Maternity and Pediatric Nursing
5th Edition
• Author(s)Susan Scott Ricci; Terri Kyle; Susan Carman
• PublisherPublished by Wolters Kluwer Health Copyright©
2025
• Print ISBN: 9781975220419
TEST BANK
Chapter 1: The History of Maternal and
Newborn Health and Health Care
A community health nurse is reviewing data to identify priority
areas for a new maternal-child health initiative. Which measure
is the most sensitive indicator of a community's overall health
status and the quality of its prenatal services?
A. Maternal mortality rate
B. Infant mortality rate
C. Child morbidity rate from asthma
D. Adolescent suicide rate
Correct Answer: B
Rationales:
• Correct: The infant mortality rate is widely recognized as a
key indicator of a nation's or community's overall health
, status. It reflects the effectiveness of prenatal care, maternal
health, socioeconomic conditions, and access to quality
healthcare services.
• Incorrect A: While critically important, the maternal
mortality rate is a more specific indicator of obstetric care
and women's health services rather than the broadest
community health status.
• Incorrect C: Morbidity rates for specific conditions like
asthma are important but reflect a specific disease process
rather than the overall health system's effectiveness.
• Incorrect D: The adolescent suicide rate is a significant
public health concern but is influenced by complex mental
health and social factors, making it less direct an indicator
of general healthcare quality.
Teaching Point: Infant mortality is the most sensitive
benchmark for a community's overall health.
Citation: Ricci, S., Kyle, T., & Carman, S.
(2021). Maternity and Pediatric Nursing (5th ed.). Chapter
1, Health Status of Women and Children.
2. Chapter 1, The History of Maternal and Newborn Health
A nursing student is preparing a presentation on the historical
impact of nurse-midwives in the United States. Which early
20th-century development was most pivotal in establishing the
foundation for professional nurse-midwifery?
A. The publication of the Sheppard-Towner Act
B. The founding of the Frontier Nursing Service by Mary
Breckinridge
,C. The establishment of the Children's Bureau
D. The introduction of twilight sleep for laboring women
Correct Answer: B
Rationales:
• Correct: Mary Breckinridge's Frontier Nursing Service
(1925) provided decentralized, community-based nurse-
midwifery care to underserved populations in rural
Kentucky, demonstrating the safety and effectiveness of the
model and paving the way for the profession.
• Incorrect A: The Sheppard-Towner Act (1921) provided
funding for maternal and child health, but it focused on
public health nursing and education, not specifically on
establishing the nurse-midwife role.
• Incorrect C: The Children's Bureau (1912) was a federal
agency that collected data and advocated for children's
welfare, but it was not directly responsible for nurse-
midwifery.
• Incorrect D: Twilight sleep involved the use of
scopolamine and morphine, representing a medicalization
of birth, which is contrary to the nurse-midwifery model of
care.
Teaching Point: The Frontier Nursing Service practically
demonstrated the efficacy of nurse-midwifery.
Citation: Ricci, S., Kyle, T., & Carman, S.
(2021). Maternity and Pediatric Nursing (5th ed.). Chapter
1, Evolution of Maternal and Newborn Nursing.
, 3. Chapter 1, Legal and Ethical Issues
A 16-year-old pregnant client at 24 weeks gestation admits to
using cocaine regularly. The nurse is concerned about the
potential for legal action mandating treatment. This situation
best exemplifies which ethical and legal concept?
A. Informed consent
B. Stem cell research
C. Maternal-fetal conflict
D. Refusal of medical treatment
Correct Answer: C
Rationales:
• Correct: Maternal-fetal conflict occurs when the rights or
actions of the pregnant woman are perceived to be in direct
opposition to the well-being of the fetus. State intervention,
such as court-ordered treatment, is a potential legal
response in such cases.
• Incorrect A: Informed consent involves a patient's right to
receive information and make voluntary decisions, which is
related but not the central conflict here.
• Incorrect B: Stem cell research is unrelated to this clinical
scenario of substance use during pregnancy.
• Incorrect D: While the client may refuse treatment, the
core issue is the conflict between her autonomy and the
state's interest in protecting the fetus.
Teaching Point: Maternal substance use can create a legal
conflict between maternal autonomy and fetal rights.
Citation: Ricci, S., Kyle, T., & Carman, S.
