Maternity and Women's Health Care 13th Edition
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Lowdermilk
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, Maternity and Women's Health Care 13th Edition j j j j j j
Lowdermilk
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Chapter 01: 21st Century Maternity and Women’s Health
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jNursing Lowdermilk: Maternity & Women’s Health Care,
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j13th Edition
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MULTIPLE CHOICE j
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 j
b. Cigarette smoking j
c. Poor nutritional status j j
d. Limited maternal education j j
ANS: A
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-Hispanic black
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infants are almost twice as likely as non-Hispanic white infants to be of LBW
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jand to die in the first year of life.. Race is a nonmodifiable risk factor.
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jCigarette smoking is an important factor inpotential infant mortality rates, but it
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jis not the most important. Additionally, smoking is a modifiable risk factor.
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jPoor nutrition is an important factor in potential infant mortality rates, but it is
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jnot the most important. Additionally, nutritional status is a modifiable risk factor.
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jMaternal education is an important factor in potential infant mortality rates, but it
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jis not the most important. Additionally, maternal education is a modifiable risk
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factor.
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PTS: 1 DIF: Cognitive Level: j
UnderstandTOP: j Nursing Process: Assessment j j
MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN nTanBd.MCaO
inM
tenance, Antepartum Care
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2. A 23-year-old African-American woman is pregnant with her first child. Based on
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current statistics for infant mortality, which intervention is most important for the
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nurse to includein the client’s plan of care?
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a. Perform a nutrition assessment. j j j
b. Refer the woman to a social worker. j j j j j j
c. Advise the woman to see an obstetrician, not a midwife. j j j j j j j j j
d. Explain to the woman the importance of keeping her prenatal care appointments. j j j j j j j j j j j
ANS: D
Consistent prenatal care is the best method of preventing or controlling risk factors
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associated with infant mortality. Nutritional status is an important modifiable risk
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factor, butit is not the most important action a nurse should take in this
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situation. The client may needassistance from a social worker at some time during
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her pregnancy, but a referral to a socialworker is not the most important
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aspect the nurse should address at this time. If the woman has identifiable high-risk
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problems,then her health care may need to be provided by a physician.
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However, it cannot 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 j j j j j j j j j j j j
most important aspect on which the nurse should focus at this time, and it is not
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appropriate for a nurse to advise or manage the type of care a client is to receive.
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PTS: 1 DIF: Cognitive Level: j
UnderstandTOP:
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Planning
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, Maternity and Women's Health Care 13th Edition j j j j j j
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MSC: Client Needs: Health Promotion and Maintenance
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3. The nurses working at a newly established birthing center have begun to
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compare theirperformance in providing maternal-newborn care against
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clinicalstandards. This comparison process is most commonly known as what?
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a. Best practices network j j
b. Clinical benchmarking j
c. Outcomes-oriented pracNtiU
ceRS jj
d. Evidence-based practice j
ANS: C
Outcomes-oriented practice measures the effectiveness of the interventions and j j j j j j j j
quality of care against benchmarks or standards. The term best practice refers
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jto aprogram or servicethat has been recognized for its excellence. Clinical
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benchmarking is a process used to compare one’s own performance against the
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performance of the best in an area of service. The term evidence-based practice
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refers to the provision of care based on evidence gainedthrough research and
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clinical trials.
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PTS: 1 DIF: Cognitive Level: j
UnderstandTOP: Nursing Process: Evaluation j j j
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
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jobtaining an initial assessment of a 21-year-old Hispanic client with limited English
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proficiency. Which intervention is the most important for the nurse to
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implement?
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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. j j j j j j j
c. Provide the client with handouts. j j j j
d. Assess whether the client understands the discussion. j j j j j j
ANS: D
Nurses contribute to health literacy by using simple, common words, avoiding
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jargon, and evaluating whether the client understands the discussion. Speaking
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slowly and clearly and focusing on what is important will increase understanding.
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Most client education materials are written at a level too high for the average
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adult and may not be useful for a client withlimited English proficiency.
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PTS: 1 DIF: Cognitive Level: j
ApplyhTOP: Nursing
Process:Implementation
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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 j
c. Free-standing birth clinics j j
d. Physician-
drivencareANS: j j
B
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Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, j j j j j j j j j j
partners, grandparents, and siblings may be present for the birth and participate in
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activitiessuch as cutting the baby’s umbilical cord. Both midwives and physicians
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perform vaginal deliveries. Free-standing clinics are an example of alternative birth
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options. Contemporarymaternity nursing is driven by the relationship between
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jnursesand their clients. j j j
PTS: 1 DIF: Cognitive Level: j
UnderstandTOP: Nursing Process: Planning j j j
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
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jgirl after beingin labor for 43 hours. The baby died 3 days later from sepsis. On
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whatgrounds 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. j j j j j j j j j
b. Client was past her due date by 3 days. j j j j j j j j
c. Standard of care was not met. j j j j j
d. Client refused electronic fetal monitoring. j j j j
ANS: C
Not meeting the standard of care is a legitimate factor for a case of
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jnegligence. An inexperienced maternity nurse would need to display competency before j j j j j j j j j j
beingassigned tocare for clients on his or her own. This client may have
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jbeen past her due date; however, aterm pregnancy often goes beyond 40 weeks of
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jgestation.
Although fetal monitoring is thestandard of care, the client has the right to
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refusetreatment. This refusal is not a case for negligence, but informed
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jconsent should be properly obtained, and the client should have signed an against
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jmedical adviceform when refusing any treatment that is within the standard of
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care.
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PTS: 1 DIF: Cognitive Level: j
AnalyzeTOP: Nursing Process: j j
Implementation
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
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jriskand lowvolume, his or her best action in this situation would be what?
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a. Ask another nurse. j j
b. Discuss the procedure with the client’s physician. j j j j j j
c. Look up the procedure in a nursing textbook. j j j j j j j
d. First consult the agency procedure manual j j j j j
ANS: D
Following the agency’s policies and procedures manual is always best when
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seekinginformation on correct client procedures. These policies should reflect the current
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standardsof care and the individual state’s guidelines. Each nurse is responsible
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jfor his or her own practice. Relying on another nurse may not always be a
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jsafe practice. Each nurse is obligated to follow the standards of care for
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jsafe client care delivery. Physicians are responsible for their own client care
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jactivity. Nurses may follow safe orders from physicians, but they are also
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jresponsible for the activities that they, as nurses, are to carry out. Information provided j j j j j j j j j j j j j
jin a nursing textbook is basic information for general knowledge. Furthermore,
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jthe information ina textbook may not reflect the current standard of care or the
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jindividual state or hospital policies. j j j j
