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,Chapter 01: 21st Century Maternity Nursing
MULTIPLE CHOICE
1. When providing care for a pregnant woman, the nurse should be aware that one of the most frequently
reported maternal medical risk factors is:
a. Diabetes mellitus. c. Chronic hypertension.
b. Mitral valve prolapse (MVP). d. Anemia.
ANS: A
The most frequently reported maternal medical risk factors are diabetes and hypertension associated with
pregnancy. Both of these conditions are associated with maternal obesity. There are no studies that indicate
MVP is among the most frequently reported maternal risk factors. Hypertension associated with pregnancy,
not chronic hypertension, is one of the most frequently reported maternal medical risk factors. Although
anemia is a concern in pregnancy, it is not one of the most frequently reported maternal medical risk factors in
pregnancy.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 6
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
2. To ensure optimal outcomes for the patient, the contemporary maternity nurse must incorporate both
teamwork and communication with clinicians into her care delivery, The SBAR technique of communication is
an easy-to-remember mechanism for communication. Which of the following correctly defines this acronym?
a. Situation, baseline assessment, response
b. Situation, background, assessment, recommendation
c. Subjective background, assessment, recommendation
d. Situation, background, anticipated recommendation
ANS: B
The situation, background, assessment, recommendation (SBAR) technique provides a specific framework for
communication among health care providers. Failure to communicate is one of the major reasons for errors in
health care. The SBAR technique has the potential to serve as a means to reduce errors.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 14
OBJ: Nursing Process: Assessment, Planning
MSC: Client Needs: Safe and Effective Care Environment
3. The role of the professional nurse caring for childbearing families has evolved to emphasize:
a. Providing care to patients directly at the bedside.
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,b. Primarily hospital care of maternity patients.
c. Practice using an evidence-based approach.
d. Planning patient care to cover longer hospital stays.
ANS: C
Professional nurses are part of the team of health care providers who collaboratively care for patients
throughout the childbearing cycle. Providing care to patients directly at the bedside is one of the nurses tasks;
however, it does not encompass the concept of the evolved professional nurse. Throughout the prenatal period,
nurses care for women in clinics and physicians offices and teach classes to help families prepare for
childbirth. Nurses also care for childbearing families in birthing centers and in the home. Nurses have been
critically important in developing strategies to improve the well-being of women and their infants and have led
the efforts to implement clinical practice guidelines using an evidence-based approach. Maternity patients have
experienced a decreased, rather than an increased, length of stay over the past 2 decades.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
4. 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 a nutrition assessment is not the most
important action a nurse should take in this situation. The patient 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, 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
patient is to receive.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance
5. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-
old Hispanic patient with limited English proficiency. It is important for the nurse to:
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, a. Use maternity ijargon iin iorder ifor ithe ipatient ito ibecome ifamiliar iwith ithese iterms.
b. Speak iquickly iand iefficiently ito iexpedite ithe i visit.
c. Provide ithe ipatient i with ihandouts.
d. Assess iwhether i the ipatient iunderstands ithe i discussion.
ANS: iD
Nurses icontribute ito ihealth iliteracy iby iusing isimple, icommon iwords; iavoiding ijargon; iand ievaluating
iwhether ithe ipatient iunderstands ithe idiscussion. iSpeaking islowly iand iclearly iand ifocusing ion iwhat iis
iimportant iincrease iunderstanding. iMost ipatient ieducation imaterials iare iwritten iat itoo i high ia i level i for
ithe iaverage iadult iand i may inot ibe iuseful ifor ia iclient iwith ilimited iEnglish iproficiency.
PTS: i1 iDIF: iCognitive iLevel: iApplication iREF: i5
OBJ: iNursing iProcess: iEvaluation iMSC: iClient iNeeds: i Health iPromotion iand i Maintenance
6. When imanaging ihealth icare ifor ipregnant iwomen iat ia iprenatal iclinic, ithe inurse ishould irecognize
ithat ithe imost isignificant ibarrier ito iaccess ito icare iis ithe ipregnant iwomans:
a. Age. c. Educational ilevel.
b. Minority istatus. d. Inability ito ipay.
ANS: iD
The imost isignificant ibarrier ito ihealth icare iaccess iis ithe iinability ito ipay ifor iservices; ithis iis icompounded
iby ithe ifact ithat imany iphysicians irefuse ito icare ifor iwomen iwho icannot ipay. iAlthough iadolescent
ipregnant iclients istatistically ireceive iless iprenatal icare, iage iis inot ithe imost isignificant i barrier.
i Significant i disparities i in imorbidity iand imortality irates iexist ifor iminority iwomen; ihowever, iminority
istatus iis inot ithe imost isignificant ibarrier ito iaccess iof icare. iDisparities iin ieducational ilevel iare iassociated
iwith imorbidity iand imortality irates; ihowever, ieducational ilevel iis inot ithe imost isignificant ibarrier ito
iaccess iof icare.
PTS: i1 iDIF: iCognitive iLevel: iKnowledge iREF:
i5 iOBJ: iNursing iProcess: iAssessment
MSC: iClient iNeeds: iSafe iand iEffective i Care iEnvironment
7. What iis ithe i primary irole i of ipracticing inurses iin ithe iresearch iprocess?
a. Designing iresearch istudies
b. Collecting idata i for iother iresearchers
c. Identifying iresearchable iproblems
d. Seeking ifunding ito isupport iresearch istudies
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