5th Edition
• Author(s)Susan Scott Ricci; Terri Kyle; Susan Carman
• PublisherPublished by Wolters Kluwer Health Copyright©
2025
• Print ISBN: 9781975220419
TEST BANK
Chapter 1: The History of Maternal and
Newborn Health and Health Care
A community health nurse is reviewing data to identify priority
areas for a new maternal-child health initiative. Which measure
is the most sensitive indicator of a community's overall health
status and the quality of its prenatal services?
A. Maternal mortality rate
B. Infant mortality rate
C. Child morbidity rate from asthma
D. Adolescent suicide rate
Correct Answer: B
Rationales:
• Correct: The infant mortality rate is widely recognized as a
key indicator of a nation's or community's overall health
, status. It reflects the effectiveness of prenatal care, maternal
health, socioeconomic conditions, and access to quality
healthcare services.
• Incorrect A: While critically important, the maternal
mortality rate is a more specific indicator of obstetric care
and women's health services rather than the broadest
community health status.
• Incorrect C: Morbidity rates for specific conditions like
asthma are important but reflect a specific disease process
rather than the overall health system's effectiveness.
• Incorrect D: The adolescent suicide rate is a significant
public health concern but is influenced by complex mental
health and social factors, making it less direct an indicator
of general healthcare quality.
Teaching Point: Infant mortality is the most sensitive
benchmark for a community's overall health.
Citation: Ricci, S., Kyle, T., & Carman, S.
(2021). Maternity and Pediatric Nursing (5th ed.). Chapter
1, Health Status of Women and Children.
2. Chapter 1, The History of Maternal and Newborn Health
A nursing student is preparing a presentation on the historical
impact of nurse-midwives in the United States. Which early
20th-century development was most pivotal in establishing the
foundation for professional nurse-midwifery?
A. The publication of the Sheppard-Towner Act
B. The founding of the Frontier Nursing Service by Mary
Breckinridge
,C. The establishment of the Children's Bureau
D. The introduction of twilight sleep for laboring women
Correct Answer: B
Rationales:
• Correct: Mary Breckinridge's Frontier Nursing Service
(1925) provided decentralized, community-based nurse-
midwifery care to underserved populations in rural
Kentucky, demonstrating the safety and effectiveness of the
model and paving the way for the profession.
• Incorrect A: The Sheppard-Towner Act (1921) provided
funding for maternal and child health, but it focused on
public health nursing and education, not specifically on
establishing the nurse-midwife role.
• Incorrect C: The Children's Bureau (1912) was a federal
agency that collected data and advocated for children's
welfare, but it was not directly responsible for nurse-
midwifery.
• Incorrect D: Twilight sleep involved the use of
scopolamine and morphine, representing a medicalization
of birth, which is contrary to the nurse-midwifery model of
care.
Teaching Point: The Frontier Nursing Service practically
demonstrated the efficacy of nurse-midwifery.
Citation: Ricci, S., Kyle, T., & Carman, S.
(2021). Maternity and Pediatric Nursing (5th ed.). Chapter
1, Evolution of Maternal and Newborn Nursing.
, 3. Chapter 1, Legal and Ethical Issues
A 16-year-old pregnant client at 24 weeks gestation admits to
using cocaine regularly. The nurse is concerned about the
potential for legal action mandating treatment. This situation
best exemplifies which ethical and legal concept?
A. Informed consent
B. Stem cell research
C. Maternal-fetal conflict
D. Refusal of medical treatment
Correct Answer: C
Rationales:
• Correct: Maternal-fetal conflict occurs when the rights or
actions of the pregnant woman are perceived to be in direct
opposition to the well-being of the fetus. State intervention,
such as court-ordered treatment, is a potential legal
response in such cases.
• Incorrect A: Informed consent involves a patient's right to
receive information and make voluntary decisions, which is
related but not the central conflict here.
• Incorrect B: Stem cell research is unrelated to this clinical
scenario of substance use during pregnancy.
• Incorrect D: While the client may refuse treatment, the
core issue is the conflict between her autonomy and the
state's interest in protecting the fetus.
Teaching Point: Maternal substance use can create a legal
conflict between maternal autonomy and fetal rights.
Citation: Ricci, S., Kyle, T., & Carman, S.
