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Chapter01: 21st Century Maternity andWomen’s HealthNursing
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Lowdermilk: Maternity & Women’s Health Care, 12th 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)
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infant, 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
The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic black
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women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are almost twice
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as likely as non-Hispanic white infants to be of LBW and to die in the first year of life.. Race is a
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nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant mortality
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rates, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor
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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.
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Additionally, maternal education is a modifiable risk factor.
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PTS: 1 DIF: CognitiveLevel:Understand B B
TOP: Nursing Process: Assessment
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MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN nTanBd.M
CaOinMtenance, Antepartum Care B B b B B
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
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statistics for infant mortality, which intervention is most important for the nurse to include in
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the client’s plan of care?
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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 associated
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with infant mortality. Nutritional status is an important modifiable risk factor, but it is not the
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most 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
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the most important aspect the nurse should address at this time. If the woman has identifiable
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high-risk problems, then her health care may need to be provided by a physician. However, it
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cannot be assumed that all African-American women have high-risk issues. In addition,
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advising the woman to see an obstetrician is not the most important aspect on which the nurse
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should focus at this time, and it is not appropriate for a nurse to advise or manage the type of
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care a client is to receive.
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PTS: 1 DIF: CognitiveLevel:Understand B B
TOP: Nursing Process: Planning
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, Maternity and Women's Health Care 12th Edition Lowdermilk Test Bank B B B B B B B B B
MSC: Client Needs: Health Promotion and Maintenance
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3. During a prenatal intake interview, the nurse is in the process of obtaining an initial
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assessment of a 21-year-old Hispanic client with limited English proficiency. Which
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intervention is the most important for the nurse to implement?
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a. Usematernity jargon to enable the client to become familiar with these terms.
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b. Speak quickly and efficiently to expedite the visit.
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c. Provide the client with handouts. B B B B
d. Assess whether the client understands the discussion.
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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
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English proficiency.
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PTS: 1 DIF: CognitiveLevel:Apply B B
TOP: Nursing Process: Implementation
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MSC: Client Needs: Health Promotion and Maintenance
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4. 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
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comparison process is most commonly known as what?
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a. Best practices network B B
b. Clinical benchmarking B
c. Outcomes-oriented pracNtiU ceR SI NG TB.C OM 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
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own performance against the performance of the best in an area of service. The term evidence-
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based practice refers to the provision of care based on evidence gained through research and
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clinical trials.
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PTS: 1 DIF: CognitiveLevel:Understand B B
TOP: Nursing Process: Evaluation
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MSC: Client Needs: Safe and Effective Care Environment
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5. 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
c. Free-standing birth clinics B B
d. Physician-drivencare B
ANS: B
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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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PTS: 1 DIF: CognitiveLevel:Understand B B
TOP: Nursing Process: Planning
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MSC: Client Needs: Health Promotion and Maintenance
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6. 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
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inexperienced maternity nurse would need to display competency before being assigned to
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care for clients on his or her own. This client may have been past her due date; however, a term
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pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the standard
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of care, the client has the right to refuse treatment. This refusal is not a case for negligence,
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but informed consent 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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NURSINGTB.COM
PTS: 1 DIF: CognitiveLevel:Analyze B B
TOP: Nursing Process: Implementation
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MSC: Client Needs: Safe and Effective Care Environment
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7. When the nurse is unsure how to perform a client care procedure that is high risk and low
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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. First consult the agency procedure manual B B B B B
ANS: D B
Following the agency’s policies and procedures manual is always best when seeking
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Binformation on correct client procedures. These policies should reflect the current standards of
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Bcare and the individual state’s guidelines. Each nurse is responsible for his or her own practice.
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BRelying on another nurse may not always be a safe practice. Each nurse is obligated to follow
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Bthe standards of care for safe client care delivery. Physicians are responsible for their own
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Bclient care activity. Nurses may follow safe orders from physicians, but they are also
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Bresponsible for the activities that they, as nurses, are to carry out. Information provided in a
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nursing textbook is basic information for general knowledge. Furthermore, the information in a
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Btextbook may not reflect the current standard of care or the individual state or hospital policies.
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, Maternity and Women's Health Care 12th Edition Lowdermilk Test Bank
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PTS: 1 DIF: Cognitive Level: Understand B B
TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity B B B B B B
8. A nurse caring for a pregnant client should be aware that the U.S. birth rate shows what
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trend?
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a. Births to unmarried women are more likely to have less favorable outcomes.
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b. Birth rates for women 40 to 44 years of age are declining.
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c. Cigarette smoking among pregnant women continues to increase. B B B B B B B
d. Rates of pregnancy and abortion among teenagers are lower in the United States
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than in any other industrialized country.
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ANS: A B
LBW infants and preterm births are more likely because of the large number of teenagers in the
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unmarried group. Birth rates for women in their early 40s continue to increase. Fewer
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pregnant women smoke. Teen pregnancy and abortion rates are higher in the United States than
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in any other industrial country.
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PTS: 1 DIF: Cognitive Level: Understand B B
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity B B B B B B
9. A recently graduated nurse is attempting to understand the reason for increasing health care
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spending in the United States. Which information gathered from research best explains the
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rationale for these higher costs compared with other developed countries?
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a. Higher rate of obesity among pregnant women B B B B B B
b. Limited access to technology B B B
c. Increased use of health N caUreRsS
erIviN
cG
esTaB
lo.
ngCwOiM
th lower prices B B B B B
d. Homogeneity of the population B B B
ANS: A B
Health care is one of the fastest growing sectors of the U.S. economy. Currently, 17.5% of the
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gross domestic product is spent on health care. Higher spending in the United States, as
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compared with 12 other industrialized countries, is related to higher prices and readily
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accessible technology along with greater obesity rates among women. More than one third of
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women in the United States are obese. In the population in the United States, 16% are
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uninsured and have limited access to health care. Maternal morbidity and mortality are
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directly related to racial disparities.
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PTS: 1 DIF: CognitiveLevel:Understand B B
TOP: Teaching and Learning
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MSC: Client Needs: Safe and Effective Care Environment
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10. Which statement best describes maternity nursing care that is based on knowledge gained
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through research and clinical trials?
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a. Maternitynursing care is derived from the Nursing Intervention Classification. B B B B B B B B B
b. Maternity nursing care is known as evidence-based practice. B B B B B B B
c. Maternity nursing care is at odds with the Cochrane School of traditional nursing.B B B B B B B B B B B B
d. Maternitynursing care is an outgrowth oftelemedicine. B B B B B B B
ANS: B
B B
