Maternity and Women's Health Care 13th Edition Lowdermilk Test
v v v v v v v v
, Maternity and Women's Health Care 13th Edition Lowdermilk Test v v v v v v v v
Chapter 01: 21st Century Maternity and Women’s Health Nursing Lowdermilk:
v v v v v v v v v
Maternity & Women’s Health Care, 12th Edition
v v v v v v v
MULTIPLE CHOICE v
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW)
v v v v v v v v v v v v v
infant, which factor is the most important for the nurse to consider?
v v v v v v v v v v v v
a. African-American race v
b. Cigarette smoking v
c. Poor nutritional status v v
d. Limited maternal education v v
ANS: A v
The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic
v v v v v v v v v v v v v v v
black women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are
v v v v v v v v v v v
almost twice as likely as non-Hispanic white infants to be of LBW and to die in the first
v v v v v v v v v v v v v v v v v v
year of life.. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in
v v v v v v v v v v v v v v v v
potential infant mortality rates, but it is not the most important. Additionally, smoking is a
v v v v v v v v v v v v v v v
modifiable risk factor. Poor nutrition is an important factor in potential infant mortality
v v v v v v v v v v v v v
rates, but it is not the most important. Additionally, nutritional status is a modifiable risk
v v v v v v v v v v v v v v v
factor. Maternal education is an important factor in potential infant mortality rates, but it is
v v v v v v v v v v v v v v v
not the most important. Additionally, maternal education is a modifiable risk factor.
v v v v v v v v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Assessment
v v v
MSC: Client Needs: HealtN PrRoS
hU mI
v ioG
otN nTanBd.M
CaOinMtenance, Antepartum Care
v v v v v
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
v v v v v v v v v v v v
statistics for infant mortality, which intervention is most important for the nurse to include
v v v v v v v v v v v v v v
in the client’s plan of care?
v v v v v v
a. Perform a nutrition assessment. v v v
b. Refer the woman to a social worker. v v v v v v
c. Advise the woman to see an obstetrician, not a midwife. v v v v v v v v v
d. Explain to the woman the importance of keeping her prenatal care appointments.
v v v v v v v v v v v
ANS: D v
Consistent prenatal care is the best method of preventing or controlling risk factors
v v v v v v v v v v v v
associated with infant mortality. Nutritional status is an important modifiable risk factor, but
v v v v v v v v v v v v v
it is not the most important action a nurse should take in this situation. The client may need
v v v v v v v v v v v v v v v v v v
assistance from a social worker at some time during her pregnancy, but a referral to a social
v v v v v v v v v v v v v v v v v
worker is not the most important aspect the nurse should address at this time. If the woman
v v v v v v v v v v v v v v v v v
has identifiable high-risk problems, then her health care may need to be provided by a
v v v v v v v v v v v v v v v
physician. However, it cannot be assumed that all African-American women have high-risk
v v v v v v v v v v v v
issues. In addition, advising the woman to see an obstetrician is not the most important
v v v v v v v v v v v v v v v
aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to
v v v v v v v v v v v v v v v v v v v
advise or manage the type of care a client is to receive.
v v v v v v v v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Planning
v v v
, Maternity and Women's Health Care 13th Edition Lowdermilk Test
v v v v v v v v
MSC: Client Needs: Health Promotion and Maintenance
v v v v v v
3. The nurses working at a newly established birthing center have begun to compare their
v v v v v v v v v v v v v
performance in providing maternal-newborn care against clinical standards. This
v v v v v v v v v
comparison process is most commonly known as what?
v v v v v v v v
a. Best practices network
v v
b. Clinical benchmarking v
c. Outcomes-oriented pracNtiUceR S v
d. Evidence-based practice v
ANS: C v
Outcomes-oriented practice measures the effectiveness of the interventions and quality of v v v v v v v v v v
care against benchmarks or standards. The term best practice refers to a program or service
v v v v v v v v v v v v v v v
that has been recognized for its excellence. Clinical benchmarking is a process used to
v v v v v v v v v v v v v v
compare one’s own performance against the performance of the best in an area of service.
v v v v v v v v v v v v v v v
The term evidence-based practice refers to the provision of care based on evidence gained
v v v v v v v v v v v v v v
through research and clinical trials.
v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Evaluation
v v v
MSC: Client Needs: Safe and Effective Care Environment
v v v v v v v
4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
v v v v v v v v v v v v v v
assessment of a 21-year-old Hispanic client with limited English proficiency. Which
v v v v v v v v v v v
intervention is the most important for the nurse to implement?
