Obstetric Nurse Professional and Ethical Issues Questions and Answers

Question 1

A 32-year-old patient in active labor has a fetal heart rate tracing that is persistently Category III.
The obstetrician strongly recommends an emergency cesarean section, but the patient, who has decision-making capacity, refuses the surgery based on her personal beliefs.
What is the nurse's primary ethical responsibility in this situation?

Accepted Answer

Inform the patient of the risks of refusal, document her decision thoroughly, and continue to provide supportive nursing care.

Answer

Request a psychiatric evaluation to determine if the patient is competent to refuse treatment.

Answer

Contact the hospital's legal department to initiate a court order to perform the surgery against the patient's will.

Answer

Prepare the operating room and surgical team, assuming the patient will change her mind under duress.

Question 2

Which of the following is the MOST crucial element for ensuring legally valid informed consent for an invasive procedure, such as an external cephalic version (ECV)?

Accepted Answer

Confirmation from the provider that the patient understands the procedure's risks, benefits, and alternatives.

Answer

The patient's signature on the consent form witnessed by the nurse.

Answer

A family member being present during the explanation of the procedure.

Answer

The nurse providing a detailed summary of the procedure to the patient.

Question 3

A nurse working on the labor and delivery unit learns that a high-profile celebrity has been admitted. The nurse is not assigned to the celebrity's care but accesses her electronic health record (EHR) out of curiosity. This action is a direct violation of which professional standard?

Accepted Answer

Patient Confidentiality (HIPAA)

Answer

Beneficence

Answer

Veracity

Answer

Scope of Practice

Question 4

An obstetric nurse is caring for a patient with a continuous epidural infusion for labor pain. Which of the following tasks falls outside the typical scope of practice for a registered nurse?

Accepted Answer

Administering the initial test dose of anesthetic into the epidural catheter after placement.

Answer

Monitoring the patient's blood pressure and the fetal heart rate every 15 minutes after a bolus.

Answer

Increasing the basal infusion rate per a specific order from the anesthesia provider.

Answer

Assessing the patient's sensory level using a cold stimulus to check the effectiveness of the block.

Question 5

A newborn is showing signs of neonatal abstinence syndrome (NAS). The mother tearfully admits to the nurse that she used unprescribed opioids during pregnancy and is afraid her baby will be taken away. What is the nurse's most appropriate initial action that balances ethical duties?

Accepted Answer

Provide compassionate, non-judgmental care to the infant and initiate a referral to social work to provide the mother with resources.

Answer

Immediately report the mother to Child Protective Services without further discussion.

Answer

Inform the mother that losing custody is a definite consequence of her actions.

Answer

Focus care exclusively on the infant's withdrawal symptoms and avoid discussing the mother's substance use.

Question 6

A nurse observes a colleague repeatedly dismissing a laboring patient's pain based on the colleague's stated belief that 'women of that culture always exaggerate.' The nurse recognizes this as a failure to uphold which specific professional nursing standard?

Accepted Answer

Culturally Congruent Practice

Answer

Resource Utilization

Answer

Evidence-Based Practice

Answer

Chain of Command