Maternity and Women's Health Care 13th Edition Lowdermilk Test
b b b b b b b b
, Maternity and Women's Health Care 13th Edition Lowdermilk Test b b b b b b b b
Chapter01:21st Century Maternity andWomen’s HealthNursing Lowdermilk:
b b b b b b b b b
Maternity & Women’s Health Care, 13th Edition
b b b b b b b
MULTIPLE CHOICE b
1. In evaluating the level of a pregnant woman’s risk ofhaving a low-birth-weight (LBW)
b b b b b b b b b b b b b
infant, which factor is the most important for the nurse to consider?
b b b b b b b b b b b b
a. African-American race b
b. Cigarette smoking b
c. Poor nutritional status b b
d. Limited maternal education b b
ANS: A b
The rise in the overall LBW rates were due to increases in LBW births to non-Hispanic black
b b b b b b b b b b b b b b b b
women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants are almost twice
b b b b b b b b b b b b
as likely as non-Hispanic white infants to be of LBW and to die in the first year of life.. Race is a
b b b b b b b b b b b b b b b b b b b b b b
nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant mortality
b b b b b b b b b b b b b
rates, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor
b b b b b b b b b b b b b b b b
nutrition is an important factor in potential infant mortality rates, but it is not the most
b b b b b b b b b b b b b b b b
important. Additionally, nutritional status is a modifiable risk factor. Maternal education is an
b b b b b b b b b b b b b
important factor in potential infant mortality rates, but it is not the most important. Additionally,
b b b b b b b b b b b b b b b
maternal education is a modifiable risk factor.
b b b b b b b
PTS: 1 DIF: CognitiveLevel: Understand b b
TOP: Nursing Process: Assessment
b b b
MSC: Client Needs: HealtN hUPrRoS
mI ioG
otN nTanBd.MCaO
inM
btenance, Antepartum Care
b b b b b
2. A 23-year-old African-American woman is pregnant with her first child. Based on current
b b b b b b b b b b b b
statistics for infant mortality, which intervention is most important for the nurse to include in
b b b b b b b b b b b b b b b
the client’s plan of care?
b b b b b
a. Perform a nutrition assessment. b b b
b. Refer the woman to a social worker. b b b b b b
c. Advise the woman to see an obstetrician, not a midwife. b b b b b b b b b
d. Explain to the woman the importance of keeping her prenatal care appointments. b b b b b b b b b b b
ANS: D b
Consistent prenatal care is the best method of preventing or controlling risk factors associatedb b b b b b b b b b b b b
with infant mortality. Nutritional statusis an important modifiablerisk factor, but it is not the
b b b b b b b b b b b b b b b b
most important action a nurse should take in this situation. The client may need assistance from a
b b b b b b b b b b b b b b b b b
social worker at some time during her pregnancy, but a referral to a social worker is not the most
b b b b b b b b b b b b b b b b b b b
important aspect the nurse should address at this time. If the woman has identifiable high-risk
b b b b b b b b b b b b b b b
problems, then her health care may need to be provided by a physician. However, it cannot be
b b b b b b b b b b b b b b b b b
assumed that all African-American women have high-risk issues. In addition, advising the
b b b b b b b b b b b b
woman to see an obstetrician is not the most important aspect on which the nurse should focus at
b b b b b b b b b b b b b b b b b b
this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to
b b b b b b b b b b b b b b b b b b b b b b
receive.
b
PTS: 1 DIF: CognitiveLevel: Understand b b
TOP: Nursing Process: Planning
b b b
, Maternity and Women's Health Care 13th Edition Lowdermilk Test b b b b b b b b
MSC: Client Needs: Health Promotion and Maintenance
b b b b b b
3. The nurses working at a newly established birthing center have begun to compare their
b b b b b b b b b b b b b
performance in providing maternal-newborn care against clinical standards. This
b b b b b b b b b
comparison process is most commonly known as what?
b b b b b b b b
a. Best practices network b b
b. Clinical benchmarking b
c. Outcomes-oriented pracNt iU ceR S b
d. Evidence-based practice b
ANS: C b
Outcomes-oriented practice measures the effectiveness of the interventions and quality of care b b b b b b b b b b b
against benchmarks or standards. The term best practice refers to a program or service that has
b b b b b b b b b b b b b b b b
been recognized for its excellence. Clinical benchmarking is a process used to compare one’s
b b b b b b b b b b b b b b
own performance against the performance of the best in an area of service. The term evidence-
b b b b b b b b b b b b b b b b
based practice refers to the provision of care based on evidence gained through research and
b b b b b b b b b b b b b b
clinical trials.
b b
PTS: 1 DIF: CognitiveLevel: Understand b b
TOP: Nursing Process: Evaluation
b b b
MSC: Client Needs: Safe and Effective Care Environment
b b b b b b b
4. During a prenatal intake interview, the nurse is in the process of obtaining an initial
b b b b b b b b b b b b b b
assessment of a 21-year-old Hispanic client with limited English proficiency. Which
b b b b b b b b b b b
intervention is the most important for the nurse to implement?
