Chapter 2 OB Flashcards

During which phase of the cycle of violence does the batterer become contrite and remorseful?

1. Battering
2. Honeymoon
3. Tension-building
4. Increased drug taking

The United States ranks poorly in terms of worldwide infant mortality rates. Which factor has the greatest impact on decreasing the mortality rate of infants?

1. Providing more women’s shelters
2. Ensuring early and adequate prenatal care
3. Resolving all language and cultural differences
4. Enrolling pregnant women in the Medicaid program by their eighth month of pregnancy

The nurse is planning a teaching session for staff on ethical theories. Which situation best reflects the Deontologic theory?

1. Approving a physician-assisted suicide
2. Supporting the transplantation of fetal tissue and organs
3. Using experimental medications for the treatment of AIDS
4. Initiating resuscitative measures on a 90-year-old patient with terminal cancer

Which step of the nursing process is being used when the nurse decides whether an ethical dilemma exists?

a. Analysis
b. Planning
c. Evaluation

d. Assessment

The nurse is interviewing a patient who is 6-weeks pregnant. The patient asks the nurse, "Why is elective abortion considered such an ethical issue?" Which response by the nurse is the most appropriate?

1. Abortion requires third-party consent.
2. The U.S. Supreme Court ruled that life begins at conception.
3. Abortion law is unclear about a woman's constitutional rights.
4. There is a conflict between the rights of the woman and the rights of the fetus.

At the present time, which agency governs surrogate parenting?

1. State law
2. Federal law
3. Individual court decision
4. Protective child services

Which patient will most likely seek prenatal care?

1. A 15-year-old patient who tells her friends, “I just don’t believe that I am pregnant”
2. A 28-year-old who is in her second pregnancy and abuses drugs and alcohol
3. A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic
4. A 30-year-old who is in her fifth pregnancy and delivered her last infant at home with the help of her mother and sister

A medical-surgical nurse is asked to float to a women’s health unit to care for patients who are scheduled for therapeutic abortions. The nurse refuses to accept this assignment and expresses her personal beliefs as being incongruent with this medical practice. The nursing supervisor states that the unit is short-staffed and the nurse is familiar with caring for postoperative patients. In consideration of legal and ethical practices, can the nursing supervisor enforce this assignment?

1. The staff nurse has the responsibility of accepting any assignment that is made while working for a healthcare unit, so the nursing supervisor is within his or her rights to enforce this assignment.
2. Because the unit is short-staffed, the staff nurse should accept the assignment to provide care by benefit of her or his experience to patients who need care.
3. The staff nurse has expressed a legitimate concern based on his or her feelings; the nursing supervisor does not have the authority to enforce this assignment.
4. The nursing supervisor should emphasize that this assignment requires care of a surgical patient for which the staff nurse is adequately trained and should therefore enforce the assignment.

With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?

1. The nurse did not document fetal heart tones (FHR) during the second stage of labor.
2. The patient was only provided ice chips during the labor period, which lasted 8 hours.
3. The nurse allowed the patient to use the bathroom rather than a bedpan during the first stage of labor.
4. The nurse asked family members to leave the room when she prepared to do a pelvic exam on the patient.

A nurse is working with an active labor patient who is in preterm labor and has been designated as high risk. The patient is very apprehensive and asks the nurse, “Is everything going to be all right?” The nurse replies, “Yes, everything will be okay.” Following delivery via an emergency cesarean birth, the newborn undergoes resuscitation and does not survive. The patient is distraught over the outcome and blames the nurse for telling her that everything would be okay. Which ethical principle did the nurse violate?

a. Autonomy
b. Fidelity
c. Beneficence
d. Accountability

A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 woman who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, –1 station, and vertex with membranes intact. The patient asks the nurse if she can break her water so that her labor can go faster. The nurse’s response, based on the ethical principle of nonmaleficence, is which of the following?

1. Tell the patient that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
2. Have the patient write down her request and then call the physician for an order to implement the amniotomy.
3. Instruct the patient that only a physician or certified midwife can perform this procedure.
4. Give the patient an enema to stimulate labor.

