rMaternity & Women’s Health Care, 12th Edition
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MULTIPLE CHOICE r
1. In evaluating thelevelofapregnant woman’sriskof havingalow-birth-weight (LBW)
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infant, which factor is the most important for the nurse to consider?
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a. African-American race r
b. Cigarette smoking r
c. Poornutritional status r r
d. Limited maternal education tt r
ANS: A
The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic black
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rwomen (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are almost
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rtwice as likely as non-Hispanic white infants to be of LBW and to die in the first yearoflife..
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rRace is anonmodifiable risk factor. Cigarettesmokingisan important factorin potential infant
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rmortality rates, but it is not the most important. Additionally, smoking is a modifiable risk
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rfactor. Poor nutrition is an important factor in potential infant mortality rates, but it is not
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rthe most important. Additionally, nutritional status is a modifiable risk factor. Maternal
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reducation is an important factor in potential infant mortality rates, but it is not the most
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rimportant. Additionally, maternal education is a modifiable risk factor.
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PTS: 1 DIF: CognitiveLevel:Understand r
rTOP: Nursing Process: Assessment r r
MSC: Client Needs: HealtN PrRoS
hU mI ioG
otN nTanBd.MCaO
inM
tenance, Antepartum Care
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
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statistics for infant mortality, which intervention is most important for the nurse to include in
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the client’s plan of care?
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a. Perform a nutrition assessment. r tt r
b. Referthe womanto a social worker. r r r r r
c. Advisethe woman tosee an obstetrician, not a midwife. r r r r r r r
d. Explain tothe woman theimportance ofkeeping herprenatal care appointments.
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ANS: D
Consistent prenatal care is the best method of preventing or controlling risk factors
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rassociatedwithinfantmortality. Nutritionalstatusis an importantmodifiableriskfactor,but it is r r r r tt r r r r r
rnot the most important action a nurse should take in this situation. The client may need
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rassistance from asocial worker at some timeduring her pregnancy, but areferral toa social
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rworker is not the most important aspect the nurse should address at this time. If the woman
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rhas identifiable high-risk problems, then her health care may need to be provided by a
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rphysician. However, it cannot be assumed that all African-American women have high-risk
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rissues. In addition, advising the woman to see an obstetrician is not the most important
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raspect on which the nurse should focus at this time, and it is not appropriate for a nurse to
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radvise or manage the type of care a client is to receive.
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PTS: 1 DIF: CognitiveLevel:Understand r
rTOP: Nursing Process: Planning r r
, MSC: ClientNeeds: Health Promotionand Maintenance
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3. Thenursesworkingat anewlyestablishedbirthingcenter havebegunto comparetheir tt r r
performance in providing maternal-newborn care against clinical standards. This
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comparison process is most commonly known as what?
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a. Bestpracticesnetwork r
b. Clinicalbenchmarking
c. Outcomes-oriented pracNti Uc eRS r r r r
d. Evidence-based practice r
ANS: C
Outcomes-oriented practice measures the effectiveness of the interventions and quality of r r r r r r r r r r
careagainst benchmarks or standards. Theterm bestpractice refers toaprogram or service
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that has been recognized for its excellence. Clinical benchmarking is a process used to
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compare one’s own performance against the performance of the best in an area of service.
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The term evidence-based practice refers to the provision of care based on evidence gained
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through research and clinical trials.
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PTS: 1 DIF: CognitiveLevel:Understand
TOP: Nursing Process: Evaluation
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MSC: Client Needs: SafeandEffective Care Environment
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4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
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assessment of a 21-year-old Hispanic client with limited English proficiency. Which
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intervention is the most important for the nurse to implement?
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a. Usematernityjargon toenable theclient tobecome familiarwiththese terms. r r r r r r r r r r
b. Speakquickly and efficientlyto expeditethe visit.
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c. Provide theclient withhandouts. tt r r r
d. Assesswhetherthe client understands thediscussion. r r r
ANS: D
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
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are written at a level too high for the average adult and may not be useful for a client with
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limited English proficiency.
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PTS: 1 DIF: CognitiveLevel:Apply
TOP: Nursing Process: Implementation
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MSC: Client Needs: Health Promotionand Maintenance
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5. Whichstatement best exemplifiescontemporarymaternitynursing? r r r
a. Use of midwives forall vaginal deliveries
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b. Family-centered care r
c. Free-standing birth clinics r r
d. Physician-driven care tt
r ANS: B r
, Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, r r r r r r r r r r
partners, grandparents, and siblings maybe present forthe birthand participate inactivities
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such as cutting the baby’s umbilical cord. Both midwives and physicians perform vaginal
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deliveries. Free-standing clinics are an example of alternative birth options. Contemporary
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maternity nursing is driven by the relationship between nurses and their clients.
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PTS: 1 DIF: CognitiveLevel:Understand r
TOP: Nursing Process: Planning
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MSC: Client Needs: Health Promotionand Maintenance
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6. A38-year-oldHispanicwomanvaginallydelivered a9-pound,6-ounce babygirlafter being in r r r r
labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could the
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woman have a legitimate legal case for negligence?
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a. Inexperiencedmaternitynursewas assigned tocareforthe client. r r r r r r r r
b. Client was past her duedate by3 days. r r r r r r
c. Standardofcare was not met. r r r r
d. Client refused electronicfetalmonitoring. tt r
ANS: C
Not meeting the standard of care is a legitimate factor for a case of negligence. An
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inexperiencedmaternitynurse wouldneed to displaycompetencybefore beingassigned to
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carefor clients on hisor her own. This client may have been past her due date; however, a term
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pregnancy often goesbeyond 40 weeks ofgestation. Although fetal monitoring isthe standard
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of care, the client has the right to refuse treatment. This refusal is not a case for negligence,
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but informed consent should be properly obtained, and the client should have signed an
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against medical advice form when refusing any treatment that is within the standard of care.
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PTS: 1 DIF: CognitiveLevel:Analyze
TOP: Nursing Process: Implementation
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MSC: Client Needs: SafeandEffective CareEnvironment
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7. Whenthenurseisunsure howto perform aclient careprocedurethat is high risk and low r r r r r r r tt r r r
volume, his or her best action in this situation would be what?
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a. Askanothernurse. r r
b. Discusstheprocedurewiththeclient’s physician. r r r r
c. Lookup the procedure in a nursing textbook. r r r r r r r
d. First consult the agencyproceduremanual
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ANS: D
Following the agency’s policies and procedures manual is always best when seeking
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information on correct clientprocedures. These policies shouldreflectthe current standards of
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care and the individual state’s guidelines. Each nurse is responsible for his or her own
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practice. Relying on another nurse may not always be a safe practice. Each nurse is
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obligated to follow the standards of care for safe client care delivery. Physicians are
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responsible for their own client care activity. Nurses may follow safe orders from
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physicians, but they are also responsible for the activities that they, as nurses, are to carry
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out. Information provided ina nursing textbook is basic informationforgeneral knowledge.
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Furthermore, the information in a textbook may not reflect the current standard of care or
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the individual state or hospital policies.
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