A charge nurse is teaching a newly licensed nurse about substance use disorders during pregnancy.
Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Choice A rationale

Variable decelerations are typically caused by umbilical cord compression, which can occur in various obstetric scenarios but are not a specific expected finding for placenta previa. In placenta previa, the primary issue is placental implantation over or near the cervical os, leading to distinct clinical manifestations.

Choice B rationale

Painless vaginal bleeding is the hallmark clinical finding of placenta previa. This occurs because the placenta is implanted in the lower uterine segment, potentially covering the internal cervical os. As the cervix effaces or dilates, the placenta separates from the uterine wall, leading to bleeding without the associated pain of uterine contractions.

Choice C rationale

A rigid abdomen is a classic sign of abruptio placentae, where the placenta prematurely detaches from the uterine wall. This causes internal bleeding and uterine spasm, leading to a board-like, tender abdomen, which is distinct from the typical presentation of placenta previa.

Choice D rationale

Uterine tachysystole, characterized by excessive uterine contractions, is a common finding in conditions like abruptio placentae or during labor induction. It is not typically associated with placenta previa, where the primary concern is the placental position and the risk of hemorrhage rather than abnormal contraction patterns.

Choice A rationale

Relying solely on facial recognition of staff members is an insufficient and potentially dangerous security measure. Hospital staff members can change shifts, and imposters might attempt to abduct newborns. Robust security protocols, such as mandatory identification badges and alarm systems on infant security tags, are designed to prevent unauthorized individuals from leaving the unit with an infant, providing a more reliable defense against abduction.

Choice B rationale

The instruction to remove a newborn's microchip identification band after arriving home is inaccurate and potentially misleading. Hospitals typically use infant security tags or bands that are removed by staff upon discharge, not by the parents at home. These bands are crucial for preventing abductions within the facility by triggering alarms if an infant is taken beyond designated boundaries.

Choice C rationale

Personally carrying a newborn to the nursery, especially without supervision or adherence to facility protocols, increases the risk of abduction. Hospitals often require staff to transport infants in bassinets or cribs, typically with two staff members present, to minimize opportunities for unauthorized individuals to gain access to or abduct a newborn. This procedure enhances infant safety significantly.

Choice D rationale

Bringing the newborn in the bassinet into the bathroom with the mother maintains constant direct observation and reduces the risk of abduction. This strategy minimizes the time the infant is left unattended, preventing opportunities for an abductor to seize the child. Maintaining proximity and direct line of sight is a fundamental principle of infant security in a hospital environment.