Nokea
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 responsibility of accepting any assignment that is made while working for a healthcare facility.
- B. Because the unit is short-staffed, the staff nurse should accept the assignment to provide 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.
Correct Answer: C
Rationale: The Nurse Practice Act allows nurses to refuse assignments involving practices opposed to their religious, cultural, ethical, or moral values.
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When teaching a gravid client how to perform kick (fetal movement) counts which instruction should the nurse includes.
- A. Exercise for 15 before starting the counting to help increase fetal movement
- B. Count the movements once daily for one hour, before breakfast
- C. Avoid caffeinated drinks for 24 hours before conducting the kick test.
- D. If 10 kicks are not felt within 1 hr, drink orange juice and count for another hour.
Correct Answer: D
Rationale: Drinking orange juice can stimulate fetal movement if counts are low (D).
In consideration of the historic evolution of maternity care, which treatment options were used over the past century?
- A. During the nineteenth century, women of privilege were delivered by midwives in a hospital setting.
- B. Granny midwives received their training through a period of apprenticeship.
- C. The recognition of improved obstetric outcomes was related to increased usage of hygienic practices.
- D. A shift to hospital-based births occurred as a result of medical equipment designed to facilitate birth.
Correct Answer: A
Rationale: Training of granny midwives by apprenticeship, improved health outcomes due to hygiene, and the advent of medical equipment facilitating birth were key developments.
A client at 39-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 6 cm, 90% effaced, and the fetus is at 0 station. The client's membranes rupture spontaneously, and the fluid is clear. What action should the nurse take next?
- A. Monitor the fetal heart rate pattern.
- B. Perform a vaginal examination.
- C. Encourage the client to ambulate.
- D. Administer pain medication.
Correct Answer: A
Rationale: Monitoring the fetal heart rate pattern after membrane rupture is essential to detect any changes in fetal status.
A pregnant patient asks the nurse if she can double her prenatal vitamin dose because she does not like to eat vegetables. What is the nurse's response regarding the danger of taking excessive vitamins?
- A. Increases caloric intake
- B. Has toxic effects on the fetus
- C. Increases absorption of all vitamins
- D. Promotes development of pregnancy-induced hypertension (PIH)
Correct Answer: B
Rationale: The correct answer is B: Has toxic effects on the fetus. Doubling prenatal vitamin dose can lead to excessive intake of certain vitamins like Vitamin A, which can be harmful to the fetus. Excessive vitamins can cause toxicity and harm the developing baby. Other choices are incorrect: A is irrelevant, C is misleading, and D is not related to excessive vitamin intake.
Following the vaginal delivery of a 10-pound infant, the nurse assesses a new mothers vaginal bleeding and finds that she has saturated two pads in 30 minutes and has a boggy uterus. What action should the nurse implement first?
- A. Have the client empty her bladder
- B. Inspect the perineum for lacerations
- C. Increase oxytocin IV infusion
- D. Perform fundal massage until firm
Correct Answer: D
Rationale: Fundal massage (D) helps control bleeding by stimulating uterine contractions.