, CHAPTER LIST
Section I: Introduction
Chapter 1: How to Use This Book
Section II: Generic Care Plans
Chapter 2: Nursing Care Plans (Generic)
Chapter 3: Collaborative Care Plans (Generic)
Section III: Antepartum Care
Chapter 4: Normal Pregnancy
Chapter 5: Pregnancy Complicated by Medical and Other Complications
Chapter 6: Gestational Complications
Section IV: Intrapartum Care
Chapter 7: Normal Intrapartum
Chapter 8: Intrapartum Complications
Section V: Postpartum Care
Chapter 9: Normal Postpartum Care
Chapter 10: Postpartum Complications
Section VI: Care of the Newborn
Chapter 11: Normal Newborn Care
Chapter 12: Neonatal Complications
,Chapter 1: How to Use This Book
Question 1 [MCQ – Scenario]
A postpartum nurse is caring for a primiparous mother 12 hours after birth who repeatedly states,
“I know I should breastfeed, but I am afraid I am doing everything wrong.” On assessment, the
mother avoids eye contact during feeding attempts, asks the same questions repeatedly, and is
unable to describe infant hunger cues after prior teaching. The nurse reviews the care plan
template in this textbook to determine the most appropriate next step. Which action best reflects
correct use of the nursing process within the care plan format?
A. Document a collaborative problem related to ineffective breastfeeding and wait for the lactation
consultant to formulate interventions
B. Revise the nursing diagnosis based on current assessment data, identify measurable learning
outcomes, and select NIC interventions focused on teaching and support
C. Retain the original generic teaching plan because all first-time mothers require the same
breastfeeding education sequence
D. Delay care plan revision until the end of the shift so that all postpartum findings can be entered
at one time
Answer: B. Revise the nursing diagnosis based on current assessment data, identify measurable
learning outcomes, and select NIC interventions focused on teaching and support
Rationale:
The care plan structure in this textbook is grounded in the nursing process and requires that
assessment findings drive all subsequent planning. In this situation, the mother’s repeated
questioning, uncertainty, and inability to identify feeding cues indicate the need to individualize the
nursing diagnosis and care plan rather than relying on a static generic teaching approach. After
assessment, the nurse must formulate or refine the diagnosis, define expected outcomes that are
specific and evaluable, and choose appropriate NIC interventions such as teaching, emotional
support, and breastfeeding assistance. This sequence demonstrates the core logic of the care plan
format: assessment informs diagnosis, diagnosis guides planning, planning directs implementation,
and outcomes are later evaluated against the mother’s actual progress.
Question 2 [MCQ – Scenario]
A pregnant patient at 30 weeks’ gestation is admitted with vaginal bleeding and uterine irritability.
The nurse notes maternal tachycardia, increasing anxiety, and a non-reassuring fetal heart rate
pattern. While initiating maternal assessment and documentation, the nurse also activates the unit
protocol and notifies the obstetric provider. In relation to the framework used in this textbook,
which statement best explains the care planning approach required in this situation?
,A. The nurse should use only a nursing care plan because collaborative care plans are reserved for
neonatal conditions
B. The presence of possible haemorrhage requires a collaborative care plan alongside nursing
diagnoses because physiologic instability may require interdisciplinary management
C. Collaborative care plans replace nursing diagnoses whenever a physician has already written
treatment orders
D. The nurse should postpone all care planning until the definitive medical diagnosis is confirmed
Answer: B. The presence of possible haemorrhage requires a collaborative care plan alongside
nursing diagnoses because physiologic instability may require interdisciplinary management
Rationale:
This textbook distinguishes nursing care plans from collaborative care plans while emphasizing that
they often coexist in complex maternal-newborn situations. When a patient presents with signs
suggesting a physiologic complication such as haemorrhage, the nurse must address both nurse-
managed human responses and potential complications requiring interdisciplinary surveillance and
intervention. A collaborative care plan is appropriate because the patient’s instability may require
rapid coordination with obstetric, laboratory, anaesthesia, and neonatal teams. At the same time,
the nurse continues independent nursing functions such as assessment, monitoring, support,
communication, and implementation of prescribed interventions. The overlap between the two
care planning approaches reflects the realities of maternal-newborn practice, where nursing
judgment and collaborative management are frequently inseparable.
Question 3 [MCQ – Scenario]
A student nurse writes the following care plan statement for a woman in early pregnancy:
“Knowledge deficit related to pregnancy as evidenced by first pregnancy.” The supervising nurse
reviews Chapter 1 and asks the student to correct the statement using proper nursing diagnosis
structure. Which revision best reflects the textbook’s explanation of nursing diagnoses?
