Nursing Care 4th Edition by Durham, Chapman, and Miller
, Chapter 1: Trends and Issues
Multiple Choice Questions
1.
A nurse is caring for a woman in labor with her first baby. The patient’s mother, who is present for support, comments that
delivery room practices have changed since she gave birth in the early 1980s. Which current practice would most likely
seem different to the mother?
a. Continuous fetal monitoring during labor
b. A postpartum hospital stay of 10 days
c. The involvement of the partner and family in the operating room during a cesarean birth
d. Hospital-based breastfeeding support
Correct Answer: d
Rationale:
a. Incorrect. Electronic fetal monitoring was already introduced widely in the 1970s and became routine by the early 1980s.
b. Incorrect. A 10-day postpartum stay was typical in the past; today, the stay is much shorter.
c. Incorrect. Family involvement during delivery, even in cesarean births, was uncommon then but is now encouraged;
however, this was beginning to change by the 1980s.
d. Correct. Formal breastfeeding support programs, including lactation consultants and the Baby-Friendly Hospital
Initiative, were introduced in the 1990s, making this the most notable difference to the mother.
2.
A patient with hypertension develops complications during childbirth. Despite attempts to control her blood pressure, she
dies shortly after delivery. What classification best describes this maternal death?
a. Early maternal death
b. Late maternal death
c. Direct obstetric death
d. Indirect obstetric death
Correct Answer: d
Rationale:
a. Incorrect. “Early maternal death” is not a recognized category.
b. Incorrect. Late maternal death occurs more than 42 days after the pregnancy ends.
c. Incorrect. Direct obstetric deaths result from issues directly caused by pregnancy, labor, or postpartum complications.
d. Correct. Indirect obstetric death happens when a preexisting condition, such as chronic hypertension, or one aggravated
by pregnancy, leads to death.
,3.
A nurse is teaching a new mother being discharged home. The patient worries about infant mortality and sudden infant
death syndrome (SIDS). She had a healthy full-term birth, BMI of 25, and no complications. What is the most helpful
information to provide?
a. Extracorporeal membrane oxygenation (ECMO) therapy
b. Use of exogenous pulmonary surfactant
c. The Baby-Friendly Hospital Initiative
d. The Safe to Sleep campaign
Correct Answer: d
Rationale:
a. Incorrect. ECMO is reserved for preterm infants with severe respiratory distress, not for SIDS prevention.
b. Incorrect. Surfactant administration aids premature babies with immature lungs, not SIDS.
c. Incorrect. Breastfeeding initiatives support infant health but are not designed for SIDS reduction.
d. Correct. The Safe to Sleep campaign promotes placing infants on their backs, using firm surfaces, and avoiding soft
bedding—evidence-based strategies to prevent SIDS.
4.
A 14-year-old who is 32 weeks pregnant reports genital sores and is diagnosed with syphilis. What risk does this pose to
the fetus?
a. Diabetes
b. Blindness
c. Pneumonia
d. Hypertension
Correct Answer: b
Rationale:
a. Incorrect. Maternal obesity, not syphilis, contributes to diabetes risk.
b. Correct. Congenital syphilis can result in blindness, stillbirth, or neonatal death if untreated.
c. Incorrect. Chlamydia is associated with neonatal pneumonia, not syphilis.
d. Incorrect. Teen pregnancy raises maternal hypertension risk but does not directly cause fetal hypertension.
5.
A 15-year-old pregnant patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Which complication is her
baby most at risk for?
a. Intestinal problems
b. Neonatal conjunctivitis
c. Blindness
d. Pneumonia
Correct Answer: a
Rationale:
,a. Correct. Babies born to teen mothers face higher risks for prematurity, intestinal complications, and higher infant
mortality rates.
b. Incorrect. Neonatal conjunctivitis is caused by gonorrhea, which was ruled out.
c. Incorrect. Blindness occurs with untreated gonorrhea or syphilis, not present here.
d. Incorrect. Pneumonia is associated with chlamydia, which was negative in this case.
6.
A 23-year-old woman confirms pregnancy at a clinic and says, “I don’t need to quit vaping because it won’t harm my
baby.” What is the nurse’s best reply?
a. “You’re right. E-cigarettes are safe in pregnancy.”
b. “Tobacco products, including e-cigarettes, must be avoided due to nicotine toxicity.”
c. “The FDA considers e-cigarettes safe for you but not for the baby.”
d. “They are only harmful during the first trimester.”
Correct Answer: b
Rationale:
a. Incorrect. E-cigarettes are unsafe for both mother and fetus.
b. Correct. Nicotine and other chemicals in vaping products harm fetal growth and neurological development; complete
avoidance is advised.
c. Incorrect. E-cigarettes are not approved as safe for any population by the FDA.
d. Incorrect. Vaping is harmful throughout pregnancy, not just in the first trimester.
7.
A 16-year-old who is 32 weeks pregnant with a male baby is accompanied by her mother. She states she is no longer in a
relationship with the baby’s father but will be supported by her mother. The mother asks if this will affect her child. What
is the boy at greater risk for as an adolescent?
a. Hypertension
b. Diabetes
c. Alcohol abuse
d. Intraventricular bleeding
Correct Answer: c
Rationale:
a. Incorrect. Hypertension risk is more strongly associated with adolescent mothers themselves, not their children.
b. Incorrect. Diabetes risk is tied to maternal obesity and metabolic factors, not the absence of a father.
c. Correct. Boys raised without an involved father are at higher risk of alcohol abuse, incarceration, and school failure
during adolescence.
d. Incorrect. Intraventricular bleeding is a complication of low-birth-weight infants, not an adolescent outcome.