ob exam 1
A patient who has just received confirmation that she is pregnant is distressed because she has a seizure disorder that she manages with carbamazepine. Which is the nurse's greatest concern?
Carbamazepine is teratogenic and causes neural and facial defects.
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?
Congenital syphilis
Which of the following statements is true with regard to cultural competence and cultural humility?
Cultural humility includes ongoing self-reflection and education in which health- care professionals seek to gain an awareness of their own assumptions and biases that contribute to health disparities.
The nurse works in the labor and delivery department. Which action by the nurse indicates a breach in the nursing care principles outlined by the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)?
Declines a patient assignment because of a history of illegal drug use.
The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy?
Determine whether termination is still a consideration.
The nurse is counseling a female patient who has unsuccessfully attempted to become pregnant through a variety of methods and treatments for infertility. Which psychosocial manifestation is the nurse most likely to recognize?
Difficulty accepting pregnancy if it does occur
The nurse is providing care for a patient at 30 weeks' gestation. Which topic related to patient concern or discomfort is most important for the nurse to address?
Dizziness when lying supine
The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first?
Educate the patient of the risks associated with cocaine use during pregnancy.
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?
Egalitarianism
A patient expresses a desire to become pregnant for a second time. The nurse notes that the patient's first child was born with a serious neural tube defect (NTD) and died of complications at 18 months of age. Which recommendation does the nurse make to this client?
Folic acid 4 mg/day orally for 1 month before conception through the first trimester of pregnancy
A patient is confirmed to be pregnant. Obstetric history includes two sets of twins born at 30 and 32 weeks' gestation, respectively; a singleton birth born at 39 weeks' gestation; and two pregnancies lost in the first trimester. In which way will the nurse define the patient's obstetrical history?
G6, T1, P2, A2, L5
A patient at 13 weeks' gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother?
Glucose, amino acids, and oxygen pass through the placenta from mother to baby.
A patient who is pregnant does not remember the date of her last menstrual period (LMP). In which manner does the nurse expect the estimated date of delivery (EDD) to be determined for this patient?
Having an ultrasound examination
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?
Healthy People 2020
A pregnant patient is at the prenatal clinic for a routine visit at 30 weeks' gestation. The nurse monitors the patient for indications of physiological demands by the fetus on the patient. Which finding causes the nurse concern?
Hemoglobin (Hgb) of 9.5 g/dL and hematocrit (Hct) of 30%
The maternal mortality rate for black women in the United States is:
Higher than the rate for white women, regardless of socioeconomic factors.
What is the definition of sexual orientation?
How a person characterizes their emotional and sexual attraction to others
A pregnant patient and her spouse live in the same home as the spouse's family, which is not supportive of the pregnancy. The patient feels the family is ruining the happiness about the pregnancy. Which is the most important determination for the nurse to make?
If threatened or actual abuse from household members occur toward the patient
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?
Indirect obstetric death
An experienced obstetrics (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?
Intensely studying qualitative research focused on practice enhancement
A patient who is pregnant asks the nurse when her baby is due to be born. The patient reports her last menstrual period (LMP) date as April 14. Using Naegele's rule, the nurse will set the estimated date of delivery (EDD) as what date?
January 21
The nurse is providing care for a patient in the third trimester of pregnancy. Which topic of patient education is most likely to be needed during this time?
Management for commonly experienced discomforts
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 American Nurses Association (ANA) Code of Ethics to protect both patients. Which aspect of care during an ethical dilemma will guide the nurse?
Maternity nurses are bound to advocate first and foremost for the well-being of the mother.
The nurse in an obstetrics (OB) 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?
Medical indications
The nurse on a maternity unit practices her faith as 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?
Moral distress
The nurse is providing prenatal care for a patient who is pregnant with a second child. Which understanding about complexity of a second pregnancy does the nurse use to assist the patient with the acceptance of this pregnancy?
Offer strategies for working out a new relationship with the first child.
A patient at 34 weeks' gestation is undergoing an ultrasound. The nurse notes that the amniotic fluid is estimated at between 500 and 600 mL. Which deduction does the nurse make from this finding?
Oligohydramnios is present.
A couple is planning for the birth of their first child and is discussing the difference between a physician and a midwife. Which information presented by the couple does the nurse validate as being true?
Physicians provide care for both low- and high-risk patients.
