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, Maternityand Women's Health Carei13thiEdition LowdermilkiTest
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Chapter01:21stCenturyMaternityand Women’sHealthNursing Lowdermilk: u i u
Maternity& Women’s Health Care, 12th Edition
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MULTIPLECHOICE
1. In evaluatingitheilevel ofa pregnant woman’s risk of havingialow-birth-
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weight (LBW) infant, which factor is the most important for the nurseito consider?
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a. African-Americanrace
b. Cigarettesmoking
c. Poornutritionalstatus
d. Limitedmaternaleducation
ANS: A uu
The riseiinitheioverall LBW rates were dueito increases iniLBW births to non- uu uu uu uu
Hispanicblackwomen(13.35%) and Hispanicwomen(7.21%); non-
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Hispanic black infants areialmost twice as likelyasinon-
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Hispanic white infants to beiof LBW and to dieiin the first yearoflife..Raceisanonmodifiableris
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kfactor. Cigaretteismokingisan important factorin potential infant mortalityrates, but it is not th
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eimostiimportant. Additionally, smoking isia modifiable risk factor. Poor nutrition is aniimporta
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ntifactor in potential infantimortalityrates, butiit is not the mostiimportant. Additionally, nutritio
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nal status is a modifiable riskifactor. Maternal education is an important factor in potential infant
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mortalityrates,ibut it is not the most important. Additionally, maternal education isia modifiable
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risk factor.
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PTS: 1 DIF:
CognitiveLevel:Understand TOP: u
Nursing Process: Assessment u uu
MSC: Client Needs: HealtN PrRoS
hU mI ioG
otN nTanBd.MCaO
inM
tenance, Antepartum Care
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2. A 23-year-old African-
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Americaniwoman is pregnant with her first child. Based onicurrent statisticsifor infant mortalit u
y, which intervention isimost important forthe nurseito includeiin the client’s plan of care?
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a. Performianutrition assessment.
b. Refertheiwoman toiasocial worker.
c. Advisethewomanitosee aniobstetrician, notiamidwife. u uu
d. Explaintothe womanitheimportanceofkeepingher prenatal care appointments.
ANS: D uu
Consistent prenatal careiis the best method ofpreventingor controllingirisk factors associatedw
ithinfantmortality. Nutritionalstatusiisian importantmodifiableirisk factor,but it is not themost i
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mportantiaction a nurseishould take in this situation. Theiclientimayneediassistance fromiasocia
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liworker at some timeiduringher pregnancy, but aireferral to a socialiworker is not the most impor
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tant aspectithe nurse should address at this time. If the womanihas identifiable high-
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riskiproblems, theniher health care mayneed to be provided bya physician. However, it cannot b
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eiassumed that all African-American women have high-
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riskiissues. Iniaddition, advisingitheiwoman to see aniobstetrician is not the most important aspec
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tion which the nurse shouldifocus at this time,iandiitiis notiappropriateifor ainurse to advise or man
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age the type of care a clientiis to receive.
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PTS: 1 DIF:
CognitiveLevel:Understand
TOP:Nursing Process: Planning
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, Maternityand Women's Health Carei13thiEdition LowdermilkiTest
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MSC: ClientiNeeds: Health Promotionand Maintenance
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3. Thenurses workingiat a newlyestablishedbirthingcenterhavebegunto comparetheir perf
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ormanceiin providingimaternal-
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newborn careiagainst clinical standards. This comparisoniprocess is most commonlykno
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wn as what?
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a. Bestpracticesnetwork
b. Clinicalbenchmarking
c. Outcomes-orientedpracNtiUceR S
d. Evidence-basedpractice
ANS: C uu
Outcomes-
oriented practice measures the effectiveness of theiinterventionsiand qualityof careiagainstbenc
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hmarksiorstandards. Theterm bestpracticereferstoaprogram orservice thatihas been recogniz
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edifor its excellence. Clinical benchmarking isia processiused to compareione’s own performanc
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eiagainst the performance of theibest in an area of service. The term evidence-
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based practice refersito theiprovision of care based on evidence gained through research and clin
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ical trials.
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PTS: 1 DIF:
CognitiveLevel:Understand TOP: uu
Nursing Process: Evaluation u uu
MSC: ClientiNeeds: Safeand EffectiveiCare Environment
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4. Duringa prenatal intake interview, theinurse is in the process of obtainingian initial asse uu uu uu uu
ssmentiofa21-year-
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oldHispanicclientwithlimited Englishproficiency. Whichinterventionisthemost uu uu
importantforthenursetoimplement?
