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Test Bank: Maternal-Newborn
Nursing: The Critical Components
of Nursing Care, 3rd Edition,
Roberta Durham, Linda Chapman
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TABLE OF CONTENTS
Maternity Nursing Overview
1. Trends and Issues
2. Ethics and Standards of Practice Issues
The Antepartal Period
3. Genetics, Conception, Fetal Development, and Reproductive
Technology
4. Physiological Aspects of Antepartum Care
5. The Psycho-Social-Cultural Aspects of the Antepartum Period
6. Antepartal Tests
7. High-Risk Antepartum Nursing Care
Intrapartal Period
8. Intrapartum Assessment and Interventions
9. Fetal Heart Rate Assessment
10. High-Risk Labor and Birth
11. Intrapartum and Postpartum Care of the Cesarean Birth Families
Postpartal Period
12. Postpartum Physiological Assessments and Nursing Care
13. Transition to Parenthood
14. High-Risk Postpartum Nursing Care
Neonatal Period
15. Physiological and Behavioral Responses of the Neonate
16. Discharge Planning and Teaching
17. High-Risk Neonatal Nursing Care
Women’s Health
18. Well Women’s Health
19. Alterations in Women’s Health
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Chapter 1: Trends and Issues
MULTIPLE CHOICE
1. The nurse is caring for a patient who is in labor with her first child. The patient’s mother is
present for support and notes that things have changed in the delivery room since she last
gave birth in the early 1980s. Which current trend or intervention may the patient’s mother
find most different?
1. Fetal monitoring throughout labor
2. Postpartum stay of 10 days
3. Expectant partner and family in operating room for cesarean birth
4. Hospital support for breastfeeding
ANS: 4
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 1. Discuss current trends in the management of labor and birth
Page: 4
Heading: Table 1-1: Past and Present Trends
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Evidence-Based Practice
Difficulty: Moderate
Feedback
1 This is incorrect. Fetal monitoring during labor began in the late 1970s. As such,
this likely would have occurred during the mother’s labor and delivery during
the 1980s.
2 This is incorrect. In the past, the average hospital postpartum stay was 10 days.
Presently, the average postpartum stay is 48 hours or less.
3 This is incorrect. In the past, expectant partners and families were excluded from
the labor and birth experience. Present trends involve the expectant partner and
family in the labor and birth experience, including presence in the operating
room for cesarean births.
4 This is correct. Hospital support for breastfeeding, including a lactation
consultant and employment of the Baby-Friendly Hospital Initiative, were both
enacted during the early 1990s.
PTS: 1 CON: Evidence-Based Practice
2. A patient with a history of hypertension is giving birth. During delivery, the staff was not
able to stabilize the patient’s blood pressure. As a result, the patient died shortly after
delivery. This is an example of what type of death?
1. Early maternal death
2. Late maternal death
3. Direct obstetric death
4. Indirect obstetric death
ANS: 4
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Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Discuss current trends in maternal and infant health
outcomes.
Page: 7
Heading: Trends > Maternal Death and Mortality Rates
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Hard
Feedback
1 This is incorrect. Early maternal death is not an example of maternal death.
Examples of maternal death include late maternal death, indirect obstetric death,
direct obstetric death, and pregnancy-related death.
2 This is incorrect. Late maternal death occurs 42 days after termination of
pregnancy from a direct or indirect obstetric cause.
3 This is incorrect. Direct obstetric death results from complications during
pregnancy, labor, birth, and/or postpartum period.
4 This is correct. Indirect obstetric death is caused by a preexisting disease, or a
disease that develops during pregnancy.
PTS: 1 CON: Ante/Intra/Post-partum
3. The nurse is providing education to a patient who has given birth to her first child and is
being discharged home. The patient expressed concern regarding infant mortality and
sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor,
and vaginal delivery. She has a body mass index of 25 and has no other health conditions.
The infant is healthy and was delivered full-term. What will be most helpful thing to explain
to the patient?
1. Uses of extracorporeal membrane oxygenation therapy (ECMO)
2. Uses of exogenous pulmonary surfactant
3. The Baby-Friendly Hospital Initiative
4. The Safe to Sleep campaign
ANS: 4
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of infant death.
Page: 7
Heading: Trends > Infant Mortality Rates
Integrated Processes: Nursing process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate
Feedback
1 This is incorrect. EMCO has been cited as one of the factors that has reduced
infant mortality among preterm infants.
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2 This is incorrect. Although advances in medical treatments have decreased infant
mortality, exogenous pulmonary surfactant is primarily used to reduce mortality of
preterm infants.
3 This is incorrect. The Baby-Friendly Hospital Initiative was developed to support
breastfeeding and is not directly linked to reduced infant mortality or SIDS.
4 This is correct. The Back to Sleep campaign and the Safe to Sleep campaigns were
designed to promote healthy infant sleeping habits. The decrease in SIDS from
1995 to 2015 was attributed to the Safe to Sleep campaign.
PTS: 1 CON: Health Promotion
4. The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining
of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at
increased risk of which condition?
1. Diabetes
2. Blindness
3. Pneumonia
4. Hypertension
ANS: 4
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 4. Discuss current maternal and infant health issues.
Page: 10
Heading: Issues > Teen Pregnancy > Implications of Teen Pregnancy and Birth
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Moderate
Feedback
1 This is incorrect. Maternal obesity increases a child’s risk of developing
childhood obesity and diabetes.
2 This is correct. Neonatal blindness, maternal death, and neonatal death are all
associated with a patient who contracts syphilis during pregnancy.
