Current Issues in Maternal and Child Health

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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?

  • A. The staff nurse has the reNspoRnsibIilityG of Bac.ceCptinMg any assignment that is made U S N T O while working for a health care unit, so the nursing supervisor is within his or her rights to enforce this assignment.
  • B. 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.
  • C. 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.
  • D. 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.
Correct Answer: C

Rationale: In this situation, the nurse's refusal to accept the assignment is based on personal beliefs that conflict with the nature of the medical practice (therapeutic abortions). According to the American Nurses Association (ANA) Code of Ethics, nurses have the right to refuse assignments that go against their personal, cultural, or religious beliefs. The nurse in this scenario has expressed a legitimate concern, and the nursing supervisor should respect the nurse's autonomy and should not enforce the assignment. It is essential to balance respecting the nurse's beliefs while also ensuring patient safety and adequate staffing levels.

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The nurse is providing education on the prevention of heart disease for adult females ages 35 to 44 years old.Which of the following would be most appropriate for this disease process? Select all that apply.

  • A. Taking a brisk walking for 50 minutes three times a week
  • B. Consuming a diet rich in vegetables, fruits, and whole grains
  • C. Obtaining a varicella vaccine, if no evidence of immunity
  • D. Recognizing the importance of smoking cessation
Correct Answer: A

Rationale: A. Selecting "A" because physical activity, such as brisk walking, is beneficial for heart health. Regular exercise helps in maintaining a healthy weight, lowering blood pressure, and improving overall cardiovascular health.

The nurse is caring for a patient receiving chemotherapy. What nursing intervention would they provide?

  • A. Administer antibiotics.
  • B. Administer antiemetics.
  • C. Encourage physical activity after infusion.
  • D. Encourage eating a large meal.
Correct Answer: B

Rationale: Patients receiving chemotherapy often experience nausea and vomiting as common side effects. Antiemetics are medications specifically designed to help manage and prevent these symptoms. By administering antiemetics, the nurse can help the patient feel more comfortable and reduce the risk of dehydration and other complications associated with nausea and vomiting. This intervention is crucial in supporting the patient's overall well-being and enhancing their quality of life during chemotherapy treatment.

The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the nurse delegate? (Select all that apply.)

  • A. Teaching the patient about breast care
  • B. Assessment of a patient’s lochia and perineal area
  • C. Assisting a patient to the bathroom for the first time after birth
  • D. Vital signs on a postpartum patient who delivered the night before
Correct Answer: C

Rationale: A. Teaching the patient about breast care typically requires specialized knowledge and is best performed by the nurse.

The nurse is providing education to the patient that is receiving a bisphosphate medication for osteoporosis. Which instructions should the nurse include in the teaching plan to reduce side effects and enhance absorption while taking bisphosphates? Select all that apply.

  • A. Take the medication with a small meal at the same time
  • B. Take the medication with at least 8 oz. of water.
  • C. Remain upright for at least 30 minutes after taking a dos
  • D. Take the medication on an empty stomach
Correct Answer: A

Rationale: A. Take the medication with a small meal at the same time: Bisphosphonate medications should be taken with a small meal rather than on an empty stomach to enhance absorption and reduce the risk of gastrointestinal side effects.

What STIs can cause one of the TORCH infections in the fetus?

  • A. HPV
  • B. HSV
  • C. HIV
  • D. syphilis
Correct Answer: D

Rationale: Syphilis is one of the STIs that can cause one of the TORCH infections in a fetus. TORCH infections are a group of infections that can be passed from a pregnant woman to her fetus and include toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, and syphilis. When a pregnant woman with untreated syphilis transmits the infection to her fetus, it can result in congenital syphilis, which can have serious consequences such as stillbirth, prematurity, low birth weight, and developmental delays. Syphilis is thus an important infectious cause of prenatal and neonatal morbidity and mortality.

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