MATERNITY AND PEDIATRIC
NURSING
5TH EDITION
AUTHOR(S)SUSAN SCOTT RICCI;
TERRI KYLE; SUSAN CARMAN
TEST BANK
1. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Mortality and Morbidity
Question Stem:
A community health nurse reviews local data and finds that
infant mortality is highest in families who begin prenatal care
late and have difficulty accessing transportation. Which nursing
action best addresses the most meaningful upstream factor
,affecting this outcome?
A. Teach parents how to count fetal movements in the third
trimester
B. Refer pregnant clients to prenatal care and transportation
support early in pregnancy
C. Encourage hospital birth for all clients
D. Focus education only on newborn warning signs after
delivery
Correct Answer: B
Rationale — Correct Answer:
Early access to prenatal care helps identify maternal and fetal
risks before complications progress. Transportation support
reduces barriers to care and targets a modifiable social
determinant of health that contributes to mortality and
morbidity.
Rationale — Incorrect Options:
A. Fetal movement teaching is important, but it does not
address delayed entry into care.
C. Hospital birth alone does not resolve access barriers or
improve early risk detection.
D. Postpartum education is valuable, but it occurs too late to
reduce many preventable adverse outcomes.
Teaching Point:
Early prenatal access reduces preventable maternal and infant
complications.
,Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
2. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Historical Development
Question Stem:
A nursing student says, “Maternal-newborn care has always
focused on family participation during childbirth.” Which
response by the instructor is most accurate?
A. “Family-centered birth practices became common only after
technology increased in the 1990s.”
B. “Maternal care has remained unchanged, but pediatric care
changed significantly.”
C. “Modern maternity and pediatric nursing evolved from
earlier disease-focused care to more family-centered,
preventive care.”
D. “Historically, child health care developed before maternal
health care.”
Correct Answer: C
Rationale — Correct Answer:
The evolution of maternity and pediatric nursing includes a shift
from limited, institution-based, disease-centered care to
holistic, preventive, family-centered practice. This reflects
broader changes in public health, safety, and advocacy.
,Rationale — Incorrect Options:
A. Family-centered care did not begin only in the 1990s.
B. Maternal care has changed substantially over time, especially
with safer birth practices and prevention.
D. Maternal and child health care developed together, not in
that order.
Teaching Point:
Maternal-child nursing evolved toward prevention, safety, and
family-centered care.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
3. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Health Status of Women and Children /
Morbidity
Question Stem:
During a home visit, a nurse identifies that a postpartum client
has no reliable access to food, housing, or follow-up care. The
client says, “I only need help if I get sick.” What is the nurse’s
best response?
A. “Your needs are outside the scope of nursing unless you
develop symptoms.”
B. “Social conditions can affect health before illness becomes
obvious, so we should connect you with support now.”
C. “Only newborn health outcomes are affected by social needs,
,not maternal health.”
D. “Emergency care is the best option because preventive care
is not effective.”
Correct Answer: B
Rationale — Correct Answer:
Social determinants strongly influence maternal and child
morbidity. Nursing care includes identifying risk, preventing
complications, and connecting clients to community resources
before conditions worsen.
Rationale — Incorrect Options:
A. Nursing includes prevention and resource referral, not only
symptom management.
C. Maternal health is directly affected by social risk factors.
D. Preventive care is highly effective and often reduces
emergency visits and complications.
Teaching Point:
Health disparities are addressed through prevention and
referral, not waiting for illness.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
4. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Informed Consent
,Question Stem:
A laboring client is scheduled for an urgent cesarean birth
because of fetal distress. The provider explains the procedure,
but the client asks the nurse, “Can you just sign the form for
me? I am too overwhelmed.” What is the nurse’s best action?
A. Sign the form because the procedure is urgent
B. Witness the client’s signature only after the provider has
answered questions
C. Refuse because informed consent is never needed in labor
D. Tell the client the nurse will explain the surgical risks instead
of the provider
Correct Answer: B
Rationale — Correct Answer:
The nurse may witness the signature after the provider explains
the procedure and answers questions. The nurse does not
obtain informed consent but verifies that consent appears
voluntary and informed.
Rationale — Incorrect Options:
A. The nurse cannot sign on behalf of the client.
C. Informed consent is still required unless an emergency
prevents it.
D. The provider, not the nurse, is responsible for explaining the
procedure and risks.
Teaching Point:
Witness signatures only after the provider obtains informed
consent.
,Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
5. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Assent
Question Stem:
A 13-year-old child is scheduled for a minor surgical procedure
related to a chronic condition. The parent signs the consent
form, but the child says, “I do not want this surgery.” Which
nursing action is most appropriate?
A. Ignore the child’s statement because only parental consent
matters
B. Report that assent is unnecessary for adolescents
C. Notify the provider so the child’s understanding and
willingness can be addressed
D. Tell the child that refusal is not allowed under any
circumstances
Correct Answer: C
Rationale — Correct Answer:
Children and adolescents should be given developmentally
appropriate explanations and asked for assent when possible. A
nurse should advocate for communication that respects the
child’s developing autonomy.
