SAFE MATERNITY AND PEDIATRIC
NURSING CARE
3RD EDITION
• AUTHOR(S)LUANNE LINNARD-
PALMER; GLORIA HAILE COATS
TEST BANK
Ch. 1 — Roles in Maternal–Child and Pediatric Nursing
Stem: A charge RN on the postpartum unit assigns a newly
licensed nurse (NLN) three patients: a stable post-C/S with PCA,
a mother 2 hours postpartum complaining of increasing vaginal
bleeding and dizziness, and a healthy term newborn scheduled
for routine metabolic screening. The NLN expresses concern
about managing all three independently. Which action by the
charge RN best reflects safe delegation and team assignment?
A. Reassign the NLN to the healthy newborn and keep the two
higher-risk mothers for the charge RN.
B. Allow the NLN to care for all three but require that she call
the charge RN only if she has questions.
C. Pair the NLN with an experienced RN to co-manage the
,bleeding mother while assigning the NLN the C/S patient and
the newborn.
D. Ask the NLN to prioritize tasks and report back later about
how she plans to manage three patients.
Correct answer: C
Rationales
• Correct (C): Pairing the NLN with an experienced RN for
the mother with increasing bleeding provides direct
supervision for a potential high-risk event while allowing
the NLN to manage lower-acuity patients. This preserves
patient safety, respects scope of practice for the novice
nurse, and supports skill development.
• Incorrect (A): Keeping both higher-risk mothers on the
charge RN is inefficient and may lead to missed learning for
the NLN; it also concentrates risk on one clinician rather
than distributing care safely.
• Incorrect (B): Allowing the NLN to manage three patients
independently with only an instruction to call if needed
fails to provide the necessary supervision for a novice and
delays recognition of deterioration.
• Incorrect (D): Asking the NLN to plan without immediately
providing supervision places responsibility on the novice
and delays timely delegation adjustments for a potentially
unstable patient.
,Teaching point: Match patient acuity to nurse competency;
provide direct supervision for novice nurses.
Citation: Linnard-Palmer, L., & Coats, G. H. (2025). Safe
Maternity and Pediatric Nursing Care (3rd ed.). Ch. 1.
Ch. 1 — Legalities and Ethics
Stem: During labor, a client with a planned vaginal birth
suddenly requires an emergency cesarean for fetal bradycardia.
The birth plan states "no C-section unless life-threatening." The
client is anxious and asks the nurse to delay the surgery
because she prefers to avoid a C-section. What should the nurse
do first?
A. Honor the birth plan and delay action until the client
consents.
B. Explain that the birth plan is nonbinding in emergencies and
facilitate immediate consent and surgery.
C. Contact the ethics committee to review the birth plan before
proceeding.
D. Ask the client to sign a refusal form and document the delay.
Correct answer: B
Rationales
• Correct (B): In emergent situations where maternal or fetal
lives are at risk, the nurse must explain the clinical urgency,
obtain informed consent if possible, and facilitate timely
intervention. Birth plans are informational but do not
, supersede emergent clinical decision-making aimed at
preserving life.
• Incorrect (A): Delaying a necessary emergency procedure
to honor a nonbinding preference risks harm to mother
and fetus and is not ethically or legally appropriate.
• Incorrect (C): Contacting the ethics committee causes an
inappropriate delay in time-sensitive care; ethics
consultation is not a first-line action in immediate
emergencies.
• Incorrect (D): Asking for a signed refusal in the face of
imminent risk is unsafe and may not be legally valid if the
client lacks capacity or the delay endangers life.
Teaching point: Birth plans guide care but do not prevent
urgent, life-saving interventions.
Citation: Linnard-Palmer, L., & Coats, G. H. (2025). Safe
Maternity and Pediatric Nursing Care (3rd ed.). Ch. 1.
Ch. 1 — Informed Consent
Stem: A woman in active labor requests a regional epidural. Her
most recent labs show platelets of 65,000/µL. The
anesthesiologist tells the nurse that epidural placement is
contraindicated at this platelet level. The client insists she
already consented at admission and demands pain control.
What is the nurse's best action?
A. Administer the epidural since the client already consented
NURSING CARE
3RD EDITION
• AUTHOR(S)LUANNE LINNARD-
PALMER; GLORIA HAILE COATS
TEST BANK
Ch. 1 — Roles in Maternal–Child and Pediatric Nursing
Stem: A charge RN on the postpartum unit assigns a newly
licensed nurse (NLN) three patients: a stable post-C/S with PCA,
a mother 2 hours postpartum complaining of increasing vaginal
bleeding and dizziness, and a healthy term newborn scheduled
for routine metabolic screening. The NLN expresses concern
about managing all three independently. Which action by the
charge RN best reflects safe delegation and team assignment?
A. Reassign the NLN to the healthy newborn and keep the two
higher-risk mothers for the charge RN.
B. Allow the NLN to care for all three but require that she call
the charge RN only if she has questions.
C. Pair the NLN with an experienced RN to co-manage the
,bleeding mother while assigning the NLN the C/S patient and
the newborn.
D. Ask the NLN to prioritize tasks and report back later about
how she plans to manage three patients.
Correct answer: C
Rationales
• Correct (C): Pairing the NLN with an experienced RN for
the mother with increasing bleeding provides direct
supervision for a potential high-risk event while allowing
the NLN to manage lower-acuity patients. This preserves
patient safety, respects scope of practice for the novice
nurse, and supports skill development.
• Incorrect (A): Keeping both higher-risk mothers on the
charge RN is inefficient and may lead to missed learning for
the NLN; it also concentrates risk on one clinician rather
than distributing care safely.
• Incorrect (B): Allowing the NLN to manage three patients
independently with only an instruction to call if needed
fails to provide the necessary supervision for a novice and
delays recognition of deterioration.
• Incorrect (D): Asking the NLN to plan without immediately
providing supervision places responsibility on the novice
and delays timely delegation adjustments for a potentially
unstable patient.
,Teaching point: Match patient acuity to nurse competency;
provide direct supervision for novice nurses.
Citation: Linnard-Palmer, L., & Coats, G. H. (2025). Safe
Maternity and Pediatric Nursing Care (3rd ed.). Ch. 1.
Ch. 1 — Legalities and Ethics
Stem: During labor, a client with a planned vaginal birth
suddenly requires an emergency cesarean for fetal bradycardia.
The birth plan states "no C-section unless life-threatening." The
client is anxious and asks the nurse to delay the surgery
because she prefers to avoid a C-section. What should the nurse
do first?
A. Honor the birth plan and delay action until the client
consents.
B. Explain that the birth plan is nonbinding in emergencies and
facilitate immediate consent and surgery.
C. Contact the ethics committee to review the birth plan before
proceeding.
D. Ask the client to sign a refusal form and document the delay.
Correct answer: B
Rationales
• Correct (B): In emergent situations where maternal or fetal
lives are at risk, the nurse must explain the clinical urgency,
obtain informed consent if possible, and facilitate timely
intervention. Birth plans are informational but do not
, supersede emergent clinical decision-making aimed at
preserving life.
• Incorrect (A): Delaying a necessary emergency procedure
to honor a nonbinding preference risks harm to mother
and fetus and is not ethically or legally appropriate.
• Incorrect (C): Contacting the ethics committee causes an
inappropriate delay in time-sensitive care; ethics
consultation is not a first-line action in immediate
emergencies.
• Incorrect (D): Asking for a signed refusal in the face of
imminent risk is unsafe and may not be legally valid if the
client lacks capacity or the delay endangers life.
Teaching point: Birth plans guide care but do not prevent
urgent, life-saving interventions.
Citation: Linnard-Palmer, L., & Coats, G. H. (2025). Safe
Maternity and Pediatric Nursing Care (3rd ed.). Ch. 1.
Ch. 1 — Informed Consent
Stem: A woman in active labor requests a regional epidural. Her
most recent labs show platelets of 65,000/µL. The
anesthesiologist tells the nurse that epidural placement is
contraindicated at this platelet level. The client insists she
already consented at admission and demands pain control.
What is the nurse's best action?
A. Administer the epidural since the client already consented
