A nurse is working with an active labor patient who is in preterm labor and has been designated as high risk. The patient is very apprehensive and asks the nurse, “Is everything going to be all right?” The nurse replies, “Yes, everything will be okay.” Following delivery via an emergency cesarean birth, the newborn undergoes resuscitation and does not survive. The patient is distraught over the outcome and blames the nurse for telling her that everything would be okay. Which ethical principle did the nurse violate?

Correct Answer: C

Rationale: The correct answer is C: Beneficence. The nurse violated the ethical principle of beneficence by providing false reassurance to the patient, leading to unrealistic expectations and potential harm. Beneficence is about acting in the best interest of the patient and ensuring their well-being. By misleading the patient, the nurse failed to uphold this principle. A: Autonomy is the right of the patient to make their own decisions. The nurse did not directly violate the patient's autonomy in this scenario. B: Fidelity is about being faithful to commitments and promises. The nurse did not violate fidelity, as there was no explicit promise made that was broken. D: Accountability is about taking responsibility for one's actions. While accountability is important, it is not the primary ethical principle violated in this case.

Correct Answer: D

Rationale: The correct answer is D because it demonstrates cultural competence by matching the nurse's background with the patients'. This helps establish trust, understanding, and effective communication. The nurse is more likely to be familiar with cultural norms and preferences, making the teaching more culturally relevant and impactful. A: An auditorium setting with a large number of students may not allow for individualized cultural considerations. B: Language barriers can hinder effective communication and understanding, impacting learning outcomes. C: While diversity can enrich learning, the varying backgrounds may not necessarily address specific cultural needs as effectively as a tailored approach.

Correct Answer: C

Rationale: The correct answer is C because it is important for the nurse to clarify that childbirth can indeed bring about changes in family dynamics, as adding a new member can impact relationships and roles. This is a key principle of family-centered care. Choice A emphasizes the importance of family support, which aligns with the concept. Choice B highlights the commonality of uncomplicated childbirth, which is also relevant. Choice D emphasizes the patient's autonomy in decision-making, which is another important aspect of family-centered care.

Correct Answer: D

Rationale: The correct answer is D. A multipara with 6 pregnancies and 2 children younger than 3 years may require more help and understanding when integrating the newborn into the family due to potential challenges of caring for multiple young children simultaneously. This situation can lead to increased stress, fatigue, and difficulty in managing the needs of all children effectively. In contrast, choices A, B, and C have factors that may provide more support and resources for the new mother, such as being from an upper-income family (A), coming from a large family (B), or having a supportive husband and mother (C), which can help in the integration process.

Correct Answer: B

Rationale: The correct answer is B because giving the report to the oncoming nurse in a private area ensures patient information is shared securely, maintaining patient confidentiality as required by HIPAA. Posting patient updates on social media (A) violates patient privacy. Sharing patient information with a friend (C) breaches confidentiality. Leaving computer screens unattended with patient data visible (D) risks unauthorized access. B is the only choice that aligns with HIPAA regulations by prioritizing patient privacy and security.