1. The nurse is caring for a patient who is in labor with her first child. The patient’s mother is

present for support and notes that things have changed in the delivery room since she last

gave birth in the early 1980s. Which current trend or intervention may the patient’s mother

find most different?

1. Fetal monitoring throughout labor

2. Postpartum stay of 10 days

3. Expectant partner and family in operating room for cesarean birth

4. Hospital support for breastfeeding

ANS: 4

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 1. Discuss current trends in the management of labor and birth

Page: 4

Heading: Table 1-1: Past and Present Trends

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Evidence-Based Practice

Difficulty: Moderate

Feedback

1 This is incorrect. Fetal monitoring during labor began in the late 1970s. As such,

this likely would have occurred during the mother’s labor and delivery during

the 1980s.

2 This is incorrect. In the past, the average hospital postpartum stay was 10 days.

Presently, the average postpartum stay is 48 hours or less.

3 This is incorrect. In the past, expectant partners and families were excluded from

the labor and birth experience. Present trends involve the expectant partner and

family in the labor and birth experience, including presence in the operating

room for cesarean births.

4 This is correct. Hospital support for breastfeeding, including a lactation

consultant and employment of the Baby-Friendly Hospital Initiative, were both

enacted during the early 1990s.

PTS: 1 CON: Evidence-Based Practice

2. A patient with a history of hypertension is giving birth. During delivery, the staff was not

able to stabilize the patient’s blood pressure. As a result, the patient died shortly after

delivery. This is an example of what type of death?

1. Early maternal death

2. Late maternal death

3. Direct obstetric death

4. Indirect obstetric death

ANS: 4

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 2. Discuss current trends in maternal and infant health

outcomes.

Page: 7

Heading: Trends > Maternal Death and Mortality Rates

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Reduction of Risk Potential

Cognitive Level: Application [Applying]

Concept: Ante/Intra/Post-partum

Difficulty: Hard

Feedback

1 This is incorrect. Early maternal death is not an example of maternal death.

Examples of maternal death include late maternal death, indirect obstetric death,

direct obstetric death, and pregnancy-related death.

2 This is incorrect. Late maternal death occurs 42 days after termination of

pregnancy from a direct or indirect obstetric cause.

3 This is incorrect. Direct obstetric death results from complications during

pregnancy, labor, birth, and/or postpartum period.

4 This is correct. Indirect obstetric death is caused by a preexisting disease, or a

disease that develops during pregnancy.

PTS: 1 CON: Ante/Intra/Post-partum

3. The nurse is providing education to a patient who has given birth to her first child and is

being discharged home. The patient expressed concern regarding infant mortality and

sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor,

and vaginal delivery. She has a body mass index of 25 and has no other health conditions.

The infant is healthy and was delivered full-term. What will be most helpful thing to explain

to the patient?

1. Uses of extracorporeal membrane oxygenation therapy (ECMO)

2. Uses of exogenous pulmonary surfactant

3. The Baby-Friendly Hospital Initiative

4. The Safe to Sleep campaign

ANS: 4

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 3. Identify leading causes of infant death.

Page: 7

Heading: Trends > Infant Mortality Rates

Integrated Processes: Nursing process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Health Promotion

Difficulty: Moderate

Feedback

1 This is incorrect. EMCO has been cited as one of the factors that has reduced

infant mortality among preterm infants.

2 This is incorrect. Although advances in medical treatments have decreased infant

mortality, exogenous pulmonary surfactant is primarily used to reduce mortality of

preterm infants.

3 This is incorrect. The Baby-Friendly Hospital Initiative was developed to support

breastfeeding and is not directly linked to reduced infant mortality or SIDS.

4 This is correct. The Back to Sleep campaign and the Safe to Sleep campaigns were

designed to promote healthy infant sleeping habits. The decrease in SIDS from

1995 to 2015 was attributed to the Safe to Sleep campaign.

PTS: 1 CON: Health Promotion

4. The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining

of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at

increased risk of which condition?

1. Diabetes

2. Blindness

3. Pneumonia

4. Hypertension

ANS: 4

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 4. Discuss current maternal and infant health issues.

Page: 10

Heading: Issues > Teen Pregnancy > Implications of Teen Pregnancy and Birth

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Reduction of Risk Potential

Cognitive Level: Application [Applying]

Concept: Ante/Intra/Post-partum

Difficulty: Moderate

Feedback

1 This is incorrect. Maternal obesity increases a child’s risk of developing

childhood obesity and diabetes.

2 This is correct. Neonatal blindness, maternal death, and neonatal death are all

associated with a patient who contracts syphilis during pregnancy.

