Maternity and Women's Health Care 13th Edition Lowdermilk Tes
S! S! S! S! S! S! S! S!
t
, Maternity and Women's Health Care 13th Edition Lowdermilk Tes S! S! S! S! S! S! S! S!
t
Chapter 01: 21st Century Maternity and Women’s Health Nursing
S! S! S! S! S! S! S! S! S
!
Lowdermilk: Maternity & Women’s Health Care, 13th Edition
S! S! S! S! S! S! S!
MULTIPLE CHOICE S!
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-
S! S! S! S! S! S! S! S! S! S! S! S!
weight (LBW)infant, which factor is the most important for the nurse to consider?
S! S
! S! S! S! S! S! S! S! S! S! S! S!
a. African-American race S!
b. Cigarette smoking S!
c. Poor nutritional status S! S!
d. Limited maternal education S! S!
ANS: A S !
The rise in the overall LBW rates were due to increases in LBW births to non-
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
Hispanic black women (13.35%) and Hispanic women (7.21%); non-
S! S! S! S! S! S! S! S!
Hispanic black infants are almost twice as likely as non-
S! S! S! S! S! S! S! S! S!
Hispanic white infants to be of LBW and to die in the first year of life.. Race is a nonmodi
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
fiable risk factor. Cigarette smoking is an important factor inpotential infant mortality rates
S! S! S! S! S! S! S! S! S! S
! S! S! S!
, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor n
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
utrition is an important factor in potential infant mortality rates, but it is not the most imp
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
ortant. Additionally, nutritional status is a modifiable risk factor. Maternal education is an
S! S! S! S! S! S! S! S! S! S! S! S! S
important factor in potential infant mortality rates, but it is not the most important. Additi
! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
onally, maternal education is a modifiable risk factor.
S! S! S! S! S! S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Assessment S! S!
MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN
S!S!S!nTanBd.MCaO
inM
tenance, Antepartum Care S! S! S! S!
2. A 23-year-old African-
S! S!
American woman is pregnant with her first child. Based on currentstatistics for infant m
S! S! S! S! S! S! S! S! S! S! S
! S! S! S!
ortality, which intervention is most important for the nurse to includein the client’s plan
S! S! S! S! S! S! S! S! S! S! S
! S! S! S! S!
of care? S!
a. Perform a nutrition assessment. S! S! S!
b. Refer the woman to a social worker. S! S! S! S! S! S!
c. Advise the woman to see an obstetrician, not a midwife. S! S! S! S! S! S! S! S! S!
d. Explain to the woman the importance of keeping her prenatal care appointments.
S! S! S! S! S! S! S! S! S! S! S!
ANS: D S !
Consistent prenatal care is the best method of preventing or controlling risk factors associ
S! S! S! S! S! S! S! S! S! S! S! S! S!
ated with infant mortality. Nutritional status is an important modifiable risk factor, butit is n
S! S! S! S! S! S! S! S! S! S! S! S! S
! S! S!
ot the most important action a nurse should take in this situation. The client may needassi
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S
!
stance from a social worker at some time during her pregnancy, but a referral to a socialw
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S
!
orker is not the most important aspect the nurse should address at this time. If the woman
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
has identifiable high-
S! S!
risk problems, then her health care may need to be provided by a physician. However, it c
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
annot be assumed that all African-American women have high-
S! S! S! S! S! S! S! S!
riskissues. In addition, advising the woman to see an obstetrician is not the most importan
S
! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
t aspect on which the nurse should focus at this time, and it is not appropriate for a nurse
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
to advise or manage the type of care a client is to receive.
S! S! S! S! S! S! S! S! S! S! S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Planning S! S!
, Maternity and Women's Health Care 13th Edition Lowdermilk TesS! S! S! S! S! S! S! S!
t
MSC: Client Needs: Health Promotion and Maintenance
S! S! S! S! S! S!
3. The nurses working at a newly established birthing center have begun to compare the
S! S! S! S! S! S! S! S! S! S! S! S! S!
irperformance in providing maternal-
S
! S! S! S!
newborn care against clinical standards. This comparison process is most commonly
S! S! S! S! S! S! S! S! S! S! S!
known as what? S! S!
a. Best practices network S! S!
b. Clinical benchmarking S!
c. Outcomes-oriented pracNtiU
ceRS S!
d. Evidence-based practice S!
