Chapter 1 PrepU
A 15-year-old client has just given birth and states that she does not want her infant to receive any newborn vaccines. What is the appropriate action for the nurse to take?
Withhold the vaccines.
A group of nurses are discussing the most recent statistics on death due to prematurity in the United States. Which action, if implemented, would have the greatest impact on improving outcomes?
Improve women's access to receiving prenatal care. -The best way to have a positive impact on perinatal outcomes and reduce prematurity is to improve women's access to prenatal care. Tracking the incidence of violent crime does not give information on how to improve outcomes, nor does examining health disparities between ethnic groups or identifying specific national goals related to maternal and infant care without acting on the information. None of these address the true problem.
A nurse is providing teaching to a parenting class on childhood mortality prevention. Which topic would be the priority for the nurse to include? -sex education seat belt safety immunizations obesity
seat belt safety -The leading cause of death in children is unintentional injuries and is often preventable. Seatbelt safety would be a priority topic for the nurse to discuss as that is the one that could result in an injury.
In order to advocate for children and families, the nurse must first acknowledge that the basic system in which health behavior and care are organized, secured, and performed is the:
family - The family is the basic system in which health behavior and care are organized, secured, and performed. In most families, the parents or guardians, as advocates for their child, provide health promotion and health prevention care, as well as primary management of care when the child is sick. Parents and guardians have the prime responsibility for initiating and coordinating services rendered by health professionals.
A nurse is working as part of a larger community group to develop programs to address current barriers to health care being experienced by women. The community is in the city with a large population of low-income families. On which factor should the group focus their efforts to address a main barrier to access to care?
health insurance -Although transportation, language and culture, and low health literacy are barriers to health care, health insurance is a major factor affecting access to health care. The existence of financial barriers is one of the most important factors that limits access to care. Many families do not have health insurance so they cannot afford to see health care providers for maintenance and prevention services. Many do not have enough health insurance to cover services they need or cannot pay for services.
A nurse is determining whether or not informed consent has been obtained from the family of a child who is going to have abdominal surgery. Which statement by the family would lead the nurse to suspect that informed consent is lacking? "We had to sign the form right away so the surgery could get scheduled." "He might miss some school afterwards, but he'll be feeling much better." "Although there are risks involved, our son needs the surgery to cure the problem." "We are amazed that he'll be up and walking around the day after surgery."
"We had to sign the form right away so the surgery could get scheduled." - The statement about signing the form right away suggests that the family was coerced into agreeing to the surgery without being fully informed about the risks and benefits. The key ethical issues related to informed consent for treatment have similarities to those required for research participation: Consent must be voluntary and based upon shared information about the risks and benefits of the treatment. Furthermore, the parent must understand the information and be cognitively and mentally competent to make the decision. The statements about risks, activity limitations, and postoperative care indicate that information was shared with them and that they understood it.
The nurse is teaching a birthing class to expectant fathers. A father wants to know how he can directly help his partner. How should the nurse respond? Select all that apply.
-"You can be supportive by encouraging your partner during labor." -"Providing a back rub helps with pain and provides relaxation." -"Be aware that hormonal changes may make your partner have some behavior changes temporarily." - "Involving yourself in infant care provides for better family bonding."
The nurse is reviewing the medical records of several infants. Which infant is at highest risk for death according to the infant mortality rate in the United States?
An infant born at a low birth weight - Infant mortality in the United States is associated with low birth weight, prematurity, and congenital abnormalities, among other concerns. An infant born to young or older parents, or at 38 weeks' gestation, would not be considered low birth weight or premature nor considered to be at higher risk for congenital abnormalities.
A nurse who specializes in maternal and child health care performs many varied functions in diverse settings over the course of a year. Which action would be outside the nurse's scope of practice? - Assist in the treatment and recovery of a woman with ovarian cancer. - Provide preconceptual health care to a client. - Discuss methods of alleviating morning sickness with a client in her first trimester. - Read a recent journal article on breastfeeding and its benefits for new mothers.
