,Chapter 01: 21st Century Maternity and Women’s Health Nursing
v v v v v v v v
Lowdermilk: Maternity & Women’s Health Care, 12th Edition
v v v v v v v v
MULTIPLE vCHOICE
1. In vevaluating vthe vlevel vof va vpregnant vwoman’s vrisk vof vhaving va vlow-birth-weight
v(LBW) vinfant, vwhich vfactor vis vthe vmost vimportant vfor vthe vnurse vto vconsider?
a. African-American vrace
b. Cigarette vsmoking
c. Poor vnutritional vstatus
d. Limited vmaternal veducation
ANS: v A
The vrise vin vthe voverall vLBW vrates vwere vdue vto vincreases vin vLBW vbirths vto vnon-Hispanic
vblack vwomen v(13.35%) vand vHispanic vwomen v(7.21%); vnon-Hispanic vblack vinfants vare
valmost vtwice vas vlikely vas vnon-Hispanic vwhite vinfants vto vbe vof v LBW vand vto vdie vin vthe vfirst
vyear vof vlife.. vRace vis va vnonmodifiable vrisk vfactor. vCigarette vsmoking vis van vimportant vfactor
vin vpotential vinfant vmortality vrates, vbut vit vis vnot vthe vmost vimportant. vAdditionally, vsmoking
vis va vmodifiable vrisk vfactor. vPoor vnutrition vis van vimportant vfactor vin vpotential vinfant
vmortality vrates, vbut vit vis vnot vthe vmost vimportant. vAdditionally, vnutritional vstatus vis va
vmodifiable vrisk vfactor. vMaternal veducation vis van vimportant vfactor vin vpotential vinfant
vmortality vrates, vbut vit vis vnot vthe vmost vimportant. vAdditionally, vmaternal veducation vis va
vmodifiable vrisk vfactor.
PTS: 1 DIF: Cognitive vLevel: vUnderstand
vTOP: Nursing vProcess: vAssessment
MSC: v v Client v Needs: v HealtN
hUPrRoS
mI ioG
otN nTanBd.MCaO
inM
tenance, v Antepartum v Care
2. A v23-year-old vAfrican-American vwoman vis vpregnant vwith vher vfirst vchild. vBased von
vcurrent vstatistics vfor vinfant vmortality, vwhich vintervention vis vmost vimportant vfor vthe vnurse
vto vinclude vin vthe vclient’s vplan vof vcare?
a. Perform va vnutrition vassessment.
b. Refer vthe vwoman vto va vsocial vworker.
c. Advise vthe vwoman vto vsee van vobstetrician, vnot va vmidwife.
d. Explain vto vthe vwoman vthe vimportance vof vkeeping vher vprenatal vcare vappointments.
ANS: v D
Consistent vprenatal vcare vis vthe vbest vmethod vof vpreventing vor vcontrolling vrisk vfactors
vassociated vwith vinfant vmortality. vNutritional vstatus vis van vimportant vmodifiable vrisk vfactor,
vbut vit vis vnot vthe vmost vimportant vaction va vnurse vshould vtake vin vthis vsituation. vThe vclient
vmay vneed vassistance vfrom va vsocial vworker vat vsome vtime vduring vher vpregnancy, vbut va
vreferral vto va vsocial vworker vis vnot vthe vmost vimportant vaspect vthe vnurse vshould vaddress vat
vthis vtime. vIf vthe vwoman vhas videntifiable vhigh-risk vproblems, vthen vher vhealth vcare vmay
vneed vto vbe vprovided vby va vphysician. vHowever, vit vcannot vbe vassumed vthat vall vAfrican-
American vwomen vhave vhigh-risk vissues. vIn vaddition, vadvising vthe vwoman vto vsee van
vobstetrician vis vnot vthe vmost vimportant vaspect von vwhich vthe vnurse vshould vfocus vat vthis
vtime, vand vit vis vnot vappropriate vfor va vnurse vto vadvise vor vmanage vthe vtype vof vcare va vclient vis
vto vreceive.
