Chapter 1: Trends and Issues

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	The maternal mortality rate for black women in the United States is:
1.	The same as for white women in the United States, regardless of socioeconomic factors. 	
2.	Lower than the rate for white women due to improvements in the social determinants of health.	
3.	Higher than the rate for white women, regardless of socioeconomic factors.	
4.	Higher than the rate for white women, but have improved in the last decade.	

____	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. Therefore, 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	

____	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 (BMI) 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	

____	4.	Compared with other countries in the world, the United States’ maternal mortality rate is:
1.	One of the lowest rates in the world.	
2.	The same as in other high-resource countries.	
3.	Worse than in other high-resource countries, but has improved in the last decade.	
4.	The highest rate of all high-resource countries.	

____	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 highest risk for?
1.	Respiratory disorders	
2.	Neonatal conjunctivitis	
3.	Blindness	
4.	Pneumonia	

____	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 the risk of nicotine toxicity.”	
3.	“According to the U.S. Food and Drug Administration (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.”	

____	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 of the following should the nurse indicate the child is at increased risk for during his adolescence?
1.	Hypertension	
2.	Diabetes	
3.	Alcohol abuse	
4.	Intraventricular bleeding	

____	8.	The nurse is caring for a patient at 7 weeks’ gestation. The nurse suspects that this 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.”	

____	9.	The nurse is counseling a female patient about alcohol use during pregnancy. Which statement by the patient demonstrates successful patient teaching?
1.	“I will limit my drinking to just one alcoholic beverage per day.”	
2.	“It’s best for my baby if I avoid drinking during pregnancy.”	
3.	“An occasional drink on special occasions is okay.”	
4.	“Drinking alcohol is only acceptable in the first trimester.”	

____	10.	The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following?
1.	“My child may be at increased risk for birth injury.”	
2.	“My child may have a decreased risk of developing childhood diabetes.”	
3.	“I will probably give birth vaginally.”	
4.	“I have a lower risk of developing gestational hypertension.”	

____	11.	A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands?
1.	“Due to my weight, there is a possibility that I may develop gestational diabetes.”	
2.	“I am not overweight, but I am still at risk for gestational diabetes.”	
3.	“My mother had preeclampsia during one of her pregnancies.”	
4.	“I will need to do a glucose tolerance test in my second trimester.”	

____	12.	The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first?
1.	Refer the patient to a drug abuse program.	
2.	Screen the infant for side effects associated with cocaine use.	
3.	Educate the patient of the risks associated with cocaine use during pregnancy.	
4.	Advise the patient that her baby will be okay even with the history of cocaine use.	

____	13.	A pregnant patient with a body mass index (BMI) of 35 is concerned about health effects she and her baby may face during pregnancy. During routine testing, the patient tested negative for sexually transmitted infections (STIs) and indicated that she is in a committed, long-term relationship with the child’s father. Which of the following is accurate?
1.	The patient’s infant is at increased risk of neonatal blindness.	
2.	The patient’s infant has a decreased risk of birth injury.	
3.	The patient will have an increased risk of wound infection.	
4.	The patient will have a decreased risk of preeclampsia.	

____	14.	When should women be screened for mood disorders during pregnancy? 
1.	Women should be screened at the first prenatal visit, then repeated if risk factors are present.	
2.	Women should be screened at the first prenatal visit, during the second and third trimesters, and during the first postpartum year.	
3.	Women should be screened when they have been diagnosed with a history of mental health disorders. 	
4.	Women should be screened when they have been diagnosed with a high adverse childhood experience (ACE) score.	

____	15.	A nursing student is asked to set goals that will decrease the fetal death outcomes during delivery. What guidelines will the nursing student use to assist in setting her goals?
1.	World Health Organization (WHO) maternal care guidelines	
2.	Healthy People 2020	
3.	Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) white papers	
4.	State practice act	
?

____	16.  Which of the following sexually transmitted infections (STIs) has shown the most significant increase and has led to increased infant deaths in the United States?
1. 	Congenital syphilis
2. 	HIV
3. 	Gonorrhea 
4. 	Herpes simplex 2 

____	17.	Biological weathering refers to:
1.	The physiological changes that occur in the body to all people equally across the life span.
2.	The premature aging that occurs in the body due to prolonged exposure to stressors such as 	institutionalized racism.
3.	The genetic differences that lead to early onset chronic illnesses, such as diabetes.
4.	The impact of environmental changes on the body due to climate change.