Assist in the treatment and recovery of a woman with ovarian cancer. - The primary goal of both maternal and child health nursing can be stated simply as the promotion and maintenance of optimal family health to ensure cycles of optimal childbearing and childrearing. Assisting in the treatment and recovery of a woman with ovarian cancer is the least likely function of a nurse specializing in this type of nursing. Preconceptual care, care of a woman during her first trimester, and reading journal articles regarding breastfeeding are all within the scope of practice of maternal and child health nursing.
The nurse is assessing a 9-year-old boy with pneumonia. Which finding is a factor for this child's morbidity? - Medical records reveal a history of asthma. - Child's height and weight plot at the 50th percentile on the growth chart. - Child's white blood cell (WBC) count is within normal limits. - Child is active in a Boy Scout troop.
Medical records reveal a history of asthma. -Asthma is a morbidity factor for additional childhood illness, particularly respiratory illness. The child's height and weight are appropriate and not associated with increased risk. The normal WBC count may help to determine if the pneumonia is bacterial or viral. Being in a Boy Scout troop may increase the risk of exposure, but would not be as closely associated with morbidity as is asthma.
A nurse is explaining to a young couple the advantages of seeking maternal and child health care in an ambulatory setting versus the emergency department in nonemergent situations. Which goal should the nurse emphasize the most?
Minimize the separation of children from their parents. - Separation from parents can be traumatic for young children; ambulatory settings minimize this to some degree. Ambulatory care increases responsibility for parents, has no real bearing on the number of needed hospitals (since they treat different types of clients) and the calm environment does not play a role in change in emphasis. Decreasing the number of hospital visits or increasing the number of urgent care centers could possibly result from more emphasis on ambulatory care; however, the main focus would be reducing the trauma a young child may experience receiving medical care.
The nurse is assessing a 9-year-old boy during a back-to-school checkup. Which finding is a factor for childhood injury? -Mother reports she has used alcohol and drugs. -Records show child weighed 2,450 g at birth. -The parents adopted the boy from Guatemala. -Mother reports the child is hostile to other children.
Mother reports she has used alcohol and drugs. - One of the factors associated with childhood injuries is parental drug or alcohol use. This is the leading cause for child mortality. Low-birth-weight babies are at higher risk for infant mortality. Foreign-born adoption is a factor for childhood morbidity. The child's hostility toward other children may be an environmental or psychosocial factor for childhood morbidity.
The nurse is caring for a 5-year-old girl with meningitis. What action by the nurse may be considered ethical behavior? Telling her an intramuscular injection won't hurt Scheduling a laboratory procedure at lunchtime Referring to the child as "her" when she is present Starting intravenous fluids even though the child protests
Starting intravenous fluids even though the child protests -Ignoring the child's dissent regarding proposed therapy is ethically sound. The treatment will benefit the child, and at 5 years of age the decision maker is nearly always the parent or legal guardian. However, the nurse must use developmentally appropriate techniques to inform the child about the therapy and to carry it out. Telling her an intramuscular injection won't hurt lacks veracity. Referring to the girl as "her" when she is present shows disrespect. Scheduling a laboratory procedure at lunchtime is unfair to the child and lacks justice.
The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?
The importance of crossing streets safely -Motor-vehicle accidents are a leading cause of death in this age group.
After completing an assessment, the nurse examines the information to develop a wellness diagnosis for the client to identify which potential goal? -Acute health problems -Potential problems -The potential for improvement in health -Chronic health problems
The potential for improvement in health - Wellness diagnosis identifies the potential for a client to move from one level of wellness to a higher level. The identification of potential, acute, and chronic health problems is part of the diagnostic process.
Before World War II women moved from home to hospital births. What was the primary reason for that shift in maternity care?
They were convinced that setting would improve birth outcomes. - Prior to World War II, American women moved from home to the hospital for birth in part because they were convinced that setting would improve birth outcomes. Women who labored and gave birth at home were traditionally attended to by relatives and midwives. Many women were attracted to hospitals because this showed affluence and hospitals provided pain management, which was not available in home births.
A nurse is providing care to several clients at the clinic. The nurse would obtain legal consent for care from the parent or legal guardian for which client?
a 15-year-old adolescent who is a high school student - Generally, only people over the age of majority (18 years old) can legally provide consent for health care except in the case of an emancipated minor and of a person who is no longer subject to parental control, (e.g., one who marries). Therefore, the 15-year-old adolescent would require parental consent for treatment.
