Maternity and Women's Health Care 13th Edition Lowdermilk Test
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, Maternity and Women's Health Care 13th Edition Lowdermilk Test t t t t t t t t
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 t
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 t
b. Cigarette smoking t
c. Poor nutritional status t t
d. Limited maternal education t t
ANS: A t
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
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a nonmodifiable risk factor. Cigarette smoking is an important factor inpotential infant
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mortality rates, but it is not the most important. Additionally, smoking is a modifiable risk
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factor. Poor nutrition is an important factor in potential infant mortality rates, but it is not the
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most important. Additionally, nutritional status is a modifiable risk factor. Maternal
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education is an important factor in potential infant mortality rates, but it is not the most
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important. Additionally, maternal education is a modifiable risk factor.
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PTS: 1 DIF: Cognitive Level: Understand t t
TOP: Nursing Process: Assessment
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MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN nTanBd.MCaO
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tenance, Antepartum Care t t t t
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 includein
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the client’s plan of care?
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a. Perform a nutrition assessment. t t t
b. Refer the woman to a social worker. t t t t t t
c. Advise the woman to see an obstetrician, not a midwife. t t t t t t t t t
d. Explain to the woman the importance of keeping her prenatal care appointments. t t t t t t t t t t t
ANS: D t
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, butit is not the
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most important action a nurse should take in this situation. The client may needassistance
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from a social worker at some time during her pregnancy, but a referral to a socialworker 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-riskissues. 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: Cognitive Level: Understand t t
TOP: Nursing Process: Planning
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, Maternity and Women's Health Care 13th Edition Lowdermilk Test t t t t t t t t
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-newborn care against clinical standards. This
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comparison process is most commonlyknown as what?
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a. Best practices network t t
b. Clinical benchmarking t
c. Outcomes-oriented pracNtiU
ceRS t
d. Evidence-based practice t
ANS: C t
Outcomes-oriented practice measures the effectiveness of the interventions and quality of t t t t t t t t t t
care against benchmarks or standards. The term best practice refers to a program or servicethat
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has been recognized for its excellence. Clinical benchmarking is a process used to compare
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one’s own performance against the performance of the best in an area of service. The term
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evidence-based practice refers to the provision of care based on evidence gainedthrough
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research and clinical trials.
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PTS: 1 DIF: Cognitive Level: Understand t t
TOP: Nursing Process: Evaluation
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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-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. 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. t t t t t t t
c. Provide the client with handouts. t t t t
d. Assess whether the client understands the discussion. t t t t t t
ANS: D t
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
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are written at a level too high for the average adult and may not be useful for a client with
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limited English proficiency.
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PTS: 1 DIF: Cognitive Level: Apply t t
TOP: 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 t
c. Free-standing birth clinics t t
d. Physician-driven care t
ANS: B
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, Maternity and Women's Health Care 13th Edition Lowdermilk Test t t t t t t t t
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partners, t t t t t t t t t t t
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 deliveries.
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Free-standing clinics are an example of alternative birth options. Contemporarymaternity
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nursing is driven by the relationship between nurses and their clients.
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PTS: 1 DIF: Cognitive Level: Understand t t
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 beingin
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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. t t t t t t t t t
b. Client was past her due date by 3 days. t t t t t t t t
c. Standard of care was not met. t t t t t
d. Client refused electronic fetal monitoring. t t t t
ANS: C t
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
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term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the
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standard of care, the client has the right to refuse treatment. This refusal is not a case for
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negligence, but informed consent should be properly obtained, and the client should have
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signed an against medical advice form when refusing any treatment that is within the
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standard of care.
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PTS: 1 DIF: Cognitive Level: Analyze t t
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. t t
b. Discuss the procedure with the client’s physician. t t t t t t
c. Look up the procedure in a nursing textbook. t t t t t t t
d. First consult the agency procedure manual t t t t t
ANS: D t
Following the agency’s policies and procedures manual is always best when seeking
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information on correct client procedures. These policies should reflect the current standardsof
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care and the individual state’s guidelines. Each nurse is responsible for his or her own
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practice. Relying on another nurse may not always be a safe practice. Each nurse is obligated
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to follow the standards of care for safe client care delivery. Physicians are responsible for
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their own client care activity. Nurses may follow safe orders from physicians, but they are
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also responsible for the activities that they, as nurses, are to carry out. Information provided in
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a nursing textbook is basic information for general knowledge.Furthermore, the information in
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a textbook may not reflect the current standard of care or the individual state or hospital
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policies.
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