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	18.	A woman has recently given birth to an infant born at 35 weeks and 5 days’ gestation. What long-term effects should the nurse be concerned about with the infant being born at this gestation? Select all that apply.
1.	Cerebral palsy	
2.	Respiratory disorders	
3.	Developmental delays	
4.	Visual impairments	
5.	Hearing impairments	

____	19.	An infant was recently born weighing 1,498 grams. The nurse understands that the birth weight of this infant is an important indicator of what? Select all that apply.
1.	Morbidity rate	
2.	Prenatal care	
3.	Mortality rate	
4.	Infant health	
5.	Postpartum care	

____	20.	The nurse is taking the history of a gravida 2 para 1 patient. Which findings in the patient’s history warrant further action? Select all that apply.
1.	Anemia	
2.	Severe hemorrhage	
3.	Infections	
4.	Malnutrition	
5.	Eclampsia	

Chapter 1: Trends and Issues
Answer Section

MULTIPLE CHOICE

	1.	ANS:	3
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities.
Page: 8
Heading:  Issues in Maternal-Newborn and Gender Health > Maternal Death and Mortality Rates
Integrated Processes: Population Health
Client Need: Safe and Effective Care Environment
Cognitive Level: Knowledge (Remembering)
Concept: Population Health
Difficulty: Hard

	Feedback	
1	This is incorrect. Socioeconomic factors affect maternal mortality rates. 	
2	This is incorrect. Social determinants of health have not improved for black women.	
3	This is correct. The maternal mortality ratio for black women is 2.5 times higher than for white women. Wide disparities in maternal mortality exist that are based on race, ethnicity, and geographic location.	
4	This is incorrect. The maternal mortality rate for black women is higher than for white women and has gotten worse in the last decade.	

PTS:	1	CON:	Evidence-Based Practice

	2.	ANS:	4
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 8
Heading: Issues in Maternal-Newborn and Gender Health > Maternal Death and Mortality Rates
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Population Health
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 the 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.	ANS:	4
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 3
Heading: Issues in Maternal-Newborn and Gender Health > 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. ECMO 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.	ANS:	4
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 8
Heading: Issues in Maternal-Newborn and Gender Health > Maternal Death and Mortality Rates
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment
Cognitive Level: Application [Applying]
Concept: Population Health
Difficulty: Moderate

	Feedback	
1	This is incorrect. The United States has the highest maternal mortality rate for high-resource countries.	
2	This is incorrect. The United States has the highest maternal mortality rate for high-resource countries.	
3	This is incorrect. The United States is one of the few nations in the world where the maternal mortality rate is rising.	
4	This is correct. The United States’ maternal mortality rate is the highest of all high-resource countries.	

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

	5.	ANS:	1
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities.
Page: 9
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 (RDS). 	
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.	ANS:	2
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities.
Page: 10
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: Behaviors
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.	ANS:	3
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities.
Page: 9
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 risk 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.	ANS:	3
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities.
Page: 10
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

	Feedback	
1	This is incorrect. Whether or not the woman used marijuana during her previous pregnancy is not relevant to her current care. 	
2	This is incorrect. Marijuana should not be used at any point during pregnancy.	
3	This is correct. Marijuana use during pregnancy may have a negative effect on the neurological development of the fetus.	
4	This is incorrect. There currently is no research linking marijuana use to increased risk of miscarriage.	

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

	9.	ANS:	2
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 10
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

	Feedback	
1	This is incorrect. Alcohol should not be consumed while pregnant.	
2	This is correct. Drinking alcohol while pregnant can cause low birth weight (LBW), fetal alcohol syndrome (FAS), mental retardation, and intrauterine growth restriction. 	
3	This is incorrect. Alcohol should not be consumed while pregnant. 	
4	This is incorrect. Alcohol should not be consumed while pregnant.	

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

	10.	ANS:	1
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 1. Discuss evidence-based nursing care that promotes optimal outcomes in labor and birth.
Page: 11
Heading: Issues > Overweight and Obesity
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: Difficult

	Feedback	
1	This is correct. Shoulder dystocia and other birth injuries are associated with infant macrosomia (large size) due to maternal obesity.	
2	This is incorrect. Children born to mothers who are obese are at increased risk of developing childhood obesity and diabetes.	
3	This is incorrect. Pregnant patients who are obese are at increased risk of Caesarean birth.	
4	This is incorrect. Pregnant patients who are obese have an increased risk of developing gestational diabetes and gestational hypertension.	

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

	11.	ANS:	1
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 11
Heading: Issues > Overweight and Obesity
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Difficult

	Feedback	
1	This is correct. The patient is at risk for gestational diabetes due to being obese during pregnancy.	
2	This is incorrect. The patient is overweight.	
3	This is incorrect. This response is not related to the question.	
4	This is incorrect. The patient will need to get the glucose tolerance test in the second trimester, but this response does not relate to the question.	

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

	12.	ANS:	3
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 1. Discuss evidence-based nursing care that promotes optimal outcomes in labor and birth.
Page: 10
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: Difficult

	Feedback	
1	This is incorrect. This is appropriate, but not the first action the nurse should take.	
2	This is incorrect. The infant is not screened for side effects of maternal drug use until delivery. 	
3	This is correct. The patient should be educated on possible risks associated with drug use. 	
4	This is incorrect. It is not appropriate to tell a patient “your baby will be okay” in any circumstance.	

