A 9-month-old with glaucoma requires surgery. The infant's parents are divorced. To obtain informed consent, which action would be most appropriate?

Correct Answer: D

Rationale: In this scenario, the most appropriate action is option D, determining sole or joint custody by the parents. This is because when parents are divorced, both parents typically retain legal custody rights unless specified otherwise by a court order. In the case of medical decision-making for a child, it is crucial to determine who has the legal authority to provide consent for the child's surgery. Option A, contacting the father for informed consent, may not be appropriate if the mother has equal legal custody rights. Similarly, option B, obtaining informed consent from the mother, may not be sufficient if the father also shares legal custody. Seeking a court ruling on the course of care (option C) should be a last resort if the parents cannot agree on the decision. From an educational perspective, understanding legal considerations in pediatric healthcare is vital for nurses to ensure that proper consent procedures are followed and to advocate for the best interests of the child. Nurses must be aware of legal frameworks surrounding consent and custody to navigate complex situations like this effectively.

Correct Answer: A

Rationale: In maternal and reproductive health nursing, assessing families for barriers to healthcare is crucial for providing comprehensive care. Psychosocial barriers refer to factors related to a person's psychological state, social environment, and cultural influences that may impede access to healthcare services. In this scenario, option A) Academic difficulties is an example of a psychosocial barrier to healthcare. Academic difficulties can impact a family's ability to understand health information, navigate healthcare systems, and advocate for their own health needs. It can also influence their socioeconomic status, which further affects access to care. Option B) Respiratory illness, C) Poor sanitation, and D) Inherited diseases are not examples of psychosocial barriers. While these factors can certainly impact health, they do not directly relate to the psychological, social, or cultural aspects that psychosocial barriers encompass. Educationally, understanding the different types of barriers to healthcare, including psychosocial barriers, equips nurses with the knowledge to conduct holistic assessments of families and develop tailored care plans that address not only physical health needs but also psychosocial factors that may impact health outcomes. By recognizing and addressing psychosocial barriers, nurses can help improve healthcare access and overall well-being for families.

Correct Answer: A

Rationale: Using hospital protocol for ordering a diagnostic test, determining how often the vital signs are monitored, and deciding the medication dose ordered would be the health care provider's responsibility. However, following blood pressure monitoring recommendations would be part of evidence-based practice reflected in the nursing care delivered.

Correct Answer: B

Rationale: In the context of maternal and reproductive health nursing, it is crucial to uphold a child's bill of health care rights, which includes the right to information and involvement in their care. In this scenario, telling the child the test will not hurt (option B) violates this right because it is providing false reassurance and potentially misleading information. This can undermine the child's trust in healthcare providers and compromise their understanding of the procedure. Arranging for the mother to be with the child (option A) is supportive and helps provide comfort, which aligns with the child's bill of health care rights as it promotes a sense of security and familiarity during a potentially stressful experience. Assuring the child that the test will be done quickly (option C) is also appropriate as it helps manage the child's expectations and reduce anxiety. Introducing the child to the lab technicians (option D) may also be beneficial as it can help familiarize the child with the people involved in the procedure, promoting a sense of safety and trust. However, in this specific case, providing accurate information about the test itself is more critical in respecting the child's rights. Educationally, this question highlights the importance of effective communication with pediatric patients and the ethical responsibility of healthcare providers to provide truthful and developmentally appropriate information to children undergoing medical procedures. It emphasizes the significance of respecting a child's right to information and ensuring their involvement in their healthcare decisions.

Correct Answer: D

Rationale: The nurse's responsibility related to informed consent includes the following: determining that the parents or legal guardians understand what they are signing by asking them pertinent questions, ensuring that the consent form is completed with signatures from the parents or legal guardians, and serving as a witness to the signature process.