Test Bank for Maternity and Women's Health Care, 13th Edition (Chapters 1-37)

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankMaternity andWomen's HealthCare 13thEditionLowdermilk TestBank

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankChapter 01: 21st Century Maternity and Women’s Health NursingLowdermilk: Maternity & Women’s Health Care, 12th EditionMULTIPLE CHOICE1.In evaluating the level of a pregnant woman’s risk of having a low-birth-weight (LBW)infant, which factor is the most important for the nurse to consider?a.African-American raceb.Cigarette smokingc.Poor nutritional statusd.Limited maternal educationANS: AThe rise in the overall LBW rates were due to increases in LBW births to non-Hispanicblack women (13.35%) and Hispanic women (7.21%); non-Hispanic black infants arealmost twice as likely as non-Hispanic white infants to be of LBW and to die in the firstyear of life.. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor inpotential infant mortality rates, but it is not the most important. Additionally, smoking is amodifiable risk factor. Poor nutrition is an important factor in potential infant mortalityrates, but it is not the most important. Additionally, nutritional status is a modifiable riskfactor. Maternal education is an important factor in potential infant mortality rates, but it isnot the most important. Additionally, maternal education is a modifiable risk factor.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: AssessmentMSC:ClientNeeds: HealtNhUPrRoSmIotNioGnTanBd.MCaOinMtenance, Antepartum Care2.A 23-year-old African-American woman is pregnant with her first child. Based on currentstatistics for infant mortality, which intervention is most important for the nurse to includein the client’s plan of care?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: DConsistent prenatal care is the best method of preventing or controlling risk factorsassociated with infant mortality. Nutritional status is an important modifiable risk factor, butit is not the most important action a nurse should take in this situation. The client may needassistance from a social worker at some time during her pregnancy, but a referral to a socialworker is not the most important aspect the nurse should address at this time. If the womanhas identifiable high-risk problems, then her health care may need to be provided by aphysician. However, it cannot be assumed that all African-American women have high-riskissues. In addition, advising the woman to see an obstetrician is not the most importantaspect on which the nurse should focus at this time, and it is not appropriate for a nurse toadvise or manage the type of care a client is to receive.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: Planning

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankMSC: Client Needs: Health Promotion and Maintenance3.The nurses working at a newly established birthing center have begun to compare theirperformance in providing maternal-newborn care against clinical standards. Thiscomparison process is most commonly known as what?a.Best practices networkb.Clinical benchmarkingc.Outcomes-oriented pracNtiUceRSd.Evidence-based practiceANS: COutcomes-oriented practice measures the effectiveness of the interventions and quality ofcare against benchmarks or standards. The termbest practicerefers to a program or servicethat has been recognized for its excellence. Clinical benchmarking is a process used tocompare one’s own performance against the performance of the best in an area of service.The termevidence-based practicerefers to the provision of care based on evidence gainedthrough research and clinical trials.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: EvaluationMSC: Client Needs: Safe and Effective Care Environment4.During a prenatal intake interview, the nurse is in the process of obtaining an initialassessment of a 21-year-old Hispanic client with limited English proficiency. Whichintervention is the most important for the nurse to implement?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: DNurses contribute to health literacy by using simple, common words, avoiding jargon, andevaluating whether the client understands the discussion. Speaking slowly and clearly andfocusing on what is important will increase understanding. Most client education materialsare written at a level too high for the average adult and may not be useful for a client withlimited English proficiency.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: ImplementationMSC: Client Needs: Health Promotion and Maintenance5.Which statement best exemplifies contemporary maternity nursing?a.Use of midwives for all vaginal deliveriesb.Family-centered carec.Free-standing birth clinicsd.Physician-driven careANS: B

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankContemporary maternity nursing focuses on the family’s needs and desires. Fathers,partners, grandparents, and siblings may be present for the birth and participate in activitiessuch as cutting the baby’s umbilical cord. Both midwives and physicians perform vaginaldeliveries. Free-standing clinics are an example of alternative birth options. Contemporarymaternity nursing is driven by the relationship between nurses and their clients.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance6.A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after beingin labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could thewoman 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: CNot meeting the standard of care is a legitimate factor for a case of negligence. Aninexperienced maternity nurse would need to display competency before being assigned tocare for clients on his or her own. This client may have been past her due date; however, aterm pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is thestandard of care, the client has the right to refuse treatment. This refusal is not a case fornegligence, but informed consent should be properly obtained, and the client should havesigned anagainst medical adviceform when refusing any treatment that is within thestandard of care.PTS:1DIF:Cognitive Level: AnalyzeTOP:Nursing Process: ImplementationMSC: Client Needs: Safe and Effective Care Environment7.When the nurse is unsure how to perform a client care procedure that is high risk and lowvolume, his or her best action in this situation would be what?a.Ask another nurse.b.Discuss the procedure with the client’s physician.c.Look up the procedure in a nursing textbook.d.First consult the agency procedure manualANS: DFollowing the agency’s policies and procedures manual is always best when seekinginformation on correct client procedures. These policies should reflect the current standardsof care and the individual state’s guidelines. Each nurse is responsible for his or her ownpractice. Relying on another nurse may not always be a safe practice. Each nurse isobligated to follow the standards of care for safe client care delivery. Physicians areresponsible for their own client care activity. Nurses may follow safe orders fromphysicians, but they are also responsible for the activities that they, as nurses, are to carryout. 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 orthe individual state or hospital policies.

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankPTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: ImplementationMSC: Client Needs: Physiologic Integrity8.A nurse caring for a pregnant client should be aware that the U.S. birth rate shows whattrend?a.Births to unmarried women are more likely to have less favorable outcomes.b.Birth rates for women 40 to 44 years of age are declining.c.Cigarette smoking among pregnant women continues to increase.d.Rates of pregnancy and abortion among teenagers are lower in the United Statesthan in any other industrialized country.ANS: ALBW infants and preterm births are more likely because of the large number of teenagers inthe unmarried group. Birth rates for women in their early 40s continue to increase. Fewerpregnant women smoke. Teen pregnancy and abortion rates are higher in the United Statesthan in any other industrial country.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: AssessmentMSC: Client Needs: Psychosocial Integrity9.A recently graduated nurse is attempting to understand the reason for increasing health carespending in the United States. Which information gathered from research best explains therationale for these higher costs compared with other developed countries?a.Higher rate of obesity among pregnant womenb.Limited access to technologyc.Increaseduseof healthNcaUreRsSerIviNcGesTaBlo.ngCwOiMth lower pricesd.Homogeneity of the populationANS: AHealth care is one of the fastest growing sectors of the U.S. economy. Currently, 17.5% ofthe gross domestic product is spent on health care. Higher spending in the United States, ascompared with 12 other industrialized countries, is related to higher prices and readilyaccessible technology along with greater obesity rates among women. More than one thirdof women in the United States are obese. In the population in the United States, 16% areuninsured and have limited access to health care. Maternal morbidity and mortality aredirectly related to racial disparities.PTS:1DIF:Cognitive Level: UnderstandTOP:Teaching and LearningMSC: Client Needs: Safe and Effective Care Environment10.Which statement best describes maternity nursing care that is based on knowledge gainedthrough research and clinical trials?a.Maternity nursing care is derived from the Nursing Intervention Classification.b.Maternity nursing care is known as evidence-based practice.c.Maternity nursing care is at odds with the Cochrane School of traditional nursing.d.Maternity nursing care is an outgrowth of telemedicine.ANS: B

