TEST BANK FOR FOUNDATIONS OF MATERNAL-
NEWBORN AND WOMEN’S HEALTH NURSING
8TH EDITION BY MURRAY
,Chapter 01: Maternity and Women’s Health Care Today
Foundations of Maternal-Newborn & Women’s Health Nursing, 8th Edition
MULTIPLE CHOICE
1. A nurse educator is teaching a group of nursing students about the history of family-centered
maternity care. Which statement should the nurse include in the teaching session?
a. The Sheppard-Towner Act of 1921 promoted family-centered care.
b. Changes in pharmacologic management of labor prompted family-centered care.
c. Demands by physicians for family involvement in childbirth increased the practice
of family-centered care.
d. Parental requests that infants be allowed to remain with them rather than in a
nursery initiated the practice of family-centered care.
ANS: D
As research began to identify the benefits of early, extended parent–infant contact, parents
began to insist that the infant remain with them. This gradually developed into the practice of
rooming-in and finally to family-centered maternity care. The Sheppard-Towner Act provided
funds for state-managed programs for mothers and children but did not promote
family-centered care. The changes in pharmacologic management of labor were not a factor in
family-centered maternity care. Family-centered care was a request by parents, not physicians.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Health Promotion and Maintenance
2. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth limits the
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amount of parent–infant interacUtionS?” N
WhT Oer should the nurse provide for these
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parents in order to assist them in choosing an appropriate birth setting?
a. Birth center
b. Home birth
c. Traditional hospital birth
d. Labor, birth, and recovery room
ANS: C
In the traditional hospital setting, the mother may see the infant for only short feeding periods,
and the infant is cared for in a separate nursery. Birth centers are set up to allow an increase in
parent–infant contact. Home births allow the greatest amount of parent–infant contact. The
labor, birth, recovery, and postpartum room setting allows for increased parent–infant contact.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Health Promotion and Maintenance
3. Which statement best describes the advantage of a labor, birth, recovery, and postpartum
(LDRP) room?
a. The family is in a familiar environment.
b. They are less expensive than traditional hospital rooms.
c. The infant is removed to the nursery to allow the mother to rest.
d. The woman’s support system is encouraged to stay until discharge.
ANS: D
, Sleeping equipment is provided in a private room. A hospital setting is never a familiar
environment to new parents. An LDRP room is not less expensive than a traditional hospital
room. The baby remains with the mother at all times and is not removed to the nursery for
routine care or testing. The father or other designated members of the mother’s support system
are encouraged to stay at all times.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance
4. Which nursing intervention is an independent function of the professional nurse?
a. Administering oral analgesics
b. Requesting diagnostic studies
c. Teaching the patient perineal care
d. Providing wound care to a surgical incision
ANS: C
Nurses are now responsible for various independent functions, including teaching, counseling,
and intervening in nonmedical problems. Interventions initiated by the physician and carried
out by the nurse are called dependent functions. Administrating oral analgesics is a dependent
function; it is initiated by a physician and carried out by a nurse. Requesting diagnostic
studies is a dependent function. Providing wound care is a dependent function; however, the
physician prescribes the type of wound care through direct orders or protocol.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Safe and Effective Care Environment
5. Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to
have a cesarean birth”? .
a. “Everything will be OK.”
b. “Don’t worry about it. It will be over soon.”
c. “What concerns you most about a cesarean birth?”
d. “The physician will be in later and you can talk to him.”
ANS: C
The response, “What concerns you most about a cesarean birth” focuses on what the patient is
saying and asks for clarification, which is the most therapeutic response. The response,
“Everything will be ok” is belittling the patient’s feelings. The response, “Don’t worry about
it. It will be over soon” will indicate that the patient’s feelings are not important. The
response, “The physician will be in later and you can talk to him” does not allow the patient to
verbalize her feelings when she wishes to do that.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Psychosocial Integrity
6. In which step of the nursing process does the nurse determine the appropriate interventions for
the identified nursing diagnosis?
a. Planning
b. Evaluation
c. Assessment
d. Intervention
ANS: A
, The third step in the nursing process involves planning care for problems that were identified
during assessment. The evaluation phase is determining whether the goals have been met.
During the assessment phase, data are collected. The intervention phase is when the plan of
care is carried out.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
7. Which goal is most appropriate for the collaborative problem of wound infection?
a. The patient will not exhibit further signs of infection.
b. Maintain the patient’s fluid intake at 1000 mL/8 hour.
c. The patient will have a temperature of 98.6F within 2 days.
d. Monitor the patient to detect therapeutic response to antibiotic therapy.
