TEST BANK Maternity and Women's HealthCare (13TH Edition) by Lowdermilk Complete Guide Chapter 1-37| Answers With Rationale

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Chapter 01: 21st Century Maternityand Women’s Health Nursing Lowdermilk: Maternity& Women’s
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1. In evaluatingthe level of a pregnant woman’s risk of havinga low-birth-weight (LBW)
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ka infant, which factor is the most important for the nurse to consider?
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a. African-Americanrace ka




b. Cigarette smoking ka




c. Poor nutritional status ka ka




d. Limitedmaternaleducation ka ka




ka ANS: A ka




The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic black women
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ka (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are almost twice as likely as non-
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Hispanic white infants to be of LBW and to die in the first year of life.. Race is a nonmodifiable risk
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ka factor. Cigarette smoking is an important factor in potential infant mortality rates, but it is not the most
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ka important. Additionally, smoking is a modifiable risk factor. Poor nutrition is an important factor in
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potential infant mortalityrates, but it is not the most important. Additionally, nutritional status is a
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ka modifiable risk factor. Maternal education is an important factor in potential infant mortality rates, but
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ka it is not the most important. Additionally, maternal education is a modifiable risk factor.
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PTS: 1 DIF: Cognitive Level: Understand TOP: ka ka ka Nursing Process: Assessment ka ka




ka MSC: ClientNeeds:HealtNhUPrRoSmIotNioGnTanBd.MCaOinMtenance,AntepartumCare
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2. A 23-year-old African-American woman is pregnant with her first child. Based on
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ka current statistics for infant mortality, which intervention is most important for the nurse to
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ka include in the client’s plan of care?
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a. Perform a nutrition assessment. ka ka ka




b. Refer the woman to a social worker. ka ka ka ka ka ka




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c. Advise the woman to see an obstetrician, not a midwife. ka ka ka ka ka ka ka ka ka




d. Explain to the woman the importance of keeping her prenatal care appointments.
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ka ANS: D ka




Consistent prenatal care is the best method of preventing or controlling risk factors associated with
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ka infant mortality. Nutritional status is an important modifiable risk factor, but it is not the most
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important action a nurse should take in this situation. The client mayneed assistance from a social
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ka worker at some time during her pregnancy, but a referral to a social worker is not the most important
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ka aspect the nurse should address at this time. If the woman has identifiable high-risk problems, then her
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ka health care may need to be provided by a physician. However, it cannot be assumed that all African-
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American women have high-risk issues. In addition, advising the woman to see an obstetrician is not
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ka the most important aspect on which the nurse should focus at this time, and it is not appropriate for a
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ka nurse to advise or manage the type of care a client is to receive.
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PTS: 1 DIF: Cognitive Level: Understand TOP: ka ka ka NursingProcess: Planning ka ka




MSC: Client Needs: Health Promotion and Maintenance
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3. The nurses working at a newlyestablished birthingcenter have begun to compare their
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ka performance in providing maternal-newborn care against clinical standards. This comparison
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ka process is most commonly known as what?
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a. Best practices network ka ka




b. Clinical benchmarking ka




c. Outcomes-oriented pracNtiUceRS ka




d. Evidence-basedpractice ka




ka ANS: C ka




Outcomes-oriented practice measures the effectiveness of the interventions and qualityof care against ka ka ka ka ka ka ka ka ka ka ka ka




benchmarks or standards. The term best practice refers to a program or service that has been recognized
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ka for its excellence. Clinical benchmarking is a process used to compare one’s own performance against
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ka the performance of the best in an area of service. The term evidence- based practice refers to the
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ka provision of care based on evidence gained through research and clinical trials.
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PTS: 1 DIF: Cognitive Level: Understand TOP: ka ka ka NursingProcess:Evaluation ka ka




ka MSC: Client Needs: Safe and Effective Care Environment
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4. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment
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of a 21-year-old Hispanic client with limited English proficiency. Which intervention is the most
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ka important for the nurse to implement? ka ka ka ka ka




a. Use maternityjargon to enable the client to become familiar with these terms.
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b. Speak quickly and efficiently to expedite the visit.
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c. Provide the client with handouts. ka ka ka ka




d. Assess whethertheclient understandsthediscussion. ka ka ka ka ka ka




ka ANS: D ka




Nurses contribute to health literacy by using simple, common words, avoiding jargon, and evaluating
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ka whether the client understands the discussion. Speaking slowly and clearly and focusingon what is
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important will increase understanding. Most client education materials are written at a level too high for
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ka the average adult and may not be useful for a client with limited English proficiency.
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PTS: 1 DIF: CognitiveLevel:ApplyTOP:NursingProcess:Implementation ka ka ka ka ka ka




ka MSC: Client Needs: Health Promotion and Maintenance
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5. Which statement best exemplifies contemporary maternity nursing?
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a. Use of midwives for all vaginal deliveries
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b. Family-centeredcare ka




c. Free-standing birth clinics ka ka




d. Physician-driven care ANS: B ka ka ka




Contemporarymaternitynursing focuses on the family’s needs and desires. Fathers, partners,
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ka grandparents, and siblings may be present for the birth and participate in activities such as
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cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliveries.
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Free-standingclinics are an example of alternative birth options. Contemporarymaternity nursing is ka ka ka ka ka ka ka ka ka ka ka ka




driven by the relationship between nurses and their clients.
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PTS: 1 DIF: Cognitive Level: Understand TOP: ka ka ka NursingProcess:Planning ka ka




MSC: Client Needs: Health Promotion and Maintenance
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6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after
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being in labor for 43 hours. The babydied 3 days later from sepsis. On what grounds could the woman
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have a legitimate legal case for negligence?
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a. Inexperienced maternity nurse was assigned to care for the client. ka ka ka ka ka ka ka ka ka




b. Client was past her due date by 3 days. ka ka ka ka ka ka ka ka




c. Standard of care was not met. ka ka ka ka ka




d. Clientrefusedelectronicfetalmonitoring. ka ka ka ka




ANS: C
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Not meetingthe standard of care is a legitimate factor for a case of negligence. An inexperienced
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maternity nurse would need to display competency before being assigned to care for clients on his or
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her own. This client may have been past her due date; however, a term pregnancy often goes beyond 40
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weeks of gestation. Although fetal monitoring is the standard of care, the client has the right to refuse
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treatment. This refusal is not a case for negligence, but informed consent should be properly obtained,
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and the client should have signed an against medical advice form when refusing any treatment that is
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within the standard of care.
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PTS: 1 DIF: Cognitive Level: Analyze TOP: ka ka ka NursingProcess:Implementation ka ka




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 low
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volume, his or her best action in this situation would be what?
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a. Ask another nurse. ka ka




b. Discuss the procedure with the client’s physician. ka ka ka ka ka ka




c. Look up the procedure in a nursing textbook.ka ka ka ka ka ka ka




d. Firstconsulttheagencyproceduremanual ka ka ka ka ka




ANS: D
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