RNC Inpatient Obstetrics Practice Exam III
- 1.Inpatient obstetric care results in approximately what percentage of malpractice claims in the obstetrics and gynecology?
- A.
25
- B.
50
- C.
75
- 2.Guidance for ethical nursing care is provided by the:
- A.
American Nurses Association 'Code of Ethics for Nurses'
- B.
American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) 'Guidelines for Perinatal Care'.
- C.
American Medical Association 'Code of Medical Ethics'
- 3.Disruptive clinician behavior:
- A.
Is often directly linked to clinical practice issues
- B.
Rarely involves clinical practice issues
- C.
Should be handled separately from clinical practice issues
- 4.The best approach for addressing disruptive clinician behavior is:
- A.
Immediate intervention
- B.
Monitoring trends
- C.
Peer review
- 5.Successful defense of malpractice claims is enhanced by following:
- A.
Community standards
- B.
National professional standards
- C.
Trends in practice
- 6.When a sentinel event occurs, according to the Joint Commission (TJC):
- A.
A root-cause analysis should be conducted
- B.
It must be reported to TJC within 60 days
- C.
Those involved should be placed on administrative leave pending an investigation
- 7.Based on TJC criteria, which of the following clinical situations is a sentinel event?
- A.
Any unexplained adverse occurrence
- B.
Birth of a baby with previously undiagnosed congenital abnormalities
- C.
Unanticipated death of a full-term infant
- 8.The purpose of the root-cause analysis process is to:
- A.
Determine fault of the healthcare provider or hospital
- B.
Examine institutional liability
- C.
Review potentially contributing systems
- 9.Professional nursing liability is most commonly increased by the absence of:
- A.
Adequate medical record documentation
- B.
Annual competency validation
- C.
Current unit policies and procedures
- 10.An incident -management program will:
- A.
Include "near misses" with potential for adverse outcomes
- B.
Identify and discipline those at fault
- C.
Increase institutional and nursing liability
- 11.Nurse/ Physician difference of opinion about patient management should be:
- A.
Considered unprofessional behavior
- B.
Discussed with the patient's family
- C.
Focused on the issue in question
- 12.Despite repeated requests to a physician to come to the bedside to evaluate a deteriorating maternal condition, the physician has failed to respond. The nurse appropriately:
- A.
Consults with another physician in the unit.
- B.
Institutes the chain of command/ chain of consultation.
- C.
Provides the intervention indicated.
- 13.Outcome measures of patient safety include:
- A.
How care is delivered
- B.
Policies and procedures
- C.
Rates of maternal morbidity and mortality
- 14.Structure measures of patient safety include:
- A.
The number of elective inductions of labor prior to 39 weeks' gestation
- B.
The rates of third and fourth degree lacerations
- C.
Unit protocols
- 15.Process measures of patient safety include:
- A.
How tachysystole is identified and treated
- B.
Number of nurses who are certified in fetal monitoring
- C.
Rates of cesarean birth for indeterminate fetal status
- 16.Qualitative measures of patient safety include:
- A.
Focus groups
- B.
Number of sentinel events per year
- C.
Policies and procedures consistent with national standards and guidelines
- 17.According to ACOG (2009) the preferred method of fetal assessment during labor for women with high-risk conditions is:
- A.
Dopplering FHTs every 30 minutes during early labor
- B.
Electronic fetal monitoring
- C.
Fetal scalp electrode
- 18.Elective labor induction should not occur prior to:
- A.
38
- B.
39
- C.
40
- 19.According to ACOG (2009) misoprostol is not recommended for women:
- A.
Requesting elective induction at 39 weeks
- B.
With preeclampsia
- C.
Attempting VBAC
- 20.A 25 yr old Vietnamese woman admitted to the birthing unit requests that her husband stay in the waiting area until she gives birth. The appropriate response is based on the nurses knowledge that:
- A.
All husbands should be present during labor and birth
- B.
The husband may fear his response to his wife giving birth
- C.
The woman's request should be honored
- 21.Wang Din Wah, A Laotian mother who is 24 hours postpartum, rejects the nurses' instructions to bring the newborn back to the clinic by the 7th day of life for a phenylketonuria test. Wang's reasons for this refusal are most likely based on:
- A.
Her lack of knowledge of appropriate health-care for the baby
- B.
The baby's early care being provided largely by a maternal grandmother
- C.
The first month after birth being considered a time for confinement and rest
- 22.Berta Wolf Creek is 4 hours postpartum and requests permission to take her placenta home with her. Appropriate instruction by the nurse would include:
- A.
Keeping the placenta in a leak proof container
- B.
Requiring disposal of the placenta by internment (burial)
- C.
Keeping the placenta frozen until burial
- 23.Maria Ochoa, a 23 yr old Filipino American, is 18 weeks pregnant. After receiving a prescription for prenatal vitamins, she tells the nurse that her mother warned her to take only herbal medication during pregnancy. The nurse appropriately:
- A.
Advises Maria that the pills are only vitamins and not considered medication
- B.
Assess the significance of Maria's mother's advice
- C.
Reminds her that the vitamins were ordered by the nurse-midwife
- 24.The percentage of the U.S. population who are African American or black is nearly:
- A.
6%
- B.
13%
- C.
20%
- 25.An African American/ black woman who believes she should not swallow her saliva and carries a spit cup with her during pregnancy is most likely from:
- A.
Barbados
- B.
Haiti
- C.
West Indies
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