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankEvidence-based practice is based on knowledge gained from research and clinical trials. TheNursing Intervention Classification is a method of standardizing language and categorizingcare. Dr. Cochrane systematically reviewed research trials and is part of the evidence-basedpractice movement. Telemedicine uses communication technologies to support health care.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: DiagnosisMSC: Client Needs: Safe and Effective Care Environment11.What is the minimum level of practice that a reasonably prudent nurse is expected toprovide?a.Standard of careb.Risk managementc.Sentinel eventd.Failure to rescueANS: AGuidelines for standards of care are published by various professional nursing organizations.Risk management identifies risks and establishes preventive practices, but it does not definethe standard of care. Sentinel events are unexpected negative occurrences. They do notestablish the standard of care. Failure to rescue is an evaluative process for nursing, but itdoes not define the standard of care.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: ImplementationMSC: Client Needs: Safe and Effective Care EnvironmentNURSINGTB.COM12.Using social media technology, nurses can link with other nurses who may share similarinterests, insights about practice, and advocate for clients. Which factor is the mostconcerning pitfall for nurses using this technology?a.Violation of client privacy and confidentialityb.Institutions and colleagues who may be cast in an unfavorable lightc.Unintended negative consequences for using social mediad.Lack of institutional policy governing online contactANS: AThe most significant pitfall for nurses using this technology is the violation of client privacyand confidentiality. Furthermore, institutions and colleagues can be cast in an unfavorablelight with negative consequences for those posting information. Nursing students have beenexpelled from school and nurses have been fired or reprimanded by their Board of Nursingfor injudicious posts. The American Nurses Association has published six principles forsocial networking and the nurse. All institutions should have policies guiding the use ofsocial media, and the nurse should be familiar with these guidelines.PTS:1DIF:Cognitive Level: AnalyzeTOP:Nursing Process: ImplementationMSC: Client Needs: Safe and Effective Care Environment

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBank13.During a prenatal intake interview, the client informs the nurse that she would prefer amidwife to provide both her care during pregnancy and deliver her infant. Whichinformation is most appropriate for the nurse to share with this client about resulting care?a.Midwifery care is a good option for clients who are uninsured.b.She will receive fewer interventions during the birth process.c.She should be aware that midwives are not certified.d.Her delivery can take place only at home or in a birth center.ANS: BThis client will be able to participate actively in all decisions related to the birth process andis likely to receive fewer interventions during the birth process. Midwifery services areavailable to all low-risk pregnant women, regardless of the type of insurance they have.Midwifery care in all developed countries is strictly regulated by a governing body to ensurethat core competencies are met. In the United States, this body is the American College ofNurse-Midwives (ACNM). Midwives can provide care and delivery at home, infreestanding birth centers, and in community and teaching hospitals.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Safe and Effective Care Environment14.While obtaining a detailed history from a woman who has recently immigrated fromSomalia, the nurse realizes that the client has undergone female genital mutilation. What isthe nurse’s most appropriate response in this situation?a.“This is a very abnormal practice and rarely seen in the United States.”b.“Are you aware of who performed this mutilation so that it can be reported to theauthorities?”NURSINGTB.COMc.“We will be able to restore fully your circumcision after delivery.”d.“The extent of your circumcision will affect the potential for complications.”ANS: DThe extent of the circumcision is important. The client may experience pain, bleeding,scarring, or infection and may require surgery before childbirth. Although this practice isnot prevalent in the United States, it is very common in many African and Middle Easterncountries for religious reasons. Mentioning that the practice is abnormal and rarely seen inthe United States is culturally insensitive. The infibulation may have occurred duringinfancy or childhood; consequently, the client will have little to no recollection of the event.She would have considered this to be a normal milestone during her growth anddevelopment. The International Council of Nurses has spoken out against this procedure asharmful to a woman’s health.PTS:1DIF:Cognitive Level: AnalyzeTOP:Nursing Process: AssessmentMSC: Client Needs: Psychosocial Integrity15.Maternity nurses can enhance communication among health care providers by using theSBAR technique. The acronym SBAR stands for what?a.Situation, background, assessment, recommendationb.Situation, baseline, assessment, recommendationc.Subjective, background, analysis, recommendationd.Subjective, background, analysis, review

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankANS: ASBAR is an easy-to-remember, useful, and concrete mechanism for communicatingimportant information that requires a clinician’s immediate attention.Baselineis notdiscussed as part of SBAR.Subjectiveandanalysisare not specific to the SBAR acronym.Subjective, analysis,andrevieware not specific to the SBAR acronym.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: ImplementationMSC: Client Needs: Safe and Effective Care EnvironmentMULTIPLE RESPONSE1.Greater than one third of women in the United States are now obese (body mass index[BMI] of 30 or greater). Less than one quarter of women in Canada exhibit the same BMI.Obesity in the pregnant woman increases both maternal medical risk factors and negativeoutcomes for the infant. The nurse is about to perform an assessment on a client who is 28weeks pregnant and has a BMI of 35. What are the most frequently reported complicationsfor which the nurse must be alert while assessing this client? (Select all that apply.)a.Potential miscarriageb.Diabetesc.Fetal death in uterod.Decreased fertilitye.HypertensionANS: B, EThetwomost frequently reNpUorRteSd mINateGrTnaBl m.CedicMalriskfactorsassociated with obesity arehypertension associated with pregnancy and diabetes. Decreased fertility, miscarriage, fetaldeath, and congenital anomalies are also associated with obesity. These clients oftenexperience longer hospital stays and increased use of health services.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: AssessmentMSC: Client Needs: Physiologic Integrity2.The Patient Protection and Affordable Care Act (ACA) was signed into law by PresidentObama in early 2010. The Act provides some immediate benefits, and other provisions willtake place over the next several years. The practicing nurse should have a thoroughunderstanding of how these changes will benefit his or her clients. Which outcomes aregoals of the ACA? (Select all that apply.)a.Insurance affordabilityb.Improve public healthc.Treatment of illnessd.Elimination of Medicare and Medicaide.Cost containmentANS: A, B, EThe ACA goals are to make insurance more affordable, contain costs, and strengthenMedicare and Medicaid. The Act contains provisions that promote the prevention of illnessand improve access to public health. The ultimate goal of the Act is to improve the qualityof care for all Americans while reducing waste, fraud, and abuse of the current system.

