MATERNITY AND WOMEN'S
HEALTH CARE
13TH EDITION
• AUTHOR(S)DEITRA LOWDERMILK
TEST BANK
1
Reference: Ch. 1 — Introduction to Maternity and Women’s
Health Care — 21st-Century Maternity Nursing: Advances in
Care
Stem: A postpartum unit is implementing a new perinatal safety
bundle to reduce hemorrhage rates. The nurse manager asks
you to prioritize one action that will most immediately decrease
the risk of severe postpartum hemorrhage for a patient who
just had a vaginal birth and shows a boggy fundus and excessive
lochia. Which action should you take first?
,A. Begin an oxytocin infusion per protocol.
B. Massage the fundus and reassess uterine tone.
C. Insert an indwelling urinary catheter to assess urine output.
D. Notify the physician and request an order for methergine.
Correct Answer: B
Rationale — Correct: Fundal massage is the immediate, first-
line nursing action to stimulate uterine contraction and reduce
bleeding in uterine atony; it is fast, noninvasive, and can rapidly
improve tone and reduce blood loss.
Rationale — Incorrect:
A. Oxytocin infusion is appropriate but initiation may follow
immediate interventions such as fundal massage; starting IV
medications takes longer than massage.
C. A catheter helps monitor output but does not rapidly address
uterine atony causing bleeding.
D. Physician notification is important, but immediate nurse-
initiated measures (massage) take priority to control bleeding.
Teaching Point: For uterine atony, perform fundal massage
immediately while activating hemorrhage protocols.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
2
Reference: Ch. 1 — Introduction to Maternity and Women’s
Health Care — Efforts to Reduce Health Disparities
Stem: A community health clinic serving a predominantly Black
,population has higher-than-expected rates of late prenatal care
entry. As the RN leading quality improvement, which strategy
best addresses systemic barriers and is most likely to reduce
disparities in prenatal access?
A. Sending standardized prenatal education emails to all
patients.
B. Offering evening and weekend appointment times and
transportation vouchers.
C. Requiring proof of insurance before scheduling the first visit.
D. Posting clinic hours on social media once a month.
Correct Answer: B
Rationale — Correct: Offering flexible appointment times and
transportation support directly addresses common structural
barriers (work schedules, transit access) and is an evidence-
based step to improve timely prenatal care and reduce
disparities.
Rationale — Incorrect:
A. Emails assume reliable access to technology and health
literacy, which may not address structural barriers.
C. Requiring proof of insurance creates an access barrier and
may worsen disparities.
D. Social media posts are passive and unlikely to overcome
practical access obstacles.
Teaching Point: Reduce access disparities by addressing
structural barriers (hours, transport, child care).
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
, 3
Reference: Ch. 1 — Introduction to Maternity and Women’s
Health Care — Contemporary Issues: Maternal Mortality
Stem: On an antepartum unit, a 32-year-old multiparous
patient with hypertension reports a severe pounding headache
and visual changes at 36 weeks. Based on trends in maternal
mortality and early recognition priorities, which nursing action
is highest priority?
A. Offer a pain medication such as acetaminophen and
encourage rest.
B. Assess blood pressure immediately, place on continuous fetal
monitoring, and notify the provider.
C. Schedule an outpatient ophthalmology appointment for next
week.
D. Document symptoms and reassess during the next routine
vital signs.
Correct Answer: B
Rationale — Correct: Severe headache and visual changes in a
hypertensive pregnant patient are red flags for severe
preeclampsia; immediate BP assessment, fetal monitoring, and
provider notification are urgent to prevent maternal and fetal
morbidity/mortality.
Rationale — Incorrect:
A. Symptom relief without assessment misses life-threatening
pathology.
HEALTH CARE
13TH EDITION
• AUTHOR(S)DEITRA LOWDERMILK
TEST BANK
1
Reference: Ch. 1 — Introduction to Maternity and Women’s
Health Care — 21st-Century Maternity Nursing: Advances in
Care
Stem: A postpartum unit is implementing a new perinatal safety
bundle to reduce hemorrhage rates. The nurse manager asks
you to prioritize one action that will most immediately decrease
the risk of severe postpartum hemorrhage for a patient who
just had a vaginal birth and shows a boggy fundus and excessive
lochia. Which action should you take first?
,A. Begin an oxytocin infusion per protocol.
B. Massage the fundus and reassess uterine tone.
C. Insert an indwelling urinary catheter to assess urine output.
D. Notify the physician and request an order for methergine.
Correct Answer: B
Rationale — Correct: Fundal massage is the immediate, first-
line nursing action to stimulate uterine contraction and reduce
bleeding in uterine atony; it is fast, noninvasive, and can rapidly
improve tone and reduce blood loss.
Rationale — Incorrect:
A. Oxytocin infusion is appropriate but initiation may follow
immediate interventions such as fundal massage; starting IV
medications takes longer than massage.
C. A catheter helps monitor output but does not rapidly address
uterine atony causing bleeding.
D. Physician notification is important, but immediate nurse-
initiated measures (massage) take priority to control bleeding.
Teaching Point: For uterine atony, perform fundal massage
immediately while activating hemorrhage protocols.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
2
Reference: Ch. 1 — Introduction to Maternity and Women’s
Health Care — Efforts to Reduce Health Disparities
Stem: A community health clinic serving a predominantly Black
,population has higher-than-expected rates of late prenatal care
entry. As the RN leading quality improvement, which strategy
best addresses systemic barriers and is most likely to reduce
disparities in prenatal access?
A. Sending standardized prenatal education emails to all
patients.
B. Offering evening and weekend appointment times and
transportation vouchers.
C. Requiring proof of insurance before scheduling the first visit.
D. Posting clinic hours on social media once a month.
Correct Answer: B
Rationale — Correct: Offering flexible appointment times and
transportation support directly addresses common structural
barriers (work schedules, transit access) and is an evidence-
based step to improve timely prenatal care and reduce
disparities.
Rationale — Incorrect:
A. Emails assume reliable access to technology and health
literacy, which may not address structural barriers.
C. Requiring proof of insurance creates an access barrier and
may worsen disparities.
D. Social media posts are passive and unlikely to overcome
practical access obstacles.
Teaching Point: Reduce access disparities by addressing
structural barriers (hours, transport, child care).
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
, 3
Reference: Ch. 1 — Introduction to Maternity and Women’s
Health Care — Contemporary Issues: Maternal Mortality
Stem: On an antepartum unit, a 32-year-old multiparous
patient with hypertension reports a severe pounding headache
and visual changes at 36 weeks. Based on trends in maternal
mortality and early recognition priorities, which nursing action
is highest priority?
A. Offer a pain medication such as acetaminophen and
encourage rest.
B. Assess blood pressure immediately, place on continuous fetal
monitoring, and notify the provider.
C. Schedule an outpatient ophthalmology appointment for next
week.
D. Document symptoms and reassess during the next routine
vital signs.
Correct Answer: B
Rationale — Correct: Severe headache and visual changes in a
hypertensive pregnant patient are red flags for severe
preeclampsia; immediate BP assessment, fetal monitoring, and
provider notification are urgent to prevent maternal and fetal
morbidity/mortality.
Rationale — Incorrect:
A. Symptom relief without assessment misses life-threatening
pathology.