v v v v v v v v v v
a. Use maternity jargon to enable the client to become familiar with these terms.
v v v v v v v v v v v v
b. Speak quickly and efficiently to expedite the visit.
v v v v v v v
c. Provide the client with handouts. v v v v
d. Assess whether the client understands the discussion.
v v v v v v
ANS: D v
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
v v v v v v v v v v v v
evaluating whether the client understands the discussion. Speaking slowly and clearly and
v v v v v v v v v v v v
focusing on what is important will increase understanding. Most client education materials
v v v v v v v v v v v v
are written at a level too high for the average adult and may not be useful for a client with
v v v v v v v v v v v v v v v v v v v v
limited English proficiency.
v v v
PTS: 1 DIF: Cognitive Level: Apply v v
TOP: Nursing Process: Implementation
v v v
MSC: Client Needs: Health Promotion and Maintenance
v v v v v v
5. Which statement best exemplifies contemporary maternity nursing?
v v v v v v
a. Use of midwives for all vaginal deliveries
v v v v v v
b. Family-centered care v
c. Free-standing birth clinics v v
d. Physician-driven care v
vANS: B v
, Maternity and Women's Health Care 13th Edition Lowdermilk Test v v v v v v v v
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers,
v v v v v v v v v v
partners, grandparents, and siblings may be present for the birth and participate in activities
v v v v v v v v v v v v v v
such as cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal
v v v v v v v v v v v v v
deliveries. Free-standing clinics are an example of alternative birth options. Contemporary
v v v v v v v v v v v
maternity nursing is driven by the relationship between nurses and their clients.
v v v v v v v v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Planning
v v v
MSC: Client Needs: Health Promotion and Maintenance
v v v v v v
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after being
v v v v v v v v v v v v
in labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could the
v v v v v v v v v v v v v v v v v v
woman have a legitimate legal case for negligence?
v v v v v v v v
a. Inexperienced maternity nurse was assigned to care for the client. v v v v v v v v v
b. Client was past her due date by 3 days. v v v v v v v v
c. Standard of care was not met. v v v v v
d. Client refused electronic fetal monitoring. v v v v
ANS: C v
Not meeting the standard of care is a legitimate factor for a case of negligence. An
v v v v v v v v v v v v v v v
inexperienced maternity nurse would need to display competency before being assigned to
v v v v v v v v v v v v
care for clients on his or her own. This client may have been past her due date; however, a
v v v v v v v v v v v v v v v v v v v
term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the
v v v v v v v v v v v v v v
standard of care, the client has the right to refuse treatment. This refusal is not a case for
v v v v v v v v v v v v v v v v v v
negligence, but informed consent should be properly obtained, and the client should have
v v v v v v v v v v v v v
signed an against medical advice form when refusing any treatment that is within the
v v v v v v v v v v v v v v
standard of care.
v v v
PTS: 1 DIF: Cognitive Level: Analyze v v
TOP: Nursing Process: Implementation
v v v
MSC: Client Needs: Safe and Effective Care Environment
v v v v v v v
7. When the nurse is unsure how to perform a client care procedure that is high risk and low
v v v v v v v v v v v v v v v v v
volume, his or her best action in this situation would be what?
v v v v v v v v v v v v
a. Ask another nurse. v v
b. Discuss the procedure with the client’s physician. v v v v v v
c. Look up the procedure in a nursing textbook.
v v v v v v v
d. First consult the agency procedure manual
v v v v v
ANS: D v
Following the agency’s policies and procedures manual is always best when seeking
v v v v v v v v v v v
information on correct client procedures. These policies should reflect the current standards
v v v v v v v v v v v v
of care and the individual state’s guidelines. Each nurse is responsible for his or her own
v v v v v v v v v v v v v v v v
practice. Relying on another nurse may not always be a safe practice. Each nurse is
v v v v v v v v v v v v v v v
obligated to follow the standards of care for safe client care delivery. Physicians are
v v v v v v v v v v v v v v
responsible for their own client care activity. Nurses may follow safe orders from
v v v v v v v v v v v v v
physicians, but they are also responsible for the activities that they, as nurses, are to carry
v v v v v v v v v v v v v v v v
out. Information provided in a nursing textbook is basic information for general knowledge.
v v v v v v v v v v v v v
Furthermore, the information in a textbook may not reflect the current standard of care or
v v v v v v v v v v v v v v v
the individual state or hospital policies.