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankPTS:1DIF:Cognitive Level: ComprehendTOP:Nursing Process: PlanningMSC: Client Needs: Safe and Effective Care Environment3.Which statements indicate that the nurse is practicing appropriate family-centered caretechniques? (Select all that apply.)a.The nurse commands the pregnant woman 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 client’s sister, who is a nurse, that she cannot be in the roomduring the delivery.ANS: B, CIncluding the partner in the care process and allowing the couple to make choices areimportant elements of family-centered care. The nurse should never tell the client what todo. Family-centered care involves collaboration between the health care team and the client.Unless an institutional policy limits the number of attendants at a delivery, the client shouldbe allowed to have whomever she wants present (except when the situation is an emergencyand guests are asked to leave).PTS:1DIF:Cognitive Level: AnalyzeTOP:Nursing Process: ImplementationMSC: Client Needs: Psychosocial Integrity4.Which methods help alleviate the problems associated with access to health care for thematernity client? (Select alNl tUhaRtSapIpNlyG.)TB.COMa.Provide transportation to prenatal visits.b.Provide child care to enable a pregnant woman to keep prenatal visits.c.Increase the number of providers that will care for Medicaid clients.d.Provide low-cost or no-cost health care insurance.e.Provide job training.ANS: A, B, C, DLack of transportation to prenatal visits, child care, access to skilled obstetric providers, andaffordable health insurance are prohibitive factors associated with the lack of prenatal care.Although job training may result in employment and income, the likelihood of significantchanges during the time frame of the pregnancy is remote.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankChapter 02: Community Care: The Family and CultureLowdermilk: Maternity & Women’s Health Care, 12th EditionMULTIPLE CHOICE1.A married couple lives in a single-family house with their newborn son and the husband’sdaughter from a previous marriage. Based on this information, what family form bestdescribes this family?a.Married-blended familyb.Extended familyc.Nuclear familyd.Same-sex familyANS: AMarried-blended families are formed as the result of divorce and remarriage. Unrelatedfamily members join to create a new household. Members of an extended family are kin orfamily members related by blood, such as grandparents, aunts, and uncles. A nuclear familyis a traditional family with male and female partners along with the children resulting fromthat union. A same-sex family is a family with homosexual partners who cohabit with orwithout children.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Psychosocial Integrity2.Which key factors play the most powerful role in the behaviors of individuals and families?a.Rituals and customsb.Beliefs and valuesNURSINGTB.COMc.Boundaries and channelsd.Socialization processesANS: BBeliefs and values are the most prevalent factors in the decision-making andproblem-solving behaviors of individuals and families. This prevalence is particularly trueduring times of stress and illness. Although culture may play a part in the decision-makingprocess of a family, ultimately, values and beliefs dictate the course of action taken byfamily members. Boundaries and channels affect the relationship between the familymembers and the health care team, not the decisions within the family. Socializationprocesses may help families with interactions within the community, but they are not thecriteria used for decision making within the family.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial Integrity3.What is the primary difference between hospital care and home health care?a.Home care is routinely and continuously delivered by professional staff.b.Home care is delivered on an intermittent basis by professional staff.c.Home care is delivered for emergency conditions.d.Home care is not available 24 hours a day.

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankANS: BHome care is generally delivered on an intermittent basis by professional staff members.The primary difference between health care in a hospital and home care is the absence of thecontinuous presence of professional health care providers in a client’s home. In a trueemergency, the client should be directed to call 9-1-1 or to report to the nearest hospital’semergency department. Generally, home health care entails intermittent care by aprofessional who visits the client’s home for a particular reason and provides on-site care forperiods shorter than 4 hours at a time.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: ImplementationMSC: Client Needs: Safe and Effective Care Environment4.The woman’s family members are present when the nurse arrives for a postpartum andnewborn visit. What should the nurse do?a.Observe the family members’ interactions with the newborn and one another.b.Ask the woman to meet with her and the baby alone.c.Perform a brief assessment on all family members who are present.d.Reschedule the visit for another time so that the mother and infant can be privatelyassessed.ANS: AThe nurse should introduce her or himself to the client and to the other family members whoare present. Family members in the home may be providing care and assistance to themother and infant. However, this care may not be based on sound health practices. Nursesshould take the opportunity to dispel myths while family members are present. Theresponsibility of the homeNcaUreRmSaIteNrnGalT-cBhi.ldCnuMrse isto provide care to the newpostpartum mother and to her infant, not to all family members. The nurse can politely askabout the other people in the home and their relationships with the mother. Unless anindication is given that the woman would prefer privacy, the visit may continue.PTS:1DIF:Cognitive Level: AnalyzeTOP:Nursing Process: AssessmentMSC: Client Needs: Psychosocial Integrity5.What is a limitation of a home postpartum visit?a.Distractions limit the nurse’s ability to teach.b.Identified problems cannot be resolved in the home setting.c.Necessary items for infant care are not available.d.Home visits to different families may require the nurse to travel a great distance.ANS: DOne limitation of home health visits is the distance the nurse must travel between clients.Driving directions should be obtained by telephone before the visit. The home care nurse isaccustomed to distractions but may request that the television be turned off so that attentioncan be focused on the client and her family. Problems cannot always be resolved; however,appropriate referrals may be arranged by the nurse. The nurse is required to bring anynecessary equipment, such as a thermometer, baby scale, or laptop computer, fordocumentation.PTS:1DIF:Cognitive Level: Understand

