Maternity and Women's Health Care
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
Reference: Part 1 — 21st-Century Maternity and Women’s
Health Nursing: Advances in Care of Mothers and Infants
(Lowdermilk et al., 2023, Part 1)
Question: A nurse on the antepartum unit reviews an obstetric
unit’s recent quality report showing reduced neonatal
hypothermia rates after implementing delayed cord clamping
and immediate skin-to-skin. Which nursing action most directly
supports continuation of this evidence-based change?
A. Remind staff to document Apgar scores at 1 and 5 minutes.
B. Reinforce staff education on thermoregulation and skin-to-
skin protocols.
C. Request additional warming lamps on the unit.
D. Rotate staff assignments to include more experienced nurses
with high-risk patients.
Correct Answer: B
,Rationale (correct): Reinforcing staff education on
thermoregulation and skin-to-skin ensures consistent
implementation of the evidence-based protocol that produced
the improved outcomes. Education targets the practice change
itself.
Rationale (A): Documentation of Apgar scores is important but
does not directly sustain practice change that reduced
hypothermia.
Rationale (C): Additional equipment may help but does not
address adherence to delayed cord clamping/skin-to-skin.
Rationale (D): Rotating assignments may affect workload but is
not a targeted strategy to maintain the specific evidence-based
intervention.
Teaching point: Educate staff to sustain evidence-based practice
changes and patient outcomes.
Citation: Lowdermilk et al., 2023, Part 1: Advances in the Care
of Mothers and Infants
2
Reference: Part 1 — Efforts to Reduce Health Disparities
(Lowdermilk et al., 2023, Part 1)
Question: A pregnant patient who speaks limited English
declines recommended Group B Streptococcus screening.
Which nursing action best addresses equitable care and
informed consent?
,A. Respect the refusal and document it in the chart.
B. Ask the physician to explain the risks in more detail.
C. Arrange a professional medical interpreter to discuss
benefits/risks before documentation.
D. Provide a written brochure in English and ask the patient to
sign.
Correct Answer: C
Rationale (correct): Using a professional medical interpreter
ensures the patient receives culturally and linguistically
appropriate information to make an informed decision,
reducing disparities.
Rationale (A): Documenting refusal without ensuring
understanding may perpetuate disparities and violate informed
consent standards.
Rationale (B): The physician may explain, but the nurse should
first ensure interpretation services are present to facilitate
communication.
Rationale (D): An English brochure is inadequate for limited-
English speakers and does not ensure comprehension.
Teaching point: Always use professional interpreters to support
informed maternity care.
Citation: Lowdermilk et al., 2023, Part 1: Efforts to Reduce
Health Disparities
3
, Reference: Part 1 — Contemporary Issues and Trends: Maternal
Morbidity and Mortality (Lowdermilk et al., 2023, Part 1)
Question: On postpartum rounds, a nurse notes a patient with
postpartum hypertension reports a severe, unrelieved
headache and visual spots. What is the nurse’s priority action?
A. Offer acetaminophen and reassess in 2 hours.
B. Measure blood pressure and notify the provider immediately.
C. Encourage oral fluids and bed rest.
D. Document the findings and continue routine monitoring.
Correct Answer: B
Rationale (correct): Severe headache and visual disturbances in
a postpartum patient with hypertension are red flags for severe
preeclampsia/eclampsia risk; immediate BP measurement and
notification enable urgent management.
Rationale (A): Analgesia alone is insufficient and delays urgent
evaluation.
Rationale (C): Fluids and rest do not address potential
hypertensive emergency.
Rationale (D): Documentation without immediate assessment
risks patient safety.
Teaching point: Recognize and promptly act on hypertensive
emergency warning signs postpartum.
Citation: Lowdermilk et al., 2023, Part 1: Contemporary Issues
and Trends
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
Reference: Part 1 — 21st-Century Maternity and Women’s
Health Nursing: Advances in Care of Mothers and Infants
(Lowdermilk et al., 2023, Part 1)
Question: A nurse on the antepartum unit reviews an obstetric
unit’s recent quality report showing reduced neonatal
hypothermia rates after implementing delayed cord clamping
and immediate skin-to-skin. Which nursing action most directly
supports continuation of this evidence-based change?
A. Remind staff to document Apgar scores at 1 and 5 minutes.
B. Reinforce staff education on thermoregulation and skin-to-
skin protocols.
C. Request additional warming lamps on the unit.
D. Rotate staff assignments to include more experienced nurses
with high-risk patients.
Correct Answer: B
,Rationale (correct): Reinforcing staff education on
thermoregulation and skin-to-skin ensures consistent
implementation of the evidence-based protocol that produced
the improved outcomes. Education targets the practice change
itself.
Rationale (A): Documentation of Apgar scores is important but
does not directly sustain practice change that reduced
hypothermia.
Rationale (C): Additional equipment may help but does not
address adherence to delayed cord clamping/skin-to-skin.
Rationale (D): Rotating assignments may affect workload but is
not a targeted strategy to maintain the specific evidence-based
intervention.
Teaching point: Educate staff to sustain evidence-based practice
changes and patient outcomes.
Citation: Lowdermilk et al., 2023, Part 1: Advances in the Care
of Mothers and Infants
2
Reference: Part 1 — Efforts to Reduce Health Disparities
(Lowdermilk et al., 2023, Part 1)
Question: A pregnant patient who speaks limited English
declines recommended Group B Streptococcus screening.
Which nursing action best addresses equitable care and
informed consent?
,A. Respect the refusal and document it in the chart.
B. Ask the physician to explain the risks in more detail.
C. Arrange a professional medical interpreter to discuss
benefits/risks before documentation.
D. Provide a written brochure in English and ask the patient to
sign.
Correct Answer: C
Rationale (correct): Using a professional medical interpreter
ensures the patient receives culturally and linguistically
appropriate information to make an informed decision,
reducing disparities.
Rationale (A): Documenting refusal without ensuring
understanding may perpetuate disparities and violate informed
consent standards.
Rationale (B): The physician may explain, but the nurse should
first ensure interpretation services are present to facilitate
communication.
Rationale (D): An English brochure is inadequate for limited-
English speakers and does not ensure comprehension.
Teaching point: Always use professional interpreters to support
informed maternity care.
Citation: Lowdermilk et al., 2023, Part 1: Efforts to Reduce
Health Disparities
3
, Reference: Part 1 — Contemporary Issues and Trends: Maternal
Morbidity and Mortality (Lowdermilk et al., 2023, Part 1)
Question: On postpartum rounds, a nurse notes a patient with
postpartum hypertension reports a severe, unrelieved
headache and visual spots. What is the nurse’s priority action?
A. Offer acetaminophen and reassess in 2 hours.
B. Measure blood pressure and notify the provider immediately.
C. Encourage oral fluids and bed rest.
D. Document the findings and continue routine monitoring.
Correct Answer: B
Rationale (correct): Severe headache and visual disturbances in
a postpartum patient with hypertension are red flags for severe
preeclampsia/eclampsia risk; immediate BP measurement and
notification enable urgent management.
Rationale (A): Analgesia alone is insufficient and delays urgent
evaluation.
Rationale (C): Fluids and rest do not address potential
hypertensive emergency.
Rationale (D): Documentation without immediate assessment
risks patient safety.
Teaching point: Recognize and promptly act on hypertensive
emergency warning signs postpartum.
Citation: Lowdermilk et al., 2023, Part 1: Contemporary Issues
and Trends
