INTRODUCTORY MATERNITY &
PEDIATRIC NURSING
5TH EDITION
• AUTHOR(S)NANCY HATFIELD;
CYNTHIA KINCHELOE
TEST BANK
Q1
Reference: Ch. 1 — The Nurse’s Role in a Changing Maternal–
Child Healthcare Environment
Stem: A 19-year-old primigravida at 34 weeks arrives at the
community clinic reporting intermittent contractions and mild
vaginal spotting. T 36.8°C, HR 88, RR 18, BP 118/72, fetal heart
rate 145 bpm and reactive on handheld doppler. The clinic
nurse must decide next action given limited onsite obstetric
services.
A. Reassure the client, schedule routine prenatal follow-up next
,week, and document.
B. Contact the on-call obstetric clinician and arrange urgent
transfer to the nearest facility with obstetric capability.
C. Provide oral hydration, observe for 30 minutes in clinic, and
then discharge if contractions subside.
D. Teach home rest and give written instructions for signs to
return immediately.
Correct Answer: B
Rationale — Correct: The nurse recognizes potential preterm
labor signs (contractions, spotting) and limited onsite resources.
Prompt consultation and transfer ensure maternal–fetal safety
and timely obstetric evaluation. This aligns with the nurse’s role
in appropriate triage and system navigation.
Rationale — Incorrect:
A — Unsafe because delaying evaluation may miss preterm
labor complications.
C — Observation without obstetric consultation in a facility
lacking capability is risky if condition progresses.
D — Teaching alone is insufficient when signs suggest possible
preterm labor; active referral is needed.
Teaching point: Prioritize transfer/consultation when maternal–
fetal risk exceeds facility capability.
Citation: Hatfield, N., & Kincheloe, C. (2023). Introductory
maternity & pediatric nursing (5th ed.). Ch. 1.
,Q2
Reference: Ch. 1 — The Nurse’s Role in a Changing Maternal–
Child Healthcare Environment
Stem: In a busy postpartum unit, an RN is delegating tasks. A
stable postpartum mother (vitals within normal limits, lochia
moderate, ambulating independently) needs routine fundal and
lochia check, and an admission teaching session about infant
safety. Which task is appropriate to delegate to the licensed
practical nurse (LPN)?
A. Complete and teach the full infant-safety education session
including feeding and sleep position.
B. Perform the fundal and lochia assessment and report
abnormal findings to the RN.
C. Independently modify the discharge plan based on the
mother's teaching comprehension.
D. Make clinical decisions about starting oxytocin if uterine
atony is suspected.
Correct Answer: B
Rationale — Correct: Delegation principles allow LPNs to
perform routine assessments on stable patients and report
changes to the RN. This uses team resources while preserving
RN responsibility for teaching, care planning, and complex
clinical decision-making.
Rationale — Incorrect:
A — Teaching that requires assessment of learning and
discharge readiness is RN role.
, C — Modifying the discharge plan is a judgment and
coordination task for the RN.
D — Initiating or changing medication therapy for suspected
complications is outside routine LPN delegation and requires
RN/physician order.
Teaching point: Delegate stable, routine assessments; RN
retains teaching and clinical judgment tasks.
Citation: Hatfield, N., & Kincheloe, C. (2023). Introductory
maternity & pediatric nursing (5th ed.). Ch. 1.
Q3
Reference: Ch. 1 — The Nurse’s Role in a Changing Maternal–
Child Healthcare Environment
Stem: A 2-day postpartum mother who delivered vaginally tells
the nurse she feels “sad all the time,” is crying frequently, and
reports poor sleep despite the newborn sleeping often. She
denies harming herself or the baby. Which nursing action is the
highest priority?
A. Reassure her that postpartum blues are common and
document the comment.
B. Screen further for postpartum depression, assess safety, and
notify the provider for follow-up.
C. Counsel her to increase rest and postpone screening until the
2-week visit.
D. Advise her to call a family member for support and discharge
without provider notification.