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankTOP:Nursing Process: PlanningMSC: Client Needs: Safe and Effective Care Environment6.When the services of an interpreter are needed, which is the most important factor for thenurse to consider?a.Using a family member who is fluent in both languagesb.Using an interpreter who is certified, and documenting the person’s name in thenursing notesc.Directing questions only to the interpreterd.Using an interpreter only in an emergencyANS: BUsing a certified interpreter ensures that the standards of care are met and that theinformation exchanged is reliable and unaltered. The name of the interpreter should bedocumented for legal purposes. Asking a family member to interpret may not beappropriate, although many health care personnel must adopt this approach in anemergency. Furthermore, most states require that certified interpreters be used whenpossible. When using an interpreter, the nurse should direct questions to the client. Theinterpreter is simply a means by which the nurse communicates with the client. Everyattempt should be made to contact an interpreter whenever one is needed. During anemergency, health care workers often rely on information interpreted by family members.This information may be private and should be protected under the rules established by theHealth Insurance Portability and Accountability Act (HIPAA). Furthermore, familymembers may skew information or may not be able to interpret the exact information thenurse is trying to obtain.PTS:1DIF:NUCRoSgnIitNivGeTLBev.elC:AOpMplyTOP:Nursing Process: ImplementationMSC: Client Needs: Psychosocial Integrity7.Which traditional family structure is decreasing in numbers and attributable to societalchanges?a.Extended familyb.Binuclear familyc.Nuclear familyd.Blended familyANS: CThe nuclear family has long represented the traditional American family in which husband,wife, and children live as an independent unit. As a result of rapid changes in society, thisnumber is steadily decreasing as other family configurations are socially recognized.Extended families involve additional blood relatives other than the parents. A binuclearfamily involves two households. A blended family is reconstructed after divorce andinvolves the merger of two families.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: AssessmentMSC: Client Needs: Psychosocial Integrity8.Which pictorial tool can assist the nurse in assessing the aspects of family life related tohealth care?a.Genogram

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankb.Ecomapc.Life-cycle modeld.Human development wheelANS: AA genogram depicts the relationships of the family members over generations. An ecomap isa graphic portrayal of the social relationships of the woman and her family. The life-cyclemodel, in no way, illustrates a family genogram; rather, it focuses on the stages that a personreaches throughout life. The human development wheel describes various stages of growthand development rather than the family members’ relationships to each other.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Psychosocial Integrity9.When attempting to communicate with a client who speaks a different language, whichaction is the most appropriate?a.Promptly and positively respond to project authority.b.Never use a family member as an interpreter.c.Talk to the interpreter to avoid confusing the client.d.Provide as much privacy as possible.ANS: DProviding privacy creates an atmosphere of respect and puts the client at ease. The nurseshould not rush to judgment and should ensure she or he clearly understands the client’smessage. In crisis situations, the nurse may need to use a family member or neighbor as atranslator. The nurse should speak directly to the client to create an atmosphere of respect.PTS:1DIF:NUCRoSgnIitNivGeTLBev.elC:AOpMplyTOP:Nursing Process: ImplementationMSC: Client Needs: Psychosocial Integrity10.Which key point is important for the nurse to understand regarding the perinatal continuumof care?a.Begins with conception and ends with the birthb.Begins with family planning and continues until the infant is 1 year oldc.Begins with prenatal care and continues until the newborn is 24 weeks oldd.Refers to home care onlyANS: BThe perinatal continuum of care begins with family planning and continues until the infantis 1 year old. It takes place both at home and in health care facilities. The perinatalcontinuum does not end with the birth. The perinatal continuum begins before conceptionand continues after the birth. Home care is one delivery component; health care facilities areanother.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance11.What information should the nurse be aware of regarding telephonic nursing care such aswarm lines?

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBanka.Were developed as a reaction to impersonal telephonic nursing careb.Were set up to take complaints concerning health maintenance organizations(HMOs)c.Are the second option when 9-1-1 hotlines are busyd.Refer to community service telephone lines designed to provide new parents withencouragement and basic informationANS: DWarm lines are one aspect of telephonic nursing care specifically designed to provide newparents with encouragement and basic information. Warm lines and similar servicessometimes are set up by HMOs to provide new parents with encouragement and basicinformation. The name,warm lines, may have been suggested by the termhotlines,but theseare not emergency numbers but are designed to provide new parents with encouragementand basic information.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance12.When weighing the advantages and disadvantages of planning home care for perinatalservices, what information should the nurse use in making the decision?a.Home care for perinatal services is more dangerous for vulnerable neonates at riskof acquiring an infection from the nurse.b.Home care for perinatal services is more cost-effective for the nurse than officevisits.c.Home care for perinatal services allows the nurse to interact with and includefamily membersin teacNhiUngR.SINGTB.COMd.Home care for perinatal services is made possible by the ready supply of nurseswith expertise in maternity care.ANS: CTreating the whole family is an advantage of home care. Forcing neonates out in inclementweather and in public is more risky. Office visits are more cost-effective for the providerssuch as nurses because less travel time is involved. Unfortunately, home care options arelimited by the lack of nurses with expertise in maternity care.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: ImplementationMSC: Client Needs: Psychosocial Integrity13.In what form do families tend to be the most socially vulnerable?a.Married-blended familyb.Extended familyc.Nuclear familyd.Single-parent familyANS: DThe single-parent family tends to be economically and socially vulnerable, creating anunstable and deprived environment for the growth potential of children. Themarried-blended family, the extended family, and the nuclear family are not the mostsocially vulnerable.

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankPTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial Integrity14.A client’s household consists of her husband, his mother, and another child. To whichfamily configuration does this client belong?a.Multigenerational familyb.Single-parent familyc.Married-blended familyd.Nuclear familyANS: AA multigenerational family includes three or more generations living together. Both parentsand a grandparent are living in this extended family. Single-parent families comprise anunmarried biologic or adoptive parent who may or may not be living with other adults.Married-blended families refer to those who are reconstructed after divorce. A nuclearfamily comprises male and female partners and their children living together as anindependent unit.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: AssessmentMSC: Client Needs: Psychosocial Integrity15.Which term is an accurate description of the process by which people retain some of theirown culture while adopting the practices of the dominant society?a.Acculturationb.Assimilationc.Ethnocentrismd.Cultural relativismANS: ANURSINGTB.COMAcculturation is the process by which people retain some of their own culture whileadopting the practices of the dominant society. This process takes place over the course ofgenerations. Assimilation is a loss of cultural identity. Ethnocentrism is the belief in thesuperiority of one’s own culture over the cultures of others. Cultural relativism recognizesthe roles of different cultures.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial Integrity16.Which statement about the development of cultural competence is inaccurate?a.Local health care workers and community advocates can help extend health care tounderserved populations.b.Nursing care is delivered in the context of the client’s culture but not in the contextof the nurse’s culture.c.Nurses must develop an awareness of and a sensitivity to various cultures.d.Culture’s economic, religious, and political structures influence practices thataffect childbearing.ANS: B