A patient at 30 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?
Questions the HCP's prescribed treatment.
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 the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). Which is the most important issue related to EFM the nurse manager is expecting to address?
Reduce failure to accurately assess maternal and fetal status.
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?
Respiratory disorders
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?
Risk management
The nurse is collecting health information from a patient who is early in the first trimester of pregnancy. Which topic is most important for the nurse to discuss with the patient after learning that the patient works for a commercial cleaning company?
Risk related to exposure to environmental toxins
Genomic medicine is an emerging medical discipline that involves using genomic information about an individual as part of the individual's clinical care. Which example does the nurse associate with genomic medicine?
Screening of neonates for inherited, treatable genetic diseases
The nurse is counseling a patient regarding pregnancy. The patient lost her first two pregnancies in the second trimester of gestation for undetermined reasons. Which initial advice does the nurse provide for this patient?
Seek genetic studies.
The nurse works in a urologist's office. A male patient is scheduled for routine fertility testing. For which test does the nurse refrain from making preparation?
Sexual functioning
The nurse at a prenatal clinic is aware of the important tasks that each expectant mother will need to address. When an expectant mother states, "I will give up everything I have to make sure this baby is safe and well-cared for," which task is the mother addressing?
Stating a willingness to give of oneself
A female carries one positive genetic marker for Huntington's disease. Her partner does not have any markers for the disease. For which reason is it so important for this family to identify persons with the genetic marker?
Symptoms do not manifest until 30 to 50 years of age.
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?
Tell the physician of contextual factors identifying an ethical dilemma.
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?
The Safe to Sleep campaign
The nurse is providing care in a school clinic established for the care of adolescent mothers. When assessing a patient who is 11 years of age and pregnant, which deduction regarding the patient's psychosocial development will the nurse recognize?
The adolescent is self-centered and oriented toward the present.
The new grad nurse is employed in a neonatal intensive care unit (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?
The category where aggressive care is probably futile
An infertile couple learns that the female is unable to produce viable eggs. The male partner suggests the use of a surrogate as a means of having a child. The female states, "I don't want your baby with another woman!" The nurse is aware of which psychosocial issue with this couple?
The female is experiencing self-esteem issues.
A patient at 37 weeks' gestation arrives at the labor and delivery unit and reports a rupture of her membranes. Which factor causes the nurse to anticipate the health-care provider (HCP) will prescribe a medical method of labor induction?
The fetus is viable and the barrier for a sterile uterine environment is breached.
Compared with other countries in the world, the United States' maternal mortality rate is:
The highest rate of all high-resource countries.
The nurse is discussing genetically linked diseases with a couple planning a pregnancy. The female states, "I am concerned because there is a history of sickle-cell disease in my family." Which information from the nurse is correct?
The male partner needs genetic testing.
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?
The model that focuses on quality of life
The nurse works in an infertility clinic and is interviewing a male patient whose partner has been unable to conceive. Which finding obtained during a health history will cause the nurse greatest concern?
The patient had a vasectomy reversed.
A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility?
The patient has hot flashes and mood swings.
The nurse is counseling a patient who shares the intention to become pregnant. Which finding during the collection of health information will the nurse feel the least concern to address?
The patient lives in a recently renovated house.
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?
The patient will have an increased risk of wound infection.
A couple announces to their parents that the couple is pregnant. One expectant grandmother says, "Grandchildren will call me by my first name. I am not ready to be a grandmother." Which feelings are being expressed by the grandmother?
The pregnancy presents undeniable evidence the grandmother is growing older.
Biological weathering refers to:
The premature aging that occurs in the body due to prolonged exposure to stressors such as institutionalized racism.
The nurse is counseling a couple in the third trimester of pregnancy and recommends the couple attend childbirth education classes. For which reason is the nurse least likely to recommend the classes?
The techniques will enable a medication-free delivery.
A patient in the first trimester of pregnancy states, "I don't understand how a term baby can be accommodated by my uterus." Which information by the nurse specifically addresses the patient's comment?
The uterus size increases in size 20 times over a nonpregnant uterus.
After counseling with an obstetrician about infertility, a couple is advised to undergo testicular sperm aspiration. The nurse is aware that the procedure may be recommended for which infertility?
Unsuccessful vasectomy reversal
Ethnocentrism is the belief that:
Values and practices of one's own culture are superior.
