Maternity and Women's
health care 13th Edition
Complete Study Bundle
1. 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 education class before
scheduling the first visit.
Answer: B
Rationale: 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. Brochures help awareness but alone are
insufficient to overcome access barriers. Strict policies may worsen disparities by
penalizing people facing transportation or work barriers. Requiring attendance
before the first visit creates an additional barrier and may delay care .
2. A nurse on the antepartum unit is caring for a 34-year-old woman with well-
controlled pregestational diabetes. Which action most directly reflects an
,evidence-based advance in maternal-infant care that reduces neonatal
morbidity?
A. Scheduling labor induction at 37 weeks for all women with pregestational
diabetes.
B. Coordinating a team plan to monitor fetal growth and glycemic control and
individualize timing of delivery.
C. Advising strict bed rest during the third trimester to prevent fetal macrosomia.
D. Recommending routine NICU admission for all infants of diabetic mothers.
Answer: B
Rationale: Individualized, multidisciplinary monitoring of maternal glycemic
control and fetal growth—plus collaborative planning—aligns with evidence-
based advances that reduce neonatal complications. Routine induction at 37
weeks for all women is not evidence-based; timing should be individualized.
Routine strict bed rest lacks evidence for preventing macrosomia and increases
maternal harm risks. Automatic NICU admission is unnecessary; care should be
based on infant assessment and risk .
3. A 28-year-old G1P0 in early pregnancy asks the nurse how advances in
perinatal care have reduced neonatal mortality. Which nursing response best
connects historical advances to current outcomes?
A. "Improved prenatal vitamins are the main reason newborns survive more
often."
B. "Integration of evidence-based antenatal care, neonatal resuscitation, and
regionalized perinatal centers has improved survival."
C. "Home births with midwives have led to the biggest decrease in neonatal
deaths."
D. "Most improvements are due to better genetics and cannot be influenced by
nursing care."
Answer: B
Rationale: Integration of evidence-based antenatal management, standardized
neonatal resuscitation, and regionalized perinatal centers (high-risk referral
,systems) have contributed to reductions in neonatal mortality. Prenatal vitamins
help prevent neural tube defects but alone do not account for broad declines.
Well-planned home births may be appropriate for low-risk clients, but
regionalized perinatal care has had greater impact on neonatal survival .
4. In evaluating the level of a pregnant woman's risk of having a low-birth-
weight (LBW) infant, which factor is the most important for the nurse to
consider?
A. African-American race
B. Cigarette smoking
C. Poor nutritional status
D. Limited maternal education
Answer: A
Rationale: The rise in overall LBW rates is due to increases in LBW births to non-
Hispanic Black women (13.35%) and Hispanic women (7.21%); non-Hispanic Black
infants are almost twice as likely as non-Hispanic White infants to be of LBW and
to die in the first year of life. Race is a nonmodifiable risk factor. While cigarette
smoking, poor nutrition, and limited education are important factors, they are
modifiable risk factors .
5. A community clinic serving a diverse population has higher-than-average
rates of late prenatal care. Which nurse-led strategy most directly addresses
structural barriers and reduces disparities in access?
A. Posting prenatal clinic hours on the clinic's website.
B. Scheduling all first prenatal visits between 9 AM–11 AM.
C. Partnering with community organizations to offer weekend and evening
prenatal appointments and transportation vouchers.
D. Requiring a primary-care referral before the first prenatal visit.
Answer: C
, Rationale: Offering flexible appointment times and transportation support targets
social determinants (work schedules, transit access) and reduces access
disparities. Posting hours online may help some, but it does not address
transportation, language, or scheduling barriers for underserved groups.
Restricting visits to morning hours can worsen access for working patients.
Additional referral requirements create administrative barriers and delay care .
6. During a prenatal intake interview, the nurse is obtaining an initial
assessment of a 21-year-old Hispanic client with limited English proficiency.
Which intervention is the most important for the nurse to implement?
A. Use maternity jargon to enable the client to become familiar with these terms.
B. Speak quickly and efficiently to expedite the visit.
C. Provide the client with handouts.
D. Assess whether the client understands the discussion.
Answer: D
Rationale: Nurses contribute to health literacy by using simple, common words,
avoiding jargon, and evaluating whether the client understands the discussion.
Speaking slowly and clearly and focusing on what is important will increase
understanding. Most client education materials are written at a level too high for
the average adult and may not be useful for a client with limited English
proficiency .
7. A 23-year-old African-American woman is pregnant with her first child. Based
on current statistics for infant mortality, which intervention is most important
for the nurse to include in the client's plan of care?
A. Perform a nutrition assessment.
B. Refer the woman to a social worker.
C. Advise the woman to see an obstetrician, not a midwife.
D. Explain to the woman the importance of keeping her prenatal care
appointments.