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankAlthough the cultural context of the nurse affects the delivery of nursing care and is veryimportant, the work of local health care workers and community advocates, developingsensitivity to various cultures, and the impact of economic, religious, and political structuresare all parts of cultural competence.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial IntegrityMULTIPLE RESPONSE1.While completing an assessment of a homeless woman, the nurse should be aware of whichof the following ailments this client is at a higher risk to develop?(Select all that apply.)a.Infectious diseasesb.Chronic illnessc.Anemiad.Hyperthermiae.Substance abuseANS: A, B, C, EPoor living conditions contribute to higher rates of infectious disease. Many homelessindividuals engage in sexual favors, which may expose them to sexually transmittedinfections (STIs). Poor nutrition can lead to anemia. Lifestyle factors also contribute tochronic illness. Exposure to cold temperatures and harsh environmental surroundings maylead to hypothermia. Many homeless people turn to alcohol and other substances as copingmechanisms.PTS:1DIF:NUCRoSgnIitNivGeTLBev.elC:AOnMalyzeTOP:Nursing Process: AssessmentMSC: Client Needs: Safe and Effective Care Environment

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankChapter 03: Nursing and GenomicsLowdermilk: Maternity & Women’s Health Care, 12th EditionMULTIPLE CHOICE1.A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter hasthe condition. The couple tells the nurse that they are expecting a second baby. Becausetheir daughter has PKU, they are certain that this baby will not be affected. Which responseby the nurse is the most accurate?a.“Good planning. You need to take advantage of the odds that are in your favor.”b.“I think you’d better first check with your physician.”c.“You are both carriers; therefore, each baby has a 25% chance of being affected.”d.“The ultrasound indicates a boy, and boys are not affected by PKU.”ANS: CEach child conceived by this couple has a one-in-four chance of being affected with thePKU disorder. This couple still has an increased likelihood of having a child with PKU;having one child already with PKU does not guarantee that they will not have another.These parents need to discuss their options with their physician since the pregnancy hasalready occurred. However, an opportune time has presented itself for the couple to receivecorrect teaching about inherited genetic risks. No correlation exists between gender andinheritance of the disorder, because PKU is an autosomal recessive disorder.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: PlanningMSC:ClientNeeds: HealtNhUPrRoSmIotNioGnTanBd.MCaOinMtenance2.A client is 5 months pregnant. On a routine ultrasound scan, the physician discovers that thefetus has a diaphragmatic hernia. The woman becomes distraught and asks the nurse whatshe should do. Which response would be most suitable?a.Talk to the client and refer her to a genetic counselor.b.Suggest that the client travel to a fetal treatment center for intrauterine surgery.c.Tell her that everything is going to be fine.d.Sit with the client, and calmly suggest that she consider terminating thispregnancy.ANS: ABefore the client makes any decisions, she should discuss this newly discovered informationwith a genetic counselor. Genetic counselors can help with the diagnosis and managementof families affected by genetic conditions. The discussion of potential surgery should bepursuant to genetic counseling. Telling the woman that everything is going to be fine maygive her false hope and is not accurate. All options should be discussed with the geneticcounselor. Furthermore, the guiding principle for genetic counseling is nondirection, whichrespects the right of the individual or family who are being counseled to make autonomousdecisions.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankN R I G B.C M3.A new father has just been told that his infant has trisomy 18. Which identifying physicalfeature is unique to an infant with this genetic disorder?a.Microcephaly and capillary hemangiomasb.Epicanthal folds and a simian creasec.Oblique palpebral fissures and Cri du chat syndromed.Rocker-bottom feet and clenched hands with overlapping fingersANS: DRocker-bottom feet and clenched hands with overlapping fingers are associated withtrisomy 18. Microcephaly and capillary hemangiomas are associated with trisomy 13.Epicanthal folds and a simian crease are associated with trisomy 21 (Down syndrome).Deletion of the short arm of chromosome number 5 is manifested by Cri du chat syndrome.PTS:1DIF:Cognitive Level: ApplyingTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance4.A nurse is assessing the knowledge of new parents of a child born with Klinefeltersyndrome. Which statement accurately describes this genetic disorder?a.Klinefelter syndrome is a sex chromosome abnormality.b.It affects only female children.c.The disorder is expressed as trisomy XYY.d.The child with this disorder will grow to be infertile.ANS: AKlinefelter syndrome, also known as trisomy XXY, is a sex chromosomal deviation that isexpressedin males.TurnersyUndrSomNe (mTonosomOyX) isdisplayed in females. Most maleswith Klinefelter syndrome are tall, may be infertile, and are slow to learn; however, thosewho have mosaic Klinefelter syndrome may be fertile as adults.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance5.A 32-year-old woman is pregnant for the third time. One child was born with cystic fibrosis,and the other child is healthy. The client and her partner wonder what chance this child hasof having cystic fibrosis. This type of testing is most commonly known as what?a.Occurrence riskb.Recurrence riskc.Predictive testingd.Predisposition testingANS: BThe couple already has a child with a genetic disease; therefore, this couple will be given arecurrence risk test. If a couple has not yet had a child but is known to be at risk for having achild with a genetic disease, then an occurrence risk test is administered. Predictive testingclarifies the genetic status of an asymptomatic family member. Predisposition testing differsfrom pre-symptomatic testing in that a positive result does not indicate 100% risk of acondition developing.

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankU S N TPTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance6.Cancer is now recognized as a genetic disorder that begins with one or more geneticmutations. Which type of cancer is specifically being investigated in this regard?a.Lung cancerb.Liver cancerc.Colorectal cancerd.Oral cancerANS: CColorectal cancer usually results from one or more predisposing genes and is the thirdleading cause of cancer deaths in women. Although tobacco smoke is a known causativefactor for lung cancer, an acquired mutation of an oncogene may also be present. Livercancer is not being investigated in this regard. Oral cancer may be caused by an inheritedmutation of one or more oncogenes.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance7.Which statement describes a key finding of the Human Genome Project?a.Humans produce one protein per gene.b.All human beings are 99.9% identical at the deoxyribonucleic acid (DNA) level.c.The HumanGenomePNrojeRct hIasnGot yBet.bCeenMable to translate the accumulatingraw research into anything medically practical.d.Humans have more genes than other species.ANS: BThe majority of the 0.1% genetic variations are found within and not among populations.Most human genes produce at least three proteins. The project’s research has been veryvaluable in the identification of genes involved in disease and in the development of genetictesting. There are 20,500 genes in the human genome; scientists originally estimated morethan 50,000 genes. Human genes are more efficient than the genes in other species, therebyincreasing the human genetic complexity.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance8.Which condition or treatment reduces the risk of morbidity in women with the inheritedfactor V Leiden disorder?a.Anticoagulant therapyb.Pregnancyc.Oral contraceptivesd.Hormone replacement therapyANS: A