Rationale — Incorrect Options:
A. Family consent is important, but the child’s assent also
,matters when appropriate.
B. Assent is relevant in pediatrics, especially when the child can
understand the procedure.
D. The child’s concerns should be addressed, not dismissed.
Teaching Point:
Pediatric assent supports autonomy and family-centered care.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
6. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Refusal of Medical Treatment
Question Stem:
A 36-week pregnant client with severe hypertension refuses the
recommended admission for monitoring, stating, “I’m leaving
because I do not want a baby taken from me.” Which response
by the nurse is best?
A. “You cannot refuse because your baby’s safety matters
most.”
B. “Let’s talk about your concerns and make sure you
understand the risks and options.”
C. “You should sign the refusal form immediately.”
D. “The provider can override your choice without discussion.”
Correct Answer: B
Rationale — Correct Answer:
The nurse should use therapeutic communication, assess
,understanding, and encourage discussion of risks and options.
Respect for autonomy remains essential, even when the
situation is high risk.
Rationale — Incorrect Options:
A. Coercion can damage trust and does not support ethical
care.
C. Signing refusal should not be the nurse’s first step.
D. A provider cannot ethically bypass informed discussion and
consent unless a legal emergency process applies.
Teaching Point:
Respect autonomy while exploring refusal with calm, clear risk
communication.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
7. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Advance Directives
Question Stem:
A postpartum client with metastatic cancer is admitted with
worsening respiratory status. Her chart includes an advance
directive stating she does not want intubation. Her partner says,
“Do everything possible.” What should the nurse do first?
A. Follow the partner’s request because the partner is next of
kin
B. Honor the documented advance directive and notify the
, provider
C. Ask the client’s parent to decide instead
D. Ignore the directive because she is postpartum
Correct Answer: B
Rationale — Correct Answer:
A valid advance directive guides care when the client cannot
speak for herself. The nurse should follow the documented
wishes and promptly notify the provider and team.
Rationale — Incorrect Options:
A. Family wishes do not override a valid advance directive.
C. The parent is not automatically the decision-maker.
D. Postpartum status does not cancel legal patient rights.
Teaching Point:
Advance directives guide care when family disagreement
occurs.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
8. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Confidentiality
Question Stem:
A 17-year-old client comes to the clinic requesting pregnancy
testing and asks the nurse not to tell her parents. Which
response best reflects ethical nursing practice?
NURSING
5TH EDITION
AUTHOR(S)SUSAN SCOTT RICCI;
TERRI KYLE; SUSAN CARMAN
TEST BANK
1. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Mortality and Morbidity
Question Stem:
A community health nurse reviews local data and finds that
infant mortality is highest in families who begin prenatal care
late and have difficulty accessing transportation. Which nursing
action best addresses the most meaningful upstream factor
,affecting this outcome?
A. Teach parents how to count fetal movements in the third
trimester
B. Refer pregnant clients to prenatal care and transportation
support early in pregnancy
C. Encourage hospital birth for all clients
D. Focus education only on newborn warning signs after
delivery
Correct Answer: B
Rationale — Correct Answer:
Early access to prenatal care helps identify maternal and fetal
risks before complications progress. Transportation support
reduces barriers to care and targets a modifiable social
determinant of health that contributes to mortality and
morbidity.
Rationale — Incorrect Options:
A. Fetal movement teaching is important, but it does not
address delayed entry into care.
C. Hospital birth alone does not resolve access barriers or
improve early risk detection.
D. Postpartum education is valuable, but it occurs too late to
reduce many preventable adverse outcomes.
Teaching Point:
Early prenatal access reduces preventable maternal and infant
complications.
,Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
2. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Historical Development
Question Stem:
A nursing student says, “Maternal-newborn care has always
focused on family participation during childbirth.” Which
response by the instructor is most accurate?
A. “Family-centered birth practices became common only after
technology increased in the 1990s.”
B. “Maternal care has remained unchanged, but pediatric care
changed significantly.”
C. “Modern maternity and pediatric nursing evolved from
earlier disease-focused care to more family-centered,
preventive care.”
D. “Historically, child health care developed before maternal
health care.”
Correct Answer: C
Rationale — Correct Answer:
The evolution of maternity and pediatric nursing includes a shift
from limited, institution-based, disease-centered care to
holistic, preventive, family-centered practice. This reflects
broader changes in public health, safety, and advocacy.
,Rationale — Incorrect Options:
A. Family-centered care did not begin only in the 1990s.
B. Maternal care has changed substantially over time, especially
with safer birth practices and prevention.
D. Maternal and child health care developed together, not in
that order.
Teaching Point:
Maternal-child nursing evolved toward prevention, safety, and
family-centered care.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
3. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Health Status of Women and Children /
Morbidity
Question Stem:
During a home visit, a nurse identifies that a postpartum client
has no reliable access to food, housing, or follow-up care. The
client says, “I only need help if I get sick.” What is the nurse’s
best response?