v v v v v v
v v v v v v v v
, Maternity and Women's Health Care 13th Edition Lowdermilk Test v v v v v v v v
Chapter 01: 21st Century Maternity and Women’s Health Nursing Lowdermilk:
v v v v v v v v v
Maternity & Women’s Health Care, 12th Edition
v v v v v v v
MULTIPLE CHOICE v
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW)
v v v v v v v v v v v v v
infant, which factor is the most important for the nurse to consider?
v v v v v v v v v v v v
a. African-American race v
b. Cigarette smoking v
c. Poor nutritional status v v
d. Limited maternal education v v
ANS: A v
The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic
v v v v v v v v v v v v v v v
black women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are
v v v v v v v v v v v
almost twice as likely as non-Hispanic white infants to be of LBW and to die in the first
v v v v v v v v v v v v v v v v v v
year of life.. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in
v v v v v v v v v v v v v v v v
potential infant mortality rates, but it is not the most important. Additionally, smoking is a
v v v v v v v v v v v v v v v
modifiable risk factor. Poor nutrition is an important factor in potential infant mortality
v v v v v v v v v v v v v
rates, but it is not the most important. Additionally, nutritional status is a modifiable risk
v v v v v v v v v v v v v v v
factor. Maternal education is an important factor in potential infant mortality rates, but it is
v v v v v v v v v v v v v v v
not the most important. Additionally, maternal education is a modifiable risk factor.
v v v v v v v v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Assessment
v v v
MSC: Client Needs: HealtN PrRoS
hU mI
v ioG
otN nTanBd.M
CaOinMtenance, Antepartum Care
v v v v v
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
v v v v v v v v v v v v
statistics for infant mortality, which intervention is most important for the nurse to include
v v v v v v v v v v v v v v
in the client’s plan of care?
v v v v v v
a. Perform a nutrition assessment. v v v
b. Refer the woman to a social worker. v v v v v v
c. Advise the woman to see an obstetrician, not a midwife. v v v v v v v v v
d. Explain to the woman the importance of keeping her prenatal care appointments.
v v v v v v v v v v v
ANS: D v
Consistent prenatal care is the best method of preventing or controlling risk factors
v v v v v v v v v v v v
associated with infant mortality. Nutritional status is an important modifiable risk factor, but
v v v v v v v v v v v v v
it is not the most important action a nurse should take in this situation. The client may need
v v v v v v v v v v v v v v v v v v
assistance from a social worker at some time during her pregnancy, but a referral to a social
v v v v v v v v v v v v v v v v v
worker is not the most important aspect the nurse should address at this time. If the woman
v v v v v v v v v v v v v v v v v
has identifiable high-risk problems, then her health care may need to be provided by a
v v v v v v v v v v v v v v v
physician. However, it cannot be assumed that all African-American women have high-risk
v v v v v v v v v v v v
issues. In addition, advising the woman to see an obstetrician is not the most important
v v v v v v v v v v v v v v v
aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to
v v v v v v v v v v v v v v v v v v v
advise or manage the type of care a client is to receive.
v v v v v v v v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Planning
v v v
, Maternity and Women's Health Care 13th Edition Lowdermilk Test
v v v v v v v v
MSC: Client Needs: Health Promotion and Maintenance
v v v v v v
3. The nurses working at a newly established birthing center have begun to compare their
v v v v v v v v v v v v v
performance in providing maternal-newborn care against clinical standards. This
v v v v v v v v v
comparison process is most commonly known as what?
v v v v v v v v
a. Best practices network
v v
b. Clinical benchmarking v
c. Outcomes-oriented pracNtiUceR S v
d. Evidence-based practice v
ANS: C v
Outcomes-oriented practice measures the effectiveness of the interventions and quality of v v v v v v v v v v
care against benchmarks or standards. The term best practice refers to a program or service
v v v v v v v v v v v v v v v
that has been recognized for its excellence. Clinical benchmarking is a process used to
v v v v v v v v v v v v v v
compare one’s own performance against the performance of the best in an area of service.
v v v v v v v v v v v v v v v
The term evidence-based practice refers to the provision of care based on evidence gained
v v v v v v v v v v v v v v
through research and clinical trials.
v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Evaluation
v v v
MSC: Client Needs: Safe and Effective Care Environment
v v v v v v v
4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
v v v v v v v v v v v v v v
assessment of a 21-year-old Hispanic client with limited English proficiency. Which
v v v v v v v v v v v
intervention is the most important for the nurse to implement?
