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In consideration of the historic evolution of maternity care, which treatment options were used over the past century? (Select all that apply.)
- 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: A. During the nineteenth century, women of privilege were typically delivered by midwives in a hospital setting. This practice was common among the wealthier class, as midwives were often considered the primary caregivers during childbirth.
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A nurse working in a labor and birth unit is asked to take care of two high-risk patients in the labor and birth suite: a 34 weeks’ gestation 28-year-old gravida 3, para 2 in preterm labor and a 40-year-old gravida 1, para 0 who is severely preeclamptic. The nurse refuses this assignment telling the charge nurse that based on individual patient acuity, each patient should have one-on-one care. Which ethical principle is the nurse advocating?
- A. Accountability
- B. Beneficence
- C. Justice
- D. Fidelity
Correct Answer: C
Rationale: Justice is the ethical principle that involves fair and equal distribution of resources and care. In this scenario, the nurse is advocating for justice by asserting that each high-risk patient should receive one-on-one care based on their individual acuity levels. By refusing to take on both patients simultaneously, the nurse is advocating for fairness and equal opportunity for proper care and attention for each patient. This is in line with the principle of justice, which emphasizes the importance of treating all individuals fairly and providing them with the appropriate level of care they need.
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.
The nurse is educating a 24-year-old female patient who was newly diagnosed with polycystic ovary syndrome (PCOS). The patient was prescribed an antidiabetic medication. Which medication effects should the nurse educate the patient about? Select all that apply.
- A. A period of initial weight gain
- B. A change in her integumentary system
- C. Low blood sugar until her hormones stabilize
- D. Decreased likelihood of pregnancy
Correct Answer: A
Rationale: A. A period of initial weight gain: The nurse should educate the patient about the potential for initial weight gain when starting an antidiabetic medication. This can be a common side effect, and it is important for the patient to be aware of it to avoid unnecessary concern. Weight gain may occur due to factors such as fluid retention or changes in metabolism.
The nurse is providing preoperative education on the laparoscope-assisted vaginal hysterectomy. Which statement by the patient verifies understanding of the procedure?
- A. I will use a mild douche solution to keep the surgical area clean.
- B. I'm relieved that I won't have any visible scars on my abdomen.
- C. I understand that there will be some light vaginal bleeding for several days.
- D. I understand that I must remain on bedrest until cleared by the surgeon.
Correct Answer: B
Rationale: The correct statement by the patient that demonstrates understanding of the laparoscope-assisted vaginal hysterectomy procedure is "I'm relieved that I won't have any visible scars on my abdomen." This is a relevant and accurate statement as the procedure involves minimal scarring due to the use of small incisions in the abdomen rather than a large incision. It shows understanding of one of the benefits of this surgical approach. The other statements are not accurate or relevant to the procedure.
A patient who is 6 months pregnant has sought medical attention, saying she fell down the stairs. Which scenario would cause an emergency department nurse to suspect that the woman has been battered?
- A. She avoids making eye contact and is hesitant to answer questions.
- B. The woman and her partner are having an argument that is loud and hostile.
- C. The woman has injuries on various parts of her body that are in different stages of healing.
- D. Examination reveals a fractured arm and fresh bruises. Her husband asks her about her pain.
Correct Answer: C
Rationale: In this scenario, the emergency department nurse would be most likely to suspect that the woman has been battered based on the presence of injuries on various parts of her body that are in different stages of healing. This pattern of injuries, known as the "battered woman syndrome," is a red flag for domestic violence. The varying stages of healing indicate that the injuries are not from a single accidental fall down the stairs but rather from repeated incidents of physical abuse. Additionally, the fact that the injuries are in different locations on the body further suggests that they are not the result of a single traumatic event. This situation warrants further investigation and intervention to ensure the safety and well-being of the pregnant woman and her unborn child.