A nurse is conducting a presentation for a group of pregnant women about appropriate health promotion strategies to address issues related to infant mortality. Which strategy would the nurse encourage to reduce the infant's risk for infection after birth? -breastfeeding -sleeping on the back -folic acid supplementation -newborn development support groups
breastfeeding
Infant mortality continues to be a concern. What factor has done the most to reduce infant mortality? - breastfeeding -parental education -improved prenatal care -hospital births
breastfeeding
The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained?
learning the mother is not the custodial parent -It would not be legal for this mother to give consent. A mother younger than 18 years of age or never married may not be a problem in most states because she would be considered autonomous. The physician or nurse could read the consent form to a mother who cannot read plus carefully explain the medical information in terms she understood.
A client, 6 hours post-birth, has a severe postpartum hemorrhage that the health care providers are unable to control. She succumbed to the hemorrhage in the intensive care unit. The client's death would become part of the: -neonatal morbidity rate. -neonatal mortality rate. -maternal mortality rate. -maternal morbidity rate.
maternal mortality rate. - The maternal mortality ratio is the annual number of deaths from any cause related to or aggravated by pregnancy or its management. Morbidity refers to diseases. The infant mortality rate is the number of deaths occurring in the first 12 months of life. Neonatal mortality is reflected in the infant mortality rate.
The nurse working in a free health clinic is providing care to a 1-year-old girl and her single teenage mother. Which action would be most important initially? - obtaining food stamps for the family -assessing the child's cognitive level -observing the mother/child interaction -discussing family health history
observing the mother/child interaction -The nurse's initial interactions with the parent and child can provide valuable insights into maternal-child attachment. This information can be used to inform other aspects of the health assessment. This observation is likely to precede formal assessments, such as cognitive assessment and family health history. At this point, it is not known if food stamps are needed. Assessment is the priority.
What nursing intervention by the maternity nurse is the most important in providing family-centered care? -promoting uninterrupted infant bonding -allowing doulas to attend the woman in labor -allowing siblings in the delivery room - providing early discharge
promoting uninterrupted infant bonding - Since World War II many changes and innovations have occurred in maternity care and how nurses provide this care. The evolution has gone from task-oriented nursing services, to providing education and promoting breastfeeding, to family-centered care. Promoting uninterrupted infant bonding has been identified as a priority in the development of the family unit. Allowing doulas in the delivery room, having siblings at the bedside and providing early discharge are all parts of family-centered care, but establishing bonding between the infant and the family unit is the priority.
A nurse informs a 19-year-old client that she is pregnant. The client immediately states that she plans to have an abortion. What would be the most appropriate response from the nurse to this client?
"I'll put together the information that you will need." - The nurse should not respond to this client with any judgment or biased information. The client does not have to notify the father, and the other responses show the nurse's personal bias. If a nurse has an ethical issue with this procedure, she should address it with her managers, not the client.
The nurse is working with the parents of an infant and a toddler in the clinical setting. What statement by the parent would alert the nurse to assess the children further?
"We live in an old house, and we are planning to renovate it when the kids are older." - Older homes are at risk for having lead-based paint (usually those built before the mid to late 1970s) and lead pipes used in plumbing. The nurse would further assess for the children's exposure to lead pipes, paint, paint chips, lead dust and soil containing lead dust and paint chips. Additionally during a renovation, the children will be exposed to areas with lead paint and/or dust. The other options are appropriate and demonstrate information only and not a need to further assess.
The nurse is caring for a child who says, "I'm tired of being in the hospital and I miss my own home." Which response by the nurse is most appropriate? - "Can you tell me more about how you feel?" -"I am sorry you feel that way." -"What can we do to make your room seem more like home?" -"Once you are better you can go home."
