A woman is 16 weeks pregnant and has elected to terminate her pregnancy. Which is the most common technique used for the termination of a pregnancy in the second trimester?

Correct Answer: A

Rationale: In maternal newborn nursing, understanding the various techniques for pregnancy termination is crucial. The most common technique used for terminating a pregnancy in the second trimester is Dilation and Evacuation (D&E). This procedure involves dilating the cervix and removing the contents of the uterus using surgical instruments. A) Dilation and Evacuation (D&E) is the correct answer because it is a safe and effective method for second-trimester pregnancy termination. It allows for the complete removal of the uterine contents and reduces the risk of complications. B) Methotrexate administration is primarily used for medical abortion in the first trimester and is not typically used for second-trimester terminations. C) Prostaglandin administration is more commonly used for inducing labor in cases of fetal demise or when there is a medical reason to deliver the fetus, rather than for elective terminations. D) Vacuum aspiration is a method used for first-trimester abortions and is not the preferred technique for second-trimester terminations due to the size of the fetus. Educationally, understanding the differences between these techniques is essential for nurses caring for women undergoing pregnancy terminations. It ensures they can provide accurate information, support, and appropriate care to women during this sensitive time in their lives. By knowing the most common techniques and their indications, nurses can offer comprehensive and compassionate care to women facing difficult decisions regarding their pregnancies.

Correct Answer: A

Rationale: In the context of ethical issues in maternal newborn nursing, understanding contraceptive methods is crucial to support women in making informed decisions about their reproductive health. The correct answer, option A) Standard days' variation, is a method where couples avoid intercourse during the woman's fertile window, based on her menstrual cycle. This method has a failure rate of less than 25% when used correctly. Option B) Periodic abstinence, also known as the rhythm method, relies on tracking a woman's menstrual cycle to determine fertile days. However, this method can be less reliable due to variations in cycle length and ovulation timing, resulting in a higher failure rate than standard days' variation. Option C) Postovulation is not a recognized contraceptive method. Fertility awareness methods primarily focus on identifying fertile days before ovulation to avoid pregnancy. Option D) Coitus interruptus, or withdrawal method, involves withdrawing the penis before ejaculation. This method is highly unreliable due to pre-ejaculate fluid containing sperm and the difficulty in timing withdrawal accurately. Educationally, it is essential to emphasize the importance of evidence-based contraceptive methods to prevent unintended pregnancies and promote maternal and newborn health. Nurses play a pivotal role in educating women about various contraceptive options, including their effectiveness, benefits, and limitations, to empower them to make informed choices aligned with their reproductive goals and ethical considerations.

Correct Answer: D

Rationale: In the context of ethical issues in maternal newborn nursing, understanding the different types of abortions is crucial for providing comprehensive care to pregnant individuals. The correct answer, D, "They can be either elective or therapeutic," is the most complete and accurate description of medical abortions. This answer acknowledges that medical abortions can be chosen by the individual for personal reasons (elective) or for health-related issues (therapeutic), encompassing the full spectrum of reasons for seeking this procedure. Option A, "Medical abortions are performed only for maternal health," is incorrect because it oversimplifies the reasons for medical abortions, excluding elective reasons. Option B, "They can be achieved through surgical procedures or with drugs," is incorrect because it conflates medical abortions with surgical ones, which are distinct procedures. Option C, "Medical abortions are mostly performed in the second trimester," is incorrect as medical abortions are typically performed in the first trimester. Educationally, this question highlights the importance of understanding the nuances of medical procedures in maternal newborn care. Nurses must be aware of the various reasons individuals may choose to undergo medical abortions and provide non-judgmental, supportive care regardless of the reason. This knowledge empowers nurses to offer comprehensive care that respects the autonomy and well-being of pregnant individuals.

Correct Answer: B

Rationale: The correct answer is B) Determine the woman's level of knowledge concerning contraception and her commitment to any particular method. This is the first action the nurse should take when meeting with a new client to discuss contraception because it establishes a foundation for personalized care. By assessing the woman's knowledge and preferences, the nurse can tailor the discussion to meet her specific needs, ensuring that she receives accurate information and feels empowered to make informed choices. Option A) Obtain data about the frequency of coitus is not the first step because it focuses on one aspect of the client's sexual activity rather than her overall contraceptive needs and preferences. Option C) Assess the woman's willingness to touch her genitals and cervical mucus is not the first step because it delves into intimate details without first establishing rapport, trust, and understanding of the client's knowledge and preferences. Option D) Evaluate the woman's contraceptive life plan is not the first step because it assumes the client already has a detailed plan in place, overlooking the importance of assessing her current knowledge and preferences as a starting point for developing a personalized plan. In an educational context, understanding the rationale behind prioritizing client knowledge and preferences in contraceptive discussions underscores the importance of person-centered care in nursing practice. By starting with a client-centered approach, nurses can build trust, enhance communication, and provide individualized care that meets the unique needs of each woman seeking contraceptive guidance.

Correct Answer: A

Rationale: In the context of ethical issues in maternal newborn nursing, the nurse's most appropriate response to a concern about multiple pregnancies with Clomid is option A) "Would you like to discuss further the chances of multiple pregnancies?" This response demonstrates patient-centered care by acknowledging the patient's concerns and opening the door for a comprehensive discussion about the potential risks and benefits associated with Clomid-induced multiple pregnancies. Option B is incorrect because making a definitive statement like "No one has ever had more than triplets with Clomid" is misleading and lacks ethical transparency. This type of response does not address the patient's concerns and may provide false reassurance. Option C, "Ovulation will be monitored with ultrasound," is incorrect because while monitoring ovulation is an essential aspect of Clomid therapy, it does not directly address the patient's concern about the risk of multiple pregnancies. This response lacks a patient-centered approach and fails to engage in open communication. Option D, "Ten percent is a very low risk," is incorrect because it minimizes the potential seriousness of multiple pregnancies with Clomid. This response lacks empathy and does not invite the patient to express their concerns or seek further information. In an educational context, it is crucial for nurses to prioritize patient-centered care, open communication, and ethical transparency when addressing concerns related to fertility treatments. By offering a supportive and informative response like option A, nurses can empower patients to make informed decisions about their healthcare while fostering a trusting nurse-patient relationship.