Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?

Correct Answer: D

Rationale: In the context of a patient in active labor, the nursing diagnosis that should be identified as a priority is "D) Risk for injury (maternal) related to altered sensations and positional or physical changes." This is the correct answer because during active labor, the mother is undergoing intense physical changes and sensations that can increase the risk of injury. The nurse's priority is to ensure the safety and well-being of both the mother and the baby. Option A, "Risk for anxiety related to upcoming birth," though important, is not the priority in this situation as physical safety takes precedence over emotional concerns during active labor. Option B, "Risk for imbalanced nutrition related to NPO status," is not the priority because the focus is on the labor process rather than nutrition intake. Option C, "Risk for altered family processes related to new addition to the family," is also important but not the priority during active labor when the focus is on the immediate physical well-being of the mother. In an educational context, it is crucial for nursing students to understand the prioritization of nursing diagnoses based on the patient's condition and needs. This question highlights the importance of assessing and addressing the most critical issue first to ensure optimal patient outcomes. Understanding the rationale behind prioritizing certain nursing diagnoses helps students develop clinical reasoning skills essential for effective nursing practice.

Correct Answer: A

Rationale: In the context of the Chimat Maternity Needs Assessment, the correct answer is option A) Reading peer-reviewed journal articles, as it highlights the nurse's role as a researcher. Nurses are expected to stay updated on the latest evidence-based practices and research findings to provide the best possible care to their patients. By reading peer-reviewed journal articles, nurses can integrate new knowledge into their practice, improve patient outcomes, and contribute to the advancement of nursing as a profession. Option B) Working as a member of the interdisciplinary team to provide patient care is an essential aspect of nursing practice, emphasizing collaboration and holistic patient care rather than research specifically. Option C) Helping patients to obtain home care post-discharge from the hospital involves care coordination and continuity of care, but it does not directly relate to the nurse's role as a researcher. Option D) Delegating tasks to unlicensed personnel to allow for more teaching time with patients is more about time management and delegation skills rather than engaging in research activities. In an educational context, it is crucial for nurses to understand the significance of research in improving patient outcomes and advancing the field of nursing. By actively engaging in reading and critically appraising research articles, nurses can enhance their knowledge base, critical thinking skills, and ultimately provide evidence-based care to their patients.

Correct Answer: C

Rationale: In this scenario, the most effective option for the primipara patient concerned about support during labor is option C, which is to provide information about obtaining a doula. A doula is a trained professional who provides physical, emotional, and informational support to the mother before, during, and just after childbirth. Choosing option C is beneficial for several reasons. Firstly, a doula can offer continuous support and guidance throughout the labor process, which can help alleviate the patient's fears and anxieties. Secondly, a doula can complement the care provided by the medical staff, ensuring the patient feels supported holistically. Additionally, a doula can help involve and educate family members on how they can best support the patient during labor. Option A is not the best choice as simply reassuring the patient about the highly trained nurses may not address her specific concerns about personal support. Option B, while helpful, may not fully address the patient's current apprehensions about her family members' readiness to assist her. Option D, telling the patient her feelings are normal, may not provide her with actionable solutions to address her concerns. Educationally, understanding the role and benefits of a doula can empower both healthcare providers and patients to make informed decisions about labor support options. It highlights the importance of personalized, holistic care during the childbirth process and the value of additional support beyond medical interventions.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The patient will bring a paid, trained labor support person with her during labor. A doula is a trained professional who provides physical, emotional, and informational support to the mother before, during, and just after childbirth. It is crucial for the nurse to understand this because doulas play a significant role in improving birth outcomes by reducing the need for medical interventions, decreasing the length of labor, and enhancing the mother's overall satisfaction with her birth experience. Option A) The patient will have her grandmother as a support person is incorrect because a doula is a specifically trained professional, not a family member. Option C) The patient will have a special video she will play during labor to assist with relaxation is incorrect because while relaxation techniques can be helpful during labor, a doula provides hands-on support and guidance that goes beyond simply playing a video. Option D) The patient will have a bag that contains all the approved equipment that may help with the labor process is incorrect because it does not relate to the presence of a doula, who is a support person rather than equipment. Understanding the role of a doula is essential for healthcare professionals working in maternity care, as they can collaborate effectively with doulas to provide comprehensive support to pregnant individuals during the labor and birth process. By recognizing the value of doulas, nurses can help facilitate a more positive and empowering birth experience for their patients.

Correct Answer: B

Rationale: In counseling a newly pregnant patient about the option of free-standing birth centers, it is crucial for the nurse to understand the advantages of this care setting. The correct answer, option B, "Equipped for obstetric emergencies," is the most important advantage. Free-standing birth centers are designed to handle low-risk pregnancies but are also equipped to promptly address any unexpected emergencies that may arise during labor and birth, ensuring the safety of both the mother and the baby. Options A, C, and D are incorrect in this context. Option A, "offer postpartum follow-up care," is not a distinguishing feature of free-standing birth centers as postpartum follow-up care is typically provided by various healthcare settings. Option C, "Less expensive than acute care hospitals," may be true but is not a direct advantage of free-standing birth centers in terms of the quality of care provided. Option D, "Safe, homelike births in a familiar setting," while partially true, does not capture the critical aspect of emergency preparedness which is vital in obstetric care. From an educational perspective, it is important for nurses to understand the unique features of different care settings to provide comprehensive and accurate information to patients. Emphasizing the importance of safety, emergency readiness, and appropriate care levels based on individual patient needs is essential in guiding pregnant women in making informed decisions about their birthing options.