NPS NPS Family-Centered Care and Ethics 1 — Questions and Answers
Question 1: Which approach is central to family-centered care in the NICU?
- Limiting parental visits to preserve quiet healing time
- Treating parents as partners in care and decision-making (Correct answer)
- Restricting information to reduce parental anxiety
- Delegating family communication to social workers only
Correct answer: Treating parents as partners in care and decision-making
Family-centered care positions parents as essential partners in their infant's care team, promoting parental presence, education, and shared decision-making.
Question 2: Kangaroo care (skin-to-skin contact) in the NICU has been shown to have which evidence-based benefit?
- Increased risk of infection from parental skin flora
- Improved temperature regulation, breastfeeding rates, and neurodevelopmental outcomes (Correct answer)
- Delayed parental bonding due to equipment access difficulties
- Increased oxygen requirements due to handling stress
Correct answer: Improved temperature regulation, breastfeeding rates, and neurodevelopmental outcomes
Kangaroo care improves thermoregulation, promotes breastfeeding, reduces apnea episodes, enhances parent-infant bonding, and improves long-term neurodevelopmental outcomes.
Question 3: When parents of a 23-week neonate refuse resuscitation, which ethical principle is the clinician primarily obligated to respect?
- Beneficence
- Non-maleficence
- Justice
- Autonomy (Correct answer)
Correct answer: Autonomy
Parental autonomy — the right of parents to make medical decisions for their child — must be respected within ethical and legal boundaries, including decisions at the limits of viability.
Question 4: A neonatologist believes continued intensive care for a 24-week neonate is futile. The parents disagree. What is the most appropriate next step?
- Withdraw care based on the physician's medical judgment alone
- Convene an ethics committee consultation to facilitate discussion (Correct answer)
- Transfer the patient to another institution immediately
- Continue all interventions without further discussion
Correct answer: Convene an ethics committee consultation to facilitate discussion
Ethics committee consultation provides a structured, multidisciplinary forum to facilitate communication, explore values, and find consensus when clinicians and families disagree about care goals.
Question 5: Which developmental care practice in the NICU is designed to reduce sensory overstimulation in preterm neonates?
- Continuous bright fluorescent lighting for monitoring
- Clustering of care activities to allow consolidated rest periods (Correct answer)
- Frequent position changes every 30 minutes
- Routine use of auditory stimulation for brain development
Correct answer: Clustering of care activities to allow consolidated rest periods
Clustering cares (grouping assessments, procedures, and feeding into defined periods) reduces the number of sleep interruptions and promotes neurodevelopmental recovery.
Question 6: In the context of neonatal palliative care, what does the term 'comfort care' primarily involve?
- Discontinuation of all monitoring and parental visitation
- Focusing care on relief of pain and discomfort while withdrawing life-sustaining interventions (Correct answer)
- Mandatory discontinuation of nutrition and hydration
- Transferring the neonate to hospice outside the hospital
Correct answer: Focusing care on relief of pain and discomfort while withdrawing life-sustaining interventions
Neonatal comfort care redirects the goals of treatment toward symptom relief and dignity, withdrawing or withholding life-sustaining interventions while maintaining pain management and family presence.
NPS NPS Family-Centered Care and Ethics 1
Which approach is central to family-centered care in the NICU?