Question 1

The nurse is providing care for a patient in active labor. The patient continuously asks the nurse for medication to "stop the pain." Which ethical principle does the nurse use when replying, "We need to protect the baby from being overmedicated. Let me help you with some breathing and relaxation techniques"?

Accepted Answer

B

Question 2

The nurse is assisting a patient in the use of an ethical decision-making model related to quality of life. Which question is inappropriate when using this model?

Accepted Answer

The question of whether arrangements are made for prolonging life is not directly related to quality of life. While it is important to consider end-of-life care, it is not a question that relates to the patient's experience of their own quality of life. The other questions are all appropriate for assessing quality of life.

Question 3

The nurse in an obstetrician's office is discussing a patient's request for legally terminating an unwanted pregnancy after the fetus tests positive for Down syndrome. The woman and her spouse have five children from ages 11 to 17 years, and the family lives in an isolated rural area. Which action does the nurse take?

Accepted Answer

The nurse should inform the physician of the contextual factors, as this situation raises an ethical dilemma. The decision to terminate a pregnancy due to a fetal diagnosis of Down syndrome raises the issue of discrimination based on disability, and the nurse should seek guidance from the physician regarding how to address this situation. Options A, B, and D do not address the ethical concerns and are not the most appropriate actions for the nurse to take at this time.

Question 4

An experienced OB nurse has accepted a position in labor and delivery of an inner-city hospital providing care for multicultural clients. Which action by the nurse is most helpful in preparation for this position?

Accepted Answer

The answer of An experienced OB nurse has accepted a...

Question 5

The nurse is employed in a NICU. With each new admission, the neonate is classified in a specific category regarding care. The nurse is in the process of admitting a neonate at 22 weeks gestation with multiple life-threatening conditions involving both cardiac and respiratory systems. In which category of care does the nurse expect the neonate to be placed?

Accepted Answer

Neonates at 22 weeks gestation with multiple life-threatening conditions involving both cardiac and respiratory systems have a very grim prognosis. The neonate would be placed in the category where aggressive care is probably futile.

Question 6

Parents of a neonate are grieving over their child's life-threatening disabilities. The neonate's course of treatment has changed three times in the last 24 hours due to irrational parenteral decisions. Which interventions will the NICU nurse implement in order to fulfill nursing responsibility to both the parents and the neonate? Select all that apply.

Accepted Answer

As a NICU nurse, it is important to provide support and education to grieving parents while still advocating for the best medical care for the neonate. Informing the parents of realistic expectations, using neonate's status with parental counseling, and advocating for medical support of the neonate are appropriate interventions. Allowing irrational parenteral decisions to dictate the course of treatment or giving parents the final decision-making authority could potentially harm the neonate. Eliciting parenteral input regarding medical care can be appropriate, but may be difficult in this situation where the parents are struggling with grief and making irrational decisions.

Question 7

The nurse works in the maternal-newborn unit dedicated to management of high-risk pregnancy and delivery. A patient has delivered two children who died from a genetic disorder. The current pregnancy tests positive for the same disorder. Which ethical decision-making model will the nurse use with this patient?

Accepted Answer

The ethical decision-making model that focuses on the quality of life is most appropriate in this situation. The nurse should work with the patient to understand her values and beliefs regarding quality of life and end-of-life care, and help her make a decision that is in alignment with her personal values. This model emphasizes the importance of assessing the patient's unique circumstances, including the impact of the genetic disorder on the patient and her family, and making a decision that considers the patient's overall well-being.

Question 8

The nurse is providing care for a patient in labor. The unborn fetus was diagnosed with severe microcephaly at 20 weeks' gestation. The patient tells the nurse, "We want everything done to save our baby who has as much right to a good life as anyone else." Which ethical approach does this represent?

Accepted Answer

The patient's statement reflects the ethical approach of egalitarianism, which emphasizes that every individual has equal moral worth and should have equal rights to a good life, regardless of their condition or capabilities. This approach advocates for equal treatment and opportunities for all, including the unborn fetus with severe microcephaly.

Question 9

A nurse is suspended for refusal to participate in the performance of an elective termination of a pregnancy. Which specific group's standards does the nurse use for job reinstatement?

Accepted Answer

The answer of A nurse is suspended for refusal to...

Question 10

The nurse works in a postpartum maternal-newborn unit and notices a newborn who is exhibiting signs of distress. Through investigation, the nurse learns the newborn's mother has a history of abusing street drugs. Which facility system does the nurse report as being deficient?

