A nurse who works in the emergency department (ED) is assigned to a patient who is experiencing heavy vaginal bleeding at 12 weeks’ gestation. An ultrasound has confirmed the absence of a fetal heart rate, and the patient is scheduled for a dilation and evacuation of the pregnancy. The nurse refuses to provide any further care for this patient based on moral principles. What is the nurse manager’s initial response to the nurse?

Correct Answer: D

Rationale: The nurse manager's initial response should prioritize patient care and safety. In this situation, the patient requires urgent medical attention due to heavy vaginal bleeding and the need for a dilation and evacuation procedure. The nurse's refusal to provide care based on personal moral principles can be considered as patient abandonment, which is a serious ethical and legal issue in healthcare. The nurse manager must advise the nurse to continue providing care for the patient to ensure that the patient's needs are met and to prevent harm resulting from abandonment. The nurse manager should also address the nurse's concerns separately through appropriate channels, such as discussing ethical considerations, providing support, and exploring options for accommodation or transfer if necessary.

Correct Answer: C

Rationale: It is essential to advise the patient to avoid food or drink for at least 2 hours before surgery to reduce the risk of aspiration during the procedure. An empty stomach helps prevent vomiting and aspiration of stomach contents that could potentially lead to respiratory complications during the surgical procedure. This is a crucial preoperative nursing intervention to ensure patient safety and preparation for the lumpectomy surgery. Administering pain and antiemetic medications, arranging for transportation home, and reviewing discharge instructions are important aspects of care but do not directly impact the patient's safety during the procedure like fasting before surgery does.

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.

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.

Correct Answer: A

Rationale: A. Take the medication with a small meal at the same time: Bisphosphonate medications should be taken with a small meal rather than on an empty stomach to enhance absorption and reduce the risk of gastrointestinal side effects.