Obstetric Nurse Test Obstetric Nurse Professional and Ethical Issues 2 — Questions and Answers
Question 1: A laboring patient refuses a recommended cesarean section despite documented fetal distress. What is the nurse's primary ethical obligation?
- Proceed with the cesarean without consent
- Document the refusal, inform the provider, and continue monitoring (Correct answer)
- Discharge the patient immediately
- Contact hospital security to prevent the patient from leaving
Correct answer: Document the refusal, inform the provider, and continue monitoring
Respecting patient autonomy means accepting a competent adult's refusal while ensuring the provider is notified and care continues.
Question 2: Which action best reflects the obstetric nurse's role as a patient advocate during the informed consent process?
- Obtain the signed consent form before the physician explains the procedure
- Ensure the patient understands the information provided and has had questions answered (Correct answer)
- Witness the signature without assessing the patient's comprehension
- Delegate advocacy entirely to the hospital social worker
Correct answer: Ensure the patient understands the information provided and has had questions answered
Advocacy requires verifying the patient genuinely understands risks, benefits, and alternatives before signing.
Question 3: An obstetric nurse suspects a colleague is diverting opioids from postpartum patients. The most appropriate first step is to:
- Confront the colleague privately and give them a chance to stop
- Report the suspicion to the nurse manager or designated supervisor (Correct answer)
- Document observations in the patient's medical record
- Ignore it unless a patient complains of uncontrolled pain
Correct answer: Report the suspicion to the nurse manager or designated supervisor
Suspected diversion must be reported through the proper chain of command to protect patient safety and comply with regulatory obligations.
Question 4: A postpartum patient who is a minor requests that her parents not be told about a complication from her delivery. Under HIPAA, the nurse should:
- Notify the parents anyway because the patient is a minor
- Honor the request if the minor has the legal right to consent to her own obstetric care (Correct answer)
- Disclose to parents only if the provider orders it
- Refuse to care for the patient until the situation is resolved
Correct answer: Honor the request if the minor has the legal right to consent to her own obstetric care
When a minor has the legal right to consent to obstetric care, she also controls disclosure of related health information under HIPAA.
Question 5: During a shift, a nurse realizes she made a medication error on a postpartum patient. The ethical principle of veracity requires the nurse to:
- Correct the error quietly and chart it as an unremarkable administration
- Disclose the error to the patient and provider and complete an incident report (Correct answer)
- Wait to see if the patient develops adverse effects before reporting
- Discuss the error only with the charge nurse and omit documentation
Correct answer: Disclose the error to the patient and provider and complete an incident report
Veracity (truthfulness) obligates the nurse to disclose errors to the patient and care team and report through institutional channels.
Question 6: A hospital policy conflicts with current evidence-based guidelines for intrapartum fetal monitoring. The nurse's best professional response is to:
- Silently follow the outdated policy to avoid disciplinary action
- Refuse all assignments until the policy is changed
- Raise the concern through appropriate channels such as the policy committee or unit leadership (Correct answer)
- Implement personal practice changes without informing leadership
Correct answer: Raise the concern through appropriate channels such as the policy committee or unit leadership
Nurses advance safe care by advocating for policy updates through formal channels rather than unilateral deviation or silence.
Question 7: The ethical principle of justice is most directly applied when the obstetric nurse:
- Provides more attentive care to privately insured patients
- Allocates nursing resources equitably regardless of a patient's socioeconomic status (Correct answer)
- Prioritizes patients based on personal rapport with the care team
- Defers difficult patients to less experienced staff
Correct answer: Allocates nursing resources equitably regardless of a patient's socioeconomic status
Justice requires fair, impartial distribution of care and resources without discrimination based on payer status or other non-clinical factors.
Obstetric Nurse Test Obstetric Nurse Professional and Ethical Issues 2
A laboring patient refuses a recommended cesarean section despite documented fetal distress.
What is the nurse's primary ethical obligation?