ANS: D
In a collaborative problem, the goal should be nurse-oriented and reflect the nursing
interventions of monitoring or observing. Monitoring for complications such as further signs
of infection is an independent nursing role. Intake and output is an independent nursing role.
Monitoring a patient’s temperature is an independent nursing role.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
8. Which nursing intervention is written correctly?
a. Force fluids as necessary.
b. Observe interaction with the infant.
c. Encourage turning, coughing, and deep breathing.
d. Assist to ambulate for 10N
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ANS: D
Interventions might not be carried out if they are not detailed and specific. “Force fluids” is
not specific; it does not state how much or how often. Encouraging the patient to turn, cough,
and breathe deeply is not detailed or specific. Observing interaction with the infant does not
state how often this procedure should be done. Assisting the patient to ambulate for 10
minutes within a certain timeframe is specific.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
9. The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which
response by the nurse would be the most therapeutic?
a. “You’re afraid to take the baby home?”
b. “Don’t you have a mother who can come and help?”
c. “You should read the literature I gave you before you leave.”
d. “I was scared when I took my first baby home, but everything worked out.”
ANS: A
, This response uses reflection to show concern and open communication. The other choices are
blocks to communication. Asking if the patient has a mother who can come and assist blocks
further communication with the patient. Telling the patient to read the literature before leaving
does not allow the patient to express her feelings further. Sharing your own birth experience is
inappropriate.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Psychosocial Integrity
10. The nurse is writing an expected outcome for the nursing diagnosis—acute pain related to
tissue trauma, secondary to vaginal birth, as evidenced by patient stating pain of 8 on a scale
of 10. Which expected outcome is correctly stated for this problem?
a. Patient will state that pain is a 2 on a scale of 10.
b. Patient will have a reduction in pain after administration of the prescribed
analgesic.
c. Patient will state an absence of pain 1 hour after administration of the prescribed
analgesic.
d. Patient will state that pain is a 2 on a scale of 10, 1 hour after the administration of
the prescribed analgesic.
ANS: D
The outcome should be patient-centered, measurable, realistic, and attainable and within a
specified timeframe. Patient stating that her pain is now 2 on a scale of 10 lacks a timeframe.
Patient having a reduction in pain after administration of the prescribed analgesic lacks a
measurement. Patient stating an absence of pain 1 hour after the administration of prescribed
analgesic is unrealistic.
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DIF: Cognitive Level: ApplicatU
ion S N OT BJ: NuOrsing Process Step: Planning
MSC: Patient Needs: Physiologic Integrity
11. Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?
a. Risk for anxiety related to upcoming birth
b. Risk for imbalanced nutrition related to NPO status
c. Risk for altered family processes related to new addition to the family
d. Risk for injury (maternal) related to altered sensations and positional or physical
changes
ANS: D
The nurse should determine which problem needs immediate attention. Risk for injury is the
problem that has the priority at this time because it is a safety problem. Risk for anxiety,
imbalanced nutrition, and altered family processes are not the priorities at this time.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Safe and Effective Care Environment
12. Regarding advanced roles of nursing, which statement related to clinical practice is the most
accurate?
a. Family nurse practitioners (FNPs) can assist with childbirth care in the hospital
setting.
b. Clinical nurse specialists (CNSs) provide primary care to obstetric patients.
c. Neonatal nurse practitioners provide emergency care in the postbirth setting to
, high-risk infants.
d. A certified nurse midwife (CNM) is not considered to be an advanced practice
nurse.
ANS: C
Neonatal NPs provide care for the high-risk neonate in the birth room and in the neonatal
intensive care unit, as needed. FNPs do not participate in childbirth care; however, they can
take care of uncomplicated pregnancies and postbirth care outside of the hospital setting.
CNSs work in hospital settings but do not provide primary care services to patients. A CNM is
an advanced practice nurse who receives additional certification in the specific area of
midwifery.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Evaluation
MSC: Patient Needs: Management of Care: Legal Rights and Responsibilities
13. Which statement is true regarding the shortage of nurses in the United States?
a. There are a larger proportion of younger nurses in the workforce as compared with
older nurses.
b. As a result of decreased RN-to-patient ratios, there is a decrease in patient
mortality in the clinical setting.
c. Nursing programs are turning away qualified applicants.
d. There are adequate classroom and clinical facilities for training RNs.
ANS: C
According to an Institute of Medicine (IOM) report, by the year 2020, 80% of new RNs
should hold baccalaureate degrees. Despite this need, baccalaureate and master’s programs are
turning away qualified applicants due to an insufficient number of faculty. There are a larger
proportion of older nurses inN eR
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n current research by the IOM. Increased
nurse-to-patient ratios have resulted in decreased patient mortality in the clinical setting.