A nurse working in a labor and birth unit is asked to take care of two high-risk patients in the labor and birth suite: a 34 weeks’ gestation 28-year-old gravida 3, para 2 in preterm labor and a 40-year-old gravida 1, para 0 who is severely preeclamptic. The nurse refuses this assignment telling the charge nurse that based on individual patient acuity, each patient should have one-on-one care. Which ethical principle is the nurse advocating?

a. Accountability

b. Beneficence
c. Justice
d. Fidelity

A charge nurse is working on a postpartum unit and discovers that one of the patients did not receive AM care during her shift assessment. The charge nurse questions the nurse assigned to provide care and finds out that the nurse thought “The patient should just do it by herself because she will have to do this at home.” On further questioning of the nurse, it is determined that the rest of her assigned patients were provided AM care. The assigned nurse has violated which ethical principle?

a. Justice
b. Truth
c. Confidentiality

d. Autonomy

A nurse is entering information on the patient’s electronic health record (EHR) and is called to assist in an emergency situation with regard to another patient in the labor and birth suite. The nurse rushes to the scene to assist; however, she leaves the chart open on the computer screen. The emergent patient situation is resolved satisfactorily, and the nurse comes back to the computer entry screen to complete charting. At the end of the shift, the nurse manager asks to speak with the nurse and tells her that she is concerned with what happened today on the unit because there was a breach in confidentiality. Which response by the nurse indicates that she understands the nurse manager’s concerns?

1. The nurse acknowledges that she should have made sure that her patient was safe before assisting with the emergency.
2. The nurse states that she should have logged out of the EHR prior to attending to the emergency.
3. The nurse indicates that the unit was understaffed.
4. The nurse indicates that the she changed her password following the clinical emergency to maintain confidentiality.

A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues areadbisircbe.rcnoemd /ftreosmt the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?

1. No action is indicated because the nurse is acting within the scope of practice.
2. The nurse manager should intervene and ask the nurse to clarify admission orders directly with the physician.
3. The nurse manager should review standard procedures with the nurse to validate that orders are being carried out accurately.
4. The nurse manger should review the admission procedure with the nurse.

A nurse who works in the emergency department (ED)is assigned to a patient who is experiencing heavy vaginal bleeding at 12 weeks’ gestation. An ultrasound has confirmed the absence of a fetal heart rate, and the patient is scheduled for a dilation and evacuation of the pregnancy. The nurse refuses to provide any further care for this patient based on moral principles. What is the nurse manager’s initial response to the nurse?

1. “I recall you sharing that information in your interview. I will arrange for another nurse to take report on this patient.”
2. “Because we are shorthanded today, you have to continue to provide care. There is no one else available to provide care for this patient.”
3. “I understand your point of view. You were hired to work here in the ED so you had to know this situation was possible.”
4. “Abandonment is a serious issue. I have to advise you to continue to provide care for this patient.”

The nurse is providing care to a patient who was just admitted to the labor and birth unit in active labor at term. The patient informed the nurse, “I have not received any prenatal care because I cannot afford to go to the doctor. And, this is my third baby, so I know what to expect.” What is the nurse’s primary concern when developing the patients plan of care?

1. Low birth weight
2. Oligohydramnios
3. Gestational diabetes
4. Gestational hypertension

A nurse is reviewing evidence-based teaching and learning principles. Which situation is most conducive to learning with patients of other cultures?

1. An auditorium is being used as a classroom for 300 students.
2. A teacher who speaks very little Spanish is teaching a class of Hispanic students.
3. A class is composed of students of various ages and educational backgrounds.
4. An Asian nurse provides nutritional information to a group of Asian women.

The nurse is teaching a parenting class to new parents. Which statement should the nurse include in the teaching session about the characteristics of a healthy family?

1. Adults agree on the majority of basic parenting principles.
2. The parents and children have rigid assignments for all the family tasks.
3. Young families assume total responsibility for the parenting tasks, refusing any assistance.
4. The family is overwhelmed by the significant changes that occur as a result of childbirth.

A patient who is 6 months pregnant has sought medical attention, saying she fell down the stairs. Which scenario would cause an emergency department nurse to suspect that the woman has been battered?

a. She avoids making eye contact and is hesitant to answer questions.

b. The woman and her partner are having an argument that is loud and hostile.

c. The woman has injuries on various parts of her body that are in different stages of healing.
d. Examination reveals a fractured arm and fresh bruises. Her husband asks her about her pain.

Which situation is most representative of an extended family?

