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A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 woman who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, –1 station, and vertex with membranes intact. The patient asks the nurse if she can break her water so that her labor can go faster. The nurse’s response, based on the ethical principle of nonmaleficence, is which of the following?
- A. Tell the patient that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
- B. Have the patient write down her request and then call the physician for an order to implement the amniotomy.
- C. Instruct the patient that only a physician or certified midwife can perform this procedure.
- D. Give the patient an enema to stimulate labor.
Correct Answer: A
Rationale: The correct response based on the ethical principle of nonmaleficence, which refers to the duty to do no harm, is to tell the patient that she will have to wait until she has progressed further on the vaginal exam and then perform an amniotomy. In this scenario, breaking the patient's water prematurely could introduce risks and potential harm without clear medical necessity. Performing an amniotomy too early could increase the risk of infection or cause umbilical cord prolapse, which can be harmful to both the mother and the baby. Therefore, it is important for the nurse to wait until the patient has progressed further in labor before considering an amniotomy.
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The nurse is planning a teaching session for staff on ethical theories. Which situation best reflects the Deontologic theory?
- A. Approving a physician-assisted suicide
- B. Supporting the transplantation of fetal tissue and organs
- C. Using experimental medications for the treatment of AIDS
- D. Initiating resuscitative measures on a 90-year-old patient with terminal cancer
Correct Answer: D
Rationale: Deontologic theory, also known as deontological ethics, focuses on the duty to follow moral rules and obligations regardless of the consequences. In this scenario, initiating resuscitative measures on a 90-year-old patient with terminal cancer reflects a commitment to upholding the duty to provide care and uphold the sanctity of life. Despite the patient's poor prognosis, the nurse is ethically bound to provide care according to established principles and guidelines, emphasizing duty over outcome. This aligns with the Deontologic theory's emphasis on following moral rules and obligations without consideration of the consequences.
Which of the following statements highlights the nurse’s role as a researcher?
- A. Reading peer-reviewed journal articles
- B. Working as a member of the interdisciplinary team to provide patient care
- C. Helping patient to obtain home care postdischarge from the hospital
- D. Delegating tasks to unlicensed personnel to allow for more teaching time with patients
Correct Answer: A
Rationale: Reading peer-reviewed journal articles highlights the nurse's role as a researcher because it involves staying current with the latest evidence-based practices, advancements in healthcare, and research findings. Nurses who engage in reading such articles are able to enhance their knowledge, critical thinking skills, and decision-making abilities, which are crucial aspects of conducting research and applying research findings to patient care. By continuously educating themselves through reviewing peer-reviewed literature, nurses contribute to the advancement of nursing practice and further research in the field.
Which issue is a major concern among members of lower socioeconomic groups?
- A. Practicing preventive health care
- B. Meeting health needs as they occur
- C. Maintaining an optimistic view of life
- D. Maintaining group health insurance for their families
Correct Answer: B
Rationale: Members of lower socioeconomic groups often struggle to access and afford healthcare services. Unlike those in higher socioeconomic classes who can afford preventive care, individuals in lower socioeconomic groups typically wait to seek medical care until they have significant health issues or emergencies. Factors such as cost barriers, lack of health insurance, transportation issues, and limited access to healthcare facilities contribute to this problem. As a result, the major concern among individuals in lower socioeconomic groups is the ability to meet their health needs as they occur rather than focusing on preventive healthcare practices. This issue can lead to poorer health outcomes and increased healthcare costs in the long run.
A 48-year-old female patient presents to the OB/GYN clinic for her annual examination. She states that she has had the following symptoms: mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido. Which of the following does the nurse suspect the patient is experiencing?
- A. Menopause
- B. Perimenopause
- C. Postmenopause
- D. Pregnancy
Correct Answer: B
Rationale: Perimenopause is the transitional period leading to menopause that usually begins in a woman's 40s but can start earlier. During this phase, women may experience symptoms such as mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido, as described by the patient in this case. These symptoms are caused by hormonal fluctuations as the ovaries start to produce less estrogen in preparation for menopause. Menopause occurs when a woman has not had a menstrual period for 12 consecutive months. Postmenopause, on the other hand, refers to the stage after menopause, where menopausal symptoms have generally subsided. The symptoms described by the patient are more indicative of the perimenopausal stage rather than pregnancy, as they are typical signs of hormonal changes associated with the menopausal transition.
Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?
- A. Risk for anxiety related to upcoming birth
- B. Risk for imbalanced nutrition related to NPO status
- C. Risk for altered family processes related to new addition to the family
- D. Risk for injury (maternal) related to altered sensations and positional or physical
changes
Correct Answer: D
Rationale: The priority nursing diagnosis for a patient in active labor should focus on ensuring the safety and well-being of the mother and the baby. "Risk for injury (maternal) related to altered sensations and positional or physical changes" is the most crucial diagnosis in this scenario as it directly addresses potential risks and complications that may occur during labor and delivery. This nursing diagnosis includes considerations for the physical changes the mother undergoes during labor, such as altered sensations and positioning, which can increase the risk of injury. By identifying and addressing this risk promptly, the nurse can help prevent potential harm to the mother and ensure a safe delivery process.