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Chapter 01: Maternity and Women’s Health Care Today
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Foundations of Maternal-Newborn & Women’s Health Nursing, 7th Edition L
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MULTIPLE CHOICE YFT L
1. A nurse educator is teaching a group of nursing students about the history of family-
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centered maternity care. Which statement should the nurse include in the teaching YFT L Y FT L YFT L YFT L Y FT L YFT L YFT L Y FT L Y FT L Y FT L YFT L
session?
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a. The Sheppard-Towner Act of 1921 promoted family-centered care. L
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b. Changes in pharmacologic management of labor prompted family-centered care. L
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c. Demands by physicians for family involvement in childbirth increased the practice L
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of family-centered care. YFT L Y FT L YFT L
d. Parental requests that infants be allowed to remain with them rather than in YFTL YFT L L
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a nursery initiated the practice of family-centered care.
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As research began to identify the benefits of early, extended parent–infant contact, parents
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began to insist that the infant remain with them. This gradually developed into the practice
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of rooming-in and finally to family-centered maternity care. The Sheppard-Towner Act
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provided funds for state-managed programs for mothers and children but did not promote
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family-centered care. The changes in pharmacologic management of labor were not a factor YFT L YFT L YFT L YFT L YFT L YFTL YFT L YFT L YFT L L
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in family-centered maternity care. Family-centered care was a request by parents, not
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physicians.
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DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning YFT L YFT L YFT L L
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MSC: Patient Needs: Health Promotion and Maintenance
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2. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth limits YFT L L
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the amount of parent–infant interaction?” Which answer should the nurse provide for
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these parents in order to assist them in choosing an appropriate birth setting?
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a. Birth center YFT L
b. Home birth YFT L
c. Traditional hospital birth YFT L YFT L
d. Labor, birth, and recovery room YFT L YFT L YFT L YFT L
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In the traditional hospital setting, the mother may see the infant for only short feeding
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periods, and the infant is cared for in a separate nursery. Birth centers are set up to allow an
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increase in parent–infant contact. Home births allow the greatest amount of parent–infant
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contact. The labor, birth, recovery, and postpartum room setting allows for increased
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parent–infant contact.
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DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning YFT L YFT L YFT L L
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MSC: Patient Needs: Health Promotion and Maintenance
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3. Which statement best describes the advantage of a labor, birth, recovery, and
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postpartum (LDRP) room?
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a. The family is in a familiar environment. YFT L YFT L YFTL YFT L YFT L YFT L
b. They are less expensive than traditional hospital rooms. YFT L YFT L Y FT L YFT L Y FT L YFT L YFT L
c. The infant is removed to the nursery to allow the mother to rest. L
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d. The woman’s support system is encouraged to stay until discharge. L
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ANS: D Y F T L
, Sleeping equipment is provided in a private room. A hospital setting is never a familiar Y FT L Y FT L Y FT L YFT L Y FT L YFT L Y FT L YFT L Y FT L Y FT L Y FT L YFT L YFT L Y FT L
environment to new parents. An LDRP room is not less expensive than a traditional
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hospital room. The baby remains with the mother at all times and is not removed to the
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nursery for routine care or testing. The father or other designated members of the mother’s
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support system are encouraged to stay at all times.
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DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment YFT L YFT L YFT L L
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MSC: Patient Needs: Health Promotion and Maintenance
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4. Which nursing intervention is an independent function of the professional nurse?
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a. Administering oral analgesics L
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b. Requesting diagnostic studies YFT L L
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c. Teaching the patient perineal care YFTL YFT L YFT L YFT L
d. Providing wound care to a surgical incision YFT L YFT L L
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ANS: C Y F T L
Nurses are now responsible for various independent functions, including teaching, counseling,
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and intervening in nonmedical problems. Interventions initiated by the physician and
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carried out by the nurse are called dependent functions. Administrating oral analgesics is a
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dependent function; it is initiated by a physician and carried out by a nurse. Requesting
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diagnostic studies is a dependent function. Providing wound care is a dependent function;
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however, the physician prescribes the type of wound care through direct orders or
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protocol.
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MSC: Patient Needs: Safe and Effective Care Environment
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5. Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid
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to have a cesarean birth”?
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a. “Everything will be OK.” L
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b. “Don’t worry about it. It will be over soon.” L
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c. “What concerns you most about a cesarean birth?” YFT L YFT L YFT L YFT L YFT L YFT L YFT L
d. “The physician will be in later and you can talk to him.” L
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ANS: C Y F T L
The response, “What concerns you most about a cesarean birth” focuses on what the patient
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is saying and asks for clarification, which is the most therapeutic response. The response,
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“Everything will be ok” is belittling the patient’s feelings. The response, “Don’t worry
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about it. It will be over soon” will indicate that the patient’s feelings are not important.
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The response, “The physician will be in later and you can talk to him” does not allow the
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patient to verbalize her feelings when she wishes to do that.
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DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation YFT L YFT L YFT L L
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MSC: Patient Needs: Psychosocial Integrity
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6. In which step of the nursing process does the nurse determine the appropriate interventions
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for the identified nursing diagnosis?