PTS: 1 DIF: Cognitive vLevel: vUnderstand
vTOP: Nursing vProcess: vPlanning
, MSC: v Client vNeeds: vHealth vPromotion vand vMaintenance
3. The vnurses vworking vat va vnewly vestablished vbirthing vcenter vhave vbegun vto vcompare
vtheir vperformance vin vproviding vmaternal-newborn vcare vagainst vclinical vstandards.
vThis vcomparison vprocess vis vmost vcommonly vknown vas vwhat?
a. Best vpractices vnetwork
b. Clinical vbenchmarking
c. Outcomes-oriented vpracNtiU ceR S
d. Evidence-based vpractice
ANS: v C
Outcomes-oriented vpractice vmeasures vthe veffectiveness vof vthe vinterventions vand vquality vof
vcare vagainst vbenchmarks vor vstandards. vThe vterm vbest vpractice vrefers vto va vprogram vor
vservice vthat vhas vbeen vrecognized vfor vits vexcellence. vClinical vbenchmarking vis va vprocess
vused vto vcompare vone’s vown vperformance vagainst vthe vperformance vof vthe vbest vin van varea
vof vservice. vThe vterm vevidence-based vpractice vrefers vto vthe vprovision vof vcare vbased von
vevidence vgained vthrough vresearch vand vclinical vtrials.
PTS: 1 DIF: Cognitive vLevel:vUnderstand
vTOP: Nursing vProcess: vEvaluation
MSC: v Client vNeeds: vSafe vand vEffective vCare vEnvironment
4. During va vprenatal vintake vinterview, vthe vnurse vis vin vthe vprocess vof vobtaining van
vinitial vassessment vof va v21-year-old vHispanic vclient vwith vlimited vEnglish
vproficiency. vWhich vintervention vis vthe vmost vimportant vfor vthe vnurse vto
vimplement?
a. Use vmaternity vjargon vto venable vthe vclient vto vbecome vfamiliar vwith vthese vterms.
b. Speak vquickly vand vefficiently vto vexpedite vthe vvisit.
c. Provide vthe vclient vwith vhandouts.
d. Assess vwhether vthe vclient vunderstands vthe vdiscussion.
ANS: v D
Nurses vcontribute vto vhealth vliteracy vby vusing vsimple, vcommon vwords, vavoiding vjargon,
vand vevaluating vwhether vthe vclient vunderstands vthe vdiscussion. vSpeaking vslowly vand
vclearly vand vfocusing von vwhat vis vimportant vwill vincrease vunderstanding. vMost vclient
veducation vmaterials vare vwritten vat va vlevel vtoo vhigh vfor vthe vaverage vadult vand vmay vnot vbe
vuseful vfor va vclient vwith vlimited vEnglish vproficiency.
PTS: 1 DIF: Cognitive vLevel:vApply
vTOP: Nursing vProcess: vImplementation
MSC: v Client vNeeds: vHealth vPromotion vand vMaintenance
5. Which vstatement vbest vexemplifies vcontemporary vmaternity vnursing?
a. Use vof vmidwives vfor vall vvaginal vdeliveries
b. Family-centered vcare
c. Free-standing vbirth vclinics
d. Physician-driven vcare
v ANS: v B
, Contemporary vmaternity vnursing vfocuses von vthe vfamily’s vneeds vand vdesires. vFathers,
vpartners, vgrandparents, vand vsiblings vmay vbe vpresent vfor vthe vbirth vand vparticipate vin
vactivities vsuch vas vcutting vthe vbaby’s vumbilical vcord. vBoth vmidwives vand vphysicians
vperform vvaginal vdeliveries. vFree-standing vclinics vare van vexample vof valternative vbirth
voptions. vContemporary vmaternity vnursing vis vdriven vby vthe vrelationship vbetween vnurses
vand vtheir vclients.
PTS: 1 DIF: Cognitive vLevel: vUnderstand
vTOP: Nursing vProcess: vPlanning
MSC: v Client vNeeds: vHealth vPromotion vand vMaintenance
6. A v38-year-old vHispanic vwoman vvaginally vdelivered va v9-pound, v6-ounce vbaby vgirl vafter
vbeing vin vlabor vfor v43 vhours. vThe vbaby vdied v3 vdays vlater vfrom vsepsis. vOn vwhat vgrounds
vcould vthe vwoman vhave va vlegitimate vlegal vcase vfor vnegligence?
a. Inexperienced vmaternity vnurse vwas vassigned vto vcare vfor vthe vclient.
b. Client vwas vpast vher vdue vdate vby v3 vdays.
c. Standard vof vcare vwas vnot vmet.
d. Client vrefused velectronic vfetal vmonitoring.
ANS: v C
Not vmeeting vthe vstandard vof vcare vis va vlegitimate vfactor vfor va vcase vof vnegligence. vAn
vinexperienced vmaternity vnurse vwould vneed vto vdisplay vcompetency vbefore vbeing vassigned vto
vcare vfor vclients von vhis vor vher vown. vThis vclient vmay vhave vbeen vpast vher vdue vdate; vhowever,
va vterm vpregnancy voften vgoes vbeyond v40 vweeks vof vgestation. vAlthough vfetal vmonitoring vis
vthe vstandard vof vcare, vthe vclient vhas vthe vright vto vrefuse vtreatment. vThis vrefusal vis vnot va vcase
vfor vnegligence, vbut vinformed vconsent vshould vbe vproperly vobtained, vand vthe vclient vshould
vhave vsigned van vagainst v medical vadvice vform vwhen vrefusing vany vtreatment vthat vis vwithin
vthe vstandard vof vcare.