Answer: D
health care 13th Edition
Complete Study Bundle
1. 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 education class before
scheduling the first visit.
Answer: B
Rationale: 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. Brochures help awareness but alone are
insufficient to overcome access barriers. Strict policies may worsen disparities by
penalizing people facing transportation or work barriers. Requiring attendance
before the first visit creates an additional barrier and may delay care .
2. A nurse on the antepartum unit is caring for a 34-year-old woman with well-
controlled pregestational diabetes. Which action most directly reflects an
,evidence-based advance in maternal-infant care that reduces neonatal
morbidity?
A. Scheduling labor induction at 37 weeks for all women with pregestational
diabetes.
B. Coordinating a team plan to monitor fetal growth and glycemic control and
individualize timing of delivery.
C. Advising strict bed rest during the third trimester to prevent fetal macrosomia.
D. Recommending routine NICU admission for all infants of diabetic mothers.
Answer: B
Rationale: Individualized, multidisciplinary monitoring of maternal glycemic
control and fetal growth—plus collaborative planning—aligns with evidence-
based advances that reduce neonatal complications. Routine induction at 37
weeks for all women is not evidence-based; timing should be individualized.
Routine strict bed rest lacks evidence for preventing macrosomia and increases
maternal harm risks. Automatic NICU admission is unnecessary; care should be
based on infant assessment and risk .
3. A 28-year-old G1P0 in early pregnancy asks the nurse how advances in
perinatal care have reduced neonatal mortality. Which nursing response best
connects historical advances to current outcomes?
A. "Improved prenatal vitamins are the main reason newborns survive more
often."
B. "Integration of evidence-based antenatal care, neonatal resuscitation, and
regionalized perinatal centers has improved survival."
C. "Home births with midwives have led to the biggest decrease in neonatal
deaths."
D. "Most improvements are due to better genetics and cannot be influenced by
nursing care."
Answer: B
Rationale: Integration of evidence-based antenatal management, standardized
neonatal resuscitation, and regionalized perinatal centers (high-risk referral
,systems) have contributed to reductions in neonatal mortality. Prenatal vitamins
help prevent neural tube defects but alone do not account for broad declines.
Well-planned home births may be appropriate for low-risk clients, but
regionalized perinatal care has had greater impact on neonatal survival .
4. In evaluating the level of a pregnant woman's risk of having a low-birth-
weight (LBW) infant, which factor is the most important for the nurse to
consider?
A. African-American race
B. Cigarette smoking
C. Poor nutritional status
D. Limited maternal education
Answer: A
Rationale: The rise in overall LBW rates is due to increases in LBW births to non-
Hispanic Black women (13.35%) and Hispanic women (7.21%); non-Hispanic Black
infants are almost twice as likely as non-Hispanic White infants to be of LBW and
to die in the first year of life. Race is a nonmodifiable risk factor. While cigarette
smoking, poor nutrition, and limited education are important factors, they are
modifiable risk factors .
5. A community clinic serving a diverse population has higher-than-average
rates of late prenatal care. Which nurse-led strategy most directly addresses
structural barriers and reduces disparities in access?
A. Posting prenatal clinic hours on the clinic's website.
B. Scheduling all first prenatal visits between 9 AM–11 AM.
C. Partnering with community organizations to offer weekend and evening
prenatal appointments and transportation vouchers.
D. Requiring a primary-care referral before the first prenatal visit.
Answer: C
, Rationale: Offering flexible appointment times and transportation support targets
social determinants (work schedules, transit access) and reduces access
disparities. Posting hours online may help some, but it does not address
transportation, language, or scheduling barriers for underserved groups.
Restricting visits to morning hours can worsen access for working patients.
Additional referral requirements create administrative barriers and delay care .
6. During a prenatal intake interview, the nurse is obtaining an initial
assessment of a 21-year-old Hispanic client with limited English proficiency.
Which intervention is the most important for the nurse to implement?
A. Use maternity jargon to enable the client to become familiar with these terms.
B. Speak quickly and efficiently to expedite the visit.
C. Provide the client with handouts.
D. Assess whether the client understands the discussion.
Answer: D
Rationale: Nurses contribute to health literacy by using simple, common words,
avoiding jargon, and evaluating whether the client understands the discussion.
Speaking slowly and clearly and focusing on what is important will increase
understanding. Most client education materials are written at a level too high for
the average adult and may not be useful for a client with limited English
proficiency .
7. A 23-year-old African-American woman is pregnant with her first child. Based
on current statistics for infant mortality, which intervention is most important
for the nurse to include in the client's plan of care?
A. Perform a nutrition assessment.
B. Refer the woman to a social worker.
C. Advise the woman to see an obstetrician, not a midwife.
D. Explain to the woman the importance of keeping her prenatal care
appointments.
Answer: D
