,Table of Content
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COMPLETION ................................................................................................................................................. 132
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,Chapter 1: 21st Century Maternity and Women’s Health Nursing
MULTIPLE CHOICE
1. In evaluating the level of a pregnant woman 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
SELECTED ANSWER: 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: IM:
TOPIC: 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
SELECTED ANSWER: 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: im: 14 TOPIC: Nursing Process:
N/AMSC: 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.
SELECTED ANSWER: 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: IM: TOPIC: 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.
SELECTED ANSWER: 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: im: 5 TOPIC: Nursing Process:
EvaluationMSC: 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
SELECTED ANSWER: 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 ones 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: im: 11 TOPIC: Nursing Process:
EvaluationMSC: 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
SELECTED ANSWER: B
Contemporary maternity nursing focuses on the familys needs and desires. Fathers, partners,
grandparents, and siblings may be present for the birth and participate in activities such as
cutting the babys umbilical cord. Both midwives and physiciSELECTED ANSWER
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 TOPIC: Nursing Process:
PlanningMSC: 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.
SELECTED ANSWER: 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: im: 13
TOPIC: 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 clients physician.
c. Look up the procedure in a nursing textbook.
d. Consult the agency procedure manual, and follow the guidelines for the
procedure.
SELECTED ANSWER: D
Following the agencys policies and procedures manual is always best when seeking information
on correct client procedures. These policies should reflect the current standards of care and the
individual states guidelines. Each nurse is responsible for his or her own practice. Relying on
another nurse may not always be a safe practice. Each nurse is obligated to follow the standards
, of care for safe client care delivery. PhysiciSELECTED ANSWER are responsible for their
own client care activity.Nurses may follow safe orders from physiciSELECTED ANSWER,
but they are also responsible for the activities that they, as nurses, are to carry out. Information
provided in a nursing textbook is basic information for general knowledge. Furthermore, the
information in a textbook may not reflect the current standard of care or the individual state or
hospital policies.
DIF: Cognitive Level: Understand REF: im: 13
TOPIC: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
9. The National Quality Forum has issued a list of never events specifically pertaining to
maternal and child health. These include all of the following except:
a. infant discharged to the wrong person.
b. kernicterus associated with the failure to identify and treat hyperbilirubinemia.
c. artificial insemination with the wrong donor sperm or egg.
d. foreign object retained after surgery.
SELECTED ANSWER: D
Although a foreign object retained after surgery is a never event, it does not specifically pertain
to obstetric clients. A client undergoing any type of surgery may be at risk for this event. An
infant discharged to the wrong person specifically pertains to postpartum care. Death or serious
disability as a result of kernicterus pertains to newborn assessment and care. Artificial
insemination affects families seeking care for infertility.
DIF: Cognitive Level: Remember REF: im: 4
TOPIC: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
10. A nurse caring for a pregnant client should be aware that the U.S. birth rate shows what
trend?
