Test Bank for Maternity and Women's Health Care 13th Edition by Lowdermilk,
Cashion, Alden, Olshanky, and Perry
,Chapter 01: 21st Century Maternity and Women’s Health Nursing
Lowdermilk: Maternity & Women’s Health Care, 13th Edition
MULTIPLE CHOICE
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight
(LBW) infant, which factor is the most important for the registered nurse to
consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
CORRECT CHOICE ✔✔ A
The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic
black women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are
almost twice as likely as non-Hispanic white infants to be of LBW and to die in the first
year of life.. 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.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Patient Needs: HealtNhUPrRoSmIotNioGnTanBd.MCaOinMtenance,
Antepartum Care
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
statistics for infant mortality, which intervention is most important for the registered nurse
to include in the patient’s plan of care?
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.
CORRECT CHOICE ✔✔ 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 registered nurse should take in this situation. The
patient 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 registered 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 registered nurse should focus at
this time, and it is not appropriate for a registered nurse to advise or manage the type of
care a patient is to receive.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
, MSC: Patient Needs: Health Promotion and Maintenance
3. 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 pracNtiUceRS
d. Evidence-based practice
CORRECT CHOICE ✔✔ 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 one’s 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.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Evaluation
MSC: Patient Needs: Safe and Effective Care Environment
4. During a prenatal intake interview, the registered nurse is in the process of
obtaining an initial assessment of a 21-year-old Hispanic patient with limited
English proficiency. Which intervention is the most important for the registered
nurse to implement?
a. Use maternity jargon to enable the patient to become familiar with these terms.
b. Speak quickly and efficiently to expedite the visit.
c. Provide the patient with handouts.
d. Assess whether the patient understands the discussion.
CORRECT CHOICE ✔✔ D
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
evaluating whether the patient understands the discussion. Speaking slowly and clearly
and focusing on what is important will increase understanding. Most patient education
materials are written at a level too high for the average adult and may not be useful for a
patient with limited English proficiency.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Patient Needs: Health Promotion and Maintenance
5. 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
CORRECT CHOICE
✔✔ B
, Contemporary maternity nursing focuses on the family’s needs and desires. Fathers,
partners, grandparents, and siblings may be present for the birth and participate in activities
such as cutting the baby’s umbilical cord. Both midwives and physicians 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 patients.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Patient Needs: Health Promotion and Maintenance
6. 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 registered nurse was assigned to care for the patient.
b. Patient was past her due date by 3 days.
c. Standard of care was not met.
d. Patient refused electronic fetal monitoring.
CORRECT CHOICE ✔✔ C
Not meeting the standard of care is a legitimate factor for a case of negligence. An
inexperienced maternity registered nurse would need to display competency before being
assigned to care for patients on his or her own. This patient 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 patient has the right to refuse treatment. This refusal
is not a case for negligence, but informed consent should be properly obtained, and the
patient should have signed an against medical advice form when refusing any treatment
that is within the standard of care.
PTS: 1 DIF: Cognitive Level:
Analyze TOP: Nursing Process:
Implementation
MSC: Patient Needs: Safe and Effective Care Environment
7. When the registered nurse is unsure how to perform a patient 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 patient’s physician.
c. Look up the procedure in a nursing textbook.
d. First consult the agency procedure manual
CORRECT CHOICE ✔✔ D
Following the agency’s policies and procedures manual is always best when seeking
information on correct patient procedures. These policies should reflect the current
standards of care and the individual state’s guidelines. Each registered nurse is responsible
for his or her own practice. Relying on another registered nurse may not always be a safe
practice. Each registered nurse is obligated to follow the standards of care for safe patient
care delivery. Physicians are responsible for their own patient care activity. Nurses may
follow safe orders from physicians, 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.