ANS: C S !
Outcomes-
oriented practice measures the effectiveness of the interventions and quality of care agains
S! S! S! S! S! S! S! S! S! S! S! S!
t benchmarks or standards. The term best practice refers to a program or servicethat has be
S! S! S! S! S! S! S! S! S! S! S! S! S! S
! S! S!
en recognized for its excellence. Clinical benchmarking is a process used to compare one’
S! S! S! S! S! S! S! S! S! S! S! S! S!
s own performance against the performance of the best in an area of service. The term evi
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
dence-
based practice refers to the provision of care based on evidence gainedthrough research a
S! S! S! S! S! S! S! S! S! S! S! S
! S! S!
nd clinical trials.
S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Evaluation S! S!
MSC: Client Needs: Safe and Effective Care Environment
S! S! S! S! S! S! S!
4. During a prenatal intake interview, the nurse is in the process of obtaining an initi
S! S! S! S! S! S! S! S! S! S! S! S! S! S!
al assessment of a 21-year-
S! S! S! S!
old Hispanic client with limited English proficiency. Whichintervention is the most
S! S! S! S! S! S! S! S
! S! S! S!
important for the nurse to implement?
S! S! S! S! S! S!
a. Use maternity jargon to enable the client to become familiar with these terms.
S! S! S! S! S! S! S! S! S! S! S! S!
b. Speak quickly and efficiently to expedite the visit.
S! S! S! S! S! S! S!
c. Provide the client with handouts. S! S! S! S!
d. Assess whether the client understands the discussion.S! S! S! S! S! S!
ANS: D S !
Nurses contribute to health literacy by using simple, common words, avoiding jargon, a
S! S! S! S! S! S! S! S! S! S! S! S!
ndevaluating whether the client understands the discussion. Speaking slowly and clearly
S
! S! S! S! S! S! S! S! S! S! S! S!
andfocusing on what is important will increase understanding. Most client education mate
S
! S! S! S! S! S! S! S! S! S! S! S!
rialsare written at a level too high for the average adult and may not be useful for a clie
S
! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
nt withlimited English proficiency.
S! S
! S! S!
PTS: 1 DIF:
Cognitive Level: ApplyTOP: S! S! S
!
Nursing Process: Implementation S! S!
MSC: Client Needs: Health Promotion and Maintenance
S! S! S! S! S! S!
5. Which statement best exemplifies contemporary maternity nursing?
S! S! S! S! S! S!
a. Use of midwives for all vaginal deliveries
S! S! S! S! S! S!
b. Family-centered care S!
c. Free-standing birth clinics S! S!
d. Physician-
driven careANS: B S! S
! S !
, Maternity and Women's Health Care 13th Edition Lowdermilk Tes S! S! S! S! S! S! S! S!
t
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partn
S! S! S! S! S! S! S! S! S! S! S!
ers, grandparents, and siblings may be present for the birth and participate in activitiessuch
S! S! S! S! S! S! S! S! S! S! S! S! S! S
! S!
as cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliv
S! S! S! S! S! S! S! S! S! S! S! S!
eries. Free- S!
standing clinics are an example of alternative birth options. Contemporarymaternity nursin
S! S! S! S! S! S! S! S! S! S
! S!
g is driven by the relationship between nurses and their clients.
S! S! S! S! S! S! S! S! S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Planning S! S!
MSC: Client Needs: Health Promotion and Maintenance
S! S! S! S! S! S!
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-
S! S! S! S! S! S! S! S!
ounce baby girl after beingin labor for 43 hours. The baby died 3 days later from sepsis.
S! S! S! S! S
! S! S! S! S! S! S! S! S! S! S! S! S! S!
On what grounds could the woman have a legitimate legal case for negligence?
S! S! S! S! S! S! S! S! S! S! S! S!
a. Inexperienced maternity nurse was assigned to care for the client. S! S! S! S! S! S! S! S! S!
b. Client was past her due date by 3 days. S! S! S! S! S! S! S! S!
c. Standard of care was not met. S! S! S! S! S!
d. Client refused electronic fetal monitoring. S! S! S! S!