"What can we do to make your room seem more like home?" - It is important to promote the involvement of the child in the plan of care and involve the child in decision-making to foster his empowerment. The hospitalized child is away from home and should be encouraged to participate in the care and the development of the room's environment. Asking what can be done to promote improved feelings makes the child a part of the team. Telling the child that he will go home when he is better does not address the concerns. Offering sympathy does not attempt to address the concerns. Asking about feelings in this manner is a closed question and does not solicit information from the child.
A nurse is conducting a teaching session on sudden infant death syndrome (SIDS) for expectant parents. Which information should the nurse include? Select all that apply. -Maintain neutral temperatures and avoid overheating. -Place the infant on his or her back to sleep. -Allow the infant to sleep with a bottle. -Sharing a room allows for monitoring of the infant. -Co-bedding or sharing a bed creates parental bonding.
-Maintain neutral temperatures and avoid overheating. -Place the infant on his or her back to sleep. -Sharing a room allows for monitoring of the infant. - Sharing of a room allows for monitoring and bonding of the infant as well as ease of feeding. Placing the infant on his or her back to sleep is the recommended sleeping position for all infants until 12 months of age, or until they can change their own position during sleep. Infants are not able to regulate their temperature; therefore, overheating can increase their risk for SIDS. Co-bedding increases the risk for accidental suffocation, and allowing an infant to sleep with a bottle increases risk for aspiration and infection.
The nurse completes a focused assessment on a client complaining of migraine headaches. Which items identified during the assessment would the nurse recommend the client change in an attempt to decrease the incidence of migraine headaches?
-Uses an oral contraceptive pill (OCP) -Drinks 3-4 glasses of wine in the evening - Consumes large quantities of aged cheeses and salty foods -
A client who has just given birth is concerned about the high rate of infant mortality in the United States. She is anxious about the health of her child and wants to know ways to keep her baby healthy. Which recommendation would best meet this goal? -Give the infant liquid vitamins daily. Begin feeding of solids by age 4 months. Breast-feed the infant. Place the infant on his or her back to sleep.
Breast-feed the infant. -Breast-feeding reduces the rates of infection in infants and helps to improve long-term maternal health. Placing the infant on his or her back to sleep prevents SIDS but does not prevent infections in the infant. Feeding solids early is not recommended and has no affect on prevention of infections. Vitamins will not prevent infections by themselves and only help meet daily nutritional requirements and may not be necessary.
A healthy client without a primary care provider is exploring the options available for a health care provider to assist with her pregnancy. Which health care provider can the nurse point out as a best option? - Certified nurse midwife -Lay midwife -Women's health nurse practitioner (NP) - Clinical nurse specialist (CNS)
Certified nurse midwife
A nurse is reviewing a labor plan with a client who has been admitted to the labor and birth unit. The client states that she has been drinking a significant amount of herbal teas lately to help with uterine contractions. Which is the priority action by the nurse?
Determine the type of herbal teas recently consumed. - Certain herbal teas can be used during pregnancy, and most are made with flower or berries that are safe for both mother and fetus. To determine if the herbal tea is safe or has had any effect on the status of the birth, it is important for the nurse to find out what type of tea the client has been consuming and in what quantities.
A nurse is providing cardiopulmonary resuscitation (CPR) to an infant with chronic health problems when the mother of the child tells the nurse to discontinue CPR. Which is the mostappropriate action by the nurse? -Discontinue all resuscitation efforts. -Continue chest compression only. -Stop and call 911. -Continue CPR until help arrives.
Discontinue all resuscitation efforts. - The parents of the child can determine if they wish for resuscitation efforts to continue. The nurse should stop CPR when told so by the parents.
A nursing student is preparing a presentation illustrating the Human Genome Project. Which function will the student point out as being the primary focus?
Identification of human genes and functions -The Human Genome Project was founded in 1990 and its primary purpose was to identify and label all human genes and their functions. Information from the HGP may eventually be used in genetic testing, the detection of mutations or variations in children, and gene therapy.
A nurse is doing a literature search on maternal mortality and finds that direct causes comprise the majority of maternal deaths. Direct causes are noted to be unpredictable reasons. Which action would be most appropriate to implement that would have the greatest impact on reducing these numbers? - Monitoring maternal glucose levels in mothers with type 1 diabetes. Administering oxytocic medications for increased postpartum bleeding. Referring to a cardiologist for any arrhythmias. Practicing high standards of infection control. Beginning antibiotics prior to birth for a febrile mother.
