Exam (elaborations) MATERNITY & WOMEN’S HEALTH CARE 12TH EDITION –LOWDERMILK CHAPTER 1-37

Exam (elaborations) MATERNITY & WOMEN’S HEALTH CARE 12TH EDITION –LOWDERMILK CHAPTER 1-37 . 1. A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? 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. ANS: D Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality. Nutritional status is an important modifiable risk factor, but it is not the most important action a nurse should take in this situation. The client may need assistance from a social worker at some time during her pregnancy, but a referral to a social worker is not the most important aspect the nurse should address at this time. If the woman has identifiable high-risk problems, then her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high-risk issues. In addition, advising the woman to see an obstetrician is not the most important aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to receive. DIF: Cognitive Level: Understand REF: IM: TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance. 2. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic client with limited English proficiency. Which action is the most important for the nurse to perform? 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. ANS: D 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. DIF: Cognitive Level: Apply REF: im: 5 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance. 3. The nurses working at a newly established birthing center have begun to compare their performance in providing maternal-newborn care against clinical standards. This comparison process is most commonly known as what? a. Best practices network b. Clinical benchmarking c. Outcomes-oriented practice d. Evidence-based practice ANS: C Outcomes-oriented practice measures the effectiveness of the interventions and quality of care against benchmarks or standards. The term best practice refers to a program or service that has been recognized for its excellence. Clinical benchmarking is a process used to compare ones own performance against the performance of the best in an area of service. The term evidence-based practice refers to the provision of care based on evidence gained through research and clinical trials. DIF: Cognitive Level: Understand REF: im: 11 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe and Effective Care Environment. 4. Which statement best exemplifies contemporary maternity nursing? a. Use of midwives for all vaginal deliveries b. Family-centered care c. Free-standing birth clinics d. Physician-driven care ANS: B Contemporary maternity nursing focuses on the familys needs and desires. Fathers, partners, grandparents, and siblings may be present for the birth and participate in activities such as cutting the babys umbilical cord. Both midwives and physicians perform vaginal deliveries. Free-standing clinics are an example of alternative birth options. Contemporary maternity nursing is driven by the relationship between nurses and their clients. DIF: Cognitive Level: Understand REF: pp. 8-9 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance.