The student nurse caring for a 10-year-old child addresses the parents as mom and dad during the admission interview.
Which is the best response by the preceptor to the student nurse?
I prefer to use the parents' first names when addressing them.
You did an excellent job conducting your interview with the parents, and I have no critiques for you.
It is important to address the parents by Mr. and Mrs.
or how they prefer to be addressed rather than mom and dad.
It is okay to use mom and dad when addressing the parents as long as you know that they are the parents of the client.
The Correct Answer is C
Choice A rationale
Addressing parents by their first names without permission can be seen as overly familiar and unprofessional in many cultures. The nurse must maintain professional boundaries while showing respect. While some parents might prefer first names, the nurse should never assume this level of informality at the start of a clinical relationship. Establishing a professional tone during the admission interview helps set the stage for a relationship based on mutual respect and clear clinical roles.
Choice B rationale
Providing no critique is incorrect because using labels like mom and dad is considered a breach of professional etiquette. It depersonalizes the parents and reduces their identity solely to their relationship with the patient. Effective nursing education involves teaching students to recognize the individuality of family members. Failing to correct this behavior prevents the student from learning how to build a formal, respectful rapport with the families of pediatric patients in a healthcare setting.
Choice C rationale
Using formal titles like Mr. and Mrs. or asking for preferred names is the gold standard for professional communication. Addressing parents as mom and dad can be offensive to some and lacks professional decorum. It is scientifically important to recognize the parent as an individual partner in the child's care. Respecting their identity fosters a better therapeutic alliance, which is shown to improve health outcomes and parental satisfaction during the stressful period of a child's hospital admission.
Choice D rationale
Knowing the relationship between the adult and the child does not justify using informal titles like mom and dad. Professionalism requires the nurse to maintain a certain level of formality unless invited otherwise. Using parental labels can feel patronizing to the adults and may blur the lines of the professional relationship. The preceptor must guide the student to use language that acknowledges the parents' status as autonomous adults rather than just extensions of the pediatric patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A history of perineal laceration does not automatically necessitate an episiotomy. In many cases, the perineal tissue may have healed with scar tissue that is less flexible, but the goal of modern midwifery and obstetrics is to allow the tissue to stretch naturally or tear spontaneously, which often results in less severe injury than a surgical incision. Routine episiotomy is no longer recommended based on history alone, as it increases the risk of deep extensions.
Choice B rationale
The use of oxytocin for induction is not an indication for an episiotomy. Oxytocin serves to stimulate uterine contractions and manage the progress of labor, but it does not dictate the need for surgical enlargement of the vaginal opening. The decision to perform an episiotomy is based on the immediate needs of the fetus or the integrity of the perineum during the crowning process, rather than the pharmacological method used to initiate or maintain the labor contractions.
Choice C rationale
Shoulder dystocia is a true obstetric emergency where the fetal head is delivered but the anterior shoulder becomes impacted behind the maternal symphysis pubis. An episiotomy may be performed to provide more room for the provider to perform internal maneuvers, such as the Woods' screw or Rubin maneuver. While the episiotomy does not bony obstruction, it increases the space available for the clinician's hands to rotate the fetus and relieve the impaction quickly.
Choice D rationale
Having an episiotomy during a previous delivery is not a clinical indication for a repeat procedure. Evidence suggests that routine repeat episiotomies contribute to long-term pelvic floor dysfunction and increased incidence of third and fourth-degree tears. Each labor is managed based on the current presentation of the perineum. The current standard of care emphasizes perineal massage and controlled delivery of the head to minimize the need for surgical incisions regardless of previous obstetric history.
Correct Answer is C
Explanation
Choice A rationale
Marginal placenta previa occurs when the edge of the placenta is located within 2 centimeters of the internal cervical os but does not cover it. In this scenario, as the cervix dilates, the risk of bleeding increases, but a vaginal delivery might still be considered depending on the proximity and maternal-fetal status. This description does not match the patient in the question, whose placenta entirely covers the opening, representing a more significant obstruction and higher clinical risk.
Choice B rationale
Partial placenta previa is a condition where the placenta covers a portion of the internal cervical os but not the entire opening. While this also presents a high risk for significant hemorrhage during labor as the cervix effaces and dilates, it is distinct from a total or complete obstruction. The clinical management is similar to complete previa in that a cesarean section is almost always required, but the anatomical definition differs based on the extent of the cervical coverage.
Choice C rationale
Complete placenta previa, also known as total previa, occurs when the placenta entirely covers the internal cervical os. This prevents the possibility of a safe vaginal delivery because the placenta would be delivered before the fetus, leading to catastrophic maternal hemorrhage and fetal hypoxia. The classic presentation is sudden, painless, bright red bleeding in the third trimester as the lower uterine segment thins. This finding necessitates a planned cesarean delivery to ensure the safety of both mother and neonate.
Choice D rationale
Absent placenta previa is not a standard clinical term used to describe placental positioning. The term simply implies the absence of the condition, meaning the placenta is normally implanted in the upper segment of the uterus, away from the cervical opening. In a normal pregnancy, the placenta should be fundal or lateral. Identifying the absence of previa is important for confirming that a patient is a candidate for a trial of labor, but it does not describe the pathology presented. .
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