Davidson 10e - Maternal-Newborn Nursing

Chapter 1 – ANSWER KEY NCLEX-RN® Review

1. Emancipated minor.
Rationale: An advance directive is a method to inform clients of their rights, including a
preference for treatment options. A moral dilemma is a conflict of social values and ethical
principles that support different courses of action. Mature minors are usually between the ages of
14 and 15. This client was 16, had an abortion, and was seeking birth control. Adolescents
between the ages of 16 and 18 who seek birth control can provide informed consent for the
treatment as an emancipated minor.
Nursing Process: Implementation
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Application

2. Evidence-based.
Rationale: Evidence-based practice is nursing care in which all interventions are supported by
current, valid research. Evidence-based practice allows the nurse to transform current research
findings into clinical practice. The nurse considers all forms of evidence, such as statistical data,
quality measurements, risk-management measures, and information from support services, to
deliver care that is supported by solid evidence. The other three options do not involve research,
statistical data, or quality measurements.
Nursing Process: Planning
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Comprehension

3. Contemporary childbirth centered.

Rationale: Contemporary childbirth places an emphasis on the family and family-centered
childbirth. Maternal newborn nurses focus on the specific goals of the individual childbearing
woman and her family. Collaborative practice is a comprehensive model of health care that uses
a multidisciplinary team of health professionals to provide high-quality, cost-effective care.
Primary care includes a focus on health promotion, illness prevention, and individual
responsibility for one’s own health care. Culturally competent care involves recognition and
honoring of cultural diversity, strengths, and individuality within and across all families,
including ethnic, racial, spiritual, social, economic, educational, and geographic diversity.
Nursing Process: Intervention
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Applying

4. Cultural values and beliefs.

Rationale: It is vitally important that nurses who care for women and children recognize the
importance of a family’s cultural values and beliefs, which can be quite different from those of
the nurse. Beliefs and understanding about the concepts of health and illness are part of a
family’s cultural values and belief system. Religion, education, and communication patterns are
other specific examples of cultural values that are not necessarily related to concepts of health
and illness.
Nursing Process: Planning
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Category of Client Need: Psychosocial Integrity
Cognitive Level: Applying

5. A clinical practice guideline adopted by her health care agency.

Rationale: Clinical practice guidelines and critical pathways are comprehensive interdisciplinary
care plans for a specific condition that describe the sequence and timing of interventions that
should result in expected client or patient outcomes. Clinical practice guidelines or critical
pathways are adopted within a health care setting to reduce variation in care management, to
limit costs of care, and to evaluate the effectiveness of care. Scope of practice is defined as the
limits of nursing practice set forth in state statutes. Professional nursing organizations develop
standards of care to establish minimum criteria for competent, proficient delivery of nursing
care. The Health Insurance Portability and Accountability Act (HIPAA) addresses the privacy
and security of health information and requires that standards be established for the electronic
transmission of healthcare data.
Nursing Process: Implementation
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Applying

6. Autonomy.
Rationale: Understanding the usual procedures, understanding their rationales, and understanding
any associated risks are the elements of informed consent. Informed consent is a legal concept
that protects a person’s right to autonomy and self-determination by specifying that no action
may be taken without that individual’s prior understanding and freely given consent. The right to
privacy is the right of a person to keep his or her person and property free from public scrutiny.
The rights to culturally competent care and access to care are not directly related to informed
consent.
Nursing Process: Implementation
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Applying

7. Determine populations at risk.

Rationale: The nurse is using descriptive data to determine how many children might be at risk
for lead poisoning. Specific nursing interventions have not yet been identified. The relationship
between lead exposure and health problems is already known. Specific client population data
have not yet been established for which to develop a database.
Nursing Process: Implementation
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Applying

8. The rights of the mother are paramount.

Rationale: Sixteen weeks is prior to viability. Abortion can be performed until the period of
viability. After that time, abortion is permissible only when the life or health of the mother is
threatened. Before viability, the rights of the mother are paramount; after viability, the rights of
the fetus take precedence. Court intervention should be considered a last resort, appropriate only
in extraordinary circumstances. Advances in technology have permitted the physician to treat the

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Lifespan 10e
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fetus and monitor fetal development. The fetus is increasingly viewed as a client separate from
the mother, and is no longer legally viewed as a nonperson.
Nursing Process: Application
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Applying

9. Obstetrician.
Rationale: The person ultimately responsible for the procedure should provide the information
necessary to obtain informed consent.
Nursing Process: Implementation
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Applying

10. Availability of high-risk maternal-infant care centers.

Use of a specialized antepartum maternity clinic.
Rationale: Factors influencing the decrease in maternal mortality include the increased use of
hospitals and specialized health care personnel, and the establishment of high-risk care centers.
Nursing Process: Implementation
Category of Client Need: Safe, Effective Care Environment
Cognitive Level: Analyzing

Davidson/London/Ladewig: Olds’ Maternal-Newborn Nursing & Women’s Health Across the

Lifespan 10e
© 2016 Pearson Education, Inc.