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2) Care delivered by nurse-midwives can be safe and effective and can represent a positive
response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which
often results in which of the following?
A) There is less trauma to the mother.
B) More childbirth education classes are available.
C) They are instrumental in providing change in the birth environment at work.
D) They advocate for more home healthcare agencies.
Answer: A
Explanation: A) Nurse-midwife models of care can be one way to ensure that mothers receive
excellent prenatal and intrapartum care.
B) It is appropriate for nurse-midwives, in conjunction with doctors and hospitals, to provide
childbirth classes for expectant families.
C) By working with other staff members and doctors, the nurse-midwife is able to implement
changes as needed within the birthing unit.
D) Clients are increasingly going home sooner, so there needs to be more follow-up in the home.
Page Ref: 3
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: III.A. 6. Describe how the strength and relevance of available
evidence influences the choice of interventions in provision of patient-centered care. | AACN
Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care
that respects patient and family preferences. | NLN Competencies: Context and Environment:
Read and interpret data; apply health promotion/disease prevention strategies; apply health
policy; conduct population-based transcultural health assessments and interventions. |
Nursing/Integrated Concepts: Nursing Process: Planning.
Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

2
Copyright © 2020 Pearson Education, Inc.
3) The nurse is telling a new client how advanced technology has permitted the physician to do
which of the following?
A) Treat the fetus and monitor fetal development.
B) Deliver at home with a nurse-midwife and doula.
C) Have the father act as the coach and cut the umbilical cord.
D) Breastfeed a new baby on the delivery table.
Answer: A
Explanation: A) The fetus is increasingly viewed as a patient separate from the mother, although
treatment of the fetus necessarily involves the mother.
B) A nurse-midwife and a doula are not examples of technological care.
C) Fathers being present during labor and coaching their partners represents nontechnological
care during childbirth.
D) Breastfeeding is not an example of technology impacting care.
Page Ref: 2—3
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care
that respects patient and family preferences. | NLN Competencies: Teamwork: Scope of practice,
roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated
Concepts: Nursing Process: Implementation.
Learning Outcome: 6 Evaluate the potential impact of some of the special situations in
contemporary maternity care.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

3
Copyright © 2020 Pearson Education, Inc.
4) A nurse is examining different nursing roles. Which example best illustrates an advanced
practice nursing role?
A) A registered nurse who is the manager of a large obstetrical unit
B) A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections)
C) A clinical nurse specialist working as a staff nurse on a mother-baby unit
D) A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-
risk infants
Answer: D
Explanation: A) A registered nurse who is the manager of a large obstetrical unit is a
professional nurse who has graduated from an accredited program in nursing and completed the
licensure examination.
B) A registered nurse who is a circulating nurse at surgical deliveries (cesarean sections) is a
professional nurse who has graduated from an accredited program in nursing and completed the
licensure examination.
C) A clinical nurse specialist working as a staff nurse on a mother-baby unit might have the
qualifications for an advanced practice nursing staff member but is not working in that capacity.
D) A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk
infants is working in an advanced practice nursing role. This nurse has specialized knowledge
and competence in a specific clinical area, and is master's prepared.
Page Ref: 5
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: II.A.2. Describe scopes of practice and roles of healthcare
team members. | AACN Essentials Competencies: VI. 6. Compare/contrast the roles and
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.
scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork:
Scope of practice, roles, and responsibilities of health care team members, including overlaps. |
Nursing/Integrated Concepts: Nursing Process: Assessment.
Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

4
Copyright © 2020 Pearson Education, Inc.
5) A nursing student investigating potential career goals is strongly considering becoming a
nurse practitioner (NP). The major focus of the NP is on which of the following?
A) Leadership
B) Physical and psychosocial clinical assessment
C) Independent care of the high-risk pregnant client
D) Tertiary prevention
Answer: B
Explanation: A) Leadership might be a quality of the NP, but it is not the major focus.
B) Physical and psychosocial clinical assessment is the major focus of the NP.
C) NPs cannot provide independent care of the high-risk pregnant client, but must work under a
physician's supervision.
D) The NP cannot do tertiary prevention as a major focus.
Page Ref: 5
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: II.A.2. Describe scopes of practice and roles of healthcare
team members. | AACN Essentials Competencies: VI. 2. Compare/contrast the roles and
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.
scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork:
Scope of practice, roles, and responsibilities of health care team members, including overlaps. |
Nursing/Integrated Concepts: Nursing Process: Assessment.
Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