ANS: C S !
Not meeting the standard of care is a legitimate factor for a case of negligence. An inex
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
perienced maternity nurse would need to display competency before being assigned tocar
S! S! S! S! S! S! S! S! S! S! S! S
!
e for clients on his or her own. This client may have been past her due date; however, at
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S
!
erm pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is th
S! S! S! S! S! S! S! S! S! S! S! S! S!
estandard of care, the client has the right to refuse treatment. This refusal is not a case f
S
! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
or negligence, but informed consent should be properly obtained, and the client should h
S! S! S! S! S! S! S! S! S! S! S! S! S!
ave signed an against medical advice form when refusing any treatment that is within th
S! S! S! S! S! S! S! S! S! S! S! S! S! S!
e standard of care.
S! S! S!
PTS: 1 DIF:
Cognitive Level: AnalyzeTOP: S! S! S
!
Nursing Process: Implementation S! S!
MSC: Client Needs: Safe and Effective Care Environment
S! S! S! S! S! S! S!
7. When the nurse is unsure how to perform a client care procedure that is high risk and lo
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
wvolume, his or her best action in this situation would be what?
S
! S! S! S! S! S! S! S! S! S! S! S!
a. Ask another nurse. S! S!
b. Discuss the procedure with the client’s physician. S! S! S! S! S! S!
c. Look up the procedure in a nursing textbook. S! S! S! S! S! S! S!
d. First consult the agency procedure manual S! S! S! S! S!
ANS: D S !
Following the agency’s policies and procedures manual is always best when seeking infor
S! S! S! S! S! S! S! S! S! S! S! S!
mation on correct client procedures. These policies should reflect the current standardsof c
S! S! S! S! S! S! S! S! S! S! S! S
! S!
are and the individual state’s guidelines. Each nurse is responsible for his or her own prac
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
tice. Relying on another nurse may not always be a safe practice. Each nurse is obligated
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
to follow the standards of care for safe client care delivery. Physicians are responsible for
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
their own client care activity. Nurses may follow safe orders from physicians, but they are
S! S! S! S! S! S! S! S! S! S! S! S! S! S!
also responsible for the activities that they, as nurses, are to carry out. Information provid
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
ed in a nursing textbook is basic information for general knowledge.Furthermore, the infor
S! S! S! S! S! S! S! S! S! S! S
! S! S!
mation in a textbook may not reflect the current standard of care or the individual state or
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
hospital policies. S!
S! S! S! S! S! S! S! S!
t
, Maternity and Women's Health Care 13th Edition Lowdermilk Tes S! S! S! S! S! S! S! S!
t
Chapter 01: 21st Century Maternity and Women’s Health Nursing
S! S! S! S! S! S! S! S! S
!
Lowdermilk: Maternity & Women’s Health Care, 13th Edition
S! S! S! S! S! S! S!
MULTIPLE CHOICE S!
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-
S! S! S! S! S! S! S! S! S! S! S! S!
weight (LBW)infant, which factor is the most important for the nurse to consider?
S! S
! S! S! S! S! S! S! S! S! S! S! S!
a. African-American race S!
b. Cigarette smoking S!
c. Poor nutritional status S! S!
d. Limited maternal education S! S!
ANS: A S !
The rise in the overall LBW rates were due to increases in LBW births to non-
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
Hispanic black women (13.35%) and Hispanic women (7.21%); non-
S! S! S! S! S! S! S! S!
Hispanic black infants are almost twice as likely as non-
S! S! S! S! S! S! S! S! S!
Hispanic white infants to be of LBW and to die in the first year of life.. Race is a nonmodi
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
fiable risk factor. Cigarette smoking is an important factor inpotential infant mortality rates
S! S! S! S! S! S! S! S! S! S
! S! S! S!
, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor n
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
utrition is an important factor in potential infant mortality rates, but it is not the most imp
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
ortant. Additionally, nutritional status is a modifiable risk factor. Maternal education is an
S! S! S! S! S! S! S! S! S! S! S! S! S
important factor in potential infant mortality rates, but it is not the most important. Additi
! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
onally, maternal education is a modifiable risk factor.
S! S! S! S! S! S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Assessment S! S!
MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN
S!S!S!nTanBd.MCaO
inM
tenance, Antepartum Care S! S! S! S!
2. A 23-year-old African-
S! S!
American woman is pregnant with her first child. Based on currentstatistics for infant m
S! S! S! S! S! S! S! S! S! S! S
! S! S! S!
ortality, which intervention is most important for the nurse to includein the client’s plan
S! S! S! S! S! S! S! S! S! S! S
! S! S! S! S!
of care? S!
a. Perform a nutrition assessment. S! S! S!
b. Refer the woman to a social worker. S! S! S! S! S! S!
c. Advise the woman to see an obstetrician, not a midwife. S! S! S! S! S! S! S! S! S!
d. Explain to the woman the importance of keeping her prenatal care appointments.
S! S! S! S! S! S! S! S! S! S! S!
ANS: D S !
Consistent prenatal care is the best method of preventing or controlling risk factors associ
S! S! S! S! S! S! S! S! S! S! S! S! S!
ated with infant mortality. Nutritional status is an important modifiable risk factor, butit is n
S! S! S! S! S! S! S! S! S! S! S! S! S
! S! S!
ot the most important action a nurse should take in this situation. The client may needassi
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S
!
stance from a social worker at some time during her pregnancy, but a referral to a socialw
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S
!
orker is not the most important aspect the nurse should address at this time. If the woman
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
has identifiable high-
S! S!
risk problems, then her health care may need to be provided by a physician. However, it c
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
annot be assumed that all African-American women have high-
S! S! S! S! S! S! S! S!
riskissues. In addition, advising the woman to see an obstetrician is not the most importan
S
! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
t aspect on which the nurse should focus at this time, and it is not appropriate for a nurse
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
to advise or manage the type of care a client is to receive.
S! S! S! S! S! S! S! S! S! S! S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Planning S! S!
, Maternity and Women's Health Care 13th Edition Lowdermilk TesS! S! S! S! S! S! S! S!
t
MSC: Client Needs: Health Promotion and Maintenance
S! S! S! S! S! S!
3. The nurses working at a newly established birthing center have begun to compare the
S! S! S! S! S! S! S! S! S! S! S! S! S!
irperformance in providing maternal-
S
! S! S! S!
newborn care against clinical standards. This comparison process is most commonly
S! S! S! S! S! S! S! S! S! S! S!
known as what? S! S!
a. Best practices network S! S!
b. Clinical benchmarking S!
c. Outcomes-oriented pracNtiU
ceRS S!
d. Evidence-based practice S!
ANS: C S !
Outcomes-
oriented practice measures the effectiveness of the interventions and quality of care agains
S! S! S! S! S! S! S! S! S! S! S! S!
t benchmarks or standards. The term best practice refers to a program or servicethat has be
S! S! S! S! S! S! S! S! S! S! S! S! S! S
! S! S!
en recognized for its excellence. Clinical benchmarking is a process used to compare one’
S! S! S! S! S! S! S! S! S! S! S! S! S!
s own performance against the performance of the best in an area of service. The term evi
S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
dence-
based practice refers to the provision of care based on evidence gainedthrough research a
S! S! S! S! S! S! S! S! S! S! S! S
! S! S!
nd clinical trials.
S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Evaluation S! S!
MSC: Client Needs: Safe and Effective Care Environment
S! S! S! S! S! S! S!
4. During a prenatal intake interview, the nurse is in the process of obtaining an initi
S! S! S! S! S! S! S! S! S! S! S! S! S! S!
al assessment of a 21-year-
S! S! S! S!
old Hispanic client with limited English proficiency. Whichintervention is the most
S! S! S! S! S! S! S! S
! S! S! S!
important for the nurse to implement?
S! S! S! S! S! S!
a. Use maternity jargon to enable the client to become familiar with these terms.
S! S! S! S! S! S! S! S! S! S! S! S!
b. Speak quickly and efficiently to expedite the visit.
S! S! S! S! S! S! S!
c. Provide the client with handouts. S! S! S! S!
d. Assess whether the client understands the discussion.S! S! S! S! S! S!
ANS: D S !