A. Deficient knowledge related to unfamiliarity with prenatal self-care as evidenced by repeated
questions about nutrition, warning signs, and medication safety
B. Pregnancy-related learning problem secondary to nulliparity as evidenced by needing education
C. Risk for deficient knowledge related to first pregnancy as evidenced by lack of experience
D. Anxiety related to inadequate teaching as evidenced by being pregnant for the first time
Answer: A. Deficient knowledge related to unfamiliarity with prenatal self-care as evidenced by
repeated questions about nutrition, warning signs, and medication safety
Rationale:
A properly structured nursing diagnosis in the NANDA-style format includes the diagnostic label,
related factors, and defining characteristics when the problem is actual rather than potential. The
corrected statement identifies a recognized problem, links it to a cause that nursing care can
address, and supports it with observable assessment findings. Simply being a first-time mother is
not, by itself, a defining characteristic; it is neither adequate evidence nor a sufficient diagnostic
formulation. The chapter emphasizes that the nurse must avoid vague or circular wording and
,instead construct diagnoses from actual patient data. This precision strengthens the clinical
usefulness of the care plan by making interventions and outcomes more targeted and measurable.
Question 4 [MCQ – Recall]
Within the nursing process framework used throughout this textbook, which step involves
determining whether the patient’s expected outcomes have been achieved?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
Answer: D. Evaluation
Rationale:
Evaluation is the phase of the nursing process in which the nurse compares the patient’s actual
responses and progress with the outcomes identified during planning. In this textbook, expected
outcomes are not simply listed; they are intended to become measurable standards against which
nursing effectiveness can be judged. Evaluation requires the nurse to reassess the patient,
determine whether goals were met, partially met, or unmet, and then revise the care plan if
needed. This step closes the loop of the nursing process and ensures that care remains responsive
rather than routine.
Question 5 [MCQ – Recall]
Which component of a nursing diagnosis identifies the cues, symptoms, or evidence that support
the presence of an actual problem?
A. Related factors
B. Diagnostic label
C. Defining characteristics
D. Expected outcomes
Answer: C. Defining characteristics
Rationale:
Defining characteristics are the assessment findings that substantiate an actual nursing diagnosis.
They are the clinical indicators—such as observed behaviours, reported symptoms, or measurable
changes—that demonstrate the presence of the problem identified by the diagnostic label. In the
structure described in this chapter, the diagnostic label names the human response, related factors
explain contributing causes or circumstances, and defining characteristics show why the nurse
concluded that the diagnosis is present. Their inclusion is essential because care planning must be
evidence-driven and grounded in patient-specific assessment data.
,Question 6 [MCQ – Recall]
According to the framework described in this chapter, NIC refers to:
A. A standardized classification of nursing interventions used to guide and document nursing
actions
B. A taxonomy of medical complications requiring physician-led treatment
C. A format for writing nursing diagnoses in problem-etiology-symptom form
D. A hierarchy of expected outcomes used to classify patient acuity
Answer: A. A standardized classification of nursing interventions used to guide and document
nursing actions
Rationale:
NIC, or Nursing Interventions Classification, provides standardized terminology for nursing
treatments and actions. In the care plan structure used by this textbook, NIC supports the
selection, organization, and documentation of interventions that correspond to the patient’s
identified nursing diagnoses and expected outcomes. By using classified intervention language, the
nurse improves clarity, consistency, and communication across caregivers while maintaining a link
between nursing judgment and nursing action. NIC also reinforces the professional identity of
nursing by distinguishing nurse-initiated interventions within the broader care process.
Question 7 [MCQ – Recall]
Which statement best distinguishes a potential nursing problem from an actual nursing problem?
A. A potential problem has defining characteristics already present, whereas an actual problem
does not
B. A potential problem identifies vulnerability to a problem that has not yet manifested, whereas
an actual problem is supported by current assessment findings
C. A potential problem is always collaborative, whereas an actual problem is always independent
D. A potential problem does not require nursing interventions until symptoms develop
Answer: B. A potential problem identifies vulnerability to a problem that has not yet manifested,
whereas an actual problem is supported by current assessment findings
Rationale:
The distinction between actual and potential nursing problems is central to accurate care planning.