5
Copyright © 2020 Pearson Education, Inc.
6) The nurse manager is consulting with a certified nurse-midwife about a client. What is the role
of the CNM?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

A) Be prepared to manage independently the care of women at low risk for complications during
pregnancy and birth.
B) Give primary care for high-risk clients who are in hospital settings.
C) Give primary care for healthy newborns.
D) Obtain a physician consultation for any technical procedures at delivery.
E) Be educated in two disciplines of nursing.
Answer: A, C, E
Explanation: A) A CNM is prepared to manage independently the care of women at low risk for
complications during pregnancy and birth and the care of healthy newborns.
B) CNMs cannot give primary care for high-risk clients who are in hospital settings. The
physician provides the primary care.
C) A CNM is prepared to manage independently the care of women at low risk for complications
during pregnancy and birth and the care of healthy newborns.
D) The CNM does not need to obtain a physician consultation for any technical procedures at
delivery.
E) The CNM is educated in the disciplines of nursing and midwifery.
Page Ref: 5
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: II.A.2. Describe scopes of practice and roles of healthcare
team members. | AACN Essentials Competencies: VI. 1. Compare/contrast the roles and
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.
scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork:
Scope of practice, roles, and responsibilities of health care team members, including overlaps. |
Nursing/Integrated Concepts: Nursing Process: Planning.
Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

6
Copyright © 2020 Pearson Education, Inc.
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7) The registered nurse who has completed a master's degree program and passed a national
certification exam has clinic appointments with clients who are pregnant or seeking well-woman
care. What is the role of this nurse considered to be?
A) Professional nurse
B) Certified registered nurse (RNC)
C) Clinical nurse specialist
D) Nurse practitioner
Answer: D
Explanation: A) A professional nurse is one who has completed an accredited basic educational
program and has passed the NCLEX-RN® exam.
B) A certified registered nurse (RNC) has shown expertise in the field and has taken a national
certification exam.
C) A clinical nurse specialist has completed a master's degree program, has specialized
knowledge and competence in a specific clinical area, and often is employed in hospitals on
specialized units.
D) A nurse practitioner has completed either a master's or doctoral degree in nursing and passed
a certification exam, and functions as an advanced practice nurse. Ambulatory care settings and
the community are common sites for nurse practitioners to provide client care.
Page Ref: 5
Cognitive Level: Remembering
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: II.A.2. Describe scopes of practice and roles of healthcare
team members. | AACN Essentials Competencies: VI. 6. Compare/contrast the roles and
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.
scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork:
Scope of practice, roles, and responsibilities of health care team members, including overlaps. |
Nursing/Integrated Concepts: Nursing Process: Assessment.
Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

7
Copyright © 2020 Pearson Education, Inc.
8) While a child is being admitting to the hospital, the parent receives information about the
pediatric unit's goals, including the statement that the unit practices family-centered care. The
parent asks why that is important. The nurse responds that what communication dynamic is
characteristic of the family-centered care paradigm?
A) The mother is the principal caregiver in each family.
B) The child's physician is the key person in ensuring that the health of a child is maintained.
C) The family serves as the constant influence and continuing support in the child's life.
D) The father is the leader in each home; thus, all communications should include him.
Answer: C
Explanation: A) Culturally competent care recognizes that both matriarchal and patriarchal
households exist.
B) The physician is not present during the day-to-day routines in a child's life.
C) Family-centered care is characterized by an emphasis on the family and family involvement
throughout the pregnancy, birth, and postpartum period.
D) Culturally competent care recognizes that both matriarchal and patriarchal households exist.
Page Ref: 2
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 6.
Implement holistic, patient-centered care that reflects an understanding of human growth and
development, pathophysiology, pharmacology, medical management and nursing management
across the health-illness continuum, across the lifespan, and in all healthcare settings. | NLN
Competencies: Relationship-Centered Care: Promote and accept the patient's emotions; accept
and respond to distress in the patient and self; facilitate hope, trust and faith. | Nursing/Integrated
Concepts: Nursing Process: Planning.
Learning Outcome: 4 Identify specific factors that contribute to a family's value system.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

