MATERNITY AND PEDIATRIC NURSING
5TH EDITION
AUTHOR(S)SUSAN SCOTT RICCI; TERRI
KYLE; SUSAN CARMAN
TEST BANK
1)
Reference — Ch. 1 — Informed Consent
Question Stem — A 28-year-old woman in active labor with
mild intellectual disability tells the nurse she does not
understand why the obstetrician wants to place an epidural.
She says, “I don’t want it,” but appears confused when the
provider explains risks and benefits quickly. What is the nurse’s
best initial action?
Options
A. Accept her refusal and document that she lacks capacity.
B. Ask the provider to delay the decision and give a simple
explanation plus a support person to help decision-making.
C. Obtain written consent immediately since labor is
,progressing rapidly.
D. Contact child protective services because she cannot consent
for herself.
Correct Answer — B
Rationales — Correct: The nurse first assesses capacity and
supports informed decision-making by slowing the explanation,
using plain language, and involving a support person to help her
understand and express preferences. This promotes autonomy
while ensuring comprehension.
Incorrect A: Prematurely documenting lack of capacity without
an assessment and attempts to facilitate understanding
undermines autonomy.
Incorrect C: Forcing immediate written consent without
ensuring comprehension risks invalid consent.
Incorrect D: Contacting protective services is inappropriate
unless there is evidence of abuse or incapacity after thorough
assessment.
Teaching Point — Assess capacity and facilitate understanding
before concluding incapacity.
Citation — Ricci, S. S., Kyle, T., & Carman, S. (2024). Maternity
and Pediatric Nursing (5th Ed.). Ch. 1.
2)
Reference — Ch. 1 — Assent
Question Stem — A 15-year-old with cystic fibrosis is scheduled
for a clinical trial; her parents have signed consent, but she
,refuses participation. How should the nurse proceed?
Options
A. Enroll the adolescent because parental consent overrides her
refusal.
B. Respect her refusal and do not enroll her even though
parents consented.
C. Explain the study again, explore her concerns, and document
her refusal if it persists.
D. Ask the provider to coerce her into assent because
participation is beneficial.
Correct Answer — C
Rationales — Correct: The nurse should explore reasons for
refusal, provide age-appropriate information, and respect the
adolescent’s developing autonomy; if refusal persists,
document and communicate it because assent is ethically
important.
Incorrect A: Parental consent does not ethically—or often
legally—override a competent adolescent’s refusal to
participate in research.
Incorrect B: Immediate nonenrollment without attempting to
address concerns misses an opportunity for education and
shared decision-making.
Incorrect D: Coercion violates ethical standards and jeopardizes
voluntary assent.
Teaching Point — Obtain assent from minors; respect their
refusal after appropriate explanation.
, Citation — Ricci, S. S., Kyle, T., & Carman, S. (2024). Maternity
and Pediatric Nursing (5th Ed.). Ch. 1.
3)
Reference — Ch. 1 — Confidentiality
Question Stem — An 18-year-old pregnant adolescent tells the
nurse she tested positive for chlamydia and asks that this not be
shared with her parents. Which response is most appropriate?
Options
A. Tell her confidentiality is absolute and you will not inform
anyone.
B. Explain confidentiality limits, provide treatment options, and
encourage disclosure while maintaining privacy unless reporting
is required.
C. Notify her parents immediately because she is still a minor
for medical decisions.
D. Refuse her request and report her to school authorities.
Correct Answer — B
Rationales — Correct: The nurse should explain limits of
confidentiality, offer treatment and counseling, encourage
voluntary disclosure, and respect privacy; reporting is only
required if mandated by law (e.g., certain notifiable diseases).
Incorrect A: Confidentiality is not absolute; the nurse must
explain exceptions and public health reporting requirements.
Incorrect C: Many jurisdictions permit minors to consent to STI
treatment; automatic parental notification breaches
5TH EDITION
AUTHOR(S)SUSAN SCOTT RICCI; TERRI
KYLE; SUSAN CARMAN
TEST BANK
1)
Reference — Ch. 1 — Informed Consent
Question Stem — A 28-year-old woman in active labor with
mild intellectual disability tells the nurse she does not
understand why the obstetrician wants to place an epidural.
She says, “I don’t want it,” but appears confused when the
provider explains risks and benefits quickly. What is the nurse’s
best initial action?
Options
A. Accept her refusal and document that she lacks capacity.
B. Ask the provider to delay the decision and give a simple
explanation plus a support person to help decision-making.
C. Obtain written consent immediately since labor is
,progressing rapidly.
D. Contact child protective services because she cannot consent
for herself.
Correct Answer — B
Rationales — Correct: The nurse first assesses capacity and
supports informed decision-making by slowing the explanation,
using plain language, and involving a support person to help her
understand and express preferences. This promotes autonomy
while ensuring comprehension.
Incorrect A: Prematurely documenting lack of capacity without
an assessment and attempts to facilitate understanding
undermines autonomy.
Incorrect C: Forcing immediate written consent without
ensuring comprehension risks invalid consent.
Incorrect D: Contacting protective services is inappropriate
unless there is evidence of abuse or incapacity after thorough
assessment.
Teaching Point — Assess capacity and facilitate understanding
before concluding incapacity.
Citation — Ricci, S. S., Kyle, T., & Carman, S. (2024). Maternity
and Pediatric Nursing (5th Ed.). Ch. 1.
2)
Reference — Ch. 1 — Assent
Question Stem — A 15-year-old with cystic fibrosis is scheduled
for a clinical trial; her parents have signed consent, but she
,refuses participation. How should the nurse proceed?
Options
A. Enroll the adolescent because parental consent overrides her
refusal.
B. Respect her refusal and do not enroll her even though
parents consented.
C. Explain the study again, explore her concerns, and document
her refusal if it persists.
D. Ask the provider to coerce her into assent because
participation is beneficial.
Correct Answer — C
Rationales — Correct: The nurse should explore reasons for
refusal, provide age-appropriate information, and respect the
adolescent’s developing autonomy; if refusal persists,
document and communicate it because assent is ethically
important.
Incorrect A: Parental consent does not ethically—or often
legally—override a competent adolescent’s refusal to
participate in research.
Incorrect B: Immediate nonenrollment without attempting to
address concerns misses an opportunity for education and
shared decision-making.
Incorrect D: Coercion violates ethical standards and jeopardizes
voluntary assent.
Teaching Point — Obtain assent from minors; respect their
refusal after appropriate explanation.
, Citation — Ricci, S. S., Kyle, T., & Carman, S. (2024). Maternity
and Pediatric Nursing (5th Ed.). Ch. 1.
3)
Reference — Ch. 1 — Confidentiality
Question Stem — An 18-year-old pregnant adolescent tells the
nurse she tested positive for chlamydia and asks that this not be
shared with her parents. Which response is most appropriate?
Options
A. Tell her confidentiality is absolute and you will not inform
anyone.
B. Explain confidentiality limits, provide treatment options, and
encourage disclosure while maintaining privacy unless reporting
is required.
C. Notify her parents immediately because she is still a minor
for medical decisions.
D. Refuse her request and report her to school authorities.
Correct Answer — B
Rationales — Correct: The nurse should explain limits of
confidentiality, offer treatment and counseling, encourage
voluntary disclosure, and respect privacy; reporting is only
required if mandated by law (e.g., certain notifiable diseases).
Incorrect A: Confidentiality is not absolute; the nurse must
explain exceptions and public health reporting requirements.
Incorrect C: Many jurisdictions permit minors to consent to STI
treatment; automatic parental notification breaches