An actual problem is one that currently exists and is supported by defining characteristics identified
during assessment. A potential problem, often expressed as a risk state, describes a vulnerability
based on relevant risk factors even though the problem has not yet occurred. This distinction
affects how the nurse writes the diagnosis, chooses interventions, and evaluates outcomes. For
potential problems, nursing care focuses heavily on prevention, monitoring, and risk reduction
rather than treatment of existing manifestations.
, Question 8 [MCQ – Comprehension]
Why does the textbook emphasize the use of generic care plans as a foundation rather than as a
complete substitute for patient-specific care planning?
A. Generic care plans are intended to eliminate the need for repeated maternal-newborn
assessment
B. Generic care plans provide a structured starting point, but patient findings determine which
diagnoses, outcomes, and interventions are relevant in a specific situation
C. Generic care plans are used only by students and are inappropriate in clinical practice
D. Generic care plans should be followed exactly to ensure standardized care across all maternal-
newborn settings
Answer: B. Generic care plans provide a structured starting point, but patient findings determine
which diagnoses, outcomes, and interventions are relevant in a specific situation
Rationale:
Generic care plans are useful because they organize common patterns of nursing care, but they are
not meant to replace individualized clinical judgment. The textbook presents them as frameworks
that help the nurse anticipate likely needs while still requiring full assessment of the individual
patient. Maternal-newborn nursing care varies according to gestational stage, labour status,
physiologic responses, emotional adaptation, learning needs, and risk factors. Therefore, the nurse
must select, modify, and prioritize elements of the generic plan based on current patient data. This
approach balances efficiency with professional accountability and prevents formulaic care.
Question 9 [MCQ – Comprehension]
In the care plan format described in this chapter, expected outcomes are most valuable because
they:
A. Replace the need for nursing diagnoses when patient problems are obvious
B. Convert broad patient needs into measurable targets that guide intervention selection and later
evaluation
C. Serve primarily as legal protection for the institution
D. Allow the nurse to document interventions without reference to patient response
Answer: B. Convert broad patient needs into measurable targets that guide intervention selection
and later evaluation
Rationale:
Expected outcomes operationalize the goals of nursing care by translating identified problems into
concrete, assessable patient responses. In the framework of this textbook, outcomes are not
decorative statements; they direct what the nurse is trying to accomplish and provide the criteria by
which effectiveness is later judged. Well-written outcomes influence intervention selection because
they clarify whether the focus is symptom reduction, knowledge acquisition, physiologic stability,
Section I: Introduction
Chapter 1: How to Use This Book
Section II: Generic Care Plans
Chapter 2: Nursing Care Plans (Generic)
Chapter 3: Collaborative Care Plans (Generic)
Section III: Antepartum Care
Chapter 4: Normal Pregnancy
Chapter 5: Pregnancy Complicated by Medical and Other Complications
Chapter 6: Gestational Complications
Section IV: Intrapartum Care
Chapter 7: Normal Intrapartum
Chapter 8: Intrapartum Complications
Section V: Postpartum Care
Chapter 9: Normal Postpartum Care
Chapter 10: Postpartum Complications
Section VI: Care of the Newborn
Chapter 11: Normal Newborn Care
Chapter 12: Neonatal Complications
,Chapter 1: How to Use This Book
Question 1 [MCQ – Scenario]
A postpartum nurse is caring for a primiparous mother 12 hours after birth who repeatedly states,
“I know I should breastfeed, but I am afraid I am doing everything wrong.” On assessment, the
mother avoids eye contact during feeding attempts, asks the same questions repeatedly, and is
unable to describe infant hunger cues after prior teaching. The nurse reviews the care plan
template in this textbook to determine the most appropriate next step. Which action best reflects
correct use of the nursing process within the care plan format?
A. Document a collaborative problem related to ineffective breastfeeding and wait for the lactation
consultant to formulate interventions
B. Revise the nursing diagnosis based on current assessment data, identify measurable learning
outcomes, and select NIC interventions focused on teaching and support
C. Retain the original generic teaching plan because all first-time mothers require the same
breastfeeding education sequence
D. Delay care plan revision until the end of the shift so that all postpartum findings can be entered
at one time
Answer: B. Revise the nursing diagnosis based on current assessment data, identify measurable
learning outcomes, and select NIC interventions focused on teaching and support
Rationale:
The care plan structure in this textbook is grounded in the nursing process and requires that
assessment findings drive all subsequent planning. In this situation, the mother’s repeated
questioning, uncertainty, and inability to identify feeding cues indicate the need to individualize the
nursing diagnosis and care plan rather than relying on a static generic teaching approach. After
assessment, the nurse must formulate or refine the diagnosis, define expected outcomes that are
specific and evaluable, and choose appropriate NIC interventions such as teaching, emotional
support, and breastfeeding assistance. This sequence demonstrates the core logic of the care plan
format: assessment informs diagnosis, diagnosis guides planning, planning directs implementation,
and outcomes are later evaluated against the mother’s actual progress.
