OB Chapter 1: 21st Century Maternity Nursing

1. 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.

b. Mitral valve prolapse (MVP).

c. Chronic hypertension.

d. Anemia.

a. Diabetes mellitus.

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

b. Situation, background, assessment, recommendation

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.

c. Practice using an evidence-based approach.

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.

d. Explain to the woman the importance of keeping her prenatal care appointments.

5. 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.

d. Assess whether the patient understands the discussion.

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 woman's:

a. Age.

b. Minority status.

c. Educational level.

d. Inability to pay.

d. Inability to pay.

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

c. Identifying researchable problems

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 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.

d. Consult the agency procedure manual and follow the guidelines for the procedure.

9. 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

a. Implementing programs to ensure women's early participation in ongoing prenatal care

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.

c. Recognize the value of clients' input into their health care.

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.

b. She delivered a girl.

c. The standards of care were not met.

d. She refused fetal monitoring.

c. The standards of care were not met.

12. 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.

a. A higher rate of obesity among pregnant women.

13. The term used to describe legal and professional responsibility for practice for maternity nurses is:

a. Collegiality.

b. Ethics.

c. Evaluation.

d. Accountability.

d. Accountability.

14. 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.

a. Violation of patient privacy and confidentiality.

15. 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.

b. Blends complementary and alternative therapies with conventional Western treatment.

16. 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.

c. Births occurring in the hospital accounted for 99% of births.

17. 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.

d. Newborn infants remain with the mother and are encouraged to breastfeed.

18. 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.

a. Births to unmarried women are more likely to have less favorable outcomes.

19. 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.

b. Known as evidence-based practice.

20. 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.

a. The standard of care.

21. 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.

b. The client will receive fewer interventions during the birth process.

22. While obtaining a detailed history from a woman who has recently emigrated from Somalia, the nurse realizes that the client has undergone female genital mutilation (FGM). The nurse's best response to this patient is:

a. "This is a very abnormal practice and rarely seen in the United States."

b. "Do you know who performed this so that it can be reported to the authorities?"

c. "We will be able to restore your circumcision fully after delivery."

d. "The extent of your circumcision will affect the potential for complications."

d. "The extent of your circumcision will affect the potential for complications."

23. To ensure patient safety, the practicing nurse must have knowledge of the current Joint Commission's "Do Not Use" list of abbreviations. Which of the following is acceptable for use?

a. q.o.d. or Q.O.D.

b. MSO4 or MgSO4

c. International Unit

d. Lack of a leading zero

c. International Unit

24. Healthy People 2020 has established national health priorities that focus on a number of maternal-child health indicators. Nurses are assuming greater roles in assessing family health and providing care across the perinatal continuum. Therefore it is important for the nurse to be aware that significant progress has been made in:

a. The reduction of fetal deaths and use of prenatal care.

b. Low birth weight and preterm birth.

c. Elimination of health disparities based on race.

d. Infant mortality and the prevention of birth defects.

a. The reduction of fetal deaths and use of prenatal care.

25. Which interventions would help alleviate the problems associated with access to health care for maternity patients (Select all that apply)?

a. Provide transportation to prenatal visits.

b. Provide childcare so that a pregnant woman may keep prenatal visits.

c. Mandate that physicians make house calls.

d. Provide low-cost or no-cost health care insurance.

e. Provide job training.

A, B, D

26. Which of the following statements indicate that the nurse is practicing appropriate family-centered care techniques (Select all that apply)?

a. The nurse commands the mother to do as she is told.

b. The nurse allows time for the partner to ask questions.

c. The nurse allows the mother and father to make choices when possible.

d. The nurse informs the family about what is going to happen.

e. The nurse tells the patient's sister, who is a nurse, that she cannot be in the room during the delivery.

B, C