Ethical Issues in Maternal Newborn Nursing

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The nurse is providing care to a 46-year-old female patient. The patient appears hesitant when asked of her sexual history, and the nurse discovers that the patient is a lesbian. What education should the nurse provide to this patient pertaining to her health?

  • A. Lesbians often are at higher risk for menstrual disorders, abnormal insulin production, and infertility.
  • B. Lesbians often are at higher risk due to lower socioeconomic disparities than their heterosexual counterparts.
  • C. Lesbians often refuse choices in health care such as the HPV vaccine as many feel they are not at risk.
  • D. Lesbians often have fewer health issues than their heterosexual counterparts due to their strong support systems.
Correct Answer: A

Rationale: The education that the nurse should provide to the lesbian patient pertains to her health includes the fact that lesbians often are at higher risk for menstrual disorders, abnormal insulin production, and infertility. It is important for the nurse to be aware of potential health risks that may affect lesbians specifically, as this knowledge can help in providing appropriate care and interventions. By addressing these specific health concerns, the nurse can promote the patient's overall well-being and empower her to take proactive steps to maintain her health.

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A client is scheduled for surgery after a recent breast cancer diagnosis. The nurse is discussing the procedure with the client. To allay her fears, which explanation best describes a skin-sparing mastectomy?

  • A. Removal of the breast, nipple, and areola, leaving only the skin
  • B. Removal of the breast, nipple, areola, and axillary node dissection
  • C. Incision on the outside of the breast, leaving the nipple intact
  • D. Removal of both breasts in their entirety
Correct Answer: A

Rationale: A skin-sparing mastectomy involves removing the breast, nipple, and areola while keeping the skin intact for possible reconstruction.

A nurse is conducting an infertility assessment for a newly admitted client. Which of the following factors should the nurse identify as affecting the client's fertility?

  • A. Premature ovarian failure
  • B. Renal calculi
  • C. Dysmenorrhea
  • D. Recurrent urinary tract infection
Correct Answer: A

Rationale: Premature ovarian failure leads to decreased estrogen production and lack of ovulation, significantly affecting fertility.

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?

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

Rationale: In an obstetric setting, failure to document fetal heart tones (FHR) during the second stage of labor is a critical breach of duty by the nurse. Monitoring FHR is essential to assess fetal well-being and detect any signs of distress or complications during labor. Neglecting to document this important vital sign could result in delayed recognition of fetal distress, potentially leading to adverse outcomes for the baby and the mother. Therefore, this intervention indicates negligence on the part of the nurse in this scenario.

Which nursing intervention does not apply to a diagnosis of 'Deficient knowledge' related to conception?

  • A. Assess the current level of factors promoting conception.'
  • B. Provide information regarding conception in a supportive manner.'
  • C. Evaluate the couple's support system.'
  • D. Identify and describe the basic infertility tests.'
Correct Answer: C

Rationale: Evaluating the support system is more appropriate for a diagnosis related to ineffective coping rather than knowledge deficits.

The nurses working at a newly established birthing center have begun to compare their performance in providing maternal-newborn care against clinical standards. This comparison process is most commonly known as what?

  • A. Best practices network
  • B. Clinical benchmarking
  • C. Outcomes-oriented practice
  • D. Evidence-based practice
Correct Answer: C

Rationale: Outcomes-oriented practice measures the effectiveness of interventions and quality of care against benchmarks or standards.

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