1. Question Name: 0001 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
When providing
... [Show More] care for a pregnant woman, the nurse should be aware that one of the most
frequently reported maternal medical risk factors is:
* A. Diabetes mellitus.
B. Mitral valve prolapse (MVP).
C. Chronic hypertension.
D. Anemia.
Correct Answer: A
Explanation/Rationale:
ANS: A
The most frequently reported maternal medical risk factors are diabetes and hypertension
associated with pregnancy. Both of these conditions are associated with maternal obesity. There
are no studies that indicate MVP is among the most frequently reported maternal risk factors.
Hypertension associated with pregnancy, not chronic hypertension, is one of the most frequently
reported maternal medical risk factors. Although anemia is a concern in pregnancy, it is not one
of the most frequently reported maternal medical risk factors in pregnancy.
2. Question Name: 0002 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
To ensure optimal outcomes for the patient, the contemporary maternity nurse must incorporate
both teamwork and communication with clinicians into her care delivery, The SBAR technique of
communication is an easy-to-remember mechanism for communication. Which of the following
correctly defines this acronym?
A. Situation, baseline assessment, response
* B. Situation, background, assessment, recommendation
C. Subjective background, assessment, recommendation
D. Situation, background, anticipated recommendation
Correct Answer: B
Explanation/Rationale:
ANS: B
The situation, background, assessment, recommendation (SBAR) technique provides a specific
framework for communication among health care providers. Failure to communicate is one of
the major reasons for errors in health care. The SBAR technique has the potential to serve as a
means to reduce errors.
3. Question Name: 0003 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
The role of the professional nurse caring for childbearing families has evolved to emphasize:
A. Providing care to patients directly at the bedside.
B. Primarily hospital care of maternity patients.
* C. Practice using an evidence-based approach.
D. Planning patient care to cover longer hospital stays.
Correct Answer: C
Explanation/Rationale:
ANS: C
Professional nurses are part of the team of health care providers who collaboratively care for
patients throughout the childbearing cycle. Providing care to patients directly at the bedside is
one of the nurse’s tasks; however, it does not encompass the concept of the evolved professional
nurse. Throughout the prenatal period, nurses care for women in clinics and physician’s offices
and teach classes to help families prepare for childbirth. Nurses also care for childbearing
families in birthing centers and in the home. Nurses have been critically important in developing
strategies to improve the well-being of women and their infants and have led the efforts to
implement clinical practice guidelines using an evidence-based approach. Maternity patients
have experienced a decreased, rather than an increased, length of stay over the past 2 decades.
4. Question Name: 0004 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
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.
Correct Answer: D
Explanation/Rationale:
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 a nutrition
assessment is not the most important action a 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 nurse should address at this time. If the woman has
identifiable high-risk problems, 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 patient is to receive.
5. Question Name: 0005 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of
a 21-year-old Hispanic patient with limited English proficiency. It is important for the nurse to:
A. Use maternity jargon in order for 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.
Correct Answer: D
Explanation/Rationale:
ANS: D
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 increase understanding. Most patient education materials are
written at too high a level for the average adult and may not be useful for a client with limited
English proficiency.
6. Question Name: 0006 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
When managing health care for pregnant women at a prenatal clinic, the nurse should recognize
that the most significant barrier to access to care is the pregnant woman’s:
A. Age.
B. Minority status.
C. Educational level.
* D. Inability to pay.
Correct Answer: D
Explanation/Rationale:
ANS: D
The most significant barrier to health care access is the inability to pay for services; this is
compounded by the fact that many physicians refuse to care for women who cannot pay.
Although adolescent pregnant clients statistically receive less prenatal care, age is not the most
significant barrier. Significant disparities in morbidity and mortality rates exist for minority
women; however, minority status is not the most significant barrier to access of care. Disparities
in educational level are associated with morbidity and mortality rates; however, educational level
is not the most significant barrier to access of care.
7. Question Name: 0007 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
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
Correct Answer: C
Explanation/Rationale:
ANS: C
When problems are identified, research can be conducted properly. 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 one factor of research. Financial support is necessary to
conduct research, but it is not the primary role of the nurse in the research process.
8. Question Name: 0008 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
When the nurse is unsure about how to perform a patient care procedure, the best action would be
to:
A. Ask another nurse.
B. Discuss the procedure with the patient’s physician.
C. Look up the procedure in a nursing textbook.
* D. Consult the agency procedure manual and follow the guidelines for the procedure.
Correct Answer: D
Explanation/Rationale:
ANS: D
It is always best to follow the agency’s policies and procedures manual when seeking
information on correct patient procedures. These policies should reflect the current standards of
care and state guidelines. Each nurse is responsible for her own practice. Relying on another
nurse may not always be 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 individual state or hospital policies.