Which of the following is an appropriate question to include on intake and history forms?
What is your sexual orientation?
When should women be screened for mood disorders during pregnancy?
Women should be screened at the first prenatal visit, during the second and third trimesters, and during the first postpartum year.
The labor and delivery nursing staff is conducting research to determine the benefits of childbirth education (CBE). Which finding does evidence-based practice (EBP) support?
Women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery.
The more prepared a pregnant woman feels for the birth of her baby, the more it will lower her anxiety and fear. This behavior is referred to as __________
nesting behavior
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?
"Due to my weight, there is a possibility that I may develop gestational diabetes."
A mother has a child who is 4 years of age, and she is expecting another child. The mother expresses concern to the nurse about how the older sibling will receive the newborn. Which intervention shared by the mother does the nurse discourage?
"I think that I will just bring the new baby home as a surprise."
The nurse is counseling a female patient about alcohol use during pregnancy. Which statement by the patient demonstrates successful patient teaching?
"It's best for my baby if I avoid drinking during pregnancy."
A patient who is pregnant shares details of being in a physically and psychologically abusive relationship with her baby's father. Which statement by the nurse is most appropriate regarding intimate partner violence (IPV)?
"Let's explore ways to protect you and stop the abuse you have been enduring."
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?
"My child may be at increased risk for birth injury."
A patient in the second trimester of pregnancy seems distressed. With encouragement, the patient states, "I have been totally avoiding physical contact with my husband to avoid prompting any sexual activity." Which statement by the nurse is the best response?
"Nonsexual expressions of affection are important for both of you."
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?
"Tobacco products, including electronic cigarettes, should not be used during pregnancy due to the risk of nicotine toxicity."
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?
"Using marijuana while pregnant can have a negative effect on the neurological development of your baby."
A patient is experiencing pregnancy complications. Which factors will affect the client's ability to manage this situation? Select all that apply. 1. Current health status 2. Existence of a support network 3. Previously used coping skills 4. Perceived threat to self or fetus 5. Implemented nursing interventions
1, 2, 3, 4, 5
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
1, 2, 3, 4, 5
An infertile couple voices concern to the nurse about assisted reproductive technologies (ART). The nurse agrees that ART has created numerous dilemmas. Which potential questions does the nurse discuss with the couple? Select all that apply. 1. Which partner has ownership of the embryos? 2. Should a child be told about donors or surrogates? 3. Are there parental rights for sperm donors? 4. Does a fertility donor have financial obligations? 5. What happens to any surplus embryos?
1, 2, 3, 5
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
1, 2, 3, 5
A female patient with a history of infertility is scheduled to have a hysterosalpingogram. Which findings can be detected with this procedure? Select all that apply. 1. Tubal occlusions 2. Uterine fibroids 3. Cervical irritation 4. Bicornuate uterus 5. Vaginal infection
1, 2, 4
A patient in the third trimester of pregnancy reports having heartburn nearly every day. Which recommendations does the nurse make to alleviate the problem? Select all that apply. 1. Avoid consuming spicy, fatty, or fried food. 2. Maintain good posture. 3. Assume a low Fowler position after meals. 4. Avoid eating 3 hours before bedtime. 5. Consume three moderate-sized meals daily.
