Maternity and Women's Health Care 13th Edition Lowdermilk Test
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, Maternity and Women's Health Care 13th Edition Lowdermilk Test 1i 1i 1i 1i 1i 1i 1i 1i
Chapter 01: 21st Century Maternity and Women’s Health Nursing
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Lowdermilk: Maternity & Women’s Health Care, 13th Edition
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MULTIPLE CHOICE 1i
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 1i
b. Cigarette smoking 1i
c. Poor nutritional status 1i 1i
d. Limited maternal education 1i 1i
ANS: A 1 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: 1i 1i i
1
Nursing Process: Assessment 1i 1i
MSC: Client Needs: HealtN
hUPrRoS
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otN nTanBd.MCaO
inM
tenance, Antepartum Care 1i 1i 1i 1i
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. 1i 1i 1i
b. Refer the woman to a social worker. 1i 1i 1i 1i 1i 1i
c. Advise the woman to see an obstetrician, not a midwife. 1i 1i 1i 1i 1i 1i 1i 1i 1i
d. Explain to the woman the importance of keeping her prenatal care appointments.
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ANS: D 1 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- 1i
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: 1i 1i i
1
Nursing Process: Planning 1i 1i
, Maternity and Women's Health Care 13th Edition Lowdermilk Test 1i 1i 1i 1i 1i 1i 1i 1i
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- 1i 1i 1i
newborn care against clinical standards. This comparison process is most commonly
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known as what? 1i 1i
a. Best practices network 1i 1i
b. Clinical benchmarking 1i
c. Outcomes-oriented pracNtiU
ceRS 1i
d. Evidence-based practice 1i
ANS: C 1 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: 1i 1i i
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Nursing Process: Evaluation 1i 1i
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? 1i 1i 1i 1i 1i
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. 1i 1i 1i 1i
d. Assess whether the client understands the discussion.
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ANS: D 1 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: 1i 1i i
1
Nursing Process: Implementation 1i 1i
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 1i
c. Free-standing birth clinics 1i 1i
d. Physician-
driven careANS: B 1i 1i 1 i
, Maternity and Women's Health Care 13th Edition Lowdermilk Test 1i 1i 1i 1i 1i 1i 1i 1i
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partne
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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- 1i
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: 1i 1i i
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Nursing Process: Planning 1i 1i
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. 1i 1i 1i 1i 1i 1i 1i 1i 1i
b. Client was past her due date by 3 days. 1i 1i 1i 1i 1i 1i 1i 1i
c. Standard of care was not met. 1i 1i 1i 1i 1i
d. Client refused electronic fetal monitoring. 1i 1i 1i 1i
ANS: C 1 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: 1i 1i i
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Nursing Process: Implementation 1i 1i
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. 1i 1i
b. Discuss the procedure with the client’s physician. 1i 1i 1i 1i 1i 1i
c. Look up the procedure in a nursing textbook. 1i 1i 1i 1i 1i 1i 1i
d. First consult the agency procedure manual 1i 1i 1i 1i 1i
ANS: D 1 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.
