RNC-NIC Family Integration & Ethical Care 2 — Questions and Answers
Question 1: A father of a 28-week premature infant refuses to hold his baby, stating he is afraid of hurting him. What is the nurse's best response?
- Tell him he must participate in care to support bonding
- Acknowledge his fear and offer to guide him through supported holding with staff present (Correct answer)
- Inform him that skin-to-skin contact is mandatory per unit policy
- Suggest he observe from a distance until he feels ready on his own
Correct answer: Acknowledge his fear and offer to guide him through supported holding with staff present
Acknowledging fears and offering guided support respects paternal autonomy while facilitating bonding.
Question 2: Which ethical principle is MOST directly applied when allowing parents to be present during resuscitation of their neonate?
- Justice
- Nonmaleficence
- Autonomy (Correct answer)
- Veracity
Correct answer: Autonomy
Allowing parents to witness resuscitation respects their autonomous right to be present during a critical event involving their child.
Question 3: A family from a culture that relies on a traditional healer declines antibiotic therapy for their neonate's confirmed sepsis. The nurse's priority action is to:
- Report the family to child protective services immediately
- Administer the antibiotics without consent to protect the infant
- Engage the ethics committee and explore culturally sensitive compromise (Correct answer)
- Document the refusal and take no further action
Correct answer: Engage the ethics committee and explore culturally sensitive compromise
Ethics committee involvement and cultural negotiation protect the infant while respecting family values and promoting collaborative decision-making.
Question 4: The NICU nurse is implementing Family-Centered Care (FCC). Which action BEST exemplifies this model?
- Scheduling family visits only during designated hours to maintain routine
- Inviting parents to participate in daily care rounds and goal-setting (Correct answer)
- Limiting parental presence during procedures to reduce parental anxiety
- Educating parents only after the infant is stable enough for discharge
Correct answer: Inviting parents to participate in daily care rounds and goal-setting
Including parents in rounds and goal-setting is a hallmark of FCC, recognizing them as integral members of the care team.
Question 5: Parents of a 23-week gestation infant request full resuscitation despite the medical team's recommendation for comfort care. The most appropriate next step is:
- Override parental wishes based on medical futility guidelines
- Initiate full resuscitation without further discussion
- Hold a family meeting with the attending physician and ethics consultant (Correct answer)
- Defer entirely to parental wishes and begin aggressive intervention immediately
Correct answer: Hold a family meeting with the attending physician and ethics consultant
A family meeting with ethics support facilitates shared decision-making and ensures all perspectives are considered at the limits of viability.
Question 6: Which statement BEST describes the concept of 'veracity' in neonatal ethical care?
- Providing equal resources to all NICU patients regardless of prognosis
- Telling families the truth about their infant's condition even when it is difficult (Correct answer)
- Avoiding actions that cause harm to vulnerable neonates
- Respecting each family's right to make care decisions
Correct answer: Telling families the truth about their infant's condition even when it is difficult
Veracity is the ethical obligation to be truthful with patients and families, even when delivering difficult news.
Question 7: A nurse notices a colleague disclosing a NICU patient's prognosis to the grandparents without parental consent. The nurse should:
- Ignore the situation as grandparents are family members
- Immediately correct the colleague in front of the grandparents
- Report the breach of confidentiality to the charge nurse and document it (Correct answer)
- Ask the grandparents to keep the information confidential
Correct answer: Report the breach of confidentiality to the charge nurse and document it
Reporting a HIPAA breach to the charge nurse and documenting it follows proper protocol to protect patient and family privacy rights.
RNC-NIC Family Integration & Ethical Care 2
A father of a 28-week premature infant refuses to hold his baby, stating he is afraid of hurting him.
What is the nurse's best response?