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

	13.	ANS:	3
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 11
Heading: Issues > Overweight and Obesity
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum 
Difficulty: Difficult

	Feedback	
1	This is incorrect. Infants born to mothers with certain sexually transmitted infections (STIs) are at increased risk of neonatal blindness.	
2	This is incorrect. Infants born to obese pregnant women have an increased risk of birth injury related to macrosomia. 	
3	This is correct. Obese pregnant patients are at increased risk for wound infections.	
4	This is incorrect. Obese pregnant patients have an increased risk of developing certain conditions, including gestational diabetes, gestational hypertension, and preeclampsia.	

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

	14.	ANS:	2
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 1. Discuss Evidence-Based Care That Promotes Optimal Outcomes in Labor and Birth.
Page: 12
Heading: Issues > Perinatal Depression and Mood Disorders
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1	This is incorrect. All women need to be screened, not just those suspected of having mood disorders.	
2	This is correct. All women need to be screened throughout pregnancy and first year post birth.	
3	This is incorrect. All women need to be screened, not just those with a history of mood disorders.	
4	This is incorrect. All women, including those with a high ACE score, need to be screened.	

PTS:	1	CON:	Health Promotion	

	15.	ANS:	2
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 5. Identify the primary maternal and infant goals of Healthy People 2030.
Page: 15
Heading: Maternal and Child Health Goals
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1	This is incorrect. The WHO guidelines are too broad for this purpose and the nurse will need to use national goals.	
2	This is correct. The national goals for improving maternal and infant health are 
found in Healthy People 2030. 	
3	This is incorrect. AWHONN white papers will present positions but not necessarily detail health promotion goals.	
4	This is incorrect. State practice acts specify legal requirements rather than health promotion goals.	

PTS:	1	CON:	Health Promotion	

	16.	ANS:	1
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities.
Page: 12
Heading: Issues > Sexually Transmitted Infections
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Comprehension [Understanding]
Concept: Health Promotion
Difficulty: Moderate

	Feedback	
1	This is correct. Congenital syphilis has quadrupled from 2015 to 2019 and shown a 22% increase in neonatal deaths. 	
2	This is incorrect. All reportable STIs have increased by 30%. During pregnancy, HIV can pass through the placenta and infect the fetus.	
3	This is incorrect. All reportable STIs have increased by 30%. Gonorrhea can cause neonatal blindness.	
4	This is incorrect. Neonatal herpes usually only affects the baby's eyes, mouth, or skin. In these cases, most babies will make a complete recovery with antiviral treatment. Death can occur in immunocompromised neonates.  	

PTS:	1	CON:	Health Promotion	

	17.	ANS:	2
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities. 
Page: 14
Heading: Issues > Racism and Discrimination
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential 
Cognitive Level: Knowledge (Remembering)
Concept: Population Health
Difficulty: Moderate

	Feedback	
1	This is incorrect. Not all physiological changes occur equally across the life span.	
2	This is correct. Systemic racism and ongoing discrimination create persistent stressors in the body that cause biological weathering.	
3	This is incorrect. Genetic differences do not cause biological weathering.	
4	This is incorrect. Climate change does not cause biological weathering.	

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

MULTIPLE RESPONSE

18.	ANS:	1, 2, 3, 4, 5
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 7
Heading: Issues in Maternal-Newborn and Gender Health > Preterm Birth
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Evidence-Based Practice
Difficulty: Difficult

	Feedback	
1	This is correct. Cerebral palsy is a long-term effect of preterm birth.	
2	This is correct. Respiratory disorders are a long-term effect of preterm birth.	
3	This is correct. Developmental delays are a long-term effect of preterm birth.	
4	This is correct. Visual impairments are a long-term effect of preterm birth.	
5	This is correct. Hearing impairments are a long-term effect of preterm birth.	

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

	19.	ANS:	1, 3, 4
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 3. Identify leading causes of maternal and infant morbidity and mortality in the United States.
Page: 7
Heading:  Issues in Maternal-Newborn and Gender Health > Neonatal Birth Weight Rates
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Ante/Intra/Post-partum
Difficulty: Moderate

	Feedback	
1	This is correct. Morbidity rate is an outcome of low birth weight.	
2	This is incorrect. Prenatal care is not an outcome of low birth weight.	
3	This is correct. Mortality rate is an outcome of low birth weight.	
4	This is correct. Infant health is an outcome of low birth weight.	
5	This is incorrect. Postpartum care is not an outcome of low birth weight.	

PTS:	1	CON:	Health Promotion	

	20.	ANS:	1, 2, 3, 5
Chapter: Chapter 1 Trends and Issues
Chapter Learning Objective: 2. Examine maternal and infant health outcomes in the United States and analyze how the social determinants of health impact outcomes and lead to health disparities.
Page: 9
Heading: Issues in Maternal-Newborn and Gender Health > Maternal Death and Mortality Rates
Integrated Processes: Nursing Process 
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Clinical Judgement
Difficulty: Difficult

	Feedback	
1	This is correct. Anemia is a primary cause of maternal death.	
2	This is correct. Severe hemorrhage is a primary cause of maternal death.	
3	This is correct. Infection is a primary cause of maternal death.	
4	This is incorrect. Malnutrition is not a primary cause of maternal death.	
5	This is correct. Eclampsia is a primary cause of maternal death.	

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