PTS: 1 DIF: Cognitive vLevel:vAnalyze
vTOP: Nursing vProcess: vImplementation
MSC: v Client vNeeds: vSafe vand vEffective vCare vEnvironment
7. When vthe vnurse vis vunsure vhow vto vperform va vclient vcare vprocedure vthat vis vhigh vrisk vand
vlow vvolume, vhis vor vher vbest vaction vin vthis vsituation vwould vbe vwhat?
a. Ask vanother vnurse.
b. Discuss vthe vprocedure vwith vthe vclient’s vphysician.
c. Look vup vthe vprocedure vin va vnursing vtextbook.
d. First vconsult vthe vagency vprocedure vmanual
ANS: v D
Following vthe vagency’s vpolicies vand vprocedures vmanual vis valways vbest vwhen vseeking
vinformation von vcorrect vclient vprocedures. vThese vpolicies vshould vreflect vthe vcurrent
vstandards vof vcare vand vthe vindividual vstate’s vguidelines. vEach vnurse vis vresponsible vfor vhis
vor vher vown vpractice. vRelying von vanother vnurse vmay vnot valways vbe va vsafe vpractice. vEach
vnurse vis vobligated vto vfollow vthe vstandards vof vcare vfor vsafe vclient vcare vdelivery. vPhysicians
vare vresponsible vfor vtheir vown vclient vcare vactivity. vNurses vmay vfollow vsafe vorders vfrom
vphysicians, vbut vthey vare valso vresponsible vfor vthe vactivities vthat vthey, vas vnurses, vare vto
vcarry vout. vInformation vprovided vin va vnursing vtextbook vis vbasic vinformation vfor vgeneral
vknowledge. vFurthermore, vthe vinformation vin va vtextbook vmay vnot vreflect vthe vcurrent
vstandard vof vcare vor vthe vindividual vstate vor vhospital vpolicies.
v v v v v v v v
Lowdermilk: Maternity & Women’s Health Care, 12th Edition
v v v v v v v v
MULTIPLE vCHOICE
1. In vevaluating vthe vlevel vof va vpregnant vwoman’s vrisk vof vhaving va vlow-birth-weight
v(LBW) vinfant, vwhich vfactor vis vthe vmost vimportant vfor vthe vnurse vto vconsider?
a. African-American vrace
b. Cigarette vsmoking
c. Poor vnutritional vstatus
d. Limited vmaternal veducation
ANS: v A
The vrise vin vthe voverall vLBW vrates vwere vdue vto vincreases vin vLBW vbirths vto vnon-Hispanic
vblack vwomen v(13.35%) vand vHispanic vwomen v(7.21%); vnon-Hispanic vblack vinfants vare
valmost vtwice vas vlikely vas vnon-Hispanic vwhite vinfants vto vbe vof v LBW vand vto vdie vin vthe vfirst
vyear vof vlife.. vRace vis va vnonmodifiable vrisk vfactor. vCigarette vsmoking vis van vimportant vfactor
vin vpotential vinfant vmortality vrates, vbut vit vis vnot vthe vmost vimportant. vAdditionally, vsmoking
vis va vmodifiable vrisk vfactor. vPoor vnutrition vis van vimportant vfactor vin vpotential vinfant
vmortality vrates, vbut vit vis vnot vthe vmost vimportant. vAdditionally, vnutritional vstatus vis va
vmodifiable vrisk vfactor. vMaternal veducation vis van vimportant vfactor vin vpotential vinfant
vmortality vrates, vbut vit vis vnot vthe vmost vimportant. vAdditionally, vmaternal veducation vis va
vmodifiable vrisk vfactor.
PTS: 1 DIF: Cognitive vLevel: vUnderstand
vTOP: Nursing vProcess: vAssessment
MSC: v v Client v Needs: v HealtN
hUPrRoS
mI ioG
otN nTanBd.MCaO
inM
tenance, v Antepartum v Care
2. A v23-year-old vAfrican-American vwoman vis vpregnant vwith vher vfirst vchild. vBased von
vcurrent vstatistics vfor vinfant vmortality, vwhich vintervention vis vmost vimportant vfor vthe vnurse
vto vinclude vin vthe vclient’s vplan vof vcare?
a. Perform va vnutrition vassessment.
b. Refer vthe vwoman vto va vsocial vworker.
c. Advise vthe vwoman vto vsee van vobstetrician, vnot va vmidwife.
d. Explain vto vthe vwoman vthe vimportance vof vkeeping vher vprenatal vcare vappointments.
