Options Counseling Pre-Assessment

Welcome to the Options Counseling Module Assessment for Provide's Unintended Pregnancy Prevention and Care in Nursing Curriculum.
Please complete this Pre-Assessment before using the module. At the end of this survey, we will provide you with a link to the Post-Assessment, to fill out when you are done with the module.

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* 1. Institutions may contact Provide for a "site code" that allows them to access their own assessment results. If you have been given a site and student code, please enter them here; otherwise, please enter the name of your institution.

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* 2. Which best represents your current role?

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* 3. Which other modules in this Unintended Pregnancy Prevention and Care in Nursing Curriculum have you already completed?

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* 4. Factors contributing to unintended pregnancy come include: (Check all that apply)

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* 5. Approximately what percentage of pregnancies in America are unintended?

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* 6. What percentages of children born from unintended pregnancies are placed for adoption?

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* 7. Placing a child for adoption means you cannot see the child again.

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* 8. Which of the following health care procedures poses the least risk to a woman's health:
(Select all that apply)

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* 9. Can minors obtain contraceptive and abortion services without parental consent?

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* 10. A 19 year old is 9 weeks pregnant with an unintended pregnancy. What are her options? (Check all that apply)

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* 11. When working with patients to help them understand their options for any health care intervention, the most important points to remember are: 1) The patient has the answers 2) Any choice a patient makes is the right one for her/him.

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* 12. To what extent do you agree with the following statements?

  Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree
Nurses need to learn how to provide non-judgmental, non-directive counseling.
Nurses need to learn how to address and support patient’s ambivalence in decision-making
Nurses need to learn how to assure that the informed consent process includes accurate information about the potential benefits and risks of any health care intervention including abortion, adoption, or continuing the pregnancy.

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* 13. Approximately what percentages of pregnancies in America are unintended?

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* 14. To what extent do you agree with the following statements?

  Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree
When caring for a patient with an unintended pregnancy, I would be able to discuss all options (parenting, adoption, or abortion).
I feel clinically competent to provide options counseling.
I feel that I am knowledgeable about pregnancy related resources.
I feel that I could make a referral to community resources for prenatal services, abortion services or adoption services.
I feel that discussing all pregnancy options without judgment or bias is consistent with professional nursing practice.
If I could not discuss all pregnancy options without judgment or bias, I would ask a colleague to provide the care the woman is requesting.

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