Maternity and Women's Health Care
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
Reference: Lowdermilk et al., 2023, Ch. 1: 21st-Century
Maternity and Women’s Health Nursing
Stem: A community health nurse is planning a postpartum
home visit for a 22-year-old first-time mother who delivered at
35 weeks via spontaneous vaginal birth and is breastfeeding.
The mother reports she’s “worried about baby’s latch” and that
she has limited family support. Which priority nursing action
addresses the highest immediate risk?
Options:
A. Provide an educational handout about breastfeeding
positions.
B. Observe a feeding and coach latch and positioning.
C. Arrange a visit with the lactation consultant next week.
D. Assess maternal mood using a postpartum screening tool.
Correct Answer: B
,Rationale (correct): Observing and coaching latch is an
immediate, actionable intervention that reduces risk of poor
intake, nipple trauma, and feeding failure—highest priority for a
breastfeeding dyad. It also provides real-time problem solving.
Rationale (incorrect):
A. Handouts are useful but passive; they don’t address
immediate poor latch.
C. Delayed referral may leave the dyad at risk now; immediate
coaching is preferable.
D. Screening for mood is important but not the single highest
immediate risk when feeding problems threaten intake.
Teaching Point: Observe and coach breastfeeding—real-time
correction prevents feeding complications.
Citation: Lowdermilk et al., 2023, Ch. 1: 21st-Century Maternity
and Women’s Health Nursing
2
Reference: Lowdermilk et al., 2023, Ch. 2: Advances in the Care
of Mothers and Infants
Stem: During prenatal rounds, a nurse reviews the chart of a
38-week gestation client with well-controlled gestational
diabetes managed by diet only. The provider plans induction at
39 weeks for “postdates.” The nurse notes the last fetal
movement count decreased. Which nursing action best
demonstrates clinical judgment?
Options:
,A. Document decreased movements and proceed with
scheduled induction.
B. Call for an immediate nonstress test (NST) and notify the
provider.
C. Reassure the client that induction will ensure fetal safety.
D. Teach the client to perform daily fetal movement counts at
home.
Correct Answer: B
Rationale (correct): Decreased fetal movements warrant
immediate fetal assessment (NST) and provider notification to
rule out compromise; timely evaluation prevents delayed
identification of distress.
Rationale (incorrect):
A. Documentation alone is inadequate when decreased
movements suggest possible compromise.
C. Reassurance without assessment neglects the safety concern.
D. Teaching is useful for prevention but does not address acute
decreased movements now.
Teaching Point: Decreased fetal movement requires prompt
fetal assessment (NST) and notification.
Citation: Lowdermilk et al., 2023, Ch. 2: Advances in the Care of
Mothers and Infants
3
Reference: Lowdermilk et al., 2023, Ch. 3: Efforts to Reduce
Health Disparities
, Stem: A clinic nurse notes that uninsured pregnant clients miss
more prenatal visits than insured clients. The nurse proposes a
plan to improve access. Which intervention most directly
targets the disparity?
Options:
A. Provide standardized prenatal education brochures to all
patients.
B. Implement clinic evening hours and sliding-scale fees for
prenatal visits.
C. Offer free childbirth classes once per year.
D. Encourage patients to obtain private insurance.
Correct Answer: B
Rationale (correct): Offering evening hours and sliding-scale
fees reduces structural barriers (time and cost), directly
addressing access disparities for uninsured/working clients.
Rationale (incorrect):
A. Brochures don’t remove access barriers like time or cost.
C. One free class yearly has limited reach and timing may not
match needs.
D. Encouraging insurance without system support is unrealistic
and doesn’t immediately reduce barriers.
Teaching Point: Reduce structural barriers (hours, cost) to
address prenatal care disparities.
Citation: Lowdermilk et al., 2023, Ch. 3: Efforts to Reduce
Health Disparities
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
Reference: Lowdermilk et al., 2023, Ch. 1: 21st-Century
Maternity and Women’s Health Nursing
Stem: A community health nurse is planning a postpartum
home visit for a 22-year-old first-time mother who delivered at
35 weeks via spontaneous vaginal birth and is breastfeeding.
The mother reports she’s “worried about baby’s latch” and that
she has limited family support. Which priority nursing action
addresses the highest immediate risk?
Options:
A. Provide an educational handout about breastfeeding
positions.
B. Observe a feeding and coach latch and positioning.
C. Arrange a visit with the lactation consultant next week.
D. Assess maternal mood using a postpartum screening tool.
Correct Answer: B
,Rationale (correct): Observing and coaching latch is an
immediate, actionable intervention that reduces risk of poor
intake, nipple trauma, and feeding failure—highest priority for a
breastfeeding dyad. It also provides real-time problem solving.
Rationale (incorrect):
A. Handouts are useful but passive; they don’t address
immediate poor latch.
C. Delayed referral may leave the dyad at risk now; immediate
coaching is preferable.
D. Screening for mood is important but not the single highest
immediate risk when feeding problems threaten intake.
Teaching Point: Observe and coach breastfeeding—real-time
correction prevents feeding complications.
Citation: Lowdermilk et al., 2023, Ch. 1: 21st-Century Maternity
and Women’s Health Nursing
2
Reference: Lowdermilk et al., 2023, Ch. 2: Advances in the Care
of Mothers and Infants
Stem: During prenatal rounds, a nurse reviews the chart of a
38-week gestation client with well-controlled gestational
diabetes managed by diet only. The provider plans induction at
39 weeks for “postdates.” The nurse notes the last fetal
movement count decreased. Which nursing action best
demonstrates clinical judgment?
Options:
,A. Document decreased movements and proceed with
scheduled induction.
B. Call for an immediate nonstress test (NST) and notify the
provider.
C. Reassure the client that induction will ensure fetal safety.
D. Teach the client to perform daily fetal movement counts at
home.
Correct Answer: B
Rationale (correct): Decreased fetal movements warrant
immediate fetal assessment (NST) and provider notification to
rule out compromise; timely evaluation prevents delayed
identification of distress.
Rationale (incorrect):
A. Documentation alone is inadequate when decreased
movements suggest possible compromise.
C. Reassurance without assessment neglects the safety concern.
D. Teaching is useful for prevention but does not address acute
decreased movements now.
Teaching Point: Decreased fetal movement requires prompt
fetal assessment (NST) and notification.
Citation: Lowdermilk et al., 2023, Ch. 2: Advances in the Care of
Mothers and Infants
3
Reference: Lowdermilk et al., 2023, Ch. 3: Efforts to Reduce
Health Disparities
, Stem: A clinic nurse notes that uninsured pregnant clients miss
more prenatal visits than insured clients. The nurse proposes a
plan to improve access. Which intervention most directly
targets the disparity?
Options:
A. Provide standardized prenatal education brochures to all
patients.
B. Implement clinic evening hours and sliding-scale fees for
prenatal visits.
C. Offer free childbirth classes once per year.
D. Encourage patients to obtain private insurance.
Correct Answer: B
Rationale (correct): Offering evening hours and sliding-scale
fees reduces structural barriers (time and cost), directly
addressing access disparities for uninsured/working clients.
Rationale (incorrect):
A. Brochures don’t remove access barriers like time or cost.
C. One free class yearly has limited reach and timing may not
match needs.
D. Encouraging insurance without system support is unrealistic
and doesn’t immediately reduce barriers.
Teaching Point: Reduce structural barriers (hours, cost) to
address prenatal care disparities.
Citation: Lowdermilk et al., 2023, Ch. 3: Efforts to Reduce
Health Disparities