There are currently numerous limitations of both classroom and clinical facilities necessary to
train new nurses adequately.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Health Promotion: Teaching/Learning
14. A hospital has achieved Magnet status. Which indicators would be consistent with this type of
certification?
a. There is stratification of communication in a directed manner between nursing
staff and administration.
b. There is increased job satisfaction of nurses, with a lower staff turnover rate.
c. Physicians are certified in their respective specialty areas.
d. All nurses have baccalaureate degrees and certification in their clinical specialty
area.
ANS: B
Magnet status is a certification offered by the ANCC (American Nurses Credentialing Center)
in which hospitals apply based on designated criteria that consider nurse job satisfaction, staff
patterns, strength, quality of nursing staff, and open communication. It is not based on
physician status. Also, certification is not required for all nurses at this point. The expectation
with Magnet status is that nurses will continue to expand their knowledge by earning
additional degrees and certification.
, DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion: Teaching/Learning
15. Which of the following statements highlights the nurse’s role as a researcher?
a. Reading peer-reviewed journal articles
b. Working as a member of the interdisciplinary team to provide patient care
c. Helping patient to obtain home care postdischarge from the hospital
d. Delegating tasks to unlicensed personnel to allow for more teaching time with
patients
ANS: A
A nurse in a researcher role should look to improve her or his knowledge base by reading and
reviewing evidence-based practice information as found in peer-reviewed journals. Working
as a member of the interdisciplinary team to provide patient care indicates that the nurse is
working as a collaborator. Helping the patient to obtain home care postdischarge from the
hospital indicates that the nurse is working as a patient advocate. Delegating tasks to
unlicensed personnel in order to allow for more teaching time with patients indicates that the
nurse is working as a manager.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion: Teaching/Learning
16. Which patient could safely be cared for by a certified nurse-midwife?
a. Gravida 3, para 2, with no complications
b. Gravida 1, para 0, with mild hypertension
c. Gravida 2, para 1, with insulin-dependent diabetes
d. Gravida 1, para 0, with bN deR
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ANS: A
A certified nurse-midwife (CNM) cares for women who are at low risk for complications. The
CNM would not care for a woman with hypertension. The CNM would not care for a woman
with insulin-dependent diabetes. The CNM would not care for a woman with borderline
pelvic measurements.
DIF: Cognitive Level: Analysis OBJ: Nursing Process Step: Evaluation
MSC: Patient Needs: Health Promotion and Maintenance
17. A primipara patient asks about possible support options for her during the labor process. She
is apprehensive that her family members will not be prepared to assist her during this time.
Which option would be most effective for this patient?
a. Reassure the patient that the labor and birth staff consists of highly trained nurses
who are well educated to take care of laboring patients so that should be sufficient.
b. Encourage the patient to take prepared childbirth classes with her husband because
that should provide the best support by a family member.
c. Provide information to the patient about obtaining a doula during the labor process.
d. Tell the patient that this is a normal feeling based on fear of the unknown and that
it will subside once she starts the labor process.
ANS: C
, Providing information about a doula addresses the patient’s concern because the doula’s
designated role is to provide support during labor. Although it is true that labor and birth
nurses are trained in their specialty, the patient is voicing concern for support so her feelings
should not be minimized. Encouraging the patient to take prepared childbirth classes is also
important; however, it does not address the patient’s concern for support. Because this patient
is a primipara, it is normal to have some anxiety over the unknown process of the labor
experience but again this response minimizes the patient’s concern.
DIF: Cognitive Level: Analysis OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Psychologic Integrity
18. The nurse states to the newly pregnant patient, “Tell me how you feel about being pregnant.”
Which communication technique is the nurse using with this patient?
a.Clarifying
b.Paraphrasing
c.Reflection
d.Structuring
ANS: A
The nurse is attempting to follow up and check the accuracy of the patient’s message.
Paraphrasing is restating words other than those used by the patient. Reflection is verbalizing
comprehension of what the patient has said. Structuring takes place when the nurse has set
guidelines or set priorities.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Analysis
MSC: Patient Needs: Health Promotion and Maintenance
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doula to the hospital during labor. What does the nurse think that this means?
a. The patient will have her grandmother as a support person.
b. The patient will bring a paid, trained labor support person with her during labor.
c. The patient will have a special video she will play during labor to assist with
relaxation.
d. The patient will have a bag that contains all the approved equipment that may help
with the labor process.
