HEALTH CARE
13TH EDITION
• AUTHOR(S)DEITRA LOWDERMILK
TEST BANK
1
Reference: Ch. 1 — 21st-Century Maternity and Women’s
Health Nursing — Trends in Nursing Practice
Stem: A postpartum unit is piloting a nurse-driven early
warning system to detect maternal deterioration. A primiparous
client 8 hours postpartum has BP 150/98 mm Hg, HR 102, urine
output 20 mL/hr for 2 hours, and reports a severe headache.
The nurse must decide next action to ensure safety.
,A. Continue routine postpartum vitals and reassess in 4 hours.
B. Notify the provider immediately and prepare for magnesium
sulfate orders.
C. Encourage oral fluids and obtain a repeat BP in 1 hour.
D. Document findings and delegate reassessment to UAP.
Correct Answer: B
Rationale — Correct: Elevated BP, oliguria, tachycardia, and
severe headache postpartum suggest severe preeclampsia;
immediate provider notification and preparation for magnesium
sulfate (per protocols) reduce risk of eclampsia and cerebral
complications. Rapid intervention prioritizes maternal safety.
Rationales — Incorrect:
A. Waiting 4 hours is unsafe — deterioration can be rapid in
severe preeclampsia.
C. Oral fluids and waiting are insufficient — oliguria and
headache are red flags requiring urgent evaluation.
D. Delegating without provider notification delays critical
treatment and is unsafe.
Teaching Point: Severe postpartum hypertension with
headache signals possible severe preeclampsia — act
immediately.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
2
,Reference: Ch. 1 — Advances in the Care of Mothers and
Infants — Neonatal outcomes
Stem: In a community hospital implementing kangaroo mother
care (KMC) for stable late-preterm newborns, a nurse assesses a
35-week infant who is skin-to-skin with the mother. The infant is
breathing regularly, has stable temperature, and is latching
intermittently. Which nursing action best supports evidence-
based outcomes?
A. Remove infant every 2 hours for routine assessments in the
nursery.
B. Educate and support continuous skin-to-skin with feeding
support as needed.
C. Delay KMC until full-term corrected age is reached.
D. Recommend formula supplementation to prevent
hypoglycemia.
Correct Answer: B
Rationale — Correct: KMC with support for breastfeeding
improves thermoregulation, bonding, and breastfeeding rates
for stable late-preterm infants; nurse education and support
optimize outcomes and reduce NICU transfers.
Rationales — Incorrect:
A. Frequent removal interrupts benefits of KMC and increases
stress/heat loss risk.
C. Delaying KMC deprives infant of proven benefits; it’s
indicated for stable preterms.
, D. Routine formula supplementation undermines breastfeeding
and is not indicated unless infant shows hypoglycemia.
Teaching Point: Support continuous skin-to-skin care and
breastfeeding support for stable late-preterm infants.
Citation: Lowdermilk, D. (2023). Maternity and Women’s Health
Care (13th ed.). Ch. 1.
3
Reference: Ch. 1 — Efforts to Reduce Health Disparities —
Community interventions
Stem: A public-health nurse is designing a prenatal outreach
program for a low-income neighborhood with high preterm
birth rates and limited prenatal care access. Which program
element should the nurse prioritize to address disparities and
improve outcomes?
A. Offer childbirth classes exclusively on weekends.
B. Provide mobile prenatal clinics with culturally competent
staff and transportation support.
C. Distribute generic brochures at community centers.
D. Require referrals only from primary care providers.
Correct Answer: B
Rationale — Correct: Mobile clinics with culturally competent
staff and transportation address structural barriers (access,