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Chapter 01: 21st Century Maternity and Women’s Health Nursing
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Lowdermilk: Maternity & Women’s Health Care, 11th Edition
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MULTIPLE
!!CHOICE
1. 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
ANS: ! ! A
For !!African-American !!births, !!the !!incidence !!of !!LBW !!infants !!is !!twice !!that !!of !!Caucasian
!!births. !!Race !!is !!a !!nonmodifiable !!risk !!factor. !!Cigarette !!smoking !!is !!an !!important !!factor
!!in !!potential !!infant !!mortality !!rates, !!but !!it !!is !!not !!the !!most !!important. !!Additionally,
!!smoking !!is !!a !!modifiable !!risk !!factor. !!Poor !!nutrition !!is !!an !!important !!factor !!in !!potential
!!infant !!mortality !!rates, !!but !!it !!is !!not!the !!most !!important. !!Additionally, !!nutritional !!status
!!is !!a !!modifiable !!risk !!factor. !!Maternal !!education !!is !!an !!important !!factor !!in !!potential
!!infant !!mortality !!rates, !!but !!it !!is !!not !!the !!most !!important. !!Additionally, !!maternal
!!education !!is !!a !!modifiable !!risk !!factor.
DIF: Cognitive !!Level: !!Understand REF: !!p.
!!6!TOP: ! ! Nursing !!Process: !!Assessment
MSC: ! ! Client !!Needs: !!Health !!Promotion !!and !!Maintenance, !!Antepartum !!Care
2. What !!is !!the !!primary !!role !!of !!practicing !!nurses !!in !!the !!research !!process?
a. Designing !!research !!studies
b. Collecting !!data !!for !!other !!researchers
c. Identifying !!researchable !!problems
d. Seeking !!funding !!to !!support !!research
!! studies
ANS: ! ! C
When !!problems !!are !!identified, !!research !!can !!be !!properly !!conducted. !!Research !!of !!health
!!care !!issues !!leads !!to !!evidence-based !!practice !!guidelines. !!Designing !!research !!studies !!is
!!only !!one !!factor !!of !!the !!research !!process. !!Data !!collection !!is !!another !!factor !!of !!research.
!!Financial !!support!is !!necessary !!to !! conduct !!research, !!but !!it !!is !!not !!the !!primary !!role !!of
!!the !!nurse !!in !!the !!research !!process.
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DIF: Cognitive !!Level: !!Understand REF: !! !! !!p. !!14 TOP: ! ! Nursing !!Process:
!!N/A!MSC: ! ! Client !! Needs: !!Safe !!and !!Effective !!Care !!Environment
3. 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
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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: !! !! !!p. !!6 TOP: ! ! Nursing !!Process:
!!Planning!MSC: ! ! Client !!Needs: !!Health !!Promotion !!and !!Maintenance
4. 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: !! !! !!p. !!5 TOP: ! ! Nursing !!Process:
!!Evaluation!MSC: ! ! Client !!Needs: !!Health !!Promotion !!and !!Maintenance
5. 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 !!one’s !!own !!performance !!against !!the !!performance !!of !!the !!best !!in !!an
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!!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: !! !! !!p. !!11 TOP: ! ! Nursing !!Process:
!!Evaluation!MSC: ! ! Client !!Needs: !!Safe !!and !!Effective !!Care !!Environment