8
Copyright © 2020 Pearson Education, Inc.
9) The current emphasis on federal healthcare reform has yielded what unexpected benefit?
A) Assessment of the details of the family's income and expenditures
B) Case management to limit costly, unnecessary duplication of services
C) Many healthcare providers and consumers are becoming more aware of the vitally important
role nurses play in providing excellent care to clients and families
D) Education of the family about the need for keeping regular well-child visit appointments
Answer: C
Explanation: A) Financial assessment is more commonly the function of a social worker. The
social worker is part of the interdisciplinary team working with clients, and this professional's
expertise is helping clients get into the appropriate programs.
B) The case management activity mentioned will not provide a source of funding.
C) Nurses must clearly articulate their role in the changing environment to define and
differentiate practice roles and the educational preparation required for their new roles.
D) The education of the family will not provide a source of funding.
Page Ref: 4
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A. 4. Examine how the safety, quality and cost effectiveness
of health care can be improved through the active involvement of patients and families. | AACN
Essentials Competencies: VI. 1. Compare/contrast the roles and perspectives of the nursing
profession with other care professionals on the healthcare team (i.e. scope of discipline,
education, and licensure requirements). | NLN Competencies: Context and Environment: Read
and interpret data; apply health promotion/disease prevention strategies; apply health policy;
conduct population-based transcultural health assessments and interventions. | Nursing/Integrated
Concepts: Nursing Process: Implementation.
Learning Outcome: 2 Compare the nursing roles available to the maternal-newborn nurse.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

9
Copyright © 2020 Pearson Education, Inc.
10) For prenatal care, the client is attending a clinic held in a church basement. The client's care
is provided by registered nurses and a certified nurse-midwife. What is this type of prenatal care?
A) Secondary care
B) Tertiary care
C) Community care
D) Unnecessarily costly care
Answer: C
Explanation: A) Secondary care is specialized care; an example is checking the hemoglobin
A1C of a diabetic client at an endocrine clinic.
B) Tertiary care is very specialized, and includes trauma units and neonatal intensive care units.
C) Prenatal care is primary care. Community care is often provided at clinics in neighborhoods to
facilitate clients' access to primary care, including prenatal care and prevention of illness.
D) Community care decreases costs while improving client outcomes, and is not unnecessarily
expensive.
Page Ref: 3
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care
Standards: QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of
patient-centered care. | AACN Essentials Competencies: VI. 1. Compare/contrast the roles and
perspectives of the nursing profession with other care professionals on the healthcare team (i.e.
scope of discipline, education, and licensure requirements). | NLN Competencies: Context and
Environment: Environmental health; health promotion/disease prevention (e.g. transmission of
disease, disease patterns, epidemiological principles); chronic disease management; health care
systems; transcultural approaches to health; family dynamics. | Nursing/Integrated Concepts:
Nursing Process: Implementation.
Learning Outcome: 3 Describe the use of community-based nursing care in meeting the needs of
childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

10
Copyright © 2020 Pearson Education, Inc.
11) The nurse at an elementary school is performing TB screenings on all of the students.
Permission slips were returned for all but the children of one family. When the nurse phones to
obtain permission, the parent states in clearly understandable English that permission cannot be
given because the grandmother is out of town for 2 more weeks. Which cultural element is
contributing to the dilemma that faces the nurse?
A) Permissible physical contact with strangers
B) Beliefs about the concepts of health and illness
C) Religion and social beliefs
D) Presence and influence of the extended family
Answer: D
Explanation: A) The situation the nurse faces is not being caused by permissible contact with
strangers.
B) The situation the nurse faces is not caused by beliefs about the concepts of health and illness.
C) The situation the nurse faces is not caused by religion and social beliefs.
D) The presence and influence of the extended family is contributing to the situation the nurse
faces. In many cultures, a family elder is the primary decision maker when it comes to health
care. In this case, the parent cannot grant permission to the nurse until the parent consults the
grandmother.
Page Ref: 4
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Screening
Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social
backgrounds function as sources of patient, family, and community values. | AACN Essentials
Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects
patient and family preferences. | NLN Competencies: Context and Environment: Analyze ethical
challenges presented by ambiguous and uncertain clinical situations; self-assess one's own
tolerance for ambiguity and uncertainty; accept the possibility of multiple "right" answers (rather
than one right answer thinking) in patient care and other professional situations. |
Nursing/Integrated Concepts: Nursing Process: Planning.
Learning Outcome: 4 Identify specific factors that contribute to a family's value system.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