3 This is incorrect. Chlamydial pneumonia is associated with maternal chlamydia.

4 This is incorrect. Teen mothers may have a higher risk of contracting sexually

transmitted illnesses and hypertension during pregnancy; however, maternal

syphilis is not associated with fetal hypertension.

PTS: 1 CON: Ante/Intra/Post-partum

5. The nurse is caring for a 15-year-old female who is pregnant with her first child. In her

previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and

HIV. Based on the information provided, which condition is the patient’s baby at higher risk

for?

1. Intestinal problems

2. Neonatal conjunctivitis

3. Blindness

4. Pneumonia

ANS: 1

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 4. Discuss current maternal and infant health issues.

Page: 11

Heading: Issues > Teen Pregnancy

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Reduction of Risk Potential

Cognitive Level: Application [Applying]

Concept: Health Promotion

Difficulty: Difficult

Feedback

1 This is correct. Infants born to teen mothers are at increased risk for various

conditions related to prematurity, including infant death, intestinal problems,

and/or respiratory distress syndrome.

2 This is incorrect. Infants born to teen mothers who have gonorrhea are at

increased risk of neonatal conjunctivitis and blindness.

3 This is incorrect. Infants born to teen mothers with syphilis and gonorrhea are at

increased risk of blindness.

4 This is incorrect. Infants born to teen mothers with chlamydia may be at

increased risk of developing chlamydial pneumonia.

PTS: 1 CON: Health Promotion

6. The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test.

The test confirms the patient is pregnant. The patient states, ―I do not need to stop smoking 

my electronic cigarette because it will not harm my baby.‖ Which is the best response by the

nurse?

1. ―You are correct. Electronic cigarettes are not harmful during pregnancy.‖

2. ―Tobacco products, including electronic cigarettes, should not be used during 

pregnancy due to risking nicotine toxicity.‖

3. ―According to the FDA, although electronic cigarettes are safe for you, they can 

cause harm to the fetus during pregnancy.‖

4. ―Electronic cigarettes are considered harmful only in the first trimester.‖

ANS: 2

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 4. Discuss current maternal and infant health issues.

Page: 12

Heading: Issues > Tobacco and Electronic Cigarette Use During Pregnancy

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Ante/Intra/Post-partum

Difficulty: Moderate

Feedback

1 This is incorrect. Electronic cigarettes can be harmful during pregnancy.

2 This is correct. Pregnant women should not use tobacco products or electronic

cigarettes during pregnancy.

3 This is incorrect. Electronic cigarettes are not controlled by the FDA and may be

harmful to both mother and fetus.

4 This is incorrect. Electronic cigarettes are considered harmful during pregnancy.

PTS: 1 CON: Ante/Intra/Post-partum

7. The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child,

who is male. The patient’s mother has accompanied her to today’s visit. During the nursing

assessment, the patient mentions that she is no longer in a relationship with the baby’s father

but her mother plans to help her. However, the patient’s mother asks whether this will have

any impact on the child. Which should the nurse indicate the child is at increased risk of

during his adolescence?

1. Hypertension

2. Diabetes

3. Alcohol abuse

4. Intraventricular bleeding

ANS: 3

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 4. Discuss current maternal and infant health issues.

Page: 12

Heading: Issues > Teen Pregnancy > Implications of Teen Pregnancy and Birth

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Reduction of Risk Potential

Cognitive Level: Application [Applying]

Concept: Ante/Intra/Post-partum

Difficulty: Moderate

Feedback

1 This is incorrect. Teen mothers, rather than their children, are at increased risked

of hypertension during pregnancy.

2 This is incorrect. Children born to mothers who are obese have an increased risk

of developing childhood obesity and childhood diabetes.

3 This is correct. Statistics have shown that adolescent boys without an involved

father may be at higher risk of incarceration, dropping out of school, and abusing

drugs or alcohol.

4 This is incorrect. Children born to teen mothers are at increased risk for health

problems associated with low birth weight, including intraventricular bleeding.

PTS: 1 CON: Ante/Intra/Post-partum

8. The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant

patient may have been using marijuana. With consent, the nurse confirms via urine drug

screen. Which statement by the nurse is most appropriate?

1. ―Did you smoke marijuana when pregnant with your other child?‖

2. ―To avoid negative effects on your baby, you’ll need to stop using marijuana

during your last trimester.‖

3. ―Using marijuana while pregnant can have a negative effect on the neurological 

development of your baby.‖

4. ―Marijuana use while pregnant greatly increases your risk of miscarriage.‖

ANS: 3

Chapter: Chapter 1 Trends and Issues

Chapter Learning Objective: 3. Identify leading causes of infant death.

Page: 13

Heading: Issues > Substance Abuse During Pregnancy

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Ante/Intra/Post-partum

Difficulty: Moderate