ISBN No 9780323810180, all 37 Chapters fully Covered (NEWEST 2024)
, ISBN No 9780323810180, all 37 Chapters fully Covered (NEWEST 2024)
Chapter 01: 21st Century Maternity and Health NursingLowdermilk: Maternity &
Health Care, 13th Edition
MULTIPLE CHOICE
1. In evaluating the level of a risk of having a low-birth-weight (LBW)infant, which
factor is the most important for the nurse to consider?
a. African-American race
b. Cigarette smoking
c. Poor nutritional status
d. Limited maternal education
ANS: A
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 inpotential 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.
PTS: 1 DIF: Cognitive Level: UnderstandTOP:
Nursing Process: Assessment
MSC: Client Needs: HealtNPrRomI
hU NG
S otio TBd.M
n an CaO
inM
tenance, 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 nurse to includein the 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.
ANS: D
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, butit is not the most important action a
nurse should take in this situation. The client may need assistance from a social worker at some time during
her pregnancy, but a referral to a socialworker is not the most important aspect the 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-riskissues. In
addition, advising the woman to see an obstetrician is not the most important aspect on which the nurse
should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a client is
to receive.
PTS: 1 DIF: Cognitive Level: UnderstandTOP:
Nursing Process: Planning
, ISBN No 9780323810180, all 37 Chapters fully Covered (NEWEST 2024)
MSC: Client Needs: Health Promotion and Maintenance
3. The nurses working at a newly established birthing center have begun to compare theirperformance
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 pracNtiU
ceRS
d. Evidence-based practice
ANS: C
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 servicethat has been recognized for
its excellence. Clinical benchmarking is a process used to
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.
PTS: 1 DIF: Cognitive Level: UnderstandTOP:
Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
4. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a
21-year-old Hispanic client with limited English proficiency. Which intervention is the most
important for the nurse to implement?
a. Use maternity jargon to enable the client to become familiar with these terms.
b. Speak quickly and efficiently to expedite the visit.
c. Provide the client with handouts.
d. Assess whether the client understands the discussion.
ANS: D
Nurses contribute to health literacy by using simple, common words, avoiding jargon, and evaluating
whether the client understands the discussion. Speaking slowly and clearly and focusing on what is
important will increase understanding. Most client education materials are written at a level too high for
the average adult and may not be useful for a client withlimited English proficiency.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client 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
ANS: B
, ISBN No 9780323810180, all 37 Chapters fully Covered (NEWEST 2024)
partners,
grandparents, and siblings may be present for the birth and participate in activities
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 clients.
PTS: 1 DIF: Cognitive Level: UnderstandTOP:
Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after beingin 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 nurse was assigned to care for the client.
b. Client was past her due date by 3 days.
c. Standard of care was not met.
d. Client refused electronic fetal monitoring.
ANS: C
Not meeting the standard of care is a legitimate factor for a case of negligence. An inexperienced
maternity nurse would need to display competency before being assigned tocare for clients on his or her
own. This client may have been past her due date; however, aterm pregnancy often goes beyond 40 weeks
of gestation. Although fetal monitoring is thestandard of care, the client has the right to refuse treatment.
This refusal is not a case for negligence, but informed consent should be properly obtained, and the client
should have signed an against medical advice form when refusing any treatment that is within the
standard of care.
PTS: 1 DIF: Cognitive Level: AnalyzeTOP:
Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
7. When the nurse is unsure how to perform a client care procedure that is high risk and lowvolume, his or
her best action in this situation would be what?
a. Ask another nurse.
b. Discuss the procedure with the physician.
c. Look up the procedure in a nursing textbook.
d. First consult the agency procedure manual
ANS: D
information on correct
client procedures. These policies should reflect the current standards
guidelines. Each nurse is responsible for his or her own practice. Relying on another nurse may not always
be a safe practice. Each nurse is obligated to follow the standards of care for safe client care delivery.
Physicians are responsible for their own client 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.