11
Copyright © 2020 Pearson Education, Inc.
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12) A maternity client is in need of surgery. Which healthcare member is legally responsible for
obtaining informed consent for an invasive procedure?
A) The nurse
B) The physician
C) The unit secretary
D) The social worker
Answer: B
Explanation: A) It is not the nurse's legal responsibility to obtain informed consent.
B) Informed consent is a legal concept designed to allow clients to make intelligent decisions
regarding their own health care. Informed consent means that a client, or a legally designated
decision maker, has granted permission for a specific treatment or procedure based on full
information about that specific treatment or procedure as it relates to that client under the
specific circumstances of the permission. The individual who is ultimately responsible for the
treatment or procedure should provide the information necessary to obtain informed consent. In
most instances, this is a physician.
C) Unit secretaries are not responsible for obtaining informed consent.
D) It is not within a social worker's scope of practice to obtain informed consent.
Page Ref: 7—8
Cognitive Level: Remembering
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I. B. 12. Facilitate informed patient consent for care. | AACN
Essentials Competencies: VIII. 1. Demonstrate the professional standards of moral, ethical, and
legal conduct. | NLN Competencies: Context and Environment: Code of ethics (e.g. American
Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional
standards (ANA Social Policy Statement [ANA, 2003]; HIPAA [Health Insurance Portability
and Accountability Act]); ethical decision making modes; scope of practice considerations;
principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated
Concepts: Nursing Process: Planning.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

12
Copyright © 2020 Pearson Education, Inc.
13) A nurse who tells family members the sex of a newborn baby without first consulting the
parents would have committed which of the following?
A) A breach of privacy
B) Negligence
C) Malpractice
D) A breach of ethics
Answer: A
Explanation: A) A breach of privacy would have been committed in this situation, because
informing other family members of the child's sex without the parents' consent violates the
parents' right to privacy. The right to privacy is the right of a person to keep his person and
property free from public scrutiny (or even from other family members).
B) Negligence is a punishable legal offense, and is more serious.
C) Malpractice is a punishable legal offense, and is more serious.
D) No breach of ethics has been committed in this situation.
Page Ref: 8
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Ethical Practice
Standards: QSEN Competencies: I. B. 13. Assess own level of communication skill in
encounters with patient and families. | AACN Essentials Competencies: IV. 8. Uphold ethical
standards related to data security, regulatory requirements, confidentiality and clients' right to
privacy. | NLN Competencies: Context and Environment: Code of ethics (e.g. American Nurses
Association 2005; International Council of Nurses, 2006); regulatory and professional standards
(ANA Social Policy Statement [ANA, 2003]; HIPAA [Health Insurance Portability and
Accountability Act]); ethical decision making modes; scope of practice considerations; principles
of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts:
Nursing Process: Implementation.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

