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Which patient could safely be cared for by a certified nurse-midwife?
- A. Gravida 3, para 2, with no complications
- B. Gravida 1, para 0, with mild hypertension
- C. Gravida 2, para 1, with insulin-dependent diabetes N R I G B.C M U S N T O
- D. Gravida 1, para 0, with borderline pelvic measurements
Correct Answer: A
Rationale: A patient who is Gravida 3, para 2, with no complications can safely be cared for by a certified nurse-midwife. This patient has had two previous pregnancies, both resulting in successful deliveries, and is currently not experiencing any complications. Nurse-midwives are trained to provide care for low-risk pregnancies and deliveries, making this patient an appropriate candidate for their care. Patients with mild hypertension (choice B), insulin-dependent diabetes (choice C), or borderline pelvic measurements (choice D) would likely require additional monitoring and potential intervention beyond the scope of practice of a certified nurse-midwife.
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Regarding advanced roles of nursing, which statement related to clinical practice is the most accurate?
- A. Family nurse practitioners (FNPs) can assist with childbirth care in the hospital setting.
- B. Clinical nurse specialists (CNSs) provide primary care to obstetric patients.
- C. Neonatal nurse practitioners provide emergency care in the postbirth setting to high-risk infants.
- D. A certified nurse midwife (CNM) is not considered to be an advanced practice nurse.
Correct Answer: C
Rationale: The most accurate statement related to clinical practice among the choices presented is that neonatal nurse practitioners provide emergency care in the postbirth setting to high-risk infants. Neonatal nurse practitioners specialize in the care of newborns, particularly those who are premature or have health complications. They work in settings such as neonatal intensive care units (NICUs) and provide specialized care to meet the needs of high-risk infants. Neonatal nurse practitioners collaborate with neonatologists and other healthcare professionals to ensure that these fragile patients receive the necessary care and attention. This role involves advanced clinical skills and knowledge in the care of neonates, making it a crucial part of the healthcare team for newborns in need of specialized care.
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.
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.
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.
The nurse is caring for a 33-year-old female patient who has just undergone laparoscopic removal of endometrial lesions. Which statement by the patient illustrates her understanding of the disease process and prognosis?
- A. I realize that this is not a cure for the issue, but I want to have more children within the next year.
- B. I'm happy to know that the surgeon has been able to cure me of this disease without a hysterectomy.
- C. I realize that my type 2 diabetes will be cured now that I have those lesions removed
- D. I understand that I will not have to have a colostomy now that the growths were removed from my bowels.
Correct Answer: A
Rationale: Choice A is the correct answer because the patient acknowledges that the laparoscopic removal of endometrial lesions is not a cure for her issue. She demonstrates understanding by mentioning her desire to have more children within the next year, indicating that she recognizes the need for continued monitoring and management of her condition. Choices B, C, D, and E are incorrect because they do not accurately reflect the disease process and prognosis associated with endometrial lesions.