PEDIATRIC NURSING
5TH EDITION
• AUTHOR(S)NANCY HATFIELD;
CYNTHIA KINCHELOE
TEST BANK
Q1
Reference: Ch. 1 — The Nurse’s Role in a Changing Maternal–
Child Healthcare Environment
Stem: A 19-year-old primigravida at 34 weeks arrives at the
community clinic reporting intermittent contractions and mild
vaginal spotting. T 36.8°C, HR 88, RR 18, BP 118/72, fetal heart
rate 145 bpm and reactive on handheld doppler. The clinic
nurse must decide next action given limited onsite obstetric
services.
A. Reassure the client, schedule routine prenatal follow-up next
,week, and document.
B. Contact the on-call obstetric clinician and arrange urgent
transfer to the nearest facility with obstetric capability.
C. Provide oral hydration, observe for 30 minutes in clinic, and
then discharge if contractions subside.
D. Teach home rest and give written instructions for signs to
return immediately.
Correct Answer: B
Rationale — Correct: The nurse recognizes potential preterm
labor signs (contractions, spotting) and limited onsite resources.
Prompt consultation and transfer ensure maternal–fetal safety
and timely obstetric evaluation. This aligns with the nurse’s role
in appropriate triage and system navigation.
Rationale — Incorrect:
A — Unsafe because delaying evaluation may miss preterm
labor complications.
C — Observation without obstetric consultation in a facility
lacking capability is risky if condition progresses.
D — Teaching alone is insufficient when signs suggest possible
preterm labor; active referral is needed.
Teaching point: Prioritize transfer/consultation when maternal–
fetal risk exceeds facility capability.
Citation: Hatfield, N., & Kincheloe, C. (2023). Introductory
maternity & pediatric nursing (5th ed.). Ch. 1.
,Q2
Reference: Ch. 1 — The Nurse’s Role in a Changing Maternal–
Child Healthcare Environment
Stem: In a busy postpartum unit, an RN is delegating tasks. A
stable postpartum mother (vitals within normal limits, lochia
moderate, ambulating independently) needs routine fundal and
lochia check, and an admission teaching session about infant
safety. Which task is appropriate to delegate to the licensed
practical nurse (LPN)?
A. Complete and teach the full infant-safety education session
including feeding and sleep position.
B. Perform the fundal and lochia assessment and report
abnormal findings to the RN.
C. Independently modify the discharge plan based on the
mother's teaching comprehension.
D. Make clinical decisions about starting oxytocin if uterine
atony is suspected.
Correct Answer: B
Rationale — Correct: Delegation principles allow LPNs to
perform routine assessments on stable patients and report
changes to the RN. This uses team resources while preserving
RN responsibility for teaching, care planning, and complex
clinical decision-making.
Rationale — Incorrect:
A — Teaching that requires assessment of learning and
discharge readiness is RN role.
, C — Modifying the discharge plan is a judgment and
coordination task for the RN.
D — Initiating or changing medication therapy for suspected
complications is outside routine LPN delegation and requires
RN/physician order.
Teaching point: Delegate stable, routine assessments; RN
retains teaching and clinical judgment tasks.
Citation: Hatfield, N., & Kincheloe, C. (2023). Introductory
maternity & pediatric nursing (5th ed.). Ch. 1.
Q3
Reference: Ch. 1 — The Nurse’s Role in a Changing Maternal–
Child Healthcare Environment
Stem: A 2-day postpartum mother who delivered vaginally tells
the nurse she feels “sad all the time,” is crying frequently, and
reports poor sleep despite the newborn sleeping often. She
denies harming herself or the baby. Which nursing action is the
highest priority?
A. Reassure her that postpartum blues are common and
document the comment.
B. Screen further for postpartum depression, assess safety, and
notify the provider for follow-up.
C. Counsel her to increase rest and postpone screening until the
2-week visit.
D. Advise her to call a family member for support and discharge
without provider notification.