13
Copyright © 2020 Pearson Education, Inc.
14) The nursing instructor explains to the class that according to the 1973 Supreme Court
decision in Roe v. Wade, abortion is legal if induced:
A) Before the 30th week of pregnancy.
B) Before the period of viability.
C) To provide tissue for therapeutic research.
D) Can be done any time if mother, doctor, and hospital all agree.
Answer: B
Explanation: A) This statement is not true, because the fetus is viable many weeks before the
30th week.
B) Abortion can be performed legally until the period of viability.
C) Abortion cannot be used for the sole purpose of providing tissue for therapeutic research.
D) This is not true. Legal abortion can be done only up until the time of viability.
Page Ref: 9
Cognitive Level: Remembering
Client Need/Sub: Safe and Effective Care Environment: Ethical Practice
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IV. 8. Uphold
ethical standards related to data security, regulatory requirements, confidentiality and client's
right to privacy. | NLN Competencies: Context and Environment: Code of ethics (e.g. American
Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional
standards (ANA Social Policy Statement [ANA, 2003]; HIPAA [Health Insurance Portability
and Accountability Act]); ethical decision making modes; scope of practice considerations;
principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated
Concepts: Nursing Process: Planning.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

14
Copyright © 2020 Pearson Education, Inc.
15) The nurse reviewing charts for quality improvement notes that a client experienced a
complication during labor. The nurse is uncertain whether the labor nurse took the appropriate
action during the situation. What is the best way for the nurse to determine what the appropriate
action should have been?
A) Call the nurse manager of the labor and delivery unit and ask what the nurse should have
done.
B) Ask the departmental chair of the obstetrical physicians what the best nursing action would
have been.
C) Examine other charts to find cases of the same complication, and determine how it was
handled in those situations.
D) Look in the policy and procedure book, and examine the practice guidelines published by a
professional nursing organization.
Answer: D
Explanation: A) The nurse should find the standards, and not rely on another person to
determine appropriateness of care.
B) Physician care and nursing care are very different; physicians might not be up to date on
nursing standards of care or nursing policies and procedures.
C) What nursing action was undertaken in a different situation might not be based on the policies
and procedures or other standards of care. The quality improvement nurse will obtain the most
accurate information by examining the policies, procedures, and standards of care.
D) Agency policies, procedures, and protocols contain guidelines for nursing action in specific
situations. Professional organizations such as the Association of Women's Health, Obstetrical,
and Neonatal Nurses (AWHONN) also publish standards of practice that should guide nursing
care.
Page Ref: 7
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: IV. A. 4. Explain the importance of variation and
measurement in assessing quality of care. | AACN Essentials Competencies: V. 1. Demonstrate
basic knowledge of healthcare policy, finance, and regulatory environments; including local,
state, national, and global healthcare trends. | NLN Competencies: Knowledge and Science:
Retrieve research findings and other sources of information; critique research to judge its value
and usefulness; evaluate the strength of evidence for application of research findings to clinical
practice. | Nursing/Integrated Concepts: Nursing Process: Evaluation.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

15
Copyright © 2020 Pearson Education, Inc.
16) The nurse is reviewing care of clients on a mother-baby unit. Which situation should be
reported to the supervisor?
A) A 2-day-old infant has breastfed every 2-3 hours and voided four times.
B) An infant was placed in the wrong crib after examination by the physician.
C) The client who delivered by cesarean birth yesterday received oral narcotics.
D) A primiparous client who delivered today is requesting discharge within 24 hours.
Answer: B
Explanation: A) Breastfeeding every 2 hours and voiding four times is within normal limits for a
2-day-old infant. There is no negligence in this situation.
B) Placing an infant in the wrong crib is malpractice. Malpractice is negligent action by a
professional person.
C) Receiving oral narcotics at this point in the client's stay is within normal limits. There is no
negligence in this situation.
D) If the client is feeling well and able to care for her infant, it is normal to be discharged at this
time. The mother and baby both must be within normal limits to be discharged.
Page Ref: 7
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of strategies to reduce risk
of harm to self or others. | AACN Essentials Competencies: VIII. 1. Demonstrate the
professional standards of moral, ethical, and legal conduct. | NLN Competencies: Quality and
Safety: Communicate effectively with different individuals (team members, other care providers,
patients, families, etc.) so as to minimize risks associated with handoffs among providers and
across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Evaluation.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

