Nokea
With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?
- A. The nurse did not document fetal heart tones (FHR) during the second stage of labor.
- B. The patient was only provided ice chips during the labor period, which lasted 8 hours.
- C. The nurse allowed the patient to use the bathroom rather than a bedpan during the first stage of labor.
- D. The nurse asked family members to leave the room when she prepared to do a pelvic exam on the patient.
Correct Answer: A
Rationale: In an obstetric setting, failure to document fetal heart tones (FHR) during the second stage of labor is a critical breach of duty by the nurse. Monitoring FHR is essential to assess fetal well-being and detect any signs of distress or complications during labor. Neglecting to document this important vital sign could result in delayed recognition of fetal distress, potentially leading to adverse outcomes for the baby and the mother. Therefore, this intervention indicates negligence on the part of the nurse in this scenario.
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In evaluating the level of a pregnant woman's risk of having a low-birth-weight (LBW) infant, which factor is the most important for the nurse to consider?
- A. African-American race
- B. Cigarette smoking
- C. Poor nutritional status
- D. Limited maternal education
Correct Answer: A
Rationale: For African-American births, the incidence of LBW infants is twice that of Caucasian births. Race is a nonmodifiable risk factor. Cigarette smoking, poor nutrition, and limited education are modifiable risk factors.
During which phase of the cycle of violence does the batterer become contrite and remorseful?
- A. Battering
- B. Honeymoon
- C. Tension-building
- D. Increased drug taking
Correct Answer: B
Rationale: During the cycle of violence, the batterer displays contrition and remorse during the Honeymoon phase. This phase follows the Battering phase, characterized by the abusive behavior and violence, and precedes the Tension-building phase where stress and tension begin to escalate. The Honeymoon phase is marked by the abuser showing remorse, apologizing, and trying to make amends for their violent behavior. This phase often involves the abuser being extra charming, affectionate, and demonstrating efforts to reconcile with the victim. It is important to note that the Honeymoon phase is often temporary and is part of the cycle that may repeat unless intervention and support are sought.
Which statement is most accurate regarding the reporting of IPV in the United States?
- A. Asian women report more IPV than do other minority groups.
- B. Caucasian women report less IPV than do non-Caucasians.
- C. Native-American women report IPV at a rate similar to other groups.
- D. African-American women are less likely to report IPV than Caucasian women.
Correct Answer: B
Rationale: Caucasian women report less IPV than other ethnic groups. Asian women report significantly less IPV. Native-American and Alaska Native women report significantly more IPV.
The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called what?
- A. Bimanual palpation
- B. Rectovaginal palpation
- C. Papanicolaou (Pap) test
- D. Four As procedure
Correct Answer: C
Rationale: The Pap test is used to detect cancer and should be performed regularly depending on the client's age.
The nurse in labor and birth is caring for a Muslim patient during the active phase of labor. The nurse notes that the patient quickly draws away when touched. Which intervention should the nurse implement?
- A. Ask the charge nurse to reassign you to another patient.
- B. Assume that she does not like you and decrease your time with her.
- C. Continue to touch her as much as you need to while providing care.
- D. Limit touching to a minimum because physical contact may not be acceptable in her culture.
Correct Answer: D
Rationale: The appropriate intervention for the nurse to implement in this situation is to limit touching to a minimum because physical contact may not be acceptable in the patient's culture. In Islam, modesty and privacy are significant aspects of the faith, and physical contact, especially with someone of the opposite gender, may be considered inappropriate or uncomfortable for the patient. Respecting and acknowledging the patient's cultural background and preferences is essential in providing culturally competent care. Therefore, it is important for the nurse to be mindful of the patient's boundaries and minimize any unnecessary physical contact while still providing necessary care and support during labor.