Nurses contribute to health literacy by using simple, common words, avoiding jargon, a
S! S! S! S! S! S! S! S! S! S! S! S!
ndevaluating whether the client understands the discussion. Speaking slowly and clearly
S
! S! S! S! S! S! S! S! S! S! S! S!
andfocusing on what is important will increase understanding. Most client education mate
S
! S! S! S! S! S! S! S! S! S! S! S!
rialsare written at a level too high for the average adult and may not be useful for a clie
S
! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S! S!
nt withlimited English proficiency.
S! S
! S! S!
PTS: 1 DIF:
Cognitive Level: ApplyTOP: S! S! S
!
Nursing Process: Implementation S! S!
MSC: Client Needs: Health Promotion and Maintenance
S! S! S! S! S! S!
5. Which statement best exemplifies contemporary maternity nursing?
S! S! S! S! S! S!
a. Use of midwives for all vaginal deliveries
S! S! S! S! S! S!
b. Family-centered care S!
c. Free-standing birth clinics S! S!
d. Physician-
driven careANS: B S! S
! S !
, Maternity and Women's Health Care 13th Edition Lowdermilk Tes S! S! S! S! S! S! S! S!
t
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partn
S! S! S! S! S! S! S! S! S! S! S!
ers, grandparents, and siblings may be present for the birth and participate in activitiessuch
S! S! S! S! S! S! S! S! S! S! S! S! S! S
! S!
as cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliv
S! S! S! S! S! S! S! S! S! S! S! S!
eries. Free- S!
standing clinics are an example of alternative birth options. Contemporarymaternity nursin
S! S! S! S! S! S! S! S! S! S
! S!
g is driven by the relationship between nurses and their clients.
S! S! S! S! S! S! S! S! S! S!
PTS: 1 DIF:
Cognitive Level: UnderstandTOP: S! S! S
!
Nursing Process: Planning S! S!
MSC: Client Needs: Health Promotion and Maintenance
S! S! S! S! S! S!
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-
S! S! S! S! S! S! S! S!
ounce baby girl after beingin labor for 43 hours. The baby died 3 days later from sepsis.
S! S! S! S! S
! S! S! S! S! S! S! S! S! S! S! S! S! S!
On what grounds could the woman have a legitimate legal case for negligence?
S! S! S! S! S! S! S! S! S! S! S! S!
a. Inexperienced maternity nurse was assigned to care for the client. S! S! S! S! S! S! S! S! S!
b. Client was past her due date by 3 days. S! S! S! S! S! S! S! S!
c. Standard of care was not met. S! S! S! S! S!
d. Client refused electronic fetal monitoring. S! S! S! S!
ANS: C S !
Not meeting the standard of care is a legitimate factor for a case of negligence. An inex
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perienced maternity nurse would need to display competency before being assigned tocar
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e for clients on his or her own. This client may have been past her due date; however, at
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erm pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is th
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estandard of care, the client has the right to refuse treatment. This refusal is not a case f
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or negligence, but informed consent should be properly obtained, and the client should h
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ave signed an against medical advice form when refusing any treatment that is within th
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e standard of care.
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PTS: 1 DIF:
Cognitive Level: AnalyzeTOP: S! S! S
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Nursing Process: Implementation S! S!
MSC: Client Needs: Safe and Effective Care Environment
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7. When the nurse is unsure how to perform a client care procedure that is high risk and lo
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wvolume, his or her best action in this situation would be what?
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a. Ask another nurse. S! S!
b. Discuss the procedure with the client’s physician. S! S! S! S! S! S!
c. Look up the procedure in a nursing textbook. S! S! S! S! S! S! S!
d. First consult the agency procedure manual S! S! S! S! S!
ANS: D S !
Following the agency’s policies and procedures manual is always best when seeking infor
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mation on correct client procedures. These policies should reflect the current standardsof c
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are and the individual state’s guidelines. Each nurse is responsible for his or her own prac
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tice. Relying on another nurse may not always be a safe practice. Each nurse is obligated
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to follow the standards of care for safe client care delivery. Physicians are responsible for
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their own client care activity. Nurses may follow safe orders from physicians, but they are
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also responsible for the activities that they, as nurses, are to carry out. Information provid
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ed in a nursing textbook is basic information for general knowledge.Furthermore, the infor
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mation in a textbook may not reflect the current standard of care or the individual state or
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hospital policies. S!