16
Copyright © 2020 Pearson Education, Inc.
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17) The nurse manager is planning a presentation on ethical issues in caring for childbearing
families. Which example should the nurse manager include to illustrate maternal-fetal conflict?
A) A client chooses an abortion after her fetus is diagnosed with a genetic anomaly.
B) A 39-year-old nulliparous client undergoes therapeutic insemination.
C) A family of a child with leukemia requests cord-blood banking at a sibling's birth.
D) A cesarean delivery of a breech fetus is court ordered after the client refuses.
Answer: D
Explanation: A) Abortion is a different type of ethical situation.
B) Achieving pregnancy through the use of therapeutic insemination is a form of reproductive
assistance, and is not considered a maternal-fetal conflict.
C) Cord-blood banking is a different type of ethical situation.
D) Maternal-fetal conflict is a special ethical situation where the rights of the fetus and the rights
of the mother are considered separately. Forced cesarean birth, coercion of mothers who practice
high-risk behaviors, and, perhaps most controversial, mandating experimental in utero therapy or
surgery in an attempt to correct a specific birth defect are interventions that infringe on the
mother's autonomy.
Page Ref: 9
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I. B. 9. Assess level of patient's decisional conflict and provide
access to resources. | AACN Essentials Competencies: VIII. 1. Demonstrate the professional
standards of moral, ethical, and legal conduct. | NLN Competencies: Context and Environment:
Show respect for others' values; appreciate diversity; be civil during relationships and work;
value community empowerment and social justice; work to improve social conditions affecting
health; adopt inclusive language. | Nursing/Integrated Concepts: Nursing Process: Planning.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

17
Copyright © 2020 Pearson Education, Inc.
18) Client safety goals, which are evaluated and updated regularly, are requirements for what?
A) Clinical practice guidelines
B) Scope of practice
C) Accreditation
D) Standards of care
Answer: C
Explanation: A) Clinical practice guidelines are adopted within a healthcare setting to reduce
variation in care management, to limit costs of care, and to evaluate the effectiveness of care.
B) State nurse practice acts protect the public by broadly defining the legal scope of practice
within which every nurse must function and by excluding untrained or unlicensed individuals
from practicing nursing.
C) The Joint Commission has identified client safety as an important responsibility of healthcare
providers.
D) Standards of care establish minimum criteria for competent, proficient delivery of nursing
care.
Page Ref: 7
Cognitive Level: Remembering
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: V. A. 7. Discuss potential and actual impact of national patient
safety resources, initiatives, and regulations. | AACN Essentials Competencies: IX. 12. Create a
safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and
Safety: Value and encourage nurses' involvement in the design, selection, implementation, and
evaluation of information technologies to support patient care (e.g. as recommended by QSEN). |
Nursing/Integrated Concepts: Nursing Process: Assessment.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

18
Copyright © 2020 Pearson Education, Inc.
19) A fetus has been diagnosed with myelomeningocele. Which of the following surgeries would
be performed to correct this condition?
A) Tubal ligation
B) Intrauterine fetal surgery
C) Cesarean section
D) Sterilization
Answer: B
Explanation: A) Tubal ligation is not an intrauterine fetal surgery.
B) Intrauterine fetal surgery, which is generally considered experimental, is a therapy for
anatomic lesions that can be corrected surgically and are incompatible with life if not treated.
Examples include surgery for myelomeningocele and some congenital cardiac defects.
C) A cesarean birth is not considered an intrauterine fetal surgery.
D) Sterilization surgery does not involve the fetus.
Page Ref: 9
Cognitive Level: Remembering
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: II. B. 8. Integrate the contributions of others who play a role in
helping the patient/family achieve health goals. | AACN Essentials Competencies: VI. 1.
Compare/contrast the roles and perspectives of the nursing profession with other care
professionals on the healthcare team (i.e. scope of discipline, education, and licensure
requirements). | NLN Competencies: Teamwork: Function competently within one's own scope
of practice as leader or member of the health care team and manage delegation effectively. |
Nursing/Integrated Concepts: Nursing Process: Planning.
Learning Outcome: 5 Delineate significant legal and ethical issues that influence the practice of
nursing for childbearing families.
MNL LO: Recognize contemporary issues related to care of the childbearing family.

19
Copyright © 2020 Pearson Education, Inc.
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Welcome to our website – the perfect destination for book lovers and
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