Question 2 [MCQ – Scenario]
A pregnant patient at 30 weeks’ gestation is admitted with vaginal bleeding and uterine irritability.
The nurse notes maternal tachycardia, increasing anxiety, and a non-reassuring fetal heart rate
pattern. While initiating maternal assessment and documentation, the nurse also activates the unit
protocol and notifies the obstetric provider. In relation to the framework used in this textbook,
which statement best explains the care planning approach required in this situation?
,A. The nurse should use only a nursing care plan because collaborative care plans are reserved for
neonatal conditions
B. The presence of possible haemorrhage requires a collaborative care plan alongside nursing
diagnoses because physiologic instability may require interdisciplinary management
C. Collaborative care plans replace nursing diagnoses whenever a physician has already written
treatment orders
D. The nurse should postpone all care planning until the definitive medical diagnosis is confirmed
Answer: B. The presence of possible haemorrhage requires a collaborative care plan alongside
nursing diagnoses because physiologic instability may require interdisciplinary management
Rationale:
This textbook distinguishes nursing care plans from collaborative care plans while emphasizing that
they often coexist in complex maternal-newborn situations. When a patient presents with signs
suggesting a physiologic complication such as haemorrhage, the nurse must address both nurse-
managed human responses and potential complications requiring interdisciplinary surveillance and
intervention. A collaborative care plan is appropriate because the patient’s instability may require
rapid coordination with obstetric, laboratory, anaesthesia, and neonatal teams. At the same time,
the nurse continues independent nursing functions such as assessment, monitoring, support,
communication, and implementation of prescribed interventions. The overlap between the two
care planning approaches reflects the realities of maternal-newborn practice, where nursing
judgment and collaborative management are frequently inseparable.
Question 3 [MCQ – Scenario]
A student nurse writes the following care plan statement for a woman in early pregnancy:
“Knowledge deficit related to pregnancy as evidenced by first pregnancy.” The supervising nurse
reviews Chapter 1 and asks the student to correct the statement using proper nursing diagnosis
structure. Which revision best reflects the textbook’s explanation of nursing diagnoses?
A. Deficient knowledge related to unfamiliarity with prenatal self-care as evidenced by repeated
questions about nutrition, warning signs, and medication safety
B. Pregnancy-related learning problem secondary to nulliparity as evidenced by needing education
C. Risk for deficient knowledge related to first pregnancy as evidenced by lack of experience
D. Anxiety related to inadequate teaching as evidenced by being pregnant for the first time
Answer: A. Deficient knowledge related to unfamiliarity with prenatal self-care as evidenced by
repeated questions about nutrition, warning signs, and medication safety
Rationale:
A properly structured nursing diagnosis in the NANDA-style format includes the diagnostic label,
related factors, and defining characteristics when the problem is actual rather than potential. The
corrected statement identifies a recognized problem, links it to a cause that nursing care can
address, and supports it with observable assessment findings. Simply being a first-time mother is
not, by itself, a defining characteristic; it is neither adequate evidence nor a sufficient diagnostic
formulation. The chapter emphasizes that the nurse must avoid vague or circular wording and
,instead construct diagnoses from actual patient data. This precision strengthens the clinical
usefulness of the care plan by making interventions and outcomes more targeted and measurable.
Question 4 [MCQ – Recall]
Within the nursing process framework used throughout this textbook, which step involves
determining whether the patient’s expected outcomes have been achieved?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
Answer: D. Evaluation
Rationale:
Evaluation is the phase of the nursing process in which the nurse compares the patient’s actual
responses and progress with the outcomes identified during planning. In this textbook, expected
outcomes are not simply listed; they are intended to become measurable standards against which
nursing effectiveness can be judged. Evaluation requires the nurse to reassess the patient,
determine whether goals were met, partially met, or unmet, and then revise the care plan if
needed. This step closes the loop of the nursing process and ensures that care remains responsive
rather than routine.
Question 5 [MCQ – Recall]
Which component of a nursing diagnosis identifies the cues, symptoms, or evidence that support
the presence of an actual problem?
A. Related factors
B. Diagnostic label
C. Defining characteristics
D. Expected outcomes
Answer: C. Defining characteristics
Rationale:
Defining characteristics are the assessment findings that substantiate an actual nursing diagnosis.
