. When providing 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. c. Chronic hypertension.
b. Mitral valve prolapse
...
. When providing 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. c. Chronic hypertension.
b. Mitral valve prolapse (MVP). d. Anemia.
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.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 6
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
2. 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
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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 14
OBJ: Nursing Process: Assessment, Planning
MSC: Client Needs: Safe and Effective Care Environment
3. 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.
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 nurses tasks;
however, it does not encompassthe concept of the evolved professional nurse. Throughout the prenatal period,
nurses care for women in clinics and physicians 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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
4. 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 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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 6
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance
5. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-yearold 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.
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.
PTS: 1 DIF: Cognitive Level: Application REF: 5
OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance
6. 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. c. Educational level.
b. Minority status. d. Inability to pay.
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.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 5
OBJ: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
7. 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 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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 9
OBJ: Nursing Process: Diagnosis, Evaluation
MSC: Client Needs: Safe and Effective Care Environment
8. 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
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. 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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 11
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
9. From the nurses perspective, what measure should be the focus of the health care system to reduce the rate
of infant mortality further?
a. Implementing programsto ensure womens 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
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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 10
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
10. 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.
ANS: C
Many popular alternative healing modalities offer human-centered care based on philosophies that recognize
the value of the patients input and honor the individuals 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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 4
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
11. 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. c. The standards of care were not met.
b. She delivered a girl. d. She refused fetal monitoring.
ANS: C
Not meeting the standards of care is a legitimate factor for a case of negligence. The clients race is not a factor
for a case of negligence. The infants 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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 12
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance
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