MATERNITY AND WOMEN'S
HEALTH CARE
13TH EDITION
• AUTHOR(S)DEITRA LOWDERMILK
TEST BANK
1
Reference: Part 1 — Introduction — 21st-Century Maternity
and Women’s Health Nursing — Advances in the Care of
Mothers and Infants
Stem: A 28-year-old primigravida at 39 weeks asks the nurse
about continuous electronic fetal monitoring (EFM) offered
during labor vs intermittent auscultation. She’s low-risk and
requests to ambulate in early labor. Which response best
reflects current evidence-based maternal-newborn practice?
A. “Continuous EFM is required for all labors to prevent
,neonatal neurologic injury.”
B. “Intermittent auscultation is an appropriate option for low-
risk laboring women who wish to ambulate.”
C. “Ambulation during labor increases cesarean risk and should
be discouraged.”
D. “If you choose intermittent auscultation, you must avoid pain
medication.”
Correct answer: B
Rationale — Correct: Intermittent auscultation is evidence-
supported for low-risk labors and allows ambulation, promoting
labor progress and maternal comfort while avoiding
unnecessary monitoring interventions.
Rationale — Incorrect A: Continuous EFM is not required for all
labors and is associated with increased operative births without
improved long-term neonatal outcomes.
Rationale — Incorrect C: Ambulation generally supports labor
progress and is not associated with increased cesarean rates;
discouraging it is not evidence-based.
Rationale — Incorrect D: Choice of auscultation does not
preclude appropriate pain management; analgesia decisions are
independent.
Teaching point: Intermittent auscultation is appropriate for low-
risk, ambulating laboring women.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Part 1.
,2
Reference: Part 1 — Efforts to Reduce Health Disparities —
Social Determinants and Access to Care
Stem: A nurse in a community clinic notices lower prenatal visit
attendance among pregnant clients from a nearby refugee
community. Which initial nursing action best addresses the
disparity in access to prenatal care?
A. Provide a generic prenatal education pamphlet in English.
B. Ask clinic leadership to schedule evening clinics and bilingual
staff.
C. Require attendance at town-hall sessions before scheduling
visits.
D. Refer all clients to a tertiary hospital for prenatal care.
Correct answer: B
Rationale — Correct: Scheduling clinics at accessible times and
ensuring bilingual staff directly addresses barriers (transport,
language, work hours) and improves access and equity.
Rationale — Incorrect A: A pamphlet in English will not meet
language needs and doesn’t remove structural barriers.
Rationale — Incorrect C: Mandatory town halls create an
additional barrier and may deter attendance.
Rationale — Incorrect D: Referring to a tertiary hospital may
increase travel/time burdens and worsen access for this
community.
Teaching point: Adapt clinic logistics and language services to
reduce access barriers.
, Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Part 1.
3
Reference: Part 1 — Contemporary Issues and Trends —
Maternal Morbidity and Mortality
Stem: A postpartum unit nurse reviews the chart of a patient
who had a postpartum hemorrhage (PPH) but was stabilized.
The unit is implementing a perinatal quality improvement (QI)
bundle to reduce PPH. Which role should the nurse prioritize to
improve unit outcomes?
A. Document events only after shift change to conserve time.
B. Participate in multidisciplinary debriefings and standardized
hemorrhage drills.
C. Delegate hemorrhage education entirely to physicians.
D. Avoid reporting near-misses to maintain unit reputation.
Correct answer: B
Rationale — Correct: Participation in multidisciplinary debriefs
and drills improves team performance, protocol adherence, and
patient outcomes—core aims of QI bundles.
Rationale — Incorrect A: Delayed documentation risks loss of
critical details and impairs QI data integrity.
Rationale — Incorrect C: Education and skill competence are
interprofessional responsibilities; nurses play a central role.
HEALTH CARE
13TH EDITION
• AUTHOR(S)DEITRA LOWDERMILK
TEST BANK
1
Reference: Part 1 — Introduction — 21st-Century Maternity
and Women’s Health Nursing — Advances in the Care of
Mothers and Infants
Stem: A 28-year-old primigravida at 39 weeks asks the nurse
about continuous electronic fetal monitoring (EFM) offered
during labor vs intermittent auscultation. She’s low-risk and
requests to ambulate in early labor. Which response best
reflects current evidence-based maternal-newborn practice?
A. “Continuous EFM is required for all labors to prevent
,neonatal neurologic injury.”
B. “Intermittent auscultation is an appropriate option for low-
risk laboring women who wish to ambulate.”
C. “Ambulation during labor increases cesarean risk and should
be discouraged.”
D. “If you choose intermittent auscultation, you must avoid pain
medication.”
Correct answer: B
Rationale — Correct: Intermittent auscultation is evidence-
supported for low-risk labors and allows ambulation, promoting
labor progress and maternal comfort while avoiding
unnecessary monitoring interventions.
Rationale — Incorrect A: Continuous EFM is not required for all
labors and is associated with increased operative births without
improved long-term neonatal outcomes.
Rationale — Incorrect C: Ambulation generally supports labor
progress and is not associated with increased cesarean rates;
discouraging it is not evidence-based.
Rationale — Incorrect D: Choice of auscultation does not
preclude appropriate pain management; analgesia decisions are
independent.
Teaching point: Intermittent auscultation is appropriate for low-
risk, ambulating laboring women.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Part 1.
,2
Reference: Part 1 — Efforts to Reduce Health Disparities —
Social Determinants and Access to Care
Stem: A nurse in a community clinic notices lower prenatal visit
attendance among pregnant clients from a nearby refugee
community. Which initial nursing action best addresses the
disparity in access to prenatal care?
A. Provide a generic prenatal education pamphlet in English.
B. Ask clinic leadership to schedule evening clinics and bilingual
staff.
C. Require attendance at town-hall sessions before scheduling
visits.
D. Refer all clients to a tertiary hospital for prenatal care.
Correct answer: B
Rationale — Correct: Scheduling clinics at accessible times and
ensuring bilingual staff directly addresses barriers (transport,
language, work hours) and improves access and equity.
Rationale — Incorrect A: A pamphlet in English will not meet
language needs and doesn’t remove structural barriers.
Rationale — Incorrect C: Mandatory town halls create an
additional barrier and may deter attendance.
Rationale — Incorrect D: Referring to a tertiary hospital may
increase travel/time burdens and worsen access for this
community.
Teaching point: Adapt clinic logistics and language services to
reduce access barriers.
, Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Part 1.
3
Reference: Part 1 — Contemporary Issues and Trends —
Maternal Morbidity and Mortality
Stem: A postpartum unit nurse reviews the chart of a patient
who had a postpartum hemorrhage (PPH) but was stabilized.
The unit is implementing a perinatal quality improvement (QI)
bundle to reduce PPH. Which role should the nurse prioritize to
improve unit outcomes?
A. Document events only after shift change to conserve time.
B. Participate in multidisciplinary debriefings and standardized
hemorrhage drills.
C. Delegate hemorrhage education entirely to physicians.
D. Avoid reporting near-misses to maintain unit reputation.
Correct answer: B
Rationale — Correct: Participation in multidisciplinary debriefs
and drills improves team performance, protocol adherence, and
patient outcomes—core aims of QI bundles.
Rationale — Incorrect A: Delayed documentation risks loss of
critical details and impairs QI data integrity.
Rationale — Incorrect C: Education and skill competence are
interprofessional responsibilities; nurses play a central role.