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a. Planning
b. Evaluation
c. Assessment
d. Intervention
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, The third step in the nursing process involves planning care for problems that were identified
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during assessment. The evaluation phase is determining whether the goals have been met.
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During the assessment phase, data are collected. The intervention phase is when the plan of
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care is carried out.
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MSC: Patient Needs: Safe and Effective Care Environment
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7. Which goal is most appropriate for the collaborative problem of wound infection?
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a. The patient will not exhibit further signs of infection. YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L
b. Maintain the patient’s fluid intake at 1000 mL/8 hour. L
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c. The patient will have a temperature of 98.6F within 2 days. YFT L Y FT L YFT L YFT L YFT L YFTL YFT L L
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d. Monitor the patient to detect therapeutic response to antibiotic therapy. YFT L YFTL YFT L YFT L L
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In a collaborative problem, the goal should be nurse-oriented and reflect the nursing
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interventions of monitoring or observing. Monitoring for complications such as further signs
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of infection is an independent nursing role. Intake and output is an independent nursing
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role. Monitoring a patient’s temperature is an independent nursing role.
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DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning YFT L YFT L YFT L L
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MSC: Patient Needs: Safe and Effective Care Environment
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8. Which nursing intervention is written correctly? YFT L L
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a. Force fluids as necessary. L
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b. Observe interaction with the infant. L
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c. Encourage turning, coughing, and deep breathing. L
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d. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM. YFTL YFT L YFT L YFTL YFT L YFT L L
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ANS: D Y F T L
Interventions might not be carried out if they are not detailed and specific. “Force fluids” YFT L Y FT L Y FT L YFT L Y FT L Y FT L Y FT L YFT L YFT L Y FT L YFT L Y FT L YFT L YFT L
is not specific; it does not state how much or how often. Encouraging the patient to turn,
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cough, and breathe deeply is not detailed or specific. Observing interaction with the infant
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does not state how often this procedure should be done. Assisting the patient to ambulate
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for 10 minutes within a certain timeframe is specific.
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MSC: Patient Needs: Safe and Effective Care Environment
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9. The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which
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response by the nurse would be the most therapeutic?
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a. “You’re afraid to take the baby home?” YFT L Y FT L YFT L YFT L L
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b. “Don’t you have a mother who can come and help?” YFT L YFT L L
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c. “You should read the literature I gave you before you leave.” YFT L YFT L YFT L YFT L Y FT L L
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d. “I was scared when I took my first baby home, but everything worked out.”
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ANS: A Y F T L
, This response uses reflection to show concern and open communication. The other choices are
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blocks to communication. Asking if the patient has a mother who can come and assist
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blocks further communication with the patient. Telling the patient to read the literature
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before leaving does not allow the patient to express her feelings further. Sharing your own
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birth experience is inappropriate.
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MSC: Patient Needs: Psychosocial Integrity
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10. The nurse is writing an expected outcome for the nursing diagnosis—acute pain related
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to tissue trauma, secondary to vaginal birth, as evidenced by patient stating pain of 8 on a
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scale of 10. Which expected outcome is correctly stated for this problem?
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a. Patient will state that pain is a 2 on a scale of 10. YFT L L
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b. Patient will have a reduction in pain after administration of the prescribed L
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analgesic. YFT L
c. Patient will state an absence of pain 1 hour after administration of the prescribed L
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analgesic. YFT L
d. Patient will state that pain is a 2 on a scale of 10, 1 hour after the administration YFT L YFT L YFTL L
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of the prescribed analgesic.
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ANS: D Y F T L
The outcome should be patient-centered, measurable, realistic, and attainable and within a
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specified timeframe. Patient stating that her pain is now 2 on a scale of 10 lacks a timeframe.
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Patient having a reduction in pain after administration of the prescribed analgesic lacks a
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measurement. Patient stating an absence of pain 1 hour after the administration of prescribed
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analgesic is unrealistic.
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DIF: Cognitive Level: Application OBJ: Nursing Process Step: YFT L YFT L Y F T L L
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Planning MSC: Patient Needs: Physiologic Integrity
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11. Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?
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a. Risk for anxiety related to upcoming birth YFT L YFT L YFT L YFT L YFT L YFT L
b. Risk for imbalanced nutrition related to NPO status L
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c. Risk for altered family processes related to new addition to the family
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d. Risk for injury (maternal) related to altered sensations and positional or physical
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ANS: D Y F T L
The nurse should determine which problem needs immediate attention. Risk for injury is the
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problem that has the priority at this time because it is a safety problem. Risk for anxiety,
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imbalanced nutrition, and altered family processes are not the priorities at this time.
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DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation YFT L YFT L YFT L L
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MSC: Patient Needs: Safe and Effective Care Environment
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12. Regarding advanced roles of nursing, which statement related to clinical practice is the most YFT L YFT L L
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a. Family nurse practitioners (FNPs) can assist with childbirth care in the YFT L L
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b. Clinical nurse specialists (CNSs) provide primary care to obstetric patients. L
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c. Neonatal nurse practitioners provide emergency care in the postbirth setting to YFT L L
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