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankFactor V Leiden is the most common inherited risk factor for primary or recurrent venousthromboembolism. It is an autosomal recessive disorder that increases an individual’s riskfor blood clots in the legs and pulmonary emboli making anticoagulant therapy a primarymanagement intervention. This risk significantly increases if the woman is pregnant or istaking oral contraceptives or hormone replacement therapy. Prophylactic anticoagulationtherapy decreases the risk of comorbidities.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Physiologic Integrity9.Nurses who elect to practice in the field of obstetrics must have a basic working knowledgeof genetics. What is the correct term used to describe an individual’s genetic makeup?a.Genotypeb.Phenotypec.Karyotyped.ChromotypeANS: AThe genotype comprises all the genes the individual can pass on to a future generation. Thephenotype is the observable expression of an individual’s genotype. The karyotype is apictorial analysis of the number, form, and size of an individual’s chromosomes. Genotyperefers to an individual’s genetic makeup.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and MaintenanceNURSINGTB.COM10.The U.S. Department of Health and Human Services has designated Thanksgiving Day asNational Family History Day. The U.S. Surgeon General encourages family members todiscuss important family health information while sharing in holiday gatherings. Why is thisinitiative significant to nurses?a.Few genetic tests are available that identify this information.b.Only physicians should obtain this detailed information.c.Clients cannot accurately complete these histories on their own.d.Family history is the single most cost-effective source for genetic information.ANS: DAlthough more than 1000 genetic tests are available, the single most cost-effective piece ofgenetic information is the family history. Nurses are ideally suited to take the lead inongoing efforts to recognize the significance of the family history as an important source ofgenetic information. A computerized tool calledMy Family Health Portraitis available freeof charge (https://familyhistory.hhs.gov/fhh-web/home.action). Other tools designed to helpthe lay community in completing their family histories are available to the public.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance11.Which statement regarding genetic health care is considered a priority to the nursepracticing in this specialty?

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankU S N TOa.Genetic disorders equally affect people of all socioeconomic backgrounds, races,and ethnic groups.b.Genetic health care is more concerned with populations than individuals.c.Providing emotional support to the family during counseling is the most importantof all nursing functions.d.Taking genetic histories is the province of large universities and medical centers.ANS: CPerhaps the most important of all nursing functions is the ability to provide emotionalsupport. Nurses should be prepared to help with various stress reactions from a couplefacing the possibility of a genetic disorder. Although anyone may have a genetic disorder,certain disorders appear more often in certain ethnic and racial groups. Genetic health care ishighly individualized because treatments are based on the phenotypic responses of theindividual. Individual nurses at any facility can take a genetic history, although largerfacilities may have better support services.PTS:1DIF:Cognitive Level: AnalyzingTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial Integrity12.Which statement most accurately describes dominant genetic disorders?a.With a dominant disorder, the likelihood of the second child also having thecondition is 100%.b.An autosomal recessive disease carries a one-in-eight risk of the second child alsohaving the disorder.c.Disorders involving maternal ingestion of drugs carry a one-in-four chance ofbeing repeated in the second child.d.Theriskfactor remainsNtheRsamIe nGo mBat.teCr hoMwmany affected children are alreadyin the family.ANS: DEach pregnancy is an independent event. The risk factor (e.g., one-in-two, one-in-four)remains the same for each child, no matter how many children are born to the family. In adominant disorder, the likelihood of recurrence in subsequent children is 50% (i.e.,one-in-two). An autosomal recessive disease carries a one-in-four chance of recurrence. Indisorders involving maternal ingestion of drugs, subsequent children would be at risk only ifthe mother continued to take the drugs; the rate of risk would be difficult to calculate.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: DiagnosisMSC: Client Needs: Health Promotion and Maintenance13.Which type of genetic tests in clinical practice are most often offered to clients with a familyhistory of disease?a.Single-gene disordersb.Carrier screeningc.Predictive value testingd.Pre-dispositional testingANS: A

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankU S N TOMost tests now offered are tests for single-gene disorders in clients with clinical symptomsor clients who have a family history of a genetic disease. Carrier screening is used toidentify individuals who have a gene mutation for a genetic condition but do not displaysymptoms. Predictive value testing is used only to clarify the genetic status of asymptomaticfamily members. Pre-dispositional testing differs from the other types of genetic screeningin that a positive result does not indicate a 100% chance of developing the condition.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and MaintenanceMULTIPLE RESPONSE1.Which congenital malformations result from multifactorial inheritance? (Select all thatapply.)a.Cleft lipb.Congenital heart diseasec.Cri du chat syndromed.Anencephalye.Pyloric stenosisANS: A, B, D, ECleft lip, congenital heart disease, anencephaly, and pyloric stenosis are associated withmultifactorial inheritance. Cri du chat syndrome is related to a chromosomal deletion.PTS:1DIF:NCRognIitivGe LevB.elC:AnMalyzeTOP:Nursing Process: DiagnosisMSC: Client Needs: Psychosocial Integrity2.Which activities are included in the role of a nurse practicing in the field of genetics? (Selectall that apply.)a.Assessing the responses of family members to a genetic disorderb.Performing genetic testing, such as amniocentesisc.Constructing a family pedigree of three or more generationsd.Advising a pregnant mother whose fetus has a genetic disorder to have an abortione.Offering parents information about geneticsANS: A, C, EAssessing the responses of family members, constructing a family pedigree, and offeringparents information about genetics are activities that a genetics nurse would carry out incaring for a family undergoing genetic counseling. Physicians perform amniocentesis, butthe nurse may assist in this procedure. Being aware of their own values and beliefs andrefraining from attempting to influence the family are important responsibilities for nurses.The nurse must respect the right of the individual or family to make autonomous decisions.PTS:1DIF:Cognitive Level: ApplyingTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial Integrity

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBank3.One of the most promising clinical applications of the Human Genome Project has beenpharmacogenomic testing (the use of genetic information to guide a client’s drug therapy).Which conditions are potential candidates for pharmacogenomic application? (Select all thatapply.)a.Fragile X syndromeb.Deep vein thrombosis (DVT)c.Breast cancerd.Myocardial infarctione.HemophiliaANS: B, C, DAssociations between genetic variation and drug effect have been observed for a number ofcommonly used drugs. The conditions for which these are applicable include: DVT, breastcancer, and myocardial infarction. Gene therapy has been unsuccessfully used in hemophiliatreatment. Fragile X syndrome is the leading cause of intellectual disability and lackseffective treatment of any kind.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and MaintenanceNURSINGTB.COM

