Test Bank for Maternity and Women's Health Care 13th Edition by Lowdermilk,
Cashion, Alden, Olshanky, and Perry (STUVIA)
,Chapter 01: 21st Century Maternity and Women’s Health Nursing
Lowdermilk: Maternity & Women’s Health Care, 13th Edition
MULTIPLE CHOICE
1. In evaluating the level of a pregnant woman’s risk of having a low-birth-weight
(LBW) infant, which factor is the most important for the registered nurse to
consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
THE CORRECT SOLUTION<><> A
EXPLANATION >> The rise in the overall LBW rates were due to increases in LBW
births to non-Hispanic black women (13.35%) and Hispanic women (7.21%); non-
Hispanic black infants are almost twice as likely as non-Hispanic white infants to be of
LBW and to die in the first year of life.. Race is a nonmodifiable risk factor. Cigarette
smoking is an important factor in potential infant mortality rates, but it is not the most
important. Additionally, smoking is a modifiable risk factor. Poor nutrition is an important
factor in potential infant mortality rates, but it is not the most important. Additionally,
nutritional status is a modifiable risk factor. Maternal education is an important factor in
potential infant mortality rates, but it is not the most important. Additionally, maternal
education is a modifiable risk factor.
POINTS: 1 DIF: Cognitive Level:
Understand TOP: Nursing Process: Assessment
MSC: Patient Needs: HealthPromotionandMaintenance, Antepartum Care
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
statistics for infant mortality, which intervention is most important for the registered nurse
to include in the patient’s plan of care?
a. Perform a nutrition assessment.
b. Refer the woman to a social worker.
c. Advise the woman to see an obstetrician, not a midwife.
d. Explain to the woman the importance of keeping her prenatal care appointments.
THE CORRECT SOLUTION<><> D
EXPLANATION >>Consistent prenatal care is the best method of preventing or
controlling risk factors associated with infant mortality. Nutritional status is an important
modifiable risk factor, but it is not the most important action a registered nurse should take
in this situation. The patient may need assistance from a social worker at some time during
her pregnancy, but a referral to a social worker is not the most important aspect the
registered nurse should address at this time. If the woman has identifiable high-risk
problems, then her health care may need to be provided by a physician. However, it cannot
be assumed that all African-American women have high-risk issues. In addition, advising
the woman to see an obstetrician is not the most important aspect on which the registered
nurse should focus at this time, and it is not appropriate for a registered nurse to advise or
manage the type of care a patient is to receive.
, MSC: Patient Needs: Health Promotion and Maintenance
3. The nurses working at a newly established birthing center have begun to compare
their performance in providing maternal-newborn care against clinical standards. This
comparison process is most commonly known as what?
a. Best practices network
b. Clinical benchmarking
c. Outcomes-oriented practice
d. Evidence-based practice
THE CORRECT SOLUTION<><> C
EXPLANATION >> Outcomes-oriented practice measures the effectiveness of the
interventions and quality of care against benchmarks or standards. The term best practice
refers to a program or service that has been recognized for its excellence. Clinical
benchmarking is a process used to compare one’s own performance against the
performance of the best in an area of service. The term evidence-based practice refers to
the provision of care based on evidence gained through research and clinical trials.
POINTS: 1 DIF: Cognitive Level:
Understand TOP: Nursing Process: Evaluation
MSC: Patient Needs: Safe and Effective Care Environment
4. During a prenatal intake interview, the registered nurse is in the process of
obtaining an initial assessment of a 21-year-old Hispanic patient with limited
English proficiency. Which intervention is the most important for the registered
nurse to implement?
a. Use maternity jargon to enable the patient to become familiar with these terms.
b. Speak quickly and efficiently to expedite the visit.
c. Provide the patient with handouts.
d. Assess whether the patient understands the discussion.
THE CORRECT SOLUTION<><> D
EXPLANATION >> Nurses contribute to health literacy by using simple, common
words, avoiding jargon, and evaluating whether the patient understands the discussion.
Speaking slowly and clearly and focusing on what is important will increase
understanding. Most patient education materials are written at a level too high for the
average adult and may not be useful for a patient with limited English proficiency.
POINTS: 1 DIF: Cognitive
Level: Apply TOP: Nursing Process:
Implementation
MSC: Patient Needs: Health Promotion and Maintenance
5. Which statement best exemplifies contemporary maternity nursing?
a. Use of midwives for all vaginal deliveries
b. Family-centered care
c. Free-standing birth clinics
d. Physician-driven care
THE CORRECT
SOLUTION<><> B
, EXPLANATION >> Contemporary maternity nursing focuses on the family’s needs and
desires. Fathers, partners, grandparents, and siblings may be present for the birth and
participate in activities such as cutting the baby’s umbilical cord. Both midwives and
physicians perform vaginal deliveries. Free-standing clinics are an example of alternative
birth options. Contemporary maternity nursing is driven by the relationship between nurses
and their patients.
POINTS: 1 DIF: Cognitive Level:
Understand TOP: Nursing Process: Planning
MSC: Patient Needs: Health Promotion and Maintenance
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after
being in labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could
the woman have a legitimate legal case for negligence?
a. Inexperienced maternity registered nurse was assigned to care for the patient.
b. Patient was past her due date by 3 days.
c. Standard of care was not met.
d. Patient refused electronic fetal monitoring.
THE CORRECT SOLUTION<><> C
EXPLANATION >> Not meeting the standard of care is a legitimate factor for a case of
negligence. An inexperienced maternity registered nurse would need to display
competency before being assigned to care for patients on his or her own. This patient may
have been past her due date; however, a term pregnancy often goes beyond 40 weeks of
gestation. Although fetal monitoring is the standard of care, the patient has the right to
refuse treatment. This refusal is not a case for negligence, but informed consent should be
properly obtained, and the patient should have signed an against medical advice form
when refusing any treatment that is within the standard of care.
POINTS: 1 DIF: Cognitive Level:
Analyze TOP: Nursing Process:
Implementation
MSC: Patient Needs: Safe and Effective Care Environment
7. When the registered nurse is unsure how to perform a patient care procedure that is
high risk and low volume, his or her best action in this situation would be what?
a. Ask another nurse.
b. Discuss the procedure with the patient’s physician.
c. Look up the procedure in a nursing textbook.
d. First consult the agency procedure manual
THE CORRECT SOLUTION<><> D
EXPLANATION >> Following the agency’s policies and procedures manual is always
best when seeking information on correct patient procedures. These policies should reflect
the current standards of care and the individual state’s guidelines. Each registered nurse is
responsible for his or her own practice. Relying on another registered nurse may not
always be a safe practice. Each registered nurse is obligated to follow the standards of care
for safe patient care delivery. Physicians are responsible for their own patient care activity.
Nurses may follow safe orders from physicians, but they are also responsible for the
activities that they, as nurses, are to carry out. Information provided in a nursing textbook
is basic information for general knowledge. Furthermore, the information in a textbook
may not reflect the current standard of care or the individual state or hospital policies.
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