They are the clinical indicators—such as observed behaviours, reported symptoms, or measurable
changes—that demonstrate the presence of the problem identified by the diagnostic label. In the
structure described in this chapter, the diagnostic label names the human response, related factors
explain contributing causes or circumstances, and defining characteristics show why the nurse
concluded that the diagnosis is present. Their inclusion is essential because care planning must be
evidence-driven and grounded in patient-specific assessment data.
,Question 6 [MCQ – Recall]
According to the framework described in this chapter, NIC refers to:
A. A standardized classification of nursing interventions used to guide and document nursing
actions
B. A taxonomy of medical complications requiring physician-led treatment
C. A format for writing nursing diagnoses in problem-etiology-symptom form
D. A hierarchy of expected outcomes used to classify patient acuity
Answer: A. A standardized classification of nursing interventions used to guide and document
nursing actions
Rationale:
NIC, or Nursing Interventions Classification, provides standardized terminology for nursing
treatments and actions. In the care plan structure used by this textbook, NIC supports the
selection, organization, and documentation of interventions that correspond to the patient’s
identified nursing diagnoses and expected outcomes. By using classified intervention language, the
nurse improves clarity, consistency, and communication across caregivers while maintaining a link
between nursing judgment and nursing action. NIC also reinforces the professional identity of
nursing by distinguishing nurse-initiated interventions within the broader care process.
Question 7 [MCQ – Recall]
Which statement best distinguishes a potential nursing problem from an actual nursing problem?
A. A potential problem has defining characteristics already present, whereas an actual problem
does not
B. A potential problem identifies vulnerability to a problem that has not yet manifested, whereas
an actual problem is supported by current assessment findings
C. A potential problem is always collaborative, whereas an actual problem is always independent
D. A potential problem does not require nursing interventions until symptoms develop
Answer: B. A potential problem identifies vulnerability to a problem that has not yet manifested,
whereas an actual problem is supported by current assessment findings
Rationale:
The distinction between actual and potential nursing problems is central to accurate care planning.
An actual problem is one that currently exists and is supported by defining characteristics identified
during assessment. A potential problem, often expressed as a risk state, describes a vulnerability
based on relevant risk factors even though the problem has not yet occurred. This distinction
affects how the nurse writes the diagnosis, chooses interventions, and evaluates outcomes. For
potential problems, nursing care focuses heavily on prevention, monitoring, and risk reduction
rather than treatment of existing manifestations.
, Question 8 [MCQ – Comprehension]
Why does the textbook emphasize the use of generic care plans as a foundation rather than as a
complete substitute for patient-specific care planning?
A. Generic care plans are intended to eliminate the need for repeated maternal-newborn
assessment
B. Generic care plans provide a structured starting point, but patient findings determine which
diagnoses, outcomes, and interventions are relevant in a specific situation
C. Generic care plans are used only by students and are inappropriate in clinical practice
D. Generic care plans should be followed exactly to ensure standardized care across all maternal-
newborn settings
Answer: B. Generic care plans provide a structured starting point, but patient findings determine
which diagnoses, outcomes, and interventions are relevant in a specific situation
Rationale:
Generic care plans are useful because they organize common patterns of nursing care, but they are
not meant to replace individualized clinical judgment. The textbook presents them as frameworks
that help the nurse anticipate likely needs while still requiring full assessment of the individual
patient. Maternal-newborn nursing care varies according to gestational stage, labour status,
physiologic responses, emotional adaptation, learning needs, and risk factors. Therefore, the nurse
must select, modify, and prioritize elements of the generic plan based on current patient data. This
approach balances efficiency with professional accountability and prevents formulaic care.
Question 9 [MCQ – Comprehension]
In the care plan format described in this chapter, expected outcomes are most valuable because
they:
A. Replace the need for nursing diagnoses when patient problems are obvious
B. Convert broad patient needs into measurable targets that guide intervention selection and later
evaluation
C. Serve primarily as legal protection for the institution
D. Allow the nurse to document interventions without reference to patient response
Answer: B. Convert broad patient needs into measurable targets that guide intervention selection
and later evaluation
Rationale:
Expected outcomes operationalize the goals of nursing care by translating identified problems into
concrete, assessable patient responses. In the framework of this textbook, outcomes are not
decorative statements; they direct what the nurse is trying to accomplish and provide the criteria by
which effectiveness is later judged. Well-written outcomes influence intervention selection because
they clarify whether the focus is symptom reduction, knowledge acquisition, physiologic stability,