1, 2, 4
The nurse explains to a patient who has missed a second menstrual cycle that a combination of presumptive and probable signs is used to make a practical diagnosis of pregnancy. Which signs are expected by the nurse when making a practical diagnosis? Select all that apply. 1. Elevated human chorionic gonadotropin (hCG) levels in blood and urine 2. Brownish pigmentation on the face 3. Fetal movement detected by the examiner 4. Bluish-purple coloration of vagina and cervix 5. Occasional mild contractions
1, 2, 4
The nurse is planning an assessment on a patient in the second trimester of pregnancy. For which assessments will the nurse plan? Select all that apply. 1. Urine testing with a dipstick 2. Presence of dependent edema 3. Determine estimated date of delivery (EDD) by Naegele's rule 4. Signs or symptoms of hypertensive disorders 5. Antibody screening for Rh-negative women
1, 2, 4, 5
A male patient is diagnosed with low sperm count as the cause of infertility. Which interventions will the nurse recommend to improve the patient's sperm count? Select all that apply. 1. Yoga or relaxation techniques 2. Surgical repair of an inguinal hernia 3. Switch to underwear made from cotton 4. Avoidance of showers with hot water temperature 5. Consultation to change hypertension drugs
1, 2, 5
A patient in the third trimester of pregnancy expresses concern to the nurse about changes to her muscles, joints, and bones. Which conditions does the nurse reassure the patient are normal changes of pregnancy? Select all that apply. 1. Low back pain 2. Lordosis 3. Fractures 4. Severe muscle aches 5. Increased risk of falls
1, 2, 5
A pregnant patient tells the nurse that her spouse has been diagnosed with Couvade syndrome. Which manifestations does the nurse suspect the spouse is experiencing? Select all that apply. 1. Nausea from unidentifiable causes 2. Unexplainable abdominal pains 3. Self-imposed social isolation 4. Physical rejection of sexual advances 5. Significant recent weight gain
1, 2, 5
An infant was recently born weighing 1,498 grams. The nurse understands that the birth rate 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
1, 3, 4
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 parental decisions. Which interventions will the neonatal intensive care unit (NICU) nurse implement in order to fulfill nursing responsibility to both the parents and the neonate? Select all that apply. 1. Inform the parents as to realistic expectations. 2. Elicit parental input regarding medical care. 3. Use the neonate's status with parental counseling. 4. Advocate for medical support of the neonate. 5. Inform parents they are the final decision-makers.
1, 3, 4
The labor and delivery nurse is providing care to a patient in active labor. The nurse notes electronic fetal monitoring (EFM) changes that suggest fetal distress and monitors the fetus for an additional 20 minutes before calling the health-care provider. The health-care provider 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. 1. Lack of appropriate response to fetal compromise 2. Inappropriate use of oxytocin, causing fetal distress 3. Performance of a technical error related to monitoring 4. Delayed communication resulting in a delay of cesarean 5. Inability to initiate resuscitation to a compromised fetus
1, 3, 4
Which factors will facilitate the integration of evidence-based practice (EBP) in the maternal- newborn clinical setting? Select all that apply. 1. Frame clinical questions in the PICOT (patient, intervention, comparison, outcome and [sometimes] time) format. 2. Base practical decisions on nursing consensus. 3. Cultivate a spirit of inquiry in the workplace. 4. Encourage the use of trial-and-error methods. 5. Collect the best and most relevant evidence.
1, 3, 5
A patient in the second trimester asks the nurse questions about the Zika virus. Which of the following is correct information to give to the patient? Select all that apply. 1. The Zika virus is spread primarily through infected mosquitos but can also be sexually transmitted from a person who is infected. 2. All persons infected with the Zika virus will experience symptoms of fever, joint pain, rash, or headache. 3. Women traveling to areas known to have active mosquito transmissions of Zika should be advised to receive the Zika vaccine 3 months before travel. 4. If a woman has symptoms of Zika virus before conceiving, she should avoid getting pregnant for at least 1 month. 5, Treatment for Zika consists of rest, fluids, and medication to reduce fever and pain.
1, 5
The nurse is counseling a female patient diagnosed with anovulation as a cause of infertility. Which information does the nurse provide to the patient? Select all that apply. 1. Methods for dietary planning 2. Consultation for myomectomy 3. Refrain from unprotected sex 4. Surgical correction of fallopian tubes 5. Instructions for clomiphene citrate
1, 5
The nurse is providing teaching to a patient in the first trimester of pregnancy. Which of the following education topics/suggestions would be appropriate for the nurse to make? Select all that apply. 1. Include information on nutritional food choices emphasizing fresh fruits and vegetables. 2. Encourage daily intake of 8 to 10 glasses of fluid and up to 800 mg of caffeine per day. 3. Avoid all albacore tuna as it is not safe to eat during pregnancy due to high levels of mercury. 4. Set weight-gain goals to gain between 5 and 10 pounds during the first trimester. 5. Avoid raw sprouts of any kind.
1, 5
The nurse is preparing a prenatal plan of care for a patient who is in the first trimester of pregnancy. Which long-range goals does the nurse include in the plan of care? Select all that apply. 1. Determine parental outlook on immunizations. 2. Perform an ongoing assessment of risk status. 3. Build rapport with the childbearing family. 4. Make referral to specific resources as needed. 5. Implement a risk-appropriate intervention.