9. Question Name: 0009 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
From the nurse’s perspective, what measure should be the focus of the health care system to reduce
the rate of infant mortality further?
* A. Implementing programs to ensure women’s early participation in ongoing prenatal care
B. Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days
C. Expanding the number of neonatal intensive care units (NICUs)
D. Mandating that all pregnant women receive care from an obstetrician
Correct Answer: A
Explanation/Rationale:
ANS: A
Early prenatal care allows for early diagnosis and appropriate interventions to reduce the rate of
infant mortality. An increased length of stay has been shown to foster improved self-care and
parental education. However, it does not prevent the incidence of leading causes of infant
mortality rates, such as low birth weight. Early prevention and diagnosis reduce the rate of infant
mortality. NICUs offer care to high-risk infants after they are born. Expanding the number of
NICUs would offer better access for high-risk care, but this factor is not the primary focus for
further reduction of infant mortality rates. A mandate that all pregnant women receive obstetric
care would be nearly impossible to enforce. Furthermore, certified nurse-midwives (CNMs) have
demonstrated reliable, safe care for pregnant women.
10. Question Name: 0010 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
Alternative and complementary therapies:
A. Replace conventional Western modalities of treatment.
B. Are used by only a small number of American adults.
* C. Recognize the value of clients’ input into their health care.
D. Focus primarily on the disease an individual is experiencing.
Correct Answer: C
Explanation/Rationale:
ANS: C
Many popular alternative healing modalities offer human-centered care based on philosophies
that recognize the value of the patient’s input and honor the individual’s beliefs, values, and
desires. Alternative and complementary therapies are part of an integrative approach to health
care. An increasing number of American adults are seeking alternative and complementary health
care options. Alternative healing modalities offer an holistic approach to health, focusing on the
whole person, not just the disease.
11. Question Name: 0011 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
A 38-year-old Hispanic woman delivered a 9-pound, 6-ounce girl vaginally after being in labor for
43 hours. The baby died 3 days later from sepsis. On what grounds would the woman potentially
have a legitimate legal case for negligence?
A. She is Hispanic.
B. She delivered a girl.
* C. The standards of care were not met.
D. She refused fetal monitoring.
Correct Answer: C
Explanation/Rationale:
ANS: C
Not meeting the standards of care is a legitimate factor for a case of negligence. The client’s race
is not a factor for a case of negligence. The infant’s gender is not a factor for a case of
negligence. Although fetal monitoring is the standard of care, the client has the right to refuse
treatment. This refusal is not a case for negligence; however, informed consent should be
properly obtained, and the client should sign an against medical advice form for refusal of any
treatment that is within the standard of care.
12. Question Name: 0012 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
A newly graduated nurse is attempting to understand the reason for increasing health care spending
in the United States. Her research finds that these costs are much higher compared with other
developed countries as a result of:
* A. A higher rate of obesity among pregnant women.
B. Limited access to technology.
C. Increased usage of health care services along with lower prices.
D. Homogeneity of the population.
Correct Answer: A
Explanation/Rationale:
ANS: A
Health care is one of the fastest growing sectors of the U.S. economy. Currently, 17.4% of the
gross domestic product is spent on health care. Higher spending in the United States compared
with 12 other industrialized countries is related to higher prices and readily accessible
technology along with greater obesity rates among women. More than one third of women in the
United States are obese. Of the U.S. population, 16% is uninsured and has limited access to
health care. Maternal morbidity and mortality are directly related to racial disparities.
13. Question Name: 0013 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
The term used to describe legal and professional responsibility for practice for maternity nurses is:
A. Collegiality.
B. Ethics.
C. Evaluation.
* D. Accountability.
Correct Answer: D
Explanation/Rationale:
ANS: D
Accountability refers to legal and professional responsibility for practice. Collegiality refers to a
working relationship with one’s colleagues. Ethics refers to a code to guide practice. Evaluation
refers to examination of the effectiveness of interventions in relation to expected outcomes.
14. Question Name: 0014 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
Through the use of social media technology, nurses can link with other nurses who may share
similar interests, insights about practice, and advocate for patients. The most concerning pitfall for
nurses using this technology is:
* A. Violation of patient privacy and confidentiality.
B. Institutions and colleagues may be cast in an unfavorable light.
C. Unintended negative consequences for using social media.
D. Lack of institutional policy governing online contact.
Correct Answer: A
Explanation/Rationale:
ANS: A
The most significant pitfall for nurses using this technology is the violation of patient privacy
and confidentiality. Furthermore, institutions and colleagues can be cast in unfavorable lights
with negative consequences for those posting information. Nursing students have been expelled
from school and nurses have been fired or reprimanded by their Board of Nursing for injudicious
posts. The American Nurses Association has published six principles for social networking and
nurses. All institutions should have policies guiding the use of social media, and nurses should be
familiar with these guidelines.
