ATI RN
Needs of Maternal and Reproductive Health Clients Questions
Question 1 of 5
Which step of the nursing process is being used when the nurse decides whether an ethical dilemma exists?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Analysis. When a nurse is determining whether an ethical dilemma exists, they are engaging in critical thinking and analysis to assess the situation thoroughly. This step involves breaking down the problem, examining all relevant factors, and identifying the ethical considerations at play. Option B) Planning is not the correct answer because planning comes after the problem has been analyzed and a decision has been made. Planning involves determining the course of action to address the identified issue, which follows the analysis phase. Option C) Evaluation is also incorrect in this context. Evaluation occurs after the intervention has been implemented to assess its effectiveness in resolving the ethical dilemma. It is not the step used to determine the existence of an ethical issue. Option D) Assessment is not the correct answer because assessment involves collecting data and information about the client's health status, needs, and concerns. It is the initial step of the nursing process, which precedes the identification of ethical dilemmas. Educationally, understanding the nursing process and its various steps is crucial for nurses to provide effective and ethical care. By mastering each step - assessment, analysis, planning, implementation, and evaluation - nurses can systematically address client needs, including ethical concerns, to promote the best outcomes for their patients.
Question 2 of 5
A medical-surgical nurse is asked to float to a women's health unit to care for patients who are scheduled for therapeutic abortions. The nurse refuses to accept this assignment and expresses her personal beliefs as being incongruent with this medical practice. The nursing supervisor states that the unit is short-staffed and the nurse is familiar with caring for postoperative patients. In consideration of legal and ethical practices, can the nursing supervisor enforce this assignment?
Correct Answer: C
Rationale: The correct answer is C) The staff nurse has expressed a legitimate concern based on his or her feelings; the nursing supervisor does not have the authority to enforce this assignment. In a healthcare setting, nurses have the right to refuse an assignment if it conflicts with their personal beliefs as long as it does not violate any laws or regulations. In this case, performing therapeutic abortions may go against the nurse's personal beliefs. It is crucial to respect the nurse's autonomy and ethical stance on this matter. Option A is incorrect because while nurses are generally expected to accept assignments, there are exceptions when personal beliefs are involved. Option B is incorrect as the nurse's personal beliefs should be taken into consideration, especially in sensitive situations like therapeutic abortions. Option D is incorrect as it does not address the nurse's ethical dilemma and focuses solely on the nurse's training. Educationally, this scenario highlights the importance of respecting nurses' ethical beliefs and autonomy in decision-making. It also underscores the need for open communication between healthcare providers to ensure that patient care is not compromised while also supporting the well-being of the nursing staff.
Question 3 of 5
A nurse is working with an active labor patient who is in preterm labor and has been designated as high risk. The patient is very apprehensive and asks the nurse, 'Is everything going to be all right?' The nurse replies, 'Yes, everything will be okay.' Following delivery via an emergency cesarean birth, the newborn undergoes resuscitation and does not survive. The patient is distraught over the outcome and blames the nurse for telling her that everything would be okay. Which ethical principle did the nurse violate?
Correct Answer: B
Rationale: The correct answer is B) Fidelity. Fidelity refers to the ethical principle of being faithful and true to one's commitments and promises. In this scenario, the nurse violated fidelity by assuring the patient that everything would be okay without having certainty or control over the outcome. This breach of trust led to a sense of betrayal for the patient when the outcome was tragic. Option A) Autonomy pertains to respecting the patient's right to make their own decisions. In this case, the nurse did not violate the patient's autonomy but failed in maintaining fidelity. Option C) Beneficence involves acting in the patient's best interest. While the nurse's intention may have been to provide comfort, the lack of truthful information compromised beneficence. Option D) Accountability refers to the responsibility of healthcare professionals for their actions. While accountability is important, the primary ethical principle violated in this scenario is fidelity. In an educational context, this scenario highlights the significance of honesty and transparency in patient communication, especially in high-stress situations. Nurses must balance providing reassurance with being truthful and realistic to maintain trust and uphold ethical principles like fidelity in their practice.
Question 4 of 5
A multigravida client arrives at the labor and delivery unit and tells the nurse that her bag of water has broken. The nurse identifies the presence of meconium fluid on the perineum and determines the fetal heart rate is between 140 to 150 beats/minute. What action should the nurse implement next?
Correct Answer: A
Rationale: In this scenario, the correct action for the nurse to implement next is to complete a sterile vaginal exam (Option A). This is crucial in assessing the extent of cervical dilation and the position of the fetus to determine the progress of labor and the need for immediate interventions. Taking the maternal temperature every 2 hours (Option B) is important for monitoring signs of infection but is not the immediate priority in this situation where fetal distress is a concern. Preparing for an immediate cesarean birth (Option C) may be necessary in cases of fetal distress or other complications, but it should not be the immediate next step without further assessment through a vaginal exam. Obtaining sterile suction equipment (Option D) is important in case meconium aspiration occurs during delivery, but it is not the most immediate action needed in this scenario. Educationally, this question highlights the importance of prompt assessment and decision-making in labor and delivery situations to ensure the safety and well-being of both the mother and the baby. Understanding the significance of different assessments and interventions in such critical moments is vital for nurses working in maternal and reproductive health settings.
Question 5 of 5
A client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation. She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the nurse implement first?
Correct Answer: C
Rationale: In this scenario, the correct intervention is to obtain a specimen for urine analysis (Option C) first. The client's symptoms suggest a possibility of a urinary tract infection (UTI) or other urinary issues, which can contribute to uterine irritability and contractions. By analyzing the urine, the nurse can assess for any signs of infection or other abnormalities that may be causing the client's symptoms. Providing oral hydration (Option A) is important for pregnant clients, but in this case, addressing the potential underlying issue takes precedence. Having a complete blood count (CBC) drawn (Option B) may be necessary at some point, but it is not the initial priority. Placing the client on strict bedrest (Option D) is not supported as the first intervention without further assessment. In an educational context, this question highlights the importance of assessing and addressing potential medical issues that can impact maternal and fetal health during pregnancy. Understanding the implications of different symptoms and prioritizing interventions based on assessment findings are crucial skills for nurses caring for maternal and reproductive health clients.