A. “Your needs are outside the scope of nursing unless you
develop symptoms.”
B. “Social conditions can affect health before illness becomes
obvious, so we should connect you with support now.”
C. “Only newborn health outcomes are affected by social needs,
,not maternal health.”
D. “Emergency care is the best option because preventive care
is not effective.”
Correct Answer: B
Rationale — Correct Answer:
Social determinants strongly influence maternal and child
morbidity. Nursing care includes identifying risk, preventing
complications, and connecting clients to community resources
before conditions worsen.
Rationale — Incorrect Options:
A. Nursing includes prevention and resource referral, not only
symptom management.
C. Maternal health is directly affected by social risk factors.
D. Preventive care is highly effective and often reduces
emergency visits and complications.
Teaching Point:
Health disparities are addressed through prevention and
referral, not waiting for illness.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
4. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Informed Consent
,Question Stem:
A laboring client is scheduled for an urgent cesarean birth
because of fetal distress. The provider explains the procedure,
but the client asks the nurse, “Can you just sign the form for
me? I am too overwhelmed.” What is the nurse’s best action?
A. Sign the form because the procedure is urgent
B. Witness the client’s signature only after the provider has
answered questions
C. Refuse because informed consent is never needed in labor
D. Tell the client the nurse will explain the surgical risks instead
of the provider
Correct Answer: B
Rationale — Correct Answer:
The nurse may witness the signature after the provider explains
the procedure and answers questions. The nurse does not
obtain informed consent but verifies that consent appears
voluntary and informed.
Rationale — Incorrect Options:
A. The nurse cannot sign on behalf of the client.
C. Informed consent is still required unless an emergency
prevents it.
D. The provider, not the nurse, is responsible for explaining the
procedure and risks.
Teaching Point:
Witness signatures only after the provider obtains informed
consent.
,Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
5. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Assent
Question Stem:
A 13-year-old child is scheduled for a minor surgical procedure
related to a chronic condition. The parent signs the consent
form, but the child says, “I do not want this surgery.” Which
nursing action is most appropriate?
A. Ignore the child’s statement because only parental consent
matters
B. Report that assent is unnecessary for adolescents
C. Notify the provider so the child’s understanding and
willingness can be addressed
D. Tell the child that refusal is not allowed under any
circumstances
Correct Answer: C
Rationale — Correct Answer:
Children and adolescents should be given developmentally
appropriate explanations and asked for assent when possible. A
nurse should advocate for communication that respects the
child’s developing autonomy.
Rationale — Incorrect Options:
A. Family consent is important, but the child’s assent also
,matters when appropriate.
B. Assent is relevant in pediatrics, especially when the child can
understand the procedure.
D. The child’s concerns should be addressed, not dismissed.
Teaching Point:
Pediatric assent supports autonomy and family-centered care.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
6. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Refusal of Medical Treatment
Question Stem:
A 36-week pregnant client with severe hypertension refuses the
recommended admission for monitoring, stating, “I’m leaving
because I do not want a baby taken from me.” Which response
by the nurse is best?
A. “You cannot refuse because your baby’s safety matters
most.”
B. “Let’s talk about your concerns and make sure you
understand the risks and options.”
C. “You should sign the refusal form immediately.”
D. “The provider can override your choice without discussion.”
Correct Answer: B
Rationale — Correct Answer:
The nurse should use therapeutic communication, assess
,understanding, and encourage discussion of risks and options.
Respect for autonomy remains essential, even when the
situation is high risk.
Rationale — Incorrect Options:
A. Coercion can damage trust and does not support ethical
care.
C. Signing refusal should not be the nurse’s first step.
D. A provider cannot ethically bypass informed discussion and
consent unless a legal emergency process applies.
Teaching Point:
Respect autonomy while exploring refusal with calm, clear risk
communication.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
7. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Advance Directives
Question Stem:
A postpartum client with metastatic cancer is admitted with
worsening respiratory status. Her chart includes an advance
directive stating she does not want intubation. Her partner says,
“Do everything possible.” What should the nurse do first?
A. Follow the partner’s request because the partner is next of
kin
B. Honor the documented advance directive and notify the
, provider
C. Ask the client’s parent to decide instead
D. Ignore the directive because she is postpartum
Correct Answer: B
Rationale — Correct Answer:
A valid advance directive guides care when the client cannot
speak for herself. The nurse should follow the documented
wishes and promptly notify the provider and team.
Rationale — Incorrect Options:
A. Family wishes do not override a valid advance directive.
C. The parent is not automatically the decision-maker.
D. Postpartum status does not cancel legal patient rights.
Teaching Point:
Advance directives guide care when family disagreement
occurs.
Citation:
Maternity and Pediatric Nursing. (5th ed.). Ch. 1.
8. Reference: Ch. 1 — Perspectives on Maternal and Child
Health Care — Confidentiality
Question Stem:
A 17-year-old client comes to the clinic requesting pregnancy
testing and asks the nurse not to tell her parents. Which
response best reflects ethical nursing practice?
