Maternity and Women's Health Care
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
1
Reference: Ch. 1: 21st-Century Maternity and
Women’s Health Nursing — Role of the Nurse in
Contemporary Care
Stem: A 28-year-old woman with a history of
poorly controlled type 2 diabetes is planning
pregnancy and asks the nurse what action will
most reduce her risk of congenital anomalies.
Which nursing recommendation is best?
A. Advise starting a high-dose folic acid
supplement once pregnancy is confirmed.
B. Recommend preconception glycemic
,optimization and periconception folic acid.
C. Encourage weight loss only after pregnancy
to avoid fetal stress.
D. Tell her to stop all diabetes medications
immediately when trying to conceive.
Correct Answer: B
Rationales:
Correct (B): Preconception glycemic control and
periconception folic acid reduce risk of
congenital anomalies and adverse outcomes;
nurses should prioritize optimization before
conception.
A: Waiting until pregnancy confirmation delays
folic acid during the critical neural tube closure
period; preconception supplementation is
superior.
C: Delaying weight management until after
conception misses opportunity to optimize
metabolic status preconception.
D: Abruptly stopping diabetes medications can
,cause instability; medication review and
adjustment by the provider is indicated with
nursing support.
Teaching Point: Optimize glycemic control and
begin folic acid before conception.
Citation: Lowdermilk et al., 2023, Ch. 1: 21st-
Century Maternity and Women’s Health
Nursing.
2
Reference: Ch. 2: Advances in the Care of
Mothers and Infants — Perinatal Quality
Improvement
Stem: During a perinatal unit QI meeting, the
nurse learns the unit’s cesarean rate is above
national benchmarks. Which nursing-led action
most directly addresses this outcome?
, A. Teach all laboring women relaxation
techniques only.
B. Audit labor management documentation and
implement evidence-based labor protocols.
C. Advise physicians to perform fewer cesareans
without further analysis.
D. Increase availability of epidural analgesia to
shorten labor.
Correct Answer: B
Rationales:
Correct (B): Auditing documentation and
implementing evidence-based labor
management protocols targets system factors
driving cesarean rates and is a nurse-led quality
improvement approach.
A: Teaching relaxation is beneficial but unlikely
to substantially change unit cesarean rates by
itself.
C: Telling physicians to operate less is
nonconstructive without data and process
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
1
Reference: Ch. 1: 21st-Century Maternity and
Women’s Health Nursing — Role of the Nurse in
Contemporary Care
Stem: A 28-year-old woman with a history of
poorly controlled type 2 diabetes is planning
pregnancy and asks the nurse what action will
most reduce her risk of congenital anomalies.
Which nursing recommendation is best?
A. Advise starting a high-dose folic acid
supplement once pregnancy is confirmed.
B. Recommend preconception glycemic
,optimization and periconception folic acid.
C. Encourage weight loss only after pregnancy
to avoid fetal stress.
D. Tell her to stop all diabetes medications
immediately when trying to conceive.
Correct Answer: B
Rationales:
Correct (B): Preconception glycemic control and
periconception folic acid reduce risk of
congenital anomalies and adverse outcomes;
nurses should prioritize optimization before
conception.
A: Waiting until pregnancy confirmation delays
folic acid during the critical neural tube closure
period; preconception supplementation is
superior.
C: Delaying weight management until after
conception misses opportunity to optimize
metabolic status preconception.
D: Abruptly stopping diabetes medications can
,cause instability; medication review and
adjustment by the provider is indicated with
nursing support.
Teaching Point: Optimize glycemic control and
begin folic acid before conception.
Citation: Lowdermilk et al., 2023, Ch. 1: 21st-
Century Maternity and Women’s Health
Nursing.
2
Reference: Ch. 2: Advances in the Care of
Mothers and Infants — Perinatal Quality
Improvement
Stem: During a perinatal unit QI meeting, the
nurse learns the unit’s cesarean rate is above
national benchmarks. Which nursing-led action
most directly addresses this outcome?
, A. Teach all laboring women relaxation
techniques only.
B. Audit labor management documentation and
implement evidence-based labor protocols.
C. Advise physicians to perform fewer cesareans
without further analysis.
D. Increase availability of epidural analgesia to
shorten labor.
Correct Answer: B
Rationales:
Correct (B): Auditing documentation and
implementing evidence-based labor
management protocols targets system factors
driving cesarean rates and is a nurse-led quality
improvement approach.
A: Teaching relaxation is beneficial but unlikely
to substantially change unit cesarean rates by
itself.
C: Telling physicians to operate less is
nonconstructive without data and process