2, 3, 4, 5
The nurse notes that a patient in the third trimester of pregnancy feels unable to "mother" her unborn child. Which information about the patient helps the nurse identify the sources of the patient's ambivalence? Select all that apply. 1. The patient asks about classes for baby care. 2. The patient is estranged from her mother. 3. The patient's partner is excited about a baby. 4. The patient expresses a loss of independence. 5. The patient expresses disgust about body changes.
2, 4, 5
The nurse works in a prenatal clinic that serves a multicultural population. The nurse is culturally aware, and so, which behaviors by a patient are expected due to common restrictive beliefs? Select all that apply. 1. A pregnant woman allows a clinic staff member to take a photo of her. 2. A pregnant woman denies sexual intercourse during her third trimester. 3. A pregnant woman reaches to an overhead shelf to collect her belongings. 4. A pregnant woman avoids sitting in front of a fan or air conditioner. 5. A pregnant woman refuses to watch a televised eclipse of the moon.
2, 5
The nurse is encouraging cultural sensitivity among the nonmedical personnel in a prenatal clinic. Which type of family does the nurse identify as including children? Select all that apply. 1. Cohabitating family 2. Dyad family 3. Nuclear family 4. Extended family 5. Blended family
3, 4, 5
The nurse works in a prenatal clinic located in a multicultural city. It is important for the nurse to recognize which cultural beliefs as prescriptive? Select all that apply. 1. Drinking too much tea will stimulate the fetus and cause a premature birth. 2. The mother invites harm to the fetus during the night by sleeping on her back. 3. The satisfaction of pregnancy cravings will prevent birthmarks on the baby. 4. A safety pin attached to an undergarment will prevent fetal facial deformities. 5. The mother will aid the baby's circulation by remaining active during pregnancy.
3, 4, 5
A couple informs the nurse they have decided to make arrangements for a home birth. Which criteria will the nurse share with the couple regarding a safe home birth? Select all that apply. 1. The couple must be trained on how to be in control of the birth. 2. The birthing home must be within a 1-hour drive of a hospital. 3. The pregnant woman must be in good health with a normal pregnancy. 4. The birthing room needs to be sterile before labor and delivery. 5. Adequate medical supplies and resuscitation equipment is available.
3, 5
The nursing department of a large facility is interested in improving clinical care with the introduction of evidence-based practice (EBP). Which barriers to EBP does the nursing department expect within the facility? Select all that apply. 1. Changes in nursing academia to include how to integrate research into practice 2. A general lack of information addressing nursing-focused research and change 3. Outdated facility politics and policies that do not embrace research-based change 4. Limited resources available to clinical care providers from nursing administration 5. Resistance by other health-care professionals to providing nursing with autonomy
3, 5
The nurse works in a prenatal clinic and interacts with multiple patients from various socioeconomic backgrounds. Which patient does the nurse assess most carefully for a mental health issue?
A military veteran who was deployed twice
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?
Alcohol abuse
The nurse is teaching a class about embryonic and fetal development to couples in the early stage of pregnancy. For which reason does the nurse emphasize the first 8 weeks of gestation?
All organ systems are developing during this period.
The nurse is providing care for a patient who is 42 years of age and in the first trimester of her pregnancy. For which possible complication will the nurse closely monitor the patient and fetus?
Alterations in fetal chromosomal studies
Nurses' responsibilities for speaking up to advocate for the rights, health, and safety of patients are outlined in which of the following?
American Nurses Association Code of Ethics for Nurses
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?
Are arrangements made for prolonging life?
Mercy Ochoa, a 28-year-old Filipino American, is 18 weeks' pregnant. After receiving a prescription for prenatal vitamins, she tells the nurse that her mother has warned her to take only herbal medication during pregnancy. The nurse appropriately:
Assesses the significance of Mercy's mother's advice.
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?
Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)
The nurse is providing care for a patient close to delivery. 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"?
Beneficence
A patient arrives for her fourth month prenatal visit and expresses concern because of a leakage of yellow fluid from her breasts. Which topic does the nurse discuss during this visit?
Breast changes
A patient arrives at a maternal health client and tells the nurse she has missed a period and thinks she is pregnant. Which information shared with the nurse is a presumptive sign of pregnancy?
Breast enlargement, tenderness, and tingling
