Author Question: The patient at 30 weeks' gestation expresses a desire for the registered nurse to independently ... (Read 27 times)

CQXA · **on:** Jun 28, 2018

The patient at 30 weeks' gestation expresses a desire for the registered nurse to independently manage her perinatal care and the birth of her baby.

When the nurse explains she is not credentialed to independently manage the patient's perinatal care and delivery, the nurse is recognizing principles related to:
1. Standards of care.
2. Scope of practice.
3. Right to privacy.
4. Informed consent.

Question 2

The labor and delivery nurse and a nurse new to the labor and delivery unit are admitting a laboring patient. The patient is making groaning guttural sounds during contractions and answering questions with one-word answers.

The labor and delivery nurse simultaneously is quickly setting up the instruments and sterile field for this delivery while asking the admission questions between contractions. The experienced labor and delivery nurse has not yet completed a pelvic exam. The nurse new to labor and delivery understands that this is an example of:
1. An expert nurse assessing advanced labor and imminent delivery in the patient.
2. The correct order of steps when admitting a laboring patient.
3. Inconsistencies in an individual nurse's approach to patient care.
4. Advanced nurse practice.

wergv · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: Standards of care pertain to established minimum criteria for competent, proficient actions related to delivery of nursing care.
Rationale 2: Scope of practice is defined as the limits of nursing practice set forth in state statutes.
Rationale 3: Right to privacy involves the legal right of a person to keep her or his person and property free from public scrutiny.
Rationale 4: Informed consent is a legal concept that protects a patient's right to autonomy and self-determination in terms of his or her care.

Answer to Question 2

Correct Answer: 1
Rationale 1: An expert nurse utilizes multiple aspects of a patient's behavior (including the length of each response to a question and sounds the patient produces during contractions) in addition to the more objective findings of the pelvic exam (including dilation of the cervix) in the assessment of a laboring patient. The expert nurse has identified that the grunting and guttural sounds during contractions are involuntary pushing and that the patient is very close to delivery.
Rationale 2: Although most nurses have a routine when admitting a patient, the order of the steps will vary according to the situation at hand.
Rationale 3: Changing the order of the steps of admission is not being inconsistent; changing the order of the steps of admission is responsive to the needs of the patient at that point in time.
Rationale 4: Advanced nurse practice describes educational and certification achievement and is not used to describe the continuum from novice to expert.