ANS: v D
Consistent vprenatal vcare vis vthe vbest vmethod vof vpreventing vor vcontrolling vrisk vfactors
vassociated vwith vinfant vmortality. vNutritional vstatus vis van vimportant vmodifiable vrisk vfactor,
vbut vit vis vnot vthe vmost vimportant vaction va vnurse vshould vtake vin vthis vsituation. vThe vclient
vmay vneed vassistance vfrom va vsocial vworker vat vsome vtime vduring vher vpregnancy, vbut va
vreferral vto va vsocial vworker vis vnot vthe vmost vimportant vaspect vthe vnurse vshould vaddress vat
vthis vtime. vIf vthe vwoman vhas videntifiable vhigh-risk vproblems, vthen vher vhealth vcare vmay
vneed vto vbe vprovided vby va vphysician. vHowever, vit vcannot vbe vassumed vthat vall vAfrican-
American vwomen vhave vhigh-risk vissues. vIn vaddition, vadvising vthe vwoman vto vsee van
vobstetrician vis vnot vthe vmost vimportant vaspect von vwhich vthe vnurse vshould vfocus vat vthis
vtime, vand vit vis vnot vappropriate vfor va vnurse vto vadvise vor vmanage vthe vtype vof vcare va vclient vis
vto vreceive.
PTS: 1 DIF: Cognitive vLevel: vUnderstand
vTOP: Nursing vProcess: vPlanning
, MSC: v Client vNeeds: vHealth vPromotion vand vMaintenance
3. The vnurses vworking vat va vnewly vestablished vbirthing vcenter vhave vbegun vto vcompare
vtheir vperformance vin vproviding vmaternal-newborn vcare vagainst vclinical vstandards.
vThis vcomparison vprocess vis vmost vcommonly vknown vas vwhat?
a. Best vpractices vnetwork
b. Clinical vbenchmarking
c. Outcomes-oriented vpracNtiU ceR S
d. Evidence-based vpractice
ANS: v C
Outcomes-oriented vpractice vmeasures vthe veffectiveness vof vthe vinterventions vand vquality vof
vcare vagainst vbenchmarks vor vstandards. vThe vterm vbest vpractice vrefers vto va vprogram vor
vservice vthat vhas vbeen vrecognized vfor vits vexcellence. vClinical vbenchmarking vis va vprocess
vused vto vcompare vone’s vown vperformance vagainst vthe vperformance vof vthe vbest vin van varea
vof vservice. vThe vterm vevidence-based vpractice vrefers vto vthe vprovision vof vcare vbased von
vevidence vgained vthrough vresearch vand vclinical vtrials.
PTS: 1 DIF: Cognitive vLevel:vUnderstand
vTOP: Nursing vProcess: vEvaluation
MSC: v Client vNeeds: vSafe vand vEffective vCare vEnvironment
4. During va vprenatal vintake vinterview, vthe vnurse vis vin vthe vprocess vof vobtaining van
vinitial vassessment vof va v21-year-old vHispanic vclient vwith vlimited vEnglish
vproficiency. vWhich vintervention vis vthe vmost vimportant vfor vthe vnurse vto
vimplement?
a. Use vmaternity vjargon vto venable vthe vclient vto vbecome vfamiliar vwith vthese vterms.
b. Speak vquickly vand vefficiently vto vexpedite vthe vvisit.
c. Provide vthe vclient vwith vhandouts.
d. Assess vwhether vthe vclient vunderstands vthe vdiscussion.
ANS: v D
Nurses vcontribute vto vhealth vliteracy vby vusing vsimple, vcommon vwords, vavoiding vjargon,
vand vevaluating vwhether vthe vclient vunderstands vthe vdiscussion. vSpeaking vslowly vand
vclearly vand vfocusing von vwhat vis vimportant vwill vincrease vunderstanding. vMost vclient
veducation vmaterials vare vwritten vat va vlevel vtoo vhigh vfor vthe vaverage vadult vand vmay vnot vbe
vuseful vfor va vclient vwith vlimited vEnglish vproficiency.