Practicing high standards of infection control. - Few women die giving birth in a developed countries, but it still happens. Health care providers can have the greatest impact on reducing these numbers by implementing good infection control measures, appropriate use of antibiotics during labor and postpartum periods, and use of oxytocics for maternal bleeding to prevent hemorrhage. Diabetes and cardiac arrhythmias are not considered direct causes (i.e., they are known and predictable).
A nursing instructor is teaching a session investigating infant mortality as a standard measurement of the quality of health care in the country. The instructor determines the session is successful when the students correctly choose which factors as contributing to the high numbers of deaths in the United States? Select all that apply. -Congenital deformities and chromosomal abnormalities -Male gender of infant -Maternal complications -Preterm births -Maternal age 30 to 34 yea
Preterm births maternal complications congenital deformities and chromosomal abnormalities - Many factors contribute to the high infant mortality rates in the United States. Some of the most common factors are low gestational age and prematurity, congenital deformities and chromosomal abnormalities, and maternal complications such as cervical insufficiency, multiple births, and premature rupture of membranes. Female infants have lower mortality rates than males, and the best outcomes are in mothers who give birth between 30 and 34 years of age.
A nurse is caring for a 31-year-old pregnant client who is subjected to intimate partner violence. The client has developed a feeling of hopelessness and does not feel confident in dealing with the situation at home, which makes her feel suicidal. Which nursing intervention should the nurse offer to help the client deal with her situation?
Provide emotional support to empower the client to help herself. - In cases of intimate partner violence, nurses can serve their clients best by not trying to rescue them but by helping them build on their strengths, providing support, and empowering them to help themselves. Counseling the client's partner against violence, helping the client know the legal impact of her situation, and introducing the client to a women's rights group to garner support are not the best ways of serving the client.
A nurse witnesses a peer tell a client, "You are a mother now and you have to do what is best for you baby. You have to breastfeed her!" Which is the best action by the nurse?
Pull the nurse aside and inquire as to the content of the conversation. -The nurse overheard just a small portion of the conversation between the client and the peer nurse. The best action would be to inquire as to the content of the conversation and then determine if the peer nurse's comments were appropriate. If the comments were inappropriate, the nurse would then need to fill out an incident report.
A program designed to decrease the infant mortality rate in the United States would probably make the greatest impact if it focused on which aspect of care? - offering increased WICC availability - reducing the number of home births - increasing the education level of parents - increasing the number of women receiving prenatal care
increasing the number of women receiving prenatal care -Receiving prenatal care has proven to be a major strategy for reducing infant mortality. The other interventions will not directly impact infant mortality rates to the degree that prenatal care will.
A nurse is preparing a presentation on current American trends in maternal morbidity and mortality in order to lobby for program funding. Which statements would the nurse include? Select all that apply. - Each year 100 to 200 women die as a result of birth complications. -Most of pregnancy-related complications respond well to proper care. -Most pregnancy-related complications women experience are not preventable. -The United States ranks below more than 45 countries in rates of maternal deaths. -The leading causes of pregnancy-related mortality are hemorrhage, infection, preeclampsia-eclampsia, obstructed labor, and unsafe abortion.
The United States ranks below more than 45 countries in rates of maternal deaths. Most of pregnancy-related complications respond well to proper care. The leading causes of pregnancy-related mortality are hemorrhage, infection, preeclampsia-eclampsia, obstructed labor, and unsafe abortion. - The United States has approximately 700 to 800 women die each year as a result of pregnancy or a childbirth complication. The United States ranks 48th (in other words, below 47 other countries) in rates of maternal deaths (deaths per 100,000 live births). Most pregnancy-related complications are preventable and respond to proper care. The leading causes of pregnancy-related mortality are hemorrhage, infection, preeclampsia-eclampsia, obstructed labor, and unsafe abortion.