1. It includes adoptive children.
2. It is headed by a single parent.
3. It contains children from previous marriages.
4. It is composed of children, parents and grandparents living in the same house.

The nurse is reviewing the principles of family-centered care with a primiparous patient. Which patient statement will the nurse need to correct?

1. “Remaining focused on my family will help benefit me and my baby.”
2. “Most of the time, childbirth is uncomplicated and a healthy event for the family.”
3. “Because childbirth is normal, after my baby’s birth our family dynamics will not change."
4. "With correct information, I am able to make decisions regarding my healthcare while I am pregnant."

Which issue is a major concern among members of lower socioeconomic groups?

1. Practicing preventive health care
2. Meeting health needs as they occur
3. Maintaining an optimistic view of life
4. Maintaining group health insurance for their families.

While teaching an Asian patient regarding prenatal care, the nurse notes that the patient refuses to make eye contact. Which is the most likely cause for this behavior?

1. A submissive attitude
2. Lack of understanding
3. Embarrassment about the subject
4. Cultural beliefs about eye contact

The nurse in labor and birth is caring for a Muslim patient during the active phase of labor. The nurse notes that the patient quickly draws away when touched. Which intervention should the nurse implement?

1. Ask the charge nurse to reassign you to another patient.
2. Assume that she does not like you and decrease your time with her.
3. Continue to touch her as much as you need to while providing care.
4. Limit touching to a minimum because physical contact may not be acceptable in her culture.

Which patient may require more help and understanding when integrating the newborn into the family?

1. A primipara from an upper income family
2. A primipara who comes from a large family
3. A multipara (gravida 2) who has a supportive husband and mother
4. A multipara (gravida 6) who has two children younger than 3 years

A patient arrives to the clinic 2 hours late for her prenatal appointment. This is the third time she has been late. What is the nurses best action in response to this patients tardiness?

1. Ask the patient If she has a way to tell the time.
2. Ask the patient if she is deliberately being late for her appointments.
3. Determine if the patient wants this baby and if this is her way of acting out.
4. Determine if the patient arrives after the start time for the other types of appointments.

The clinic nurse often cares for patients who are considering an abortion. Which responsibilities does this nurse have in regard to this issue? (Select all that apply.)

1. Informing the patient about pro-life options
2. Informing the patient about pro-choice support groups
3. Being informed about abortion from a legal standpoint
4. Being informed about abortion from an ethical standpoint
5. Recognizing that this issue may result in confusion for the patient

A couple asks the nurse about the procedure for surrogate parenting. Which correct responses should the nurse provide for this couple? (Select all that apply.)

1. Donated embryos can be implanted into the surrogate mother.
2. The surrogate mother needs to have carried one previous birth to term.
3. You both need to be infertile to be eligible for surrogate parenting.
4. Conception can take place outside the surrogate mother’s body and then implanted.
5. The surrogate mother can be inseminated artificially from sperm the intended father.

Which actions by the nurse indicate compliance with the Health Insurance Portability and Accountability Act (HIPAA)? (Select all that apply.)

1. The nurse posts an update about a patient on Facebook.
2. The nurse gives the report to the oncoming nurse in a private area.
3. The nurse gives information about the patient’s status over the phone to the patient’s friend.
4. The nurse logs off any computer screen showing patient data before leaving the computer unattended.
5. The nurse puts any documentation with the patient’s information in the shred bin at the hospital before leaving for the day.

In some Middle Eastern and African cultures, female genital mutilation (female cutting) is a prerequisite for marriage. Women who now live in North America need care from nurses who are knowledgeable about the procedure and comfortable with the abnormal appearance of their genitalia. When caring for this patient, the nurse can formulate a diagnosis with the understanding that the patient may be at risk for which of the following? (Select all that apply.)

1. Infection
2. Laceration
3. Hemorrhage
4. Obstructed labor
5. Increased signs of pain response

A Vietnamese patient who speaks little English is admitted to the labor and birth unit in early labor. The nurse plans to use an interpreter during an initial assessment. Which should the nurse plan to implement with regard to using an interpreter? (Select all that apply.)

1. Face the interpreter when speaking.
2. Listen carefully to what the patient says.
3. Speak slowly and smile when appropriate.
4. Plan to use a male interpreter, even if a female interpreter is available.
5. Ask the interpreter to explain exactly what is said as much as possible, instead of paraphrasing.