v v v v v v v v v v
a. Use maternity jargon to enable the client to become familiar with these terms.
v v v v v v v v v v v v
b. Speak quickly and efficiently to expedite the visit.
v v v v v v v
c. Provide the client with handouts. v v v v
d. Assess whether the client understands the discussion.
v v v v v v
ANS: D v
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
v v v v v v v v v v v v
evaluating whether the client understands the discussion. Speaking slowly and clearly and
v v v v v v v v v v v v
focusing on what is important will increase understanding. Most client education materials
v v v v v v v v v v v v
are written at a level too high for the average adult and may not be useful for a client with
v v v v v v v v v v v v v v v v v v v v
limited English proficiency.
v v v
PTS: 1 DIF: Cognitive Level: Apply v v
TOP: Nursing Process: Implementation
v v v
MSC: Client Needs: Health Promotion and Maintenance
v v v v v v
5. Which statement best exemplifies contemporary maternity nursing?
v v v v v v
a. Use of midwives for all vaginal deliveries
v v v v v v
b. Family-centered care v
c. Free-standing birth clinics v v
d. Physician-driven care v
vANS: B v
, Maternity and Women's Health Care 13th Edition Lowdermilk Test v v v v v v v v
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers,
v v v v v v v v v v
partners, grandparents, and siblings may be present for the birth and participate in activities
v v v v v v v v v v v v v v
such as cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal
v v v v v v v v v v v v v
deliveries. Free-standing clinics are an example of alternative birth options. Contemporary
v v v v v v v v v v v
maternity nursing is driven by the relationship between nurses and their clients.
v v v v v v v v v v v v
PTS: 1 DIF: Cognitive Level: Understand v v
TOP: Nursing Process: Planning
v v v
MSC: Client Needs: Health Promotion and Maintenance
v v v v v v
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after being
v v v v v v v v v v v v
in labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could the
v v v v v v v v v v v v v v v v v v
woman have a legitimate legal case for negligence?
v v v v v v v v
a. Inexperienced maternity nurse was assigned to care for the client. v v v v v v v v v
b. Client was past her due date by 3 days. v v v v v v v v
c. Standard of care was not met. v v v v v
d. Client refused electronic fetal monitoring. v v v v
ANS: C v
Not meeting the standard of care is a legitimate factor for a case of negligence. An
v v v v v v v v v v v v v v v
inexperienced maternity nurse would need to display competency before being assigned to
v v v v v v v v v v v v
care for clients on his or her own. This client may have been past her due date; however, a
v v v v v v v v v v v v v v v v v v v
term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the
v v v v v v v v v v v v v v
standard of care, the client has the right to refuse treatment. This refusal is not a case for
v v v v v v v v v v v v v v v v v v
negligence, but informed consent should be properly obtained, and the client should have
v v v v v v v v v v v v v
signed an against medical advice form when refusing any treatment that is within the
v v v v v v v v v v v v v v
standard of care.
v v v
PTS: 1 DIF: Cognitive Level: Analyze v v
TOP: Nursing Process: Implementation
v v v
MSC: Client Needs: Safe and Effective Care Environment
v v v v v v v
7. When the nurse is unsure how to perform a client care procedure that is high risk and low
v v v v v v v v v v v v v v v v v
volume, his or her best action in this situation would be what?
v v v v v v v v v v v v
a. Ask another nurse. v v
b. Discuss the procedure with the client’s physician. v v v v v v
c. Look up the procedure in a nursing textbook.
v v v v v v v
d. First consult the agency procedure manual
v v v v v
ANS: D v
Following the agency’s policies and procedures manual is always best when seeking
v v v v v v v v v v v
information on correct client procedures. These policies should reflect the current standards
v v v v v v v v v v v v
of care and the individual state’s guidelines. Each nurse is responsible for his or her own
v v v v v v v v v v v v v v v v
practice. Relying on another nurse may not always be a safe practice. Each nurse is
v v v v v v v v v v v v v v v
obligated to follow the standards of care for safe client care delivery. Physicians are
v v v v v v v v v v v v v v
responsible for their own client care activity. Nurses may follow safe orders from
v v v v v v v v v v v v v
physicians, but they are also responsible for the activities that they, as nurses, are to carry
v v v v v v v v v v v v v v v v
out. Information provided in a nursing textbook is basic information for general knowledge.
v v v v v v v v v v v v v
Furthermore, the information in a textbook may not reflect the current standard of care or
v v v v v v v v v v v v v v v
the individual state or hospital policies.
v v v v v v
