Which complication could occur as a result of percutaneous umbilical blood sampling (PUBS)?

Correct Answer: B

Rationale: The correct answer is B: Fetal bradycardia. During PUBS, a needle is inserted into the umbilical cord to obtain fetal blood for testing. This procedure carries a risk of causing fetal bradycardia, which is a decrease in the fetal heart rate. This can be a serious complication as it may indicate fetal distress. It is important to monitor the fetal heart rate during and after the procedure to detect and address any signs of bradycardia promptly. Other choices are incorrect because: A: Postdates pregnancy - PUBS is not known to cause postdates pregnancy. C: Placenta previa - PUBS is not associated with the development of placenta previa. D: Uterine rupture - PUBS does not typically lead to uterine rupture. In summary, fetal bradycardia is the potential complication of PUBS due to the invasive nature of the procedure and the risk of affecting fetal well-being.

Correct Answer: D

Rationale: Managed care describes health care systems in which the provider or the health care system receives a predetermined capitated (fixed amount) payment for each patient enrolled in the program. Therefore, the focus of care shifts from individual illness care to prevention, early intervention, and outpatient care.

Correct Answer: C

Rationale: In the context of high-risk pregnancy, discharge planning is a crucial aspect of care that should begin as early as possible. Option C, "Upon admission to the hospital," is the correct choice for several reasons. Initiating discharge planning upon admission allows the healthcare team to assess the patient's needs, risks, and potential complications from the start. This early planning facilitates the development of a comprehensive care plan tailored to the specific high-risk pregnancy situation, ensuring that all necessary resources, education, and support are in place well in advance of discharge. Options A and B ("When the patient is ready" and "Close to the time of discharge") are incorrect because they overlook the proactive nature of discharge planning in high-risk pregnancy. Waiting until the patient feels ready or until the last minute can lead to rushed decisions, inadequate preparation, and increased risk of post-discharge complications. Option D ("After an order is written/prescribed") is also incorrect as it implies a reactive approach to discharge planning, which is not ideal in high-risk pregnancy where early identification and management of risks are key to improving outcomes for both the mother and the baby. In an educational context, understanding the importance of early discharge planning in high-risk pregnancy emphasizes the need for nurses to be proactive in assessing, planning, and coordinating care to ensure a smooth transition from hospital to home and ultimately improve patient outcomes. By starting discharge planning upon admission, nurses can address potential challenges, provide thorough education, and arrange necessary follow-up care, all of which are essential in managing high-risk pregnancies effectively.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Preventive care. Preventive care focuses on avoiding the onset of diseases or illnesses by promoting health and wellness through measures such as immunizations. The nurse providing immunizations through the public health department is engaging in preventive care by taking proactive steps to prevent the spread of communicable diseases among both children and adults. Option A) Primary care involves the provision of basic healthcare services to individuals seeking medical attention for common illnesses or injuries. While immunizations can be a part of primary care, the broader scope of care provided by the nurse in this context is preventive rather than primary. Option C) Restorative care is centered around helping individuals recover from an illness or injury. Administering immunizations is not considered restorative care as it is aimed at preventing illness rather than restoring health. Option D) Continuing care involves ongoing healthcare services provided to individuals with chronic conditions or long-term illnesses. While immunizations may be part of a broader plan of continuing care, the immediate focus of providing immunizations is on prevention rather than ongoing management of existing conditions. In an educational context, understanding the different levels of healthcare services is crucial for healthcare professionals to provide appropriate care to their patients. Recognizing the distinctions between preventive care, primary care, restorative care, and continuing care helps nurses make informed decisions about the type of care they are providing and ensures they deliver the most effective interventions for their patients' needs.

Correct Answer: B

Rationale: The correct answer is B) Healthcare Effectiveness Data and Information Set (HEDIS). In the context of high-risk pregnancy assessment, HEDIS is a standardized set of performance measures developed to assess the quality of healthcare services provided by health plans. It includes measures related to prenatal care, postpartum care, and other aspects crucial for managing high-risk pregnancies. By utilizing HEDIS data, the nurse can compare how well a specific health plan performs in managing high-risk pregnancies compared to other health plans. Option A) Pew Health Professions Commission is not directly related to gathering data on health plan comparisons for high-risk pregnancies. It focuses more on healthcare workforce issues. Option C) American Nurses Credentialing Center (ANCC) Magnet Recognition Program is a designation for nursing excellence and does not provide data on health plan performance in managing high-risk pregnancies. Option D) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a survey tool that collects feedback on patients' hospital experiences, which is different from assessing health plan performance specifically for high-risk pregnancies.