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a. Usematernityjargon to enableitheclient tobecomeifamiliarwith these terms.
b. Speakiquicklyand efficientlyto expediteithe visit.
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c. Provideitheclient withhandouts.
d. Assesswhethertheclientunderstandsthediscussion.
ANS: D uu
Nursesicontributeito health literacybyusingisimple,common words, avoidingjargon, and eval u uu u
uatingwhether the client understands the discussion.Speakingslowlyand clearlyandifocusin
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gon whatiisimportantwillincreaseiunderstanding. Mostclient educationimaterials areiwritten
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at ailevel too high for theaverage adult and maynotibe useful for a client with limited Englishipr
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oficiency.
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PTS: 1 DIF:
CognitiveLevel:Apply TOP: u
Nursing Process: Implementation uu uu
MSC: ClientNeeds: Health Promotionand Maintenance
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5. Whichstatementbestexemplifiescontemporarymaternitynursing?
a. Useof midwives forall vaginalideliveries
b. Family-centeredcare
c. Free-standingbirthclinics
d. Physician-
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, Maternityand Women's Health Carei13thiEdition LowdermilkiTest
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Contemporarymaternity nursingfocuses on the family’sineeds and desires. Fathers, partners, gr uu uu uu uu u
andparents, andisiblings maybeipresent forthebirthandparticipateiniactivities such as cuttingit
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heibaby’s umbilical cord. Both midwives and physicians perform vaginalideliveries. Free-
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standing clinicsiareian exampleiof alternative birth options. Contemporary maternity nursing isi
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drivenbytherelationship betweennursesandtheirclients.
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PTS: 1 DIF:
CognitiveLevel:Understand TOP: u
Nursing Process: Planning u uu
MSC: ClientNeeds: Health Promotionand Maintenance
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6. A38-year-old Hispanicwomanvaginallydeliveredia9-pound,6-
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ouncebabygirlafterbeinginlaborfor 43 hours. Thebabydied 3 dayslaterfrom sepsis. On uu uu uu uu uu uu uu
whatgrounds could the woman have a legitimate legal caseifor negligence?
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a. Inexperienced maternitynurseiwas assigned to careiforthe client.
b. Client wasipast herdueidateiby3 days. uu uu
c. Standardofcarewasnotmet.
d. Clientrefusedelectronicfetalmonitoring.
ANS: C uu
Not meetingithe standard of care isia legitimate factor for a case of negligence. An inexperienced uu uu
maternitynursewouldneed todisplaycompetencybeforebeingiassigned to care for clients on h
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i s or her own. Thisiclientimayhave been past her due date; however, a termipregnancy oftenigoesi
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beyondi40 weeks of gestation. Although fetal monitoringiistheistandardiof care, theiclientihas th
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eirightito refuse treatment. Thisirefusal is not aicaseifor negligence, but informed consentishould
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beiproperly obtained, and the client should have signed an against medical advice formiwhen ref
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usingianytreatment that isiwithin the standard of care.
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PTS: 1 DIF:
CognitiveLevel:AnalyzeiTOP:
Nursing Process: Implementation uu uu
MSC: ClientiNeeds: Safeand EffectiveiCareEnvironment
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7. Whenthenurseisunsure how toiperform aclient care procedurethat isihigh risk and low volu uu
me, his or her best action in thisisituation wouldibe what?
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a. Askianothernurse.
b. Discussitheiprocedure withtheclient’s physician.
c. Lookiup the procedure in a nursingtextbook.
d. Firstconsulttheagencyproceduremanual
ANS: D uu
Followingitheiagency’sipoliciesiand procedures manual isialways best when seekinginformatio uu
nonicorrect client procedures. Theseipolicies shouldreflect thecurrent standards of careiand the
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individual state’s guidelines. Each nurseiis responsible for his or her own practice. Relyingion an
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other nurse maynot always beia safe practice. Eachinurse is obligated to follow the standardsiof c
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are for safe client careidelivery. Physicians are responsible for their own client care activity. Nur
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ses mayfollow safeiorders fromiphysicians, butitheyareialso responsible for theiactivities that th
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ey, as nurses, are to carryout. Informationprovided inianursingtextbookisbasiciinformationifor
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generalknowledge. Furthermore, the information inia textbook maynotireflectitheicurrent stand
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ard of care or the individual stateior hospital policies.
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