Maternity and Women's Health Care
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
1
Reference: Ch. 1: 21st-Century Maternity and Women’s Health
Nursing — Overview of Contemporary Practice
Question stem: A public-health nurse is designing a prenatal
outreach program for a multiethnic community with high rates
of late prenatal care. Which initial action best aligns with
current evidence to reduce barriers and improve early prenatal
engagement?
A. Create and distribute a bilingual brochure about the
importance of early prenatal care.
B. Establish flexible clinic hours and partner with community
leaders to offer on-site enrollment and appointments.
C. Implement a strict appointment policy to reduce no-shows
and emphasize accountability.
D. Require prenatal clients to attend a standardized prenatal
education class before scheduling the first visit.
,Correct answer: B
Rationales:
• Correct (B): Partnering with community leaders and
offering flexible, on-site enrollment addresses structural
and social determinants of health shown to improve early
prenatal engagement. This is an evidence-based, system-
level intervention that reduces access barriers.
• A: Brochures help awareness but alone are insufficient to
overcome access and logistic barriers.
• C: Strict policies may worsen disparities by penalizing
people facing transportation or work barriers.
• D: Requiring attendance before the first visit creates an
additional barrier and may delay care.
Teaching point: Address structural barriers and partner with
communities to increase early prenatal care access.
Citation: Lowdermilk et al., 2023, Ch. 1: 21st-Century Maternity
and Women’s Health Nursing.
2
Reference: Ch. 2: Advances in the Care of Mothers and Infants
— Evidence-based Technology and Outcomes
Question stem: During triage, a laboring client who is G2P1 at
38 weeks reports decreased fetal movements for the past 12
,hours. The unit has access to bedside fetal testing and Doppler.
What is the nurse’s best first action?
A. Provide reassurance that fetal movement varies and advise
return if movements continue to decrease.
B. Offer orange juice and rest while monitoring fetal
movements at home.
C. Perform an immediate nonstress test (NST) and initiate
continuous fetal monitoring if NST is nonreactive.
D. Schedule a routine prenatal appointment for the next week
to reassess fetal movement.
Correct answer: C
Rationales:
• Correct (C): Decreased fetal movement is a warning sign;
immediate NST is the evidence-based first diagnostic step;
a nonreactive NST warrants continuous monitoring and
further evaluation.
• A: Minimizing maternal concern risks missing fetal
compromise.
• B: Oral stimulation and observation may be used at home
if minor, but 12 hours of decreased movement requires
immediate testing.
• D: Waiting a week is unsafe—this is an urgent concern.
Teaching point: Decreased fetal movement requires immediate
fetal assessment (NST) to evaluate fetal well-being.
, Citation: Lowdermilk et al., 2023, Ch. 2: Advances in the Care of
Mothers and Infants.
3
Reference: Ch. 3: Efforts to Reduce Health Disparities — Social
Determinants and Maternal Outcomes
Question stem: A nurse conducting intake for a pregnant client
learns the client lacks stable housing and has unreliable
transportation. Which documentable intervention most directly
addresses these social determinants to improve maternal
outcomes?
A. Educate on nutrition and provide printed lists of healthy
foods.
B. Refer to a community program that offers housing assistance
and transport vouchers; arrange follow-up for enrollment.
C. Remind the client that prenatal care attendance is essential
and provide appointment times.
D. Suggest the client move in with a relative while pregnant.
Correct answer: B
Rationales:
• Correct (B): Referral and active linkage to housing and
transportation resources target upstream social
determinants and are effective interventions to reduce
disparities and improve access to care.
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
1
Reference: Ch. 1: 21st-Century Maternity and Women’s Health
Nursing — Overview of Contemporary Practice
Question stem: A public-health nurse is designing a prenatal
outreach program for a multiethnic community with high rates
of late prenatal care. Which initial action best aligns with
current evidence to reduce barriers and improve early prenatal
engagement?
A. Create and distribute a bilingual brochure about the
importance of early prenatal care.
B. Establish flexible clinic hours and partner with community
leaders to offer on-site enrollment and appointments.
C. Implement a strict appointment policy to reduce no-shows
and emphasize accountability.
D. Require prenatal clients to attend a standardized prenatal
education class before scheduling the first visit.
,Correct answer: B
Rationales:
• Correct (B): Partnering with community leaders and
offering flexible, on-site enrollment addresses structural
and social determinants of health shown to improve early
prenatal engagement. This is an evidence-based, system-
level intervention that reduces access barriers.
• A: Brochures help awareness but alone are insufficient to
overcome access and logistic barriers.
• C: Strict policies may worsen disparities by penalizing
people facing transportation or work barriers.
• D: Requiring attendance before the first visit creates an
additional barrier and may delay care.
Teaching point: Address structural barriers and partner with
communities to increase early prenatal care access.
Citation: Lowdermilk et al., 2023, Ch. 1: 21st-Century Maternity
and Women’s Health Nursing.
2
Reference: Ch. 2: Advances in the Care of Mothers and Infants
— Evidence-based Technology and Outcomes
Question stem: During triage, a laboring client who is G2P1 at
38 weeks reports decreased fetal movements for the past 12
,hours. The unit has access to bedside fetal testing and Doppler.
What is the nurse’s best first action?
A. Provide reassurance that fetal movement varies and advise
return if movements continue to decrease.
B. Offer orange juice and rest while monitoring fetal
movements at home.
C. Perform an immediate nonstress test (NST) and initiate
continuous fetal monitoring if NST is nonreactive.
D. Schedule a routine prenatal appointment for the next week
to reassess fetal movement.
Correct answer: C
Rationales:
• Correct (C): Decreased fetal movement is a warning sign;
immediate NST is the evidence-based first diagnostic step;
a nonreactive NST warrants continuous monitoring and
further evaluation.
• A: Minimizing maternal concern risks missing fetal
compromise.
• B: Oral stimulation and observation may be used at home
if minor, but 12 hours of decreased movement requires
immediate testing.
• D: Waiting a week is unsafe—this is an urgent concern.
Teaching point: Decreased fetal movement requires immediate
fetal assessment (NST) to evaluate fetal well-being.
, Citation: Lowdermilk et al., 2023, Ch. 2: Advances in the Care of
Mothers and Infants.
3
Reference: Ch. 3: Efforts to Reduce Health Disparities — Social
Determinants and Maternal Outcomes
Question stem: A nurse conducting intake for a pregnant client
learns the client lacks stable housing and has unreliable
transportation. Which documentable intervention most directly
addresses these social determinants to improve maternal
outcomes?
A. Educate on nutrition and provide printed lists of healthy
foods.
B. Refer to a community program that offers housing assistance
and transport vouchers; arrange follow-up for enrollment.
C. Remind the client that prenatal care attendance is essential
and provide appointment times.
D. Suggest the client move in with a relative while pregnant.
Correct answer: B
Rationales:
• Correct (B): Referral and active linkage to housing and
transportation resources target upstream social
determinants and are effective interventions to reduce
disparities and improve access to care.