b b b b b b b b b b
a. Use maternity jargon to enable the client to become familiar with these terms.
b b b b b b b b b b b b
b. Speak quickly and efficiently to expedite the visit.
b b b b b b b
c. Provide the client with handouts. b b b b
d. Assess whether the client understands the discussion.b b b b b b
ANS: D b
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and
b b b b b b b b b b b b
evaluating whether the client understands the discussion. Speaking slowly and clearly and
b b b b b b b b b b b b
focusing on what is important will increase understanding. Most client education materials are
b b b b b b b b b b b b b
written at a level too high for the average adult and may not be useful for a client with limited
b b b b b b b b b b b b b b b b b b b b
English proficiency.
b b
PTS: 1 DIF: CognitiveLevel: Apply b b
TOP: Nursing Process: Implementation
b b b
MSC: Client Needs: Health Promotion and Maintenance
b b b b b b
5. Whichstatement best exemplifies contemporarymaternity nursing?
b b b b b b
a. Use of midwives for all vaginal deliveries
b b b b b b
b. Family-centered care b
c. Free-standing birth clinics b b
d. Physician-drivencare b
bANS: B b
, Maternity and Women's Health Care 13th Edition Lowdermilk Test b b b b b b b b
Contemporary maternity nursing focuses on the family’s needs and desires. Fathers, partners, b b b b b b b b b b b
grandparents, and siblings may be present for the birth and participate inactivities such as cutting
b b b b b b b b b b b b b b b b
the baby’s umbilical cord. Both midwives and physicians perform vaginal deliveries. Free-
b b b b b b b b b b b b
standing clinics are an example of alternative birth options. Contemporary maternity nursing is
b b b b b b b b b b b b
driven by the relationship between nurses and their clients.
b b b b b b b b b
PTS: 1 DIF: CognitiveLevel: Understand b b
TOP: Nursing Process: Planning
b b b
MSC: Client Needs: Health Promotion and Maintenance
b b b b b b
6. A38-year-old Hispanic woman vaginallydelivered a 9-pound, 6-ounce baby girl after being in
b b b b b b b b b b b b b
labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could the woman
b b b b b b b b b b b b b b b b b b
have a legitimate legal case for negligence?
b b b b b b b
a. Inexperienced maternity nurse was assigned to care for the client. b b b b b b b b b
b. Client was past her due date by3 days. b b b b b b b b
c. Standard of care was not met. b b b b b
d. Client refused electronic fetal monitoring. b b b b
ANS: C b
Not meeting the standard of care is a legitimate factor for a case of negligence. An
b b b b b b b b b b b b b b b
inexperienced maternity nurse would need to displaycompetency before being assigned to care
b b b b b b b b b b b b b
for clients on his or her own. This client may have been past her due date; however, a term
b b b b b b b b b b b b b b b b b b b
pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the standard of
b b b b b b b b b b b b b b b
care, the client has the right to refuse treatment. This refusal is not a case for negligence, but
b b b b b b b b b b b b b b b b b b
informed consent should be properly obtained, and the client should have signed an against
b b b b b b b b b b b b b b
medical advice form when refusing any treatment that is within the standard of care.
b b b b b b b b b b b b b b
PTS: 1 DIF: CognitiveLevel: Analyze b b
TOP: Nursing Process: Implementation
b b b
MSC: Client Needs: Safe and Effective Care Environment
b b b b b b b
7. When the nurse is unsure how to perform a client care procedurethat is high risk and low
b b b b b b b b b b b b b b b b b
volume, his or her best action in this situation would be what?
b b b b b b b b b b b b
a. Ask another nurse. b b
b. Discuss the procedure with the client’s physician. b b b b b b
c. Look up the procedure in a nursing textbook. b b b b b b b
d. First consult the agency procedure manual b b b b b
ANS: D b
Following the agency’s policies and procedures manual is always best when seeking
b b b b b b b b b b b
information on correct client procedures. These policies should reflect the current standards of
b b b b b b b b b b b b b
care and the individual state’s guidelines. Each nurse is responsible for his or her own practice.
b b b b b b b b b b b b b b b b
Relying on another nurse may not always be a safe practice. Each nurse is obligated to follow
b b b b b b b b b b b b b b b b b
the standards of care for safe client care delivery. Physicians are responsible for their own client
b b b b b b b b b b b b b b b b
care activity. Nurses may follow safe orders from physicians, but they are also responsible for
b b b b b b b b b b b b b b b
the activities that they, as nurses, are to carry out. Information provided in a nursing textbookis
b b b b b b b b b b b b b b b b b
basic information for general knowledge. Furthermore, the information in a textbook may not
b b b b b b b b b b b b b
reflect the current standard of care or the individual state or hospital policies.
b b b b b b b b b b b b b
