Chapter 01: 21st Century Maternity and Women’s HealthNursing
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Lowdermilk: Maternity & Women’s Health Care, 11th Edition
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MULTIPLECHOICE v
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW) infant,
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which factor is the most important for the nurse to consider?
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a. African-American race v
b. Cigarette smoking v
c. Poor nutritional status v v
d. Limited maternal education v v
ANS: A v
For African-American births, the incidence of LBW infants is twice that of Caucasian births.
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Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant
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mortality rates, but it is not the most important. Additionally, smoking is a modifiable risk factor.
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Poor nutrition is an important factor in potential infant mortality rates, but it is not the most
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important. Additionally, nutritional status is a modifiable risk factor. Maternal education is an
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important factor in potential infant mortality rates, but it is not the most important. Additionally,
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maternal education is a modifiable risk factor.
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DIF: Cognitive Level: Understand REF: p.6 v v v v
TOP: Nursing Process: Assessment
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MSC: Client Needs: Health Promotion andMaintenance, Antepartum Care
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2. Whatistheprimaryroleofpracticing nurses in the research process?
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a. Designing research studies v v
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b. Collecting data for other researchers v v v v
c. Identifying researchable problems v v
d. Seeking funding to support research studies v v v v v
ANS: C v
When problems are identified, research can be properly conducted. Research of health care
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issues leads to evidence-based practice guidelines. Designing research studies is only one factor
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of the research process. Data collection is anotherfactor of research. Financial support is
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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 v v v v TOP: NursingProcess:N/A v v v
MSC: Client Needs: Safe and Effective Care Environment
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3. A 23-year-old African-American woman is pregnant with her first child. Based on the
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statistics for infant mortality, which plan is most important for the nurse to implement?
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a. Perform a nutrition assessment. v v v
b. Refer the woman to a social worker. v v v v v v
c. Advise the woman to see an obstetrician, not a midwife. v v v v v v v v v
d. Explain to the woman the importance of keeping her prenatal care appointments.v v v v v v v v v v v
ANS: D v
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, Maternity and Women's Health Care 11th Edition Lowdermilk Test Bank v v v v v v v v v
Consistent prenatal care is the best method of preventing or controlling risk factors associated with
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infant mortality. Nutritional status is an important modifiable risk factor, but it is not the most
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important action a nurse should take in this situation. The client may need assistance from a social
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worker at some time during her pregnancy, but a referral to a social worker is not the most
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important aspect the nurse should address at this time. If the woman has identifiable high-risk
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problems, then her health care may need to be provided by a physician. However, it cannot be
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assumed that all African-American women have high-risk issues. In addition, advising the
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woman to see an obstetrician is not the most important aspect on which the nurse should focus at
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this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to
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receive.
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DIF: Cognitive Level: Understand REF: p. 6 v v v v TOP: NursingProcess:Planning v v v
MSC: Client Needs: Health Promotion and Maintenance
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4. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of
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a 21-year-old Hispanic client with limited English proficiency. Which action is the most
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important for the nurse to perform?
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a. Use maternity jargon to enable the client to become familiar with these terms.
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b. Speak quickly and efficiently to expedite the visit. v v v v v v v
c. Provide the client with handouts. v v v v
d. Assess whether the client understands the discussion. v v v v v v
ANS: D v
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
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evaluating whether the client understands the discussion. Speaking slowly and clearly and
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focusing on what is important will increase understanding. Most client education materials are
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English proficiency. USNT v O v v v
DIF: Cognitive Level: Apply REF: p. 5 v v v v TOP: NursingProcess:Evaluation v v v
MSC: Client Needs: Health Promotion and Maintenance
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5. The nurses working at a newly established birthing center have begun to compare their
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performancein providing maternal-newborn care against clinical standards. This comparison
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process is most commonly known as what?
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a. Best practices network v v
b. Clinical benchmarking v
c. Outcomes-oriented practice v
d. Evidence-based practice v
ANS: C v
Outcomes-oriented practice measures the effectiveness of the interventions and quality of care v v v v v v v v v v v
against benchmarks or standards. The term best practice refers to a program or service that has
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been recognized for its excellence. Clinical benchmarking is a process used to compare one’s
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own performance against the performance of the best in an area of service. The term evidence-
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based practice refers to the provision of care based on evidence gained through research and
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clinical trials.
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DIF: Cognitive Level: Understand REF: p. 11 v v v v TOP: NursingProcess:Evaluation v v v
MSC: Client Needs: Safe and Effective Care Environment
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, Maternity and Women's Health Care 11th Edition Lowdermilk Test Bank v v v v v v v v v
6. Which statement best exemplifies contemporary maternity nursing?
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a. Use of midwives for all vaginal deliveries v v v v v v
b. Family-centered care v
c. Free-standing birth clinics v v
d. Physician-driven care v
ANS: B v
Contemporarymaternity nursing focuses on the family’s needs and desires. Fathers, partners, v v v v v v v v v v v
grandparents, and siblings may be present for the birth and participate in activities such as
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cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal deliveries.
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Free-standing clinics are an example of alternative birth options. Contemporary maternity
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nursing is driven by the relationship between nurses and their clients.
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DIF: Cognitive Level: Understand REF: pp. 8-9 v v v v TOP: NursingProcess:Planning v v v
MSC: Client Needs: Health Promotion and Maintenance
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7. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after being in
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labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could the woman
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have a legitimate legal case for negligence?
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a. Inexperienced maternity nurse was assigned to care for the client. v v v v v v v v v
b. Client was past her due date by 3 days. v v v v v v v v
c. Standard of care was not met. v v v v v
d. Client refused electronic fetal monitoring. v v v v
ANS: C v
Not meeting the standard of care is a legitimate factor for a case of negligence. An
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inexperienced maternity nursewould need to display competency before being assigned to care
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for clients on his or her N
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ave been past her due date; however, a
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term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the
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standard of care, the client has the right to refuse treatment. This refusal is not a case for
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negligence, but informed consent should be properly obtained, and the client should have signed
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an against medical advice form when refusing any treatment that is within the standard of care.
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DIF: Cognitive Level: Analyze REF: p.13 v v v v
TOP: Nursing Process: Implementation
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MSC: Client Needs: Safe and Effective Care Environment
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8. When the nurse is unsure how to perform a client care procedure that is high risk and low
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vvolume, his or her best action in this situation would be what?
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a. Ask another nurse. v v
b. Discuss the procedure with the client’s physician. v v v v v v
c. Look up the procedure in a nursing textbook. v v v v v v v
d. Consult the agency procedure manual, and follow the guidelines for the procedure. v v v v v v v v v v v
ANS: D v
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