15. Question Name: 0015 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
An important development that affects maternity nursing is integrative health care, which:
A. Seeks to provide the same health care for all racial and ethnic groups.
* B. Blends complementary and alternative therapies with conventional Western treatment.
C. Focuses on the disease or condition rather than the background of the client.
D. Has been mandated by Congress.
Correct Answer: B
Explanation/Rationale:
ANS: B
Integrative health care tries to mix the old with the new at the discretion of the client and health
care providers. Integrative health care is a blending of new and traditional practices. Integrative
health care focuses on the whole person, not just the disease or condition. U.S. law supports
complementary and alternative therapies but does not mandate them.
16. Question Name: 0016 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
Recent trends in childbirth practices in the United States indicate that:
A. More than 15% of mothers had late or no prenatal care.
B. The percentage of Hispanics, non-Hispanic African Americans, and Caucasians who received
prenatal care was essentially the same.
* C. Births occurring in the hospital accounted for 99% of births.
D. Cesarean births have been declining as a percentage of live births.
Correct Answer: C
Explanation/Rationale:
ANS: C
Almost all births occur within the hospital setting. Only 5.2% of Caucasians mothers had either
late care or no care. There are disparities in the receipt of prenatal care by ethnicity: 12.2% of
Hispanic women and 11.8% of non-Hispanic black women received either late or no prenatal
care. The percentage of cesarean births is increasing.
17. Question Name: 0017 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
Recent trends in childbirth practice indicate that:
A. Delayed pushing is now discouraged in the second stage of labor.
B. Episiotomy rates are increasing.
C. Midwives perform more episiotomies than physicians.
* D. Newborn infants remain with the mother and are encouraged to breastfeed.
Correct Answer: D
Explanation/Rationale:
ANS: D
Breastfeeding is encouraged for newborns immediately after birth. Delayed pushing is
encouraged for several reasons. Episiotomy rates are declining. Midwives perform fewer
episiotomies than physicians.
18. Question Name: 0018 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
The nurse caring for a pregnant client should be aware that the U.S. birth rate shows which trend?
* A. Births to unmarried women are more likely to have less favorable outcomes.
B. Birth rates for women 40 to 44 years old are beginning to decline.
C. Cigarette smoking among pregnant women continues to increase.
D. The rates of maternal death owing to racial disparity are elevated in the United States.
Correct Answer: A
Explanation/Rationale:
ANS: A
Low-birth-weight infants and preterm birth are more likely because of the large number of
teenagers in the unmarried group. Birth rates for women in their early 40s continue to increase.
Fewer pregnant women smoke. In the United States, there is significant racial disparity in the
rates of maternal death.
19. Question Name: 0019 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
Maternity nursing care that is based on knowledge gained through research and clinical trials is:
A. Derived from the Nursing Intervention Classification.
* B. Known as evidence-based practice.
C. At odds with the Cochrane School of traditional nursing.
D. An outgrowth of telemedicine.
Correct Answer: B
Explanation/Rationale:
ANS: B
Evidence-based practice is based on knowledge gained from research and clinical trials. The
Nursing Intervention Classification is a method of standardizing language and categorizing care.
Dr. Cochrane systematically reviewed research trials and is part of the evidence-based practice
movement. Telemedicine uses communication technologies to support health care.
20. Question Name: 0020 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
The level of practice a reasonably prudent nurse provides is called:
* A. The standard of care.
B. Risk management.
C. A sentinel event.
D. Failure to rescue.
Correct Answer: A
Explanation/Rationale:
ANS: A
Guidelines for standards of care are published by various professional nursing organizations.
Risk management identifies risks and establishes preventive practices, but it does not define the
standard of care. Sentinel events are unexpected negative occurrences. They do not establish the
standard of care. Failure to rescue is an evaluative process for nursing, but it does not define the
standard of care.
21. Question Name: 0021 Type: MC Objective: CH 01: 21st Century Maternity Nursing Item Bank: Perry Maternal
Child Nursing Care 5th edition
During a prenatal intake interview, the client informs the nurse that she would prefer a midwife to
provide her care during pregnancy and deliver her infant. What information would be most
appropriate for the nurse to share with this patient?
A. Midwifery care is available only to clients who are uninsured because their services are less
expensive than an obstetrician. Costs are often lower than an obstetric provider.
* B. The client will receive fewer interventions during the birth process.
C. The client should be aware that midwives are not certified.
D. Delivery can take place only at the client’s home or in a birth center [Show Less]