A chronically ill child attends school regularly. The parents have signed a do not resuscitate (DNR) order for the child and presented it to the school nurse. What action should the school nurse take first? - determine the parents' wishes if death should occur at school - involve the school principal - share the information with the child's teacher - consult the school's legal team
determine the parents' wishes if death should occur at school - Children who are chronically or terminally ill can still go to school. If the parents sign and present the school nurse with a DNR order, the nurse should devise a plan for what will happen if the child should die at school. To do this, the school nurse should first talk with the parents about their wishes and write a plan of action. The teacher, the principal, and the legal team will all need to be involved so that all legal and ethical decisions can be made to honor the parents' wishes.
The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role?
facilitating return to school by working with the school nurse - Much of an adolescent's life revolves around school and peers. In helping the teen return to school, the nurse and the school nurse are achieving continuity of care and a supportive environment for healing. Teaching the mother cast care addresses the mother's learning needs and the teaching role of the nurse. Discussing driving safety with the teen is important and a factor in many adolescent injuries and deaths but is not a management activity. Changing dressings is a direct care activity of the nurse.
A nurse is reviewing the statistical outcomes related to fetal deaths nationwide and notes that the numbers have changed over the last several decades. The best explanation would be: -expectant mothers are seeking prenatal care later, resulting in decreases in the number. -improved prenatal care has reduced the numbers of fetal deaths. -increases are noted because of the growing number of pregnancies to teen mothers. -increases are noted due the increasing number of older mothers becoming pregnant.
improved prenatal care has reduced the numbers of fetal deaths. - The number of fetal deaths in the United States has fallen. This has been attributed to the improvement in the delivery of prenatal care.
A group of nurses are working to provide quality care for their clients within the current health care environment of cost containment. Which strategy(ies) would be appropriate for the nurses to use? Select all that apply. -urging clients to participate in screening programs -encouraging clients to consume organic foods to promote healthy lifestyle choices -educating clients about seeking help for problems early on -creating easy access programs for clients to receive immunizations -encouraging clients to use emergency services for minor problems
urging clients to participate in screening programs educating clients about seeking help for problems early on creating easy access programs for clients to receive immunizations - Nurses can be leaders in providing quality care within a limited-resource environment by emphasizing the importance of making healthy lifestyle and food choices, seeking early interventions for minor problems before they become major ones, and learning about health-related issues that affect clients. Mammograms, cervical cancer screenings, prenatal care, smoking cessation programs, and immunizations are a few examples of preventive care that yield positive outcomes and reduce overall health care costs. Prevention services and health education are the cornerstones of delivering quality maternal, newborn, and women's health care. Although organic foods may be considered healthy choices, they can be more costly. If encouraged, clients may opt to spend more for the organic foods, thereby limiting their choices for selecting other healthy foods. Using the emergency department for routine care would not be cost-effective.
A group of women are attending a community presentation regarding the leading health concerns of women. Which interventions should the nurse recommend to have the greatestimpact on the leading cause of death?
weight control and being knowledgeable about family history of cardiovascular disease - Cardiovascular disease is the leading cause of death of women in the United States. Interventions that address reduction of this risk would be a priority. Elevations in death rates are in part attributed to the difficulty recognizing cardiovascular concerns in women. The second leading cause of death in women is cancer, specifically lung and cervical. Lower respiratory tract infections have increased over recent years as a cause of death in women, but they are not the number one cause. Alzheimer's disease, although impacting the mortality rates of women, is not the greatest cause of death.
A nurse educator is conducting a class on intimate partner violence for a group of new graduate nurses during orientation. Which statement by the educator best reflects current practice regarding these problems in women's health? -"Asking every client about intimate partner and family violence is the best way to elicit accurate information." -"The nurse should screen for these problems at every client encounter." -"The nurse is not legally responsible for reporting suspected intimate partner violence." -"Since families are more stable than in the past, nurses are not as concerned about these problems as they used to be."
"The nurse should screen for these problems at every client encounter." - Both child and intimate partner violence is increasing in incidence. Families are more mobile than in the past. Screening for child abuse (child maltreatment) or intimate partner violence should be included in all family contacts. Nurses must be aware of the legal responsibilities for reporting violence.
