1|Pa ge
,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 nurse to consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
ANS: 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: Client Needs: Health Promotion and Maintenance, 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 nurse to include
in the client’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.
ANS: 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 nurse should take in this situation. The client 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 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 nurse should focus at this time, and it is not appropriate for a
nurse to advise or manage the type of care a client is to receive.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
2|Page
, MSC: Client 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 practice
d. Evidence-based practice
ANS: 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: Client Needs: Safe and Effective Care Environment
4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
assessment of a 21-year-old Hispanic client with limited English proficiency.
Which intervention is the most important for the nurse to implement?
a. Use maternity jargon to enable the client to become familiar with these terms.
b. Speak quickly and efficiently to expedite the visit.
c. Provide the client with handouts.
d. Assess whether the client understands the discussion.
ANS: D
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
evaluating whether the client understands the discussion. Speaking slowly and clearly and
focusing on what is important will increase understanding. Most client education
materials are written at a level too high for the average adult and may not be useful for a
client with limited English proficiency.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client 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
ANS: B
3|Page
, 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 clients.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client 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 nurse was assigned to care for the client.
b. Client was past her due date by 3 days.
c. Standard of care was not met.
d. Client refused electronic fetal monitoring.
ANS: C
Not meeting the standard of care is a legitimate factor for a case of negligence. An
inexperienced maternity nurse would need to display competency before being assigned to
care for clients on his or her own. This client 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 client has the right to refuse treatment. This refusal is not a case for
negligence, but informed consent should be properly obtained, and the client 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: Client Needs: Safe and Effective Care Environment
7. When the nurse is unsure how to perform a client 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 client’s physician.
c. Look up the procedure in a nursing textbook.
d. First consult the agency procedure manual
ANS: D
Following the agency’s policies and procedures manual is always best when seeking
information on correct client procedures. These policies should reflect the current standards
of care and the individual state’s guidelines. Each nurse is responsible for his or her own
practice. Relying on another nurse may not always be a safe practice. Each nurse is
obligated to follow the standards of care for safe client care delivery. Physicians are
responsible for their own client 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.
4|Page
,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 nurse to consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
ANS: 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: Client Needs: Health Promotion and Maintenance, 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 nurse to include
in the client’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.
ANS: 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 nurse should take in this situation. The client 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 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 nurse should focus at this time, and it is not appropriate for a
nurse to advise or manage the type of care a client is to receive.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
2|Page
, MSC: Client 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 practice
d. Evidence-based practice
ANS: 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: Client Needs: Safe and Effective Care Environment
4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
assessment of a 21-year-old Hispanic client with limited English proficiency.
Which intervention is the most important for the nurse to implement?
a. Use maternity jargon to enable the client to become familiar with these terms.
b. Speak quickly and efficiently to expedite the visit.
c. Provide the client with handouts.
d. Assess whether the client understands the discussion.
ANS: D
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
evaluating whether the client understands the discussion. Speaking slowly and clearly and
focusing on what is important will increase understanding. Most client education
materials are written at a level too high for the average adult and may not be useful for a
client with limited English proficiency.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client 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
ANS: B
3|Page
, 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 clients.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client 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 nurse was assigned to care for the client.
b. Client was past her due date by 3 days.
c. Standard of care was not met.
d. Client refused electronic fetal monitoring.
ANS: C
Not meeting the standard of care is a legitimate factor for a case of negligence. An
inexperienced maternity nurse would need to display competency before being assigned to
care for clients on his or her own. This client 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 client has the right to refuse treatment. This refusal is not a case for
negligence, but informed consent should be properly obtained, and the client 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: Client Needs: Safe and Effective Care Environment
7. When the nurse is unsure how to perform a client 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 client’s physician.
c. Look up the procedure in a nursing textbook.
d. First consult the agency procedure manual
ANS: D
Following the agency’s policies and procedures manual is always best when seeking
information on correct client procedures. These policies should reflect the current standards
of care and the individual state’s guidelines. Each nurse is responsible for his or her own
practice. Relying on another nurse may not always be a safe practice. Each nurse is
obligated to follow the standards of care for safe client care delivery. Physicians are
responsible for their own client 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.
4|Page
