rates, but it is not the most important. Additionally,
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maternal education is a modifiable risk factor.
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DIF: Cognitive Level: Understand REF: p.6 b b b b
TOP: Nursing Process: Assessment
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MSC: Client Needs: Health Promotion and Maintenance, Antepartum Care
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2. What is the primaryrole of practicing nurses in the research process?
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a. Designing research studieNs RIGB.C b b
b b b
b. Collecting data for other researchers b b b b
c. Identifying researchable problems b b
d. Seeking funding to support research studies b b b b b
ANS: C b
When problems are identified, research can be properly conducted. Research of health care issues
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leads to evidence-based practice guidelines. Designing research studies is only one factor of the
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research process. Data collection is another factor of research. Financial support is necessary to
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conduct research, but it is not the primary role of the nurse in the research process.
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DIF: Cognitive Level: Understand REF: p. 14 b b b b TOP: NursingProcess: N/A b b b
MSC: Client Needs: Safe and Effective Care Environment
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3. A 23-year-old African-American woman is pregnant with her first child. Based on the
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statistics for infant mortality, which plan is most important for the nurse to implement?
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a. Perform a nutrition assessment. b b b
b. Refer the woman to a social worker. b b b b b b
c. Advise the woman to see an obstetrician, not a midwife. b b b b b b b b b
d. Explain to the woman the importance of keeping her prenatal care appointments. b b b b b b b b b b b
ANS: D b
Consistent prenatal care is the best method of preventing or controlling risk factors
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, associatedwith infant mortality. Nutritional status is an important modifiable risk factor, but it is b b b b b b b b b b b b b
not themost important action a nurse should take in this situation. The client may need assistance
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from a social worker at some time during her pregnancy, but a referral to a social worker is not the
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most important aspect the nurse should address at this time. If the woman has identifiable high-
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risk 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 whichthe 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.
b
DIF: Cognitive Level: Understand REF: p. 6 b b b b TOP: NursingProcess: Planning b b b
MSC: Client Needs: Health Promotion and Maintenance
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4. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of
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a 21-year-old Hispanic client with limited English proficiency. Which action is the most
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important for the nurse to perform?
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a. Use maternity jargon to enable the client to become familiar with these terms.
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b. Speak quickly and efficiently to expedite the visit. b b b b b b b
c. Provide the client with handouts. b b b b
d. Assess whether the client understands the discussion. b b b b b b
ANS: D b
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
NRIGB.C
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English proficiency. b b b b
b b
DIF: Cognitive Level: Apply REF: p. 5 b b b b TOP: Nursing Process: Evaluation b b b
MSC: Client Needs: Health Promotion and Maintenance
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5. The nurses working at a newly established birthing center have begun to compare their
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performance in providing maternal-newborn care against clinical standards. This comparison
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process is most commonly known as what?
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a. Best practices network b b
b. Clinical benchmarking b
c. Outcomes-oriented practice b
d. Evidence-based practice b
ANS: C b
Outcomes-oriented practice measures the effectiveness of the interventions and quality of care b b b b b b b b b b b
against benchmarks or standards. The term best practice refers to a program or service that has
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been 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.
b
DIF: Cognitive Level: Understand REF: p. 11 b b b b TOP: Nursing Process: Evaluation b b b
MSC: Client Needs: Safe and Effective Care Environment
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6. Which statement best exemplifies contemporary maternity nursing?
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a. Use of midwives for all vaginal deliveries
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b. Family-centered care b
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, c. Free-standing birth clinics b b
d. Physician-driven care b
ANS: B b
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partners, b b b b b b b b b b b
grandparents, and siblings may be present for the birth and participate in activities such as
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cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliveries.
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Free-standing clinics are an example of alternative birth options. Contemporary maternity
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nursing is driven by the relationship between nurses and their clients.
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DIF: Cognitive Level: Understand REF: pp. 8-9 b b b b TOP: NursingProcess: Planning b b b
MSC: Client Needs: Health Promotion and Maintenance
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7. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after 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. Inexperienced maternity nurse was assigned to care for the client. b b b b b b b b b
b. Client was past her due date by 3 days. b b b b b b b b
c. Standard of care was not met. b b b b b
d. Client refused electronic fetal monitoring. b b b b
ANS: C b
Not meeting the standard of care is a legitimate factor for a case of negligence. An inexperienced
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maternity nurse would need to display competency before being assigned to
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care for clients on his or her N
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ave been past her due date; however, a term b b b b b b b b b b b b b b b
pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the standard of
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care, the client has the right to refuse treatment. This refusal is not a case for
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negligence, but infor xonsent should be properly obtained, and the client should have signed an
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against medical advice form when refusing any treatment that is within the standard of care.
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DIF: Cognitive Level: Analyze REF: p.13 b b b b
TOP: Nursing Process: Implementation
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MSC: Client Needs: Safe and Effective Care Environment
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8. When the nurse is unsure how to perform a client care procedure that is high risk and low
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b volume, his or her best action in this situation would be what?
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a. Ask another nurse. b b
b. Discuss the procedure with the client’s physician. b b b b b b
c. Look up the procedure in a nursing textbook. b b b b b b b
d. Consult the agency procedure manual, and follow the guidelines for the procedure. b b b b b b b b b b b
ANS: D b
Following the agency’s policies and procedures manual is always best when seeking information
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bon correct client procedures. These policies should reflect the current standards of care and the
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bindividual state’s guidelines. Each nurse is responsible for his or her own practice. Relying on
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banother nurse may not always be a safe practice. Each nurse is obligated to follow the standards of
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bcare for safe client care delivery. Physicians are responsible for their own client care activity.
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bNurses may follow safe orders from physicians, but they are also responsible for the activities that
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bthey, as nurses, are to carry out. Information provided in a nursing textbook is basic information
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bfor general knowledge. Furthermore, the information in a textbook may not reflect the current
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bstandard of care or the individual state or hospital policies. b b b b b b b b b
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