Accepted Answer

The answer of The nurse works in a postpartum maternal-newborn...

Question 11

The nurse is experiencing an ethical dilemma when confronted with a situation in which either the mother or fetus is predicted to die. The nurse feels bound by the ANA Code of Ethics to protect both patients. Which aspect of care during an ethical dilemma will guide the nurse?

Accepted Answer

The answer of The nurse is experiencing an ethical dilemma...

Question 12

The nurse in an OB's office is evaluating a patient who exhibits vaginal bleeding at 30 weeks gestation. The patient is prescribed bedrest at home and instructed to avoid lifting. The patient states, "I cannot go to bed, I have an 18-month-old at home." On which topic of the Jonsen model for ethical decision making will the nurse focus?

Accepted Answer

The answer of The nurse in an OB's office is...

Question 13

The nurse works in the labor and delivery department. Which action by the nurse indicates a breach in the nursing care principles outlined by AWHONN?

Accepted Answer

Refusing a patient assignment based on a history of illegal drug use is a breach of the nursing care principles outlined by AWHONN. Nurses are expected to provide care to all patients regardless of their personal history or background. This violates the ethical principle of non-discrimination and may also be against hospital policies. The other options demonstrate appropriate nursing care, such as assisting with emergencies, respecting patients' beliefs, and ensuring effective communication.

Question 14

The nurse on a maternity unit is an Orthodox Jew whose rabbi teaches that pregnancy terminations are permitted only to save the life of the mother. Which situation becomes possible if the nurse puts aside personal values and assists with elective terminations?

Accepted Answer

By assisting with elective terminations, the nurse would be going against their personal and religious beliefs, which could lead to moral distress, a conflict between their actions and their conscience.

Question 15

The nursing department of a large facility is interested in improving clinical care with the introduction of EBP. Which barriers to EBP does the nursing department expect within the facility? Select all that apply.

Accepted Answer

The answer of The nursing department of a large facility...

Question 16

A patient at 33 weeks gestation with a first pregnancy arrives at the labor and delivery unit with contractions. After monitoring the patient, the nurse determines the woman is in active labor and calls the health care provider (HCP), who prescribes a sleeping medication and sends the patient home. Which action does the nurse take?

Accepted Answer

The nurse should question the HCP's prescribed treatment as it is not appropriate for a patient in active labor at 33 weeks gestation to be sent home with a sleeping medication. The nurse should advocate for the patient's safety and well-being and communicate their concerns to the HCP.

Question 17

Which factors will facilitate the integration of evidence-based practice (EBP) in the maternity-newborn clinical setting? Select all that apply.

Accepted Answer

A) Framing clinical questions in PICOT format ensures that questions are clear and specific, enabling a better search for evidence and leading to more precise answers.

B) The collection of the best and most relevant evidence is necessary for making informed decisions about patient care.

C) Cultivating a spirit of inquiry in the workplace fosters a culture of continuous learning and encourages healthcare providers to seek out and incorporate new knowledge and best practices into their practice.

D) Encouraging the use of trial and error methods can lead to ineffective or potentially harmful practices, and is not a recommended approach to integrating EBP.

E) Basing practical decisions solely on nursing consensus may not accurately reflect the latest evidence or the best course of action for the patient.

Question 18

The labor and delivery nurse is providing care to a patient in active labor. The nurse notes EFM changes that suggest fetal distress and monitors the fetus for an additional 20 minutes before calling the health care provider. The health care provide determines that an emergency cesarean delivery is required. During transport, EFM is interrupted and not resumed due to expectations of an emergent procedure. A stillborn fetus is delivered. For which actions can the nurse be held legally responsible? Select all that apply.

Accepted Answer

The answer of The labor and delivery nurse is providing...

Question 19

The nurse manager in the labor and delivery unit decides that all unit nurses are to take a course in electronic fetal monitoring (EFM) as recommended by AWHONN. Which is the most important issue related to EFM the nurse manager is expecting to address?

Accepted Answer

The most important issue related to EFM that the nurse manager is expecting to address is the reduction of failure to accurately assess maternal and fetal status. This is because EFM is intended to monitor and assess maternal and fetal status during labor and delivery, and failure to accurately interpret the data can lead to adverse outcomes such as fetal distress or injury. While the other options may also be important benefits of EFM training, reducing the risk of inaccurate assessment is the primary goal of the training.

Quiz 2: Ethics and Standards of Practice Issues