Obstetric Nurse Test Obstetric Nurse Professional and Ethical Issues 3 — Questions and Answers
Question 1: A nurse caring for a laboring patient is asked by the patient's estranged husband for updates on her condition. The nurse should:
- Share basic status updates as a professional courtesy
- Provide information only if the patient has given written authorization (Correct answer)
- Refer all questions to the attending physician
- Release information to family members at the nurse's discretion
Correct answer: Provide information only if the patient has given written authorization
HIPAA requires patient authorization before releasing protected health information to anyone, including legal spouses.
Question 2: Which scenario best illustrates the ethical concept of non-maleficence in obstetric nursing?
- Administering oxytocin at the highest available dose to speed labor
- Withholding a uterotonic when it is not clinically indicated to avoid risk of uterine hyperstimulation (Correct answer)
- Documenting care after the fact to save time during a busy shift
- Avoiding patient education to reduce information overload
Correct answer: Withholding a uterotonic when it is not clinically indicated to avoid risk of uterine hyperstimulation
Non-maleficence means avoiding harm; withholding a drug when its risks outweigh benefits protects the patient from unnecessary injury.
Question 3: An obstetric nurse is floated to the neonatal intensive care unit where she lacks competency. She should:
- Accept the assignment and learn on the job to support the team
- Refuse and call in sick to avoid the situation
- Communicate her skill limitations to the supervisor and request appropriate orientation or reassignment (Correct answer)
- Accept the assignment but document her lack of training in the patient record
Correct answer: Communicate her skill limitations to the supervisor and request appropriate orientation or reassignment
Nurses are professionally obligated to communicate competency gaps to protect patient safety, not simply accept unsafe assignments.
Question 4: During a home visit, a postpartum nurse notices signs of intimate partner violence. The nurse's first action should be to:
- Confront the suspected abuser directly
- Privately screen the patient using a validated tool and provide safety resources (Correct answer)
- Contact law enforcement without informing the patient
- Document findings and address them at the next scheduled visit
Correct answer: Privately screen the patient using a validated tool and provide safety resources
Private screening followed by resource provision respects autonomy and safety while fulfilling the nurse's duty to identify and respond to abuse.
Question 5: A competent postpartum patient declines recommended hepatitis B vaccination for her newborn citing religious beliefs. The nurse should:
- Administer the vaccine anyway because it is standard of care
- Provide balanced education, document the informed refusal, and respect the decision (Correct answer)
- Report the parents to child protective services immediately
- Withhold discharge until the vaccine is accepted
Correct answer: Provide balanced education, document the informed refusal, and respect the decision
While the nurse should educate, competent parents have the right to refuse non-emergent newborn treatments, and the refusal must be documented.
Question 6: A nurse receives a social media friend request from a former obstetric patient. Accepting the request primarily risks violating:
- The nurse's own privacy
- Professional boundaries and the therapeutic relationship (Correct answer)
- Hospital accreditation standards
- The patient's right to anonymity
Correct answer: Professional boundaries and the therapeutic relationship
Accepting social media connections with former patients blurs professional boundaries and can compromise the therapeutic relationship.
Question 7: Which document specifically guides obstetric nurses in ethical decision-making by outlining professional duties and patient rights?
- The Joint Commission Sentinel Event Alert
- The ANA Code of Ethics for Nurses with Interpretive Statements (Correct answer)
- The CDC's Morbidity and Mortality Weekly Report
- The ACOG Practice Bulletin series
Correct answer: The ANA Code of Ethics for Nurses with Interpretive Statements
The ANA Code of Ethics provides the foundational ethical framework for all nursing practice, including obstetric nursing.
Obstetric Nurse Test Obstetric Nurse Professional and Ethical Issues 3
A nurse caring for a laboring patient is asked by the patient's estranged husband for updates on her condition.
The nurse should: