Nursing Elites

1. Kathryn would like to give birth in a medical facility that permits maternal control over labor and delivery, including choice of delivery positions, and allows the presence of family members and friends. Kathryn should consider giving birth at a __________.

• A. private home
• B. local hospital
• C. doula center
• D. freestanding birth center

Correct answer: D

Rationale: Kathryn should consider giving birth at a freestanding birth center. Freestanding birth centers provide a setting where women can have more control over their labor and delivery experience, including the choice of delivery positions, the presence of family members and friends, and involvement in decision-making throughout the process. These centers offer a more home-like environment compared to hospitals while still providing access to medical support if needed. Choices A (private home) and B (local hospital) do not necessarily guarantee the level of control and facilities Kathryn seeks. While a doula center (Choice C) can provide additional support during labor, it may not offer the same level of medical facilities and control over the birthing process as a freestanding birth center.

2. Dr. O'Connor wants 90-year-old Mr. Takashi to participate in a research study that involves moderate risks. Mr. Takashi is incapable of consenting. Which statement best expresses your advice regarding Mr. Takashi's participation in the study?

• A. He should not be allowed to participate in the study under any circumstances.
• B. He should be allowed to participate in the study regardless of the benefit.
• C. He should be allowed to participate in the study only if his participation will benefit others.
• D. He should be allowed to participate in the study only if it is likely to benefit him directly.

Correct answer: D

Rationale: Mr. Takashi should be allowed to participate in the study only if it is likely to benefit him directly. This decision aligns with the principle of beneficence in research ethics, which emphasizes maximizing benefits and minimizing risks for research participants. Since Mr. Takashi is incapable of giving consent, his participation should be based on the likelihood of direct benefits to him rather than solely for the benefit of others or solely for research purposes. Option A is too restrictive and does not consider potential benefits to Mr. Takashi. Option B is flawed as it disregards the need for the study to benefit Mr. Takashi. Option C focuses on benefiting others, which is not the primary consideration when the participant cannot give consent.

3. The effects of stress on the developing organism can be greatly reduced if the expectant mother __________.

• A. has access to social support during stressful periods
• B. takes a low dose of anti-anxiety medication
• C. takes a folic acid supplement early in pregnancy
• D. is placed on bed rest during the last trimester

Correct answer: A

Rationale: Having access to social support during stressful periods can greatly reduce the effects of stress on the developing organism. Social support can provide emotional comfort, practical assistance, and a sense of belonging, which can help the expectant mother cope with stress more effectively. This support system can also help mitigate the negative impact of stress on the developing baby during pregnancy. Choices B, C, and D are incorrect because while folic acid is important for prenatal health, it does not directly address the effects of stress. Taking anti-anxiety medication should be done under medical supervision and as a last resort due to potential risks to the developing baby. Bed rest during the last trimester is not a solution to reduce the effects of stress and may not address the underlying causes of stress.

4. Mounting evidence suggests that __________ is a major contributor to SIDS.

• A. impaired brain functioning
• B. higher-than-average birth weight
• C. organized and patterned sleep behavior
• D. a family history of chromosomal abnormalities

Correct answer: A

Rationale: Impaired brain functioning is a major contributor to Sudden Infant Death Syndrome (SIDS). Research has shown that abnormalities in the brainstem, which controls automatic functions like breathing and heart rate, can play a role in SIDS cases. As such, mounting evidence suggests that compromised brain functioning is a significant factor in the occurrence of SIDS. Choices B, C, and D are incorrect. Higher-than-average birth weight, organized and patterned sleep behavior, and a family history of chromosomal abnormalities are not identified as major contributors to SIDS according to the provided information.

5. A __________ is a means of building schemes in which an infant who has stumbled onto a new experience caused by his or her own motor activity tries to repeat the event again and again.

• A. sensorimotor reflex
• B. circular reaction
• C. mental representation
• D. goal-directed behavior

Correct answer: B

Rationale: A circular reaction is a process where an infant repeats a specific action to explore and learn about the environment through their own motor activity. This repetition helps the infant to understand the consequences of their actions and build cognitive schemes. Sensorimotor reflex (choice A) refers to automatic responses to stimuli, not a purposeful repetition of actions to learn. Mental representation (choice C) involves internal cognitive structures to represent objects or events in the mind, which is different from the repetitive behavior described in the question. Goal-directed behavior (choice D) is purposeful and intentional, unlike the repetitive nature of circular reactions in infants' learning process.

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