ANS: B
A doula is a trained labor support person who is employed by the mother to provide labor
support. She gives physical support such as massage, helps with relaxation, and provides
emotional support and advocacy throughout labor. A doula is usually not a relative of the
woman. A doula is a trained labor support person.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance
MULTIPLE RESPONSE
1. In consideration of the historic evolution of maternity care, which treatment options were used
over the past century? (Select all that apply.)
a. During the nineteenth century, women of privilege were delivered by midwives in
a hospital setting.
, b. Granny midwives received their training through a period of apprenticeship.
c. The recognition of improved obstetric outcomes was related to increased usage of
hygienic practices.
d. A shift to hospital-based births occurred as a result of medical equipment designed
to facilitate birth.
e. The use of chloroform by midwives led to decreased pain during birth.
ANS: B, C, D
Training of granny midwives was done by apprenticeship as opposed to formal medical
school training. With the advent of usage of hygienic practices, improved health outcomes
were seen with regard to a decrease in sepsis. New equipment such as forceps enabled easier
birth. Women of privilege in the nineteenth century delivered at home, attended by a midwife.
Chloroform was used by physicians and was not available to midwives.
DIF: Cognitive Level: Analysis OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Health Promotion and Maintenance
2. Many communities now offer the availability of free-standing birth centers to provide care for
low-risk women during pregnancy, birth, and postpartum. When counseling the newly
pregnant patient regarding this option, the nurse should be aware that this type of care setting
includes which advantages? (Select all that apply.)
a. Staffing by lay midwives
b. Equipped for obstetric emergencies
c. Less expensive than acute care hospitals
d. Safe, homelike births in a familiar setting
e. Access to follow-up care for 6 weeks postpartum
ANS: C, D, E .
Patients who are at low risk and desire a safe, homelike birth are very satisfied with this type
of care setting. The new mother may return to the birth center for postpartum follow-up care,
breastfeeding assistance, and family planning information for 6 weeks postpartum. Because
birth centers do not incorporate advanced technologies into their services, costs are
significantly less than in a hospital setting. The major disadvantage of this care setting is that
these facilities are not equipped to handle obstetric emergencies. Should unforeseen
difficulties occur, the patient must be transported by ambulance to the nearest hospital. Birth
centers are usually staffed by certified nurse-midwives (CNMs).
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment
3. The nurse is assessing a patient’s use of complementary and alternative therapies. Which
should the nurse document as an alternative or complementary therapy practice? (Select all
that apply.)
a. Practicing yoga daily
b. Drinking green tea in the morning
c. Taking omeprazole (Prilosec) once a day
d. Using aromatherapy during a relaxing bath
e. Wearing a lower back brace when lifting heavy objects
ANS: A, B, D
, Complementary and alternative (CAM) therapies can be defined as those systems, practices,
interventions, modalities, professions, therapies, applications, theories, and claims that are
currently not an integral part of the conventional medical system in North America. Yoga is
considered to be a mind–body alternative therapy. Green tea and aromatherapy are
biologically based complementary therapies. Prilosec and the use of a lower back brace would
be therapies consistent with those used by conventional medicine.
DIF: Cognitive Level: Analysis OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance
4. The nurse is formulating a nursing care plan for a postpartum patient. Which actions by the
nurse indicate use of critical thinking skills when formulating the care plan? (Select all that
apply.)
a. Using a standardized postpartum care plan
b. Determining priorities for each diagnosis written
c. Writing interventions from a nursing diagnosis book
d. Reflecting and suspending judgment when writing the care plan
e. Clustering data during the assessment process according to normal versus
abnormal
ANS: B, D, E
Critical thinking focuses on appraisal of the way the individual thinks, and it emphasizes
reflective skepticism. Determining priorities, reflecting and suspending judgment, and
clustering data are actions that indicate the use of critical thinking. Using a standardized care
plan and writing interventions from a nursing diagnosis book do not show that reflection
about the patient’s individual care is being done.
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DIF: Cognitive Level: ApplicatU
ion S N OT BJ: NuOrsing Process Step: Planning
MSC: Patient Needs: Physiologic Integrity
5. The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the
nurse delegate? (Select all that apply.)
a. Teaching the patient about breast care
b. Assessment of a patient’s lochia and perineal area
c. Assisting a patient to the bathroom for the first time after birth
d. Vital signs on a postpartum patient who delivered the night before
e. Assisting a postpartum patient to take a shower on the second postpartum day
ANS: D, E
Nurses must be aware that they remain legally responsible for patient assessments and must
make the critical judgments necessary to ensure patient safety when delegating tasks to
unlicensed personnel. The nurse cannot delegate assessment, teaching, or evaluation. The two
tasks that the nurse can delegate are vital signs on a stable postpartum patient and assisting a
stable postpartum patient on the second postpartum day to take a shower.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Safe and Effective Care Environment