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankChapter 04: Assessment and Health PromotionLowdermilk: Maternity & Women’s Health Care, 12th EditionMULTIPLE CHOICE1.Due to the effects of cyclic ovarian changes in the breast, when is the best time for breastself-examination (BSE)?a.Between 5 and 7 days after menses ceasesb.Day 1 of the endometrial cyclec.Midmenstrual cycled.Any time during a shower or bathANS: AThe physiologic alterations in breast size and activity reach their minimal levelapproximately 5 to 7 days after menstruation ceases. Therefore, BSE is best performedduring this phase of the menstrual cycle. Day 1 of the endometrial cycle is too early toperform an accurate BSE. After the midmenstrual cycle, breasts are likely to become tenderand increase in size, which is not the ideal time to perform BSE. Lying down after a showeror bath with a small towel under the shoulder of the side being examined is appropriateteaching for BSE. A secondary BSE may be performed while in the shower.PTS:1DIF:Cognitive Level: ApplyingTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance2.Individual irregularitiesinNthUeRovSarIiaNnG(mTeBn.strCuOalM) cycle are most often caused bywhat?a.Variations in the follicular (preovulatory) phaseb.Intact hypothalamic-pituitary feedback mechanismc.Functioning corpus luteumd.Prolonged ischemic phaseANS: AAlmost all variations in the length of the ovarian cycle are the result of variations in thelength of the follicular phase. This information discounts the other options as being correct.An intact hypothalamic-pituitary feedback mechanism would be regular, not irregular. Theluteal phase begins after ovulation. The corpus luteum is dependent on the ovulatory phaseand fertilization. During the ischemic phase, the blood supply to the functional endometriumis blocked, and necrosis develops. The functional layer separates from the basal layer, andmenstrual bleeding begins.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance3.How would the physiologic process of the sexual response best be characterized?a.Coitus, masturbation, and fantasyb.Myotonia and vasocongestionc.Erection and orgasmd.Excitement, plateau, and orgasm

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankN R I G B.C MANS: BPhysiologically, sexual response can be analyzed in terms of two processes: vasocongestionand myotonia. Coitus, masturbation, and fantasy are forms of stimulation for the physicalmanifestation of the sexual response. Erection and orgasm occur in two of the four phases ofthe sexual response cycle. Excitement, plateau, and orgasm are three of the four phases ofthe sexual response cycle.PTS:1DIF:Cognitive Level: KnowledgeTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance4.The nurse guides a woman to the examination room and asks her to remove her clothes andput on an examination gown with the front open. The woman replies, “I have specialundergarments that I do not remove for religious reasons.” Which is the most appropriateresponse from the nurse?a.“You can’t have an examination without removing all your clothes.”b.“I’ll ask the physician to modify the examination.”c.“I’ll explain the examination procedure, and then we can discuss how you cancomfortably have your examination.”d.“I have no idea how we can accommodate your beliefs.”ANS: CExplaining the examination procedure reflects cultural competence by the nurse and showsrespect for the woman’s religious practices. The nurse must respect the rich and uniquequalities that cultural diversity brings to individuals. The examination can be modified toensure that modesty is maintained. In recognizing the value of cultural differences, the nursecan modify the plan of care tUo mSeet tNhe nTeedsofOeach woman. Telling the client that herreligious practices are different or strange is inappropriate and disrespectful to the client.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial Integrity5.A woman tells the nurse that she thinks she has a vaginal infection, and has been using anover-the-counter cream for the past 2 days to treat it. How should the nurse initiallyrespond?a.Determine when she first noticed the symptoms.b.Reassure the woman that using vaginal cream is not a problem for theexamination.c.Ask the woman to describe the symptoms that indicate to her that she has a vaginalinfection.d.Ask the woman to reschedule the appointment for the examination.ANS: C

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankAn important element of the health history and physical examination is the client’sdescription of any symptoms she may be experiencing. The best response is for the nurse toinquire about the symptoms the woman is experiencing. While relevant, when the symptomsbegan is not as important as what the symptoms are.Women should not douche, usevaginal medications, or have sexual intercourse for 24 to 48 hours before obtaining a Paptest. Although the woman may need to reschedule a visit for her Pap test, her currentsymptoms should still be addressed.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: AssessmentMSC: Client Needs: Physiologic Integrity6.Preconception and prenatal care have become important components of women’s health.What is the guiding principal of preconception care?a.Ensure that pregnancy complications do not occur.b.Identify the woman who should not become pregnant.c.Encourage healthy lifestyles for families desiring pregnancy.d.Ensure that women know about prenatal care.ANS: CPreconception counseling guides couples in how to avoid unintended pregnancies, how toidentify and manage risk factors in their lives and in their environment, and how to identifyhealthy behaviors that promote the well-being of the woman and her potential fetus.Preconception care does not ensure that pregnancy complications will not occur. In manycases, problems can be identified and treated and may not recur in subsequent pregnancies.For many women, counseling can allow behavior modification before any damage is done,or a woman can make an informed decision about her willingness to accept potentialhazards.If a womanis seekNinUgRpSreIcoNnGceTptBio.nCcaOreM, thenshe islikely aware of prenatal care.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance7.Ovarian function and hormone production decline during which transitional phase?a.Climactericb.Menarchec.Menopaused.PubertyANS: AThe climacteric phase is a transitional period during which ovarian function and hormoneproduction decline.Menarcheis the term that denotes the first menstruation.Menopauserefers only to the last menstrual period.Pubertyis a broad term that denotes the entiretransitional period between childhood and sexual maturity.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Physiologic Integrity8.Which statement indicates that a client requires additional instruction regarding breastself-examination (BSE)?a.“Yellow discharge from my nipple is normal if I’m having my period.”

