Maternity and Women's Health Care 13th Edition Lowdermilk Test
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, Maternity and Women's Health Care 13th Edition Lowdermilk Test ni ni ni ni ni ni ni ni
Chapter 01: 21st Century Maternity and Women’s Health Nursing
Lowdermilk: Maternity & Women’s Health Care, 13th Edition
MULTIPLE CHOICE ni
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-
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weight (LBW)infant, which factor is the most important for the nurse to consider?
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a. African-American race ni
b. Cigarette smoking ni
c. Poor nutritional status ni ni
d. Limited maternal education ni ni
ANS: A n i
The rise in the overall LBW rates were due to increases in LBW births to non-
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Hispanic black women (13.35%) and Hispanic women (7.21%); non-
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Hispanic black infants are almost twice as likely as non-
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Hispanic white infants to be of LBW and to die in the first year of life.. Race is a nonmodifi
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able risk factor. Cigarette smoking is an important factor inpotential infant mortality rates, b
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ut it is not the most important. Additionally, smoking is a modifiable risk factor. Poor nutri
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tion is an important factor in potential infant mortality rates, but it is not the most importan
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t. Additionally, nutritional status is a modifiable risk factor. Maternal education is an impor
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tant factor in potential infant mortality rates, but it is not the most important. Additionally,
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maternal education is a modifiable risk factor.
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PTS: 1 DIF:
Cognitive Level: UnderstandTOP: ni ni i
n
Nursing Process: Assessment ni ni
MSC: Client Needs: HealtN
hUPrRoS
ninini mI ioG
otN nTanBd.MCaO
inM
tenance, Antepartum Care
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2. A 23-year-old African-
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American woman is pregnant with her first child. Based on currentstatistics for infant mor
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tality, which intervention is most important for the nurse to includein the client’s plan of c
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are?
a. Perform a nutrition assessment. ni ni ni
b. Refer the woman to a social worker. ni ni ni ni ni ni
c. Advise the woman to see an obstetrician, not a midwife.
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d. Explain to the woman the importance of keeping her prenatal care appointments.
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ANS: D n i
Consistent prenatal care is the best method of preventing or controlling risk factors associat
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ed with infant mortality. Nutritional status is an important modifiable risk factor, butit is not t
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he most important action a nurse should take in this situation. The client may needassistanc
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e from a social worker at some time during her pregnancy, but a referral to a socialworker i
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s not the most important aspect the nurse should address at this time. If the woman has ide
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ntifiable high- ni
risk problems, then her health care may need to be provided by a physician. However, it ca
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nnot be assumed that all African-American women have high-
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riskissues. In addition, advising the woman to see an obstetrician is not the most important
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aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to
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advise or manage the type of care a client is to receive.
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PTS: 1 DIF:
Cognitive Level: UnderstandTOP: ni ni i
n
Nursing Process: Planning ni ni
, Maternity and Women's Health Care 13th Edition Lowdermilk Test ni ni ni ni ni ni ni ni
MSC: Client Needs: Health Promotion and Maintenance
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3. The nurses working at a newly established birthing center have begun to compare their
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performance in providing maternal- ni ni ni
newborn care against clinical standards. This comparison process is most commonly
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known as what? ni ni
a. Best practices network ni ni
b. Clinical benchmarking ni
c. Outcomes-oriented pracNtiU
ceRS ni
d. Evidence-based practice ni
ANS: C n i
Outcomes-
oriented practice measures the effectiveness of the interventions and quality of care against
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benchmarks or standards. The term best practice refers to a program or servicethat has been
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recognized for its excellence. Clinical benchmarking is a process used to compare one’s o
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wn performance against the performance of the best in an area of service. The term evidenc
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e-
based practice refers to the provision of care based on evidence gainedthrough research an
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d clinical trials.
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PTS: 1 DIF:
Cognitive Level: UnderstandTOP: ni ni i
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Nursing Process: Evaluation ni ni
MSC: Client Needs: Safe and Effective Care Environment
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4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
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assessment of a 21-year-
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old Hispanic client with limited English proficiency. Whichintervention is the most
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important for the nurse to implement? ni ni ni ni ni
a. Use maternity 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. ni ni ni ni
d. Assess whether the client understands the discussion.
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ANS: D n i
Nurses contribute to health literacy by using simple, common words, avoiding jargon, an
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devaluating whether the client understands the discussion. Speaking slowly and clearly an
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dfocusing on what is important will increase understanding. Most client education material
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sare written at a level too high for the average adult and may not be useful for a client wit
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hlimited English proficiency.
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PTS: 1 DIF:
Cognitive Level: ApplyTOP: ni ni i
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Nursing Process: Implementation ni ni
MSC: Client Needs: Health Promotion and Maintenance
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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 ni
c. Free-standing birth clinics ni ni
d. Physician-
driven careANS: B ni ni n i
, Maternity and Women's Health Care 13th Edition Lowdermilk Test ni ni ni ni ni ni ni ni
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partneni ni ni ni ni ni ni ni ni ni ni
rs, grandparents, and siblings may be present for the birth and participate in activitiessuch as
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cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliverie
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s. Free- ni
standing clinics are an example of alternative birth options. Contemporarymaternity nursin
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g is driven by the relationship between nurses and their clients.
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PTS: 1 DIF:
Cognitive Level: UnderstandTOP: ni ni i
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Nursing Process: Planning ni ni
MSC: Client Needs: Health Promotion and Maintenance
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6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-
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ounce baby girl after beingin labor for 43 hours. The baby died 3 days later from sepsis. O
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n what grounds could the woman have a legitimate legal case for negligence?
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a. Inexperienced maternity nurse was assigned to care for the client. ni ni ni ni ni ni ni ni ni
b. Client was past her due date by 3 days. ni ni ni ni ni ni ni ni
c. Standard of care was not met. ni ni ni ni ni
d. Client refused electronic fetal monitoring. ni ni ni ni
ANS: C n i
Not meeting the standard of care is a legitimate factor for a case of negligence. An inexpe
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rienced maternity nurse would need to display competency before being assigned tocare fo
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r clients on his or her own. This client may have been past her due date; however, aterm p
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regnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is thestanda
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rd of care, the client has the right to refuse treatment. This refusal is not a case for neglige
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nce, but informed consent should be properly obtained, and the client should have signed
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an against medical advice form when refusing any treatment that is within the standard of
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care.
PTS: 1 DIF:
Cognitive Level: AnalyzeTOP: ni ni i
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Nursing Process: Implementation ni ni
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. ni ni
b. Discuss the procedure with the client’s physician. ni ni ni ni ni ni
c. Look up the procedure in a nursing textbook. ni ni ni ni ni ni ni
d. First consult the agency procedure manual ni ni ni ni ni
ANS: D n i
Following the agency’s policies and procedures manual is always best when seeking infor
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mation on correct client procedures. These policies should reflect the current standardsof ca
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re and the individual state’s guidelines. Each nurse is responsible for his or her own practic
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e. Relying on another nurse may not always be a safe practice. Each nurse is obligated to f
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ollow the standards of care for safe client care delivery. Physicians are responsible for their
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own client care activity. Nurses may follow safe orders from physicians, but they are also
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responsible 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 i
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n a textbook may not reflect the current standard of care or the individual state or hospital p
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olicies.
