Chapter 1: 21st Century Maternity and Women’s Health Nursing
MULTIPLE CHOICE
1. In evaluating the level of a pregnant womans risk of having a
... [Show More] 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
For African-American births, the incidence of LBW infants is twice that of Caucasian
births. 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.
DIF: Cognitive Level: Understand REF: IM:
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance, Antepartum Care
2. What is the primary role of practicing nurses in the research process?
a. Designing research studies
b. Collecting data for other researchers
c. Identifying researchable problems
d. Seeking funding to support research studies
ANS: C
When problems are identified, research can be properly conducted. Research of
health care issues leads to evidence-based practice guidelines. Designing research
studies is only one factor of the research process. Data collection is another factor of
research. Financial support is necessary to conduct research, but it is not the primary
role of the nurse in the research process.
DIF: Cognitive Level: Understand REF: im: 14 TOP: Nursing
Process: N/A MSC: Client Needs: Safe and Effective Care
Environment
3. A 23-year-old African-American woman is pregnant with her first child. Based
on the statistics for infant mortality, which plan is most important for the nurse to
implement?
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,
but it 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 social worker 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-risk issues. 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.
DIF: Cognitive Level: Understand REF: IM: TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
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
action is the most important for the nurse to perform?
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 with limited English proficiency.
DIF: Cognitive Level: Apply REF: im: 5 TOP: Nursing Process:
Evaluation MSC: Client Needs: Health Promotion and Maintenance
5. 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 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
service that has been recognized for its excellence. Clinical benchmarking is a process
used to compare ones 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.
DIF: Cognitive Level: Understand REF: im: 11 TOP: Nursing Process:
Evaluation MSC: Client Needs: Safe and Effective Care Environment
6. 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
Contemporary maternity nursing focuses on the familys needs and desires.
Fathers, partners, grandparents, and siblings may be present for the birth and
participate in activities such as cutting the babys 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.
DIF: Cognitive Level: Understand REF: pp. 8-9 TOP: Nursing Process:
Planning MSC: Client Needs: Health Promotion and Maintenance
7. 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 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
to care for clients on his or her own. This client 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 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.
DIF: Cognitive Level: Analyze REF: im:
13 TOP: Nursing Process:
Implementation
MSC: Client Needs: Safe and Effective Care Environment
8. When the nurse is unsure how to perform a client 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 clients physician.
c. Look up the procedure in a nursing textbook.
d. Consult the agency procedure manual, and follow the guidelines
for the procedure.
ANS: D
Following the agencys policies and procedures manual is always best when seeking
information on correct client procedures. These policies should reflect the current
standards of care and the individual states 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 [Show Less]