The nurse is caring for several families enrolled in Medicaid in the prenatal setting. Which statement by an expectant mother would alert the nurse to assess the family further? -"We just moved here from another state and I am still getting used to the new town." "My sister-in-law is due to have her baby the same month as our baby is due." "I plan to give birth in a hospital setting with my family at my side." "In my culture, we have family help us care for the baby in our home for several months."
"We just moved here from another state and I am still getting used to the new town." - Medicaid is a financial assistance program for low income families and varies from state to state in terms of eligibility and application process. When a family has moved from one state to another, there may be delays in getting Medicaid established in the new state. Hospital births are typically covered by Medicaid. Family helping with the newborn is a benefit, and would not affect Medicaid resources. The mother's sister-in-law giving birth in the same month would not be a situation the nurse would need to assess further, especially regarding Medicaid resources.
Which physician is known as the "Father of Pediatrics"?
Abraham Jacobi
A single, 18-year-old woman in her second trimester presents at the clinic with vaginal bleeding. She confides to the nurse in confidence that she has been using cocaine to "calm her nerves" and hopes it didn't harm her baby. What would be the nurse's best response to this situation?
Consult with the health care facility's institutional ethics committee for an appropriate response. - Ethical issues of fetal well-being and treatments arise with debate about the appropriate balance between the maternal and fetal interests. Issues related to problematic behaviors generally revolve around use of illicit drugs and alcohol and their harmful effect on the fetus. These cases are very difficult to resolve successfully, whether the course of action is inside or outside the legal system, and may require consultation with the IEC.
Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent? - Telephone consent with two witnesses listening simultaneously. - Explaining the needed treatment to the minor and documenting this action. - Contacting the institution's attorney to provide and document consent. - Treating the minor and obtaining written informed consent when the parent arrives.
Telephone consent with two witnesses listening simultaneously. -Telephone consent documented with two witness signatures is appropriate. None of the other options constitutes informed consent.
The nurse is admitting a client to the emergency clinic and notes that the client's gender expression is different than the gender noted in the driver's license and insurance documentation. What is the nurse's best response?
The nurse should communicate with the client based on the client's preferred pronoun.
A nurse admits a young boy who lives in a homeless shelter with his pregnant teenage mother. What would nurse realize to be a priority when planning his case management? -The toddler's situation puts him at risk for higher incidence of disease and limited access to appropriate care. -The toddler's visits to the emergency department assist in lowering his incidence of disease. -There will be adequate coordination of other available services with visits to the emergency department. -Medicaid coordination of health services from the emergency visits will cause a lower incidence of disease.
The toddler's situation puts him at risk for higher incidence of disease and limited access to appropriate care. -Factors that may increase morbidity include homelessness, poverty, chronic health disorders, and barriers to health care. Children who live in poverty have a higher incidence of disease, limited coordination of health services, and limited access to health care, except for visits to the emergency department.
A young couple are very excited to learn they are expecting their first child and question the nurse about which test they need to discover its gender. Which procedure will best provide this information to the couple?
Ultrasound
An infant at 33 weeks' gestation dies after 1 week of life in the neonatal intensive care unit. This infant's death rate would be classified under which statistical category? a.infant death under one month b. neonatal death c.preterm gestational death d. postneonatal death
neonatal death -The neonatal death rate is the number of deaths of an infant in the first 28 days of life. Gestational age is not a consideration when reporting deaths of infants. The other categories are not classifications for reporting infant deaths.
Infant mortality continues to be a concern. What factor has done the most to reduce infant mortality? -breastfeeding -hospital births -improved prenatal care -parental education
breastfeeding -After birth, health promotion strategies increase the infant's health and improve the chances of survival. Breastfeeding the infant has had the greatest impact on survival rates. Breastfeeding promotes maternal−infant bonding, decreases the rates of infant infections, and decreases the rates of allergic and autoimmune diseases. In the long term, it reduces obesity and the complications associated with obesity. Having a safe birth in the hospital does not impact what happens to the infant after hospital discharge. Better prenatal care improves the status for the mother and the outcome for the newborn, but does not guarantee the safety of the infant. Parental education impacts care to parents, but many do not have the resources to carry out these instructions after the infant's birth.