3 This is incorrect. Chlamydial pneumonia is associated with maternal chlamydia.
4 This is incorrect. Teen mothers may have a higher risk of contracting sexually
transmitted illnesses and hypertension during pregnancy; however, maternal
syphilis is not associated with fetal hypertension.
PTS: 1 CON: Ante/Intra/Post-partum
5. The nurse is caring for a 15-year-old female who is pregnant with her first child. In her
previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and
HIV. Based on the information provided, which condition is the patient’s baby at higher risk
for?
1. Intestinal problems
2. Neonatal conjunctivitis
3. Blindness
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4. Pneumonia
ANS: 1
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 4. Discuss current maternal and infant health issues.
Page: 11
Heading: Issues > Teen Pregnancy
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Difficult
Feedback
1 This is correct. Infants born to teen mothers are at increased risk for various
conditions related to prematurity, including infant death, intestinal problems,
and/or respiratory distress syndrome.
2 This is incorrect. Infants born to teen mothers who have gonorrhea are at
increased risk of neonatal conjunctivitis and blindness.
3 This is incorrect. Infants born to teen mothers with syphilis and gonorrhea are at
increased risk of blindness.
4 This is incorrect. Infants born to teen mothers with chlamydia may be at
increased risk of developing chlamydial pneumonia.
PTS: 1 CON: Health Promotion
6. The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test.
The test confirms the patient is pregnant. The patient states, “I do not need to stop smoking
my electronic cigarette because it will not harm my baby.” Which is the best response by the
nurse?
1. “You are correct. Electronic cigarettes are not harmful during pregnancy.”
2. “Tobacco products, including electronic cigarettes, should not be used during
pregnancy due to risking nicotine toxicity.”
3. “According to the FDA, although electronic cigarettes are safe for you, they can
cause harm to the fetus during pregnancy.”
4. “Electronic cigarettes are considered harmful only in the first trimester.”
ANS: 2
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 4. Discuss current maternal and infant health issues.
Page: 12
Heading: Issues > Tobacco and Electronic Cigarette Use During Pregnancy
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Moderate
Feedback
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1 This is incorrect. Electronic cigarettes can be harmful during pregnancy.
2 This is correct. Pregnant women should not use tobacco products or electronic
cigarettes during pregnancy.
3 This is incorrect. Electronic cigarettes are not controlled by the FDA and may be
harmful to both mother and fetus.
4 This is incorrect. Electronic cigarettes are considered harmful during pregnancy.
PTS: 1 CON: Ante/Intra/Post-partum
7. The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child,
who is male. The patient’s mother has accompanied her to today’s visit. During the nursing
assessment, the patient mentions that she is no longer in a relationship with the baby’s father
but her mother plans to help her. However, the patient’s mother asks whether this will have
any impact on the child. Which should the nurse indicate the child is at increased risk of
during his adolescence?
1. Hypertension
2. Diabetes
3. Alcohol abuse
4. Intraventricular bleeding
ANS: 3
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 4. Discuss current maternal and infant health issues.
Page: 12
Heading: Issues > Teen Pregnancy > Implications of Teen Pregnancy and Birth
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Moderate
Feedback
1 This is incorrect. Teen mothers, rather than their children, are at increased risked
of hypertension during pregnancy.
2 This is incorrect. Children born to mothers who are obese have an increased risk
of developing childhood obesity and childhood diabetes.
3 This is correct. Statistics have shown that adolescent boys without an involved
father may be at higher risk of incarceration, dropping out of school, and abusing
drugs or alcohol.
4 This is incorrect. Children born to teen mothers are at increased risk for health
problems associated with low birth weight, including intraventricular bleeding.
PTS: 1 CON: Ante/Intra/Post-partum
8. The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant
patient may have been using marijuana. With consent, the nurse confirms via urine drug
screen. Which statement by the nurse is most appropriate?
1. “Did you smoke marijuana when pregnant with your other child?”
2. “To avoid negative effects on your baby, you’ll need to stop using marijuana
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during your last trimester.”
3. “Using marijuana while pregnant can have a negative effect on the neurological
development of your baby.”
4. “Marijuana use while pregnant greatly increases your risk of miscarriage.”
ANS: 3
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of infant death.
Page: 13
Heading: Issues > Substance Abuse During Pregnancy
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Moderate
Feedback
1 This is incorrect. Whether or not the woman used marijuana during her previous
pregnancy is not relevant to her current care.
2 This is incorrect. Marijuana should not be used at any point during pregnancy.
3 This is correct. Marijuana use during pregnancy may have a negative effect on
the neurological development of the fetus.
4 This is incorrect. There currently is no research linking marijuana use to
increased risk of miscarriage.
PTS: 1 CON: Ante/Intra/Post-partum
9. The nurse is counseling a female patient about alcohol use during pregnancy. Which
statement by the patient demonstrates successful patient teaching?
1. “I will limit my drinking to just one alcoholic beverage per day.”
2. “It’s best for my baby if I avoid drinking during pregnancy.”
3. “An occasional drink on special occasions is okay.”
4. “Drinking alcohol is only acceptable in the first trimester.”
ANS: 2
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of infant death.
Page: 13
Heading: Issues > Substance Abuse During Pregnancy
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Moderate
Feedback
1 This is incorrect. Alcohol should not be consumed while pregnant.
2 This is correct. Drinking alcohol while pregnant can cause low birth weight,
fetal alcohol syndrome, mental retardation, and intrauterine growth restriction.