PTS: 1 DIF: Cognitive vLevel:vApply
vTOP: Nursing vProcess: vImplementation
MSC: v Client vNeeds: vHealth vPromotion vand vMaintenance
5. Which vstatement vbest vexemplifies vcontemporary vmaternity vnursing?
a. Use vof vmidwives vfor vall vvaginal vdeliveries
b. Family-centered vcare
c. Free-standing vbirth vclinics
d. Physician-driven vcare
v ANS: v B
, Contemporary vmaternity vnursing vfocuses von vthe vfamily’s vneeds vand vdesires. vFathers,
vpartners, vgrandparents, vand vsiblings vmay vbe vpresent vfor vthe vbirth vand vparticipate vin
vactivities vsuch vas vcutting vthe vbaby’s vumbilical vcord. vBoth vmidwives vand vphysicians
vperform vvaginal vdeliveries. vFree-standing vclinics vare van vexample vof valternative vbirth
voptions. vContemporary vmaternity vnursing vis vdriven vby vthe vrelationship vbetween vnurses
vand vtheir vclients.
PTS: 1 DIF: Cognitive vLevel: vUnderstand
vTOP: Nursing vProcess: vPlanning
MSC: v Client vNeeds: vHealth vPromotion vand vMaintenance
6. A v38-year-old vHispanic vwoman vvaginally vdelivered va v9-pound, v6-ounce vbaby vgirl vafter
vbeing vin vlabor vfor v43 vhours. vThe vbaby vdied v3 vdays vlater vfrom vsepsis. vOn vwhat vgrounds
vcould vthe vwoman vhave va vlegitimate vlegal vcase vfor vnegligence?
a. Inexperienced vmaternity vnurse vwas vassigned vto vcare vfor vthe vclient.
b. Client vwas vpast vher vdue vdate vby v3 vdays.
c. Standard vof vcare vwas vnot vmet.
d. Client vrefused velectronic vfetal vmonitoring.
ANS: v C
Not vmeeting vthe vstandard vof vcare vis va vlegitimate vfactor vfor va vcase vof vnegligence. vAn
vinexperienced vmaternity vnurse vwould vneed vto vdisplay vcompetency vbefore vbeing vassigned vto
vcare vfor vclients von vhis vor vher vown. vThis vclient vmay vhave vbeen vpast vher vdue vdate; vhowever,
va vterm vpregnancy voften vgoes vbeyond v40 vweeks vof vgestation. vAlthough vfetal vmonitoring vis
vthe vstandard vof vcare, vthe vclient vhas vthe vright vto vrefuse vtreatment. vThis vrefusal vis vnot va vcase
vfor vnegligence, vbut vinformed vconsent vshould vbe vproperly vobtained, vand vthe vclient vshould
vhave vsigned van vagainst v medical vadvice vform vwhen vrefusing vany vtreatment vthat vis vwithin
vthe vstandard vof vcare.
PTS: 1 DIF: Cognitive vLevel:vAnalyze
vTOP: Nursing vProcess: vImplementation
MSC: v Client vNeeds: vSafe vand vEffective vCare vEnvironment
7. When vthe vnurse vis vunsure vhow vto vperform va vclient vcare vprocedure vthat vis vhigh vrisk vand
vlow vvolume, vhis vor vher vbest vaction vin vthis vsituation vwould vbe vwhat?
a. Ask vanother vnurse.
b. Discuss vthe vprocedure vwith vthe vclient’s vphysician.
c. Look vup vthe vprocedure vin va vnursing vtextbook.
d. First vconsult vthe vagency vprocedure vmanual
ANS: v D
Following vthe vagency’s vpolicies vand vprocedures vmanual vis valways vbest vwhen vseeking
vinformation von vcorrect vclient vprocedures. vThese vpolicies vshould vreflect vthe vcurrent
vstandards vof vcare vand vthe vindividual vstate’s vguidelines. vEach vnurse vis vresponsible vfor vhis
vor vher vown vpractice. vRelying von vanother vnurse vmay vnot valways vbe va vsafe vpractice. vEach
vnurse vis vobligated vto vfollow vthe vstandards vof vcare vfor vsafe vclient vcare vdelivery. vPhysicians
vare vresponsible vfor vtheir vown vclient vcare vactivity. vNurses vmay vfollow vsafe vorders vfrom
vphysicians, vbut vthey vare valso vresponsible vfor vthe vactivities vthat vthey, vas vnurses, vare vto
vcarry vout. vInformation vprovided vin va vnursing vtextbook vis vbasic vinformation vfor vgeneral
vknowledge. vFurthermore, vthe vinformation vin va vtextbook vmay vnot vreflect vthe vcurrent
vstandard vof vcare vor vthe vindividual vstate vor vhospital vpolicies.
