Lowdermilk: Maternity Nursing, 8th Edition
Lowdermilk: Maternity Nursing, 8th Edition
Chapter 01: 21st Century Maternity Nursing: Culturally Competent, Family and
Community Focused
Test Bank
MULTIPLE CHOICE
1. 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
A
B
C
Feedback
Nutritional status is an important modifiable risk factor, but it is not the most
important action a nurse should take in this situation.
The woman may need assistance from a social worker at some time during her
pregnancy, but this 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 AfricanAmerican women have high risk issues. In addition, this 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.
Consistent prenatal care is the best method of preventing or controlling risk
factors associated with infant mortality.
2. 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 womans:
a. Age.
b. Minority status.
c. Educational level.
d. Inability to pay.
ANS: D
A
Feedback
Although adolescent pregnant patients statistically receive less prenatal care, this
factor is not the most significant barrier.
Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
B
C
D
1-2
Significant disparities in morbidity and mortality rates exist for minority women;
however, this is not the most significant barrier to access to care.
Disparities in educational level are associated with morbidity and mortality rates;
the educational level is not the most significant barrier to access to care.
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.
ANS: C
A
B
C
D
Feedback
Designing research studies is only one factor of the research process.
Data collection is one factor of research.
When problems are identified, research can be conducted properly. Research of
health care issues leads to evidence-based practice guidelines.
Financial support is necessary to conduct research, but it is not the primary role of
the nurse in the research process.
Test Bank
D
1-3
Teen pregnancy and abortion rates are higher in the United States than in any
other industrialized country.
5. 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 patients 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
A
B
C
D
Feedback
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 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 individual state or hospital policies.
It is always best to follow the agencys policies and procedures manual when
seeking information on correct patient procedures. These policies should reflect
the current standards of care and state guidelines.
ANS: C
A
B
Feedback
Alternative and complementary therapies are part of an integrative approach to
health care.
An increasing number of American adults are seeking alternative and
Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
C
D
1-4
ANS: B
A
B
C
D
Feedback
Midwives and physicians both perform vaginal deliveries.
Contemporary maternity nursing focuses on the familys needs and desires.
Free-standing clinics are an example of alternative birth options.
Contemporary maternity nursing is driven by the relationship between nurses and
their patients.
A
B
C
D
Feedback
The womans race is not a factor for a case of negligence.
The infants gender is not a factor for a case of negligence.
Not meeting the standards of care is a legitimate factor for a case of negligence.
Although fetal monitoring is the standard of care, the woman has the right to
Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
1-5
refuse treatment. This refusal is not a case for negligence, but informed consent
should be properly obtained, and the woman should sign an against medical
advice form for refusal of any treatment that is within the standard of care.
DIF: Cognitive Level: Analysis
REF: 10
OBJ: Client Needs: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
9. All of the following conditions have contributed to the increase in maternity-related
health care costs except:
a. Early postpartum discharges.
b. Liability costs.
c. The use of high-tech equipment.
d. The cost of care for low-birth-weight (LBW) infants.
ANS: A
A
B
C
D
Feedback
Early postpartum discharges have reduced costs.
The liability costs of a litigious society contribute to higher health costs.
High-tech equipment increases health costs.
LBW or high risk infants increase health costs.
Feedback
Educating mothers enables them to recognize problems they should report to their
health care provider and teaches them ways to take better care of themselves.
Late prenatal care is one factor that contributes to health disparities.
Cesarean sections are performed for various reasons, although they may be the
result of health concerns related to the mother.
Taking vitamins may improve overall health, but it does not necessarily ensure
health or dispel health disparities.
Test Bank
1-6
Feedback
Collegiality refers to a working relationship with ones colleagues.
Ethics refers to a code to guide practice.
Evaluation refers to examination of the effectiveness of interventions in relation
to expected outcomes.
Accountability refers to legal and professional responsibility for practice.
Feedback
Approximately 84% of women receive prenatal care in the first trimester.
Minority women are twice as likely to receive late prenatal care.
Almost no births occur outside the hospital.
The percentage of cesarean births is increasing.
Test Bank
1-7
ANS: B
A
B
C
D
Feedback
The Nursing Intervention Classification is a method of standardizing language
and categorizing care.
Evidence-based practice is based on knowledge gained from research and clinical
trials.
Dr. Cochrane systematically reviewed research trials and is part of the evidencebased practice movement.
Telemedicine uses communication technologies to support health care.
C
D
Feedback
This abbreviation should be written out as every other day. The period after the
Q could be mistaken for an I; the o could also be mistaken for an i.
It is too easy to confuse one medication for another. These medications are used
for very different purposes and could put a patient at risk for an adverse outcome
if the wrong medication was administered. They should be written as morphine
sulfate and magnesium sulfate.
i.u. and I.U. are no longer acceptable because they could be misread as I.V.
or the number 10.
To avoid the decimal point before a fractional number being overlooked and
causing confusion, a leading zero should always be included in such cases; e.g.,
0.4 rather than .4.
Test Bank
1-8
Feedback
These factors may be the target of research studies, but maternal and infant
mortality rates are particularly important.
City, county, and state health departments provide annual reports of births and
deaths. Maternal and infant death rates are particularly important because they
reflect health outcomes that may be preventable.
These factors may be the target of research studies, but maternal and infant
mortality rates are particularly important.
These factors may be the target of research studies, but maternal and infant
mortality rates are particularly important.
Feedback
Married-blended families are formed as the result of divorce and remarriage.
Unrelated family members join together to create a new household.
Members of an extended family are kin, or family members related by blood,
such as grandparents, aunts, and uncles.
A nuclear family is a traditional family with male and female partners along with
the children resulting from that union.
A same-sex family is a family with homosexual partners who cohabit with or
without children.
Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
1-9
17. The nurse should be aware that the criteria used to make decisions and solve problems
within families are based primarily on family:
a. Rituals and customs.
b. Values and beliefs.
c. Boundaries and channels.
d. Socialization processes.
ANS: B
A
B
C
D
Feedback
Although culture may play a part in the decision-making process of a family,
ultimately values and beliefs dictate the course of action taken by family
members.
Values and beliefs are the most prevalent factors in the decision-making and
problem-solving techniques of families.
Boundaries and channels affect the relationship between the family members and
the health care team, not the decisions within the family.
Socialization processes may help families with interactions with the community,
but they are not the criteria used for decision making within the family.
Test Bank
1-10
b. Risk management.
c. A sentinel event.
d. Failure to rescue.
ANS: A
A
B
C
D
Feedback
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.
Feedback
The nurse should not rush to judgment and should make sure that she or he
understands the patients message clearly.
In crisis situations, the nurse may need to use a family member or neighbor as an
interpreter.
The nurse should talk directly to the patient to create an atmosphere of respect.
Providing privacy creates an atmosphere of respect and puts the patient at ease.
Test Bank
1-11
ANS: C
A
B
C
D
Feedback
European Americans expect the father to take a more active role in the labor and
delivery than the other cultures.
European Americans expect the father to take a more active role in the labor and
delivery than the other cultures.
European Americans expect the father to take a more active role in the labor and
delivery than the other cultures.
European Americans expect the father to take a more active role in the labor and
delivery than the other cultures.
Mosby items and derived items 2010 by Mosby, Inc., an affiliate of Elsevier Inc.