The National Quality Forum has issued a list of 'never events' specifically pertaining to maternal and child health. These include all of the following except:

Correct Answer: D

Rationale: In this question on ethical issues in maternal newborn nursing, the correct answer is option D, "Foreign object retained after surgery," because this does not directly pertain to maternal and child health as outlined by the National Quality Forum's list of 'never events.' Retaining a foreign object after surgery is a serious medical error but is not specific to maternal and child health care. Options A, B, and C are incorrect because they directly relate to maternal and child health. Option A highlights the risk of an infant being discharged to the wrong person, which can lead to serious safety concerns for the newborn. Option B addresses the prevention of kernicterus by identifying and treating hyperbilirubinemia, a critical issue in newborn care. Option C focuses on the ethical implications of using the correct donor sperm or egg in artificial insemination procedures to maintain the integrity and accuracy of genetic information in maternal and child health care. Understanding these 'never events' in maternal and child health is crucial for nurses and healthcare providers to ensure the safety, well-being, and ethical standards of care for mothers and newborns. By being aware of these specific issues, healthcare professionals can work towards preventing errors and promoting quality care in this specialized area of nursing practice.

Correct Answer: C

Rationale: In the context of ethical issues in maternal newborn nursing, it is crucial for nurses to adhere to standards that ensure patient safety, such as The Joint Commission's 'Do Not Use' list of abbreviations. The correct answer, option C - International Unit, is acceptable for use in medication administration because it is a standardized and universally understood abbreviation that minimizes the risk of medication errors. Options A and B are incorrect because they contain abbreviations that are on The Joint Commission's 'Do Not Use' list. "q.o." (every other) and "Q.O.D." (every other day) can be misinterpreted, leading to dosing errors. Similarly, MSO4 for morphine sulfate and MgSO4 for magnesium sulfate can be confused, potentially resulting in serious harm to the patient. Option D, lack of a leading zero, is also incorrect because it is a common error that can lead to a tenfold dosing mistake. For example, writing ".5 mg" instead of "0.5 mg" can result in a dangerous overdose. Educationally, understanding and complying with standardized abbreviations is vital for patient safety and effective communication among healthcare professionals. By emphasizing the importance of using approved abbreviations and avoiding those on the 'Do Not Use' list, nurses can enhance medication safety and prevent adverse events in maternal newborn care.

Correct Answer: B

Rationale: In the context of ethical issues in maternal newborn nursing, the key factors that play the most powerful role in the behaviors of individuals and families are their beliefs and values (Option B). Beliefs and values are deeply ingrained principles that guide decision-making, actions, and interactions within a family unit. In the realm of maternal newborn nursing, these beliefs and values can significantly influence choices related to prenatal care, childbirth, infant feeding practices, and overall family dynamics. For example, a family's cultural beliefs about childbirth may impact their preferences for labor and delivery, pain management options, and postpartum care practices. Rituals and customs (Option A) also hold importance in shaping behaviors, but they are more specific practices or ceremonies that may vary across different cultures and may not always have a direct impact on everyday decision-making in healthcare settings. Boundaries and channels (Option C) refer to communication patterns and structures within families, which are significant but may not be as fundamental in influencing behaviors as beliefs and values. Socialization processes (Option D) are essential in shaping individuals' behaviors, but in the context of maternal newborn nursing, the deeply held beliefs and values of individuals and families tend to have a more direct and powerful impact on decision-making and actions. Understanding the pivotal role of beliefs and values in influencing behaviors in maternal newborn nursing is crucial for healthcare providers to provide culturally sensitive and ethically sound care that respects and aligns with the values and preferences of the individuals and families they serve. By recognizing and honoring these beliefs and values, nurses can establish trust, promote shared decision-making, and provide care that is respectful and effective.

Correct Answer: B

Rationale: The correct answer is B) Home care is delivered on an intermittent basis by professional staff. This option highlights a key distinction between hospital care and home health care. In maternal newborn nursing, home health care is typically provided periodically by healthcare professionals who visit the patient's home to deliver care as needed, such as postpartum assessments, newborn care education, or lactation support. This intermittent care model allows for personalized, individualized attention in the comfort of the patient's home. Option A is incorrect because home care is not always continuously delivered by professional staff in the same way hospital care is provided around the clock. Option C is incorrect as home care is not solely reserved for emergency conditions but rather aims to provide ongoing support and care. Option D is incorrect as home care services can be available 24 hours a day depending on the specific agency or program providing the care. Understanding the differences between hospital care and home health care is crucial for maternal newborn nurses as they may encounter situations where patients transition from hospital to home care settings. By grasping these distinctions, nurses can better educate and support their patients as they navigate the complexities of caring for themselves and their newborns at home.

Correct Answer: D

Rationale: In the context of maternal newborn nursing, the correct answer is D) Arriving at the hospital in advanced labor. This behavior is often seen in African-American clients due to various factors such as historical mistreatment in healthcare, lack of access to quality care, and systemic racism leading to distrust in the healthcare system. African-American women are more likely to delay seeking care until labor is advanced, which can result in poor outcomes for both the mother and the baby. Option A) Seeking prenatal care early in her pregnancy is a recommended behavior, but it may not always be the case for African-American clients due to various barriers they face in accessing care. Option B) Avoiding self-treatment of pregnancy-related discomfort is a general good practice for all clients and not specific to any particular racial or ethnic group. Option C) Requesting liver in the postpartum period to prevent anemia is not a common or recommended practice and is not specific to African-American clients. Educationally, this question highlights the importance of understanding the social determinants of health, cultural competence, and the impact of systemic inequalities on healthcare outcomes. It underscores the need for healthcare providers to be aware of and address these disparities to provide equitable care for all clients, regardless of their background. By recognizing these factors, nurses can better support African-American clients throughout the childbearing experience and improve maternal and newborn health outcomes.