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankN R I G B.Cb.“I should check my breasts at the same time each month, after my period.”c.“I should also feel in my armpit area while performing my breast examination.”d.“I should check each breast in a set way, such as in a circular motion.”ANS: ADischarge from the nipples requires further examination from a health care provider. Thebreasts should be checked at the same time each month. The armpit should also beexamined. A circular motion is the best method during which to ascertain any changes in thebreast tissue.PTS:1DIF:Cognitive Level: AnalyzeTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance9.A blind woman has arrived for an examination. She appears nervous and says, “I’ve neverhad a pelvic examination.” What response from the nurse would be most appropriate?a.“Being visually impaired must be very anxiety producing.”b.“Try to relax. I’ll be very gentle, and I promise not to hurt you.”c.“Your anxiety is common. I was anxious when I first had a pelvic examination.”d.“I’ll let you touch each instrument I’ll be using as I tell you how it will be used.”ANS: DThe client who is visually impaired needs to be oriented to the examination room and needsa full explanation of what the examination entails before the nurse proceeds. The statementregarding her visual disability and anxiety does not address her concerns. The nurse shouldopenly and directly communicate with sensitivity. Women who have physical disabilitiesshould be respected and involved in the assessment and physical examination to the fullextent of their abilities.TellinUg thSe cNlienTt thatshOewill not be hurt does not reflect respect orsensitivity. Although anxiety may be common, the nurse should not discuss her own issuesnor compare them to the client’s concerns.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: PlanningMSC: Client Needs: Psychosocial Integrity10.Which female reproductive organ is responsible for cyclic menstruation?a.Uterusb.Ovaryc.Vaginal vestibuled.UrethraANS: AThe uterus is responsible for cyclic menstruation while also housing and nourishing thefertilized ovum and the fetus. The ovaries are responsible for ovulation and the productionof estrogen. The vaginal vestibule is an external organ that has openings to the urethra andvagina. The urethra is not a reproductive organ, although it is found in the area.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankN R I G B.C11.Which body part both protects the pelvic structures and accommodates the growing fetusduring pregnancy?a.Perineumb.Bony pelvisc.Vaginal vestibuled.FourchetteANS: BThe bony pelvis protects and accommodates the growing fetus. The perineum covers thepelvic structures. The vaginal vestibule contains openings to the urethra and vagina. Thearea of thin, flat tissue called the fourchette is formed by the labia minor and is foundunderneath the vaginal opening.PTS:1DIF:Cognitive Level: KnowledgeTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance12.Which phase of the endometrial cycle best describes a heavy, velvety soft, fully maturedendometrium?a.Menstrualb.Proliferativec.Secretoryd.IschemicANS: CThe secretory phase extends from the day of ovulation to approximately 3 days before thenext menstrual cycle. During this secretory phase, the endometrium becomes fully matureagain.During the menstrual pUhasSe, thNe eTndometOrium isshed. The proliferative phase isaperiod of rapid growth. During the ischemic phase, the blood supply is blocked, andnecrosis develops.PTS:1DIF:Cognitive Level: UnderstandTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance13.Which part of the menstrual cycle includes the stimulated release of gonadotropin-releasinghormone (GnRH) and follicle-stimulating hormone (FSH)?a.Menstrual phaseb.Endometrial cyclec.Ovarian cycled.Hypothalamic-pituitary cycleANS: DThe cyclic release of hormones is the function of the hypothalamus and pituitary glands.The menstrual cycle is a complex interplay of events that simultaneously occur in theendometrium, hypothalamus, pituitary glands, and ovaries. The endometrial cycle consistsof four phases: menstrual phase, proliferative phase, secretory phase, and ischemic phase.The ovarian cycle remains under the influence of FSH and estrogen.PTS:1DIF:Cognitive Level: Remember

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Maternity and Women's Health Care 13th Edition Lowdermilk TestBankTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance14.What fatty acids (classified as hormones) are found in many body tissues with complexroles in many reproductive functions?a.GnRHb.Prostaglandins (PGs)c.Follicle-stimulating hormone (FSH)d.Luteinizing hormone (LH)ANS: BPGs affect smooth muscle contraction and changes in the cervix. GnRH is part of thehypothalamic-pituitary cycle, which responds to the rise and fall of estrogen andprogesterone. FSH is part of the hypothalamic-pituitary cycle, which responds to the riseand fall of estrogen and progesterone. LH is part of the hypothalamic-pituitary cycle, whichresponds to the rise and fall of estrogen and progesterone.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance15.Which statement best describes Kegel exercises?a.Kegel exercises were developed to control or reduce incontinent urine loss.b.Kegel exercises produce a pleasurable vaginal sensation.c.Kegel exercises help manage stress.d.Kegel exercises are ineffective without sufficient calcium in the diet.ANS:ANURSINGTB.COMKegel exercises help control the urge to urinate. Although these exercises may bepleasurable for some, the most important factor is the control they provide overincontinence. Kegel exercises help manage urination, not stress. Calcium in the diet isimportant but not related to Kegel exercises.PTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: PlanningMSC: Client Needs: Health Promotion and Maintenance16.The microscopic examination of scrapings from the cervix, endocervix, or other mucousmembranes to detect premalignant or malignant cells is called what?a.Bimanual palpationb.Rectovaginal palpationc.Papanicolaou (Pap) testd.Four As procedureANS: CThe Pap test is a microscopic examination for cancer that should be regularly performed,depending on the client’s age. Bimanual palpation is a physical examination of the vagina.Rectovaginal palpation is a physical examination performed through the rectum. The fourAs procedure is an intervention to help a client stop smoking.

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Test Bank for Maternity and Women's Health Care, 13th Edition (Chapters 1-37) - Page 31 preview image

Maternity and Women's Health Care 13th Edition Lowdermilk TestBankPTS:1DIF:Cognitive Level: RememberTOP:Nursing Process: ImplementationMSC: Client Needs: Physiologic Integrity17.Which questionnaire would be best for the nurse to use when screening an adolescent clientfor an eating disorder?a.Four Csb.Dietary Guidelines for Americansc.SCOFF screening toold.Dual-energy x-ray absorptiometry (DEXA) scanANS: CA screening tool specifically developed to identify eating disorders uses the acronymSCOFF. Each question scores 1 point. A score of 2 or more indicates that the client mayhave anorexia nervosa or bulimia. The letters represent the following questions:•Do you make yourselfSick because you feel too full?•Do you worry about loss ofControl over the amount that you eat?•Have you recently lost more thanOne stone (14 pounds) in a 3-month period?•Do you think that you are tooFat, even if others think you are thin?•DoesFood dominate your life?The 4 Cs are used to determine cultural competence. Dietary Guidelines for Americansprovide nutritional guidance for all, not only for those with eating disorders. The DEXAscan is used to determine bone density.PTS:1DIF:Cognitive Level: ApplyTOP:Nursing Process: DiagnosisMSC: Client Needs: Health Promotion and MaintenanceNURSINGTB.COM18.The unique muscle fibers that constitute the uterine myometrium make it ideally suited forwhat?a.Menstruationb.Birth processc.Ovulationd.FertilizationANS: BThe myometrium is made up of layers of smooth muscle that extend in three directions.These muscles assist in the birth process by expelling the fetus, ligating blood vessels afterbirth, and controlling the opening of the cervical os. These muscle fibers have nocontribution to the process of menstruation, ovulation or fertilization.PTS:1DIF:Cognitive Level: UnderstandingTOP:Nursing Process: AssessmentMSC: Client Needs: Health Promotion and Maintenance19.Which hormone is responsible for the maturation of mammary gland tissue?a.Estrogenb.Testosteronec.Prolactind.Progesterone

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