ATI RN
Needs of Maternal and Reproductive Health Clients Questions
Question 1 of 5
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?
Correct Answer: C
Rationale: The correct answer is 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. In a healthcare setting, nurses have the right to refuse an assignment if it conflicts with their personal beliefs as long as it does not violate any laws or regulations. In this case, performing therapeutic abortions may go against the nurse's personal beliefs. It is crucial to respect the nurse's autonomy and ethical stance on this matter. Option A is incorrect because while nurses are generally expected to accept assignments, there are exceptions when personal beliefs are involved. Option B is incorrect as the nurse's personal beliefs should be taken into consideration, especially in sensitive situations like therapeutic abortions. Option D is incorrect as it does not address the nurse's ethical dilemma and focuses solely on the nurse's training. Educationally, this scenario highlights the importance of respecting nurses' ethical beliefs and autonomy in decision-making. It also underscores the need for open communication between healthcare providers to ensure that patient care is not compromised while also supporting the well-being of the nursing staff.
Question 2 of 5
A multigravida client arrives at the labor and delivery unit and tells the nurse that her bag of water has broken. The nurse identifies the presence of meconium fluid on the perineum and determines the fetal heart rate is between 140 to 150 beats/minute. What action should the nurse implement next?
Correct Answer: A
Rationale: In this scenario, the correct action for the nurse to implement next is to complete a sterile vaginal exam (Option A). This is crucial in assessing the extent of cervical dilation and the position of the fetus to determine the progress of labor and the need for immediate interventions. Taking the maternal temperature every 2 hours (Option B) is important for monitoring signs of infection but is not the immediate priority in this situation where fetal distress is a concern. Preparing for an immediate cesarean birth (Option C) may be necessary in cases of fetal distress or other complications, but it should not be the immediate next step without further assessment through a vaginal exam. Obtaining sterile suction equipment (Option D) is important in case meconium aspiration occurs during delivery, but it is not the most immediate action needed in this scenario. Educationally, this question highlights the importance of prompt assessment and decision-making in labor and delivery situations to ensure the safety and well-being of both the mother and the baby. Understanding the significance of different assessments and interventions in such critical moments is vital for nurses working in maternal and reproductive health settings.
Question 3 of 5
A client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation. She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the nurse implement first?
Correct Answer: C
Rationale: In this scenario, the correct intervention is to obtain a specimen for urine analysis (Option C) first. The client's symptoms suggest a possibility of a urinary tract infection (UTI) or other urinary issues, which can contribute to uterine irritability and contractions. By analyzing the urine, the nurse can assess for any signs of infection or other abnormalities that may be causing the client's symptoms. Providing oral hydration (Option A) is important for pregnant clients, but in this case, addressing the potential underlying issue takes precedence. Having a complete blood count (CBC) drawn (Option B) may be necessary at some point, but it is not the initial priority. Placing the client on strict bedrest (Option D) is not supported as the first intervention without further assessment. In an educational context, this question highlights the importance of assessing and addressing potential medical issues that can impact maternal and fetal health during pregnancy. Understanding the implications of different symptoms and prioritizing interventions based on assessment findings are crucial skills for nurses caring for maternal and reproductive health clients.
Question 4 of 5
The nurse is teaching a woman how to use her basal body temperature (BBT) pattern as a tool to assist her in conceiving a child. Which temperature pattern indicates the occurrence of ovulation, and therefore, the best time for intercourse to ensure conception?
Correct Answer: A
Rationale: The correct answer is A) Between the time the temperature falls and rises. This temperature pattern indicates the occurrence of ovulation, which is crucial for conception. Basal body temperature typically drops just before ovulation and then rises and remains elevated after ovulation. This shift in temperature signifies the release of an egg and the fertile window for conception. Option B) Between 36 and 48 hours after the temperature rises is incorrect because ovulation usually occurs before the temperature rises, not after. Therefore, this timing would not align with the fertile window for conception. Option C) When the temperature falls and remains low for 36 hours is incorrect because a sustained low temperature does not indicate ovulation. Ovulation is typically associated with a temperature rise, not a prolonged low temperature. Option D) Within 72 hours before the temperature falls is incorrect because ovulation occurs before the temperature falls. Therefore, this timing would not align with the fertile window for conception. In an educational context, understanding basal body temperature patterns is essential for women who are trying to conceive. By tracking these patterns accurately, women can identify their most fertile days and optimize their chances of conception. Education on this topic empowers women to take control of their reproductive health and make informed decisions regarding family planning.
Question 5 of 5
A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective to prevent nipple soreness?
Correct Answer: C
Rationale: The most effective instruction to prevent nipple soreness for a breastfeeding mother is to correctly place the infant on the breast (Option C). This is crucial because proper positioning and latching ensure that the baby is effectively extracting milk without causing damage to the mother's nipples. When the baby is positioned correctly with a deep latch, nipple soreness is minimized as the baby is able to feed efficiently. Option A, wearing a cotton bra, is not directly related to preventing nipple soreness during breastfeeding. While wearing a comfortable bra is important for overall breast health, it does not address the root cause of nipple soreness. Increasing nursing time gradually (Option B) may not necessarily prevent nipple soreness. The key factor is the correct latch and positioning rather than the duration of nursing sessions. Manually expressing a small amount of milk before nursing (Option D) is not as effective as ensuring correct placement of the infant on the breast. While expressing some milk before nursing can help with engorgement or if the baby is having difficulty latching, it is not the primary method to prevent nipple soreness. In an educational context, it is vital for healthcare professionals to emphasize proper breastfeeding techniques to prevent common issues like nipple soreness. By understanding and promoting correct latch and positioning, nurses can support mothers in establishing a successful breastfeeding relationship with their infants, leading to better outcomes for both mother and baby.