HEALTH CARE
13TH EDITION
• AUTHOR(S)DEITRA LOWDERMILK
TEST BANK
1)
Reference: Ch. 1 — Advances in the Care of Mothers and
Infants — Telehealth & Access to Care
Stem: A 28-year-old primigravida at 34 weeks calls the clinic
reporting increased contractions but lives 90 minutes from the
hospital and has limited transportation. The clinic nurse reviews
her symptoms by video and notes regular contractions every 8
minutes but reassuring fetal movement and no bleeding. Which
nursing action is most appropriate?
,A. Advise her to wait and monitor contractions at home and call
back if they become more frequent.
B. Arrange urgent in-person evaluation at the nearest facility
and coordinate transport.
C. Instruct her to take oral analgesic and rest; schedule standard
in-person follow-up in 48 hours.
D. Reassure her that at 34 weeks contractions can be normal
and provide education about signs of preterm labor.
Correct answer: B
Rationale — Correct: Arrange urgent in-person evaluation and
coordinate transport. Telehealth can triage but cannot replace
assessment when preterm labor is suspected; prompt in-person
evaluation reduces risk of missed preterm labor and adverse
neonatal outcomes.
Rationale — Incorrect:
A. Waiting risks progression of preterm labor and delayed
interventions (tocolysis, steroids).
C. Giving analgesic and delaying follow-up is unsafe when
contractions are regular and preterm labor possible.
D. Reassurance alone underestimates risk; education must be
paired with immediate evaluation.
Teaching point: Telehealth triage is valuable, but suspected
preterm labor requires prompt in-person assessment.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
,2)
Reference: Ch. 1 — Efforts to Reduce Health Disparities —
Social Determinants of Health
Stem: A postpartum nurse conducts a discharge assessment for
a 22-year-old mother who lives in a household with food
insecurity, no stable childcare, and limited health literacy.
Which action should the nurse prioritize to reduce health
disparities for this family?
A. Provide a standardized teaching packet on newborn care and
breastfeeding.
B. Schedule a routine 6-week postpartum clinic appointment
and document discharge instructions.
C. Refer to community resources (WIC, home visiting, social
work) and arrange early postpartum follow-up.
D. Emphasize the importance of vaccinations and advise
returning to the ED for any concerns.
Correct answer: C
Rationale — Correct: Referring to community resources and
arranging early follow-up addresses social determinants (food,
childcare, support) and improves access to care and outcomes;
this is a priority in reducing disparities.
Rationale — Incorrect:
A. A standardized packet alone may not be understood or
accessible.
B. Routine 6-week follow-up is insufficient—early contact is
needed for vulnerable families.
, D. Emphasizing vaccines and ED use ignores upstream social
needs and does not proactively connect supports.
Teaching point: Address social determinants with resource
referrals and early follow-up to reduce disparity.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
3)
Reference: Ch. 1 — Contemporary Issues — Maternal Mortality
& Quality Improvement
Stem: During a unit quality review, the nurse discovers delayed
recognition of postpartum hemorrhage (PPH) in two recent
cases. As the charge nurse, what is the best first action to
improve patient safety?
A. Educate staff with a one-time lecture about PPH signs and
management.
B. Implement a rapid PPH response protocol and run
interdisciplinary simulation drills.
C. Increase documentation auditing to identify nurses with poor
charting.
D. Hire additional staff to ensure more frequent vital-sign
checks postpartum.
Correct answer: B
Rationale — Correct: Implementing a rapid response protocol
and simulation drills targets systems change, improves team