Nokea
Which condition would leuprolide acetate (Lupron) be prescribed for?
- A. Anovulatory cycles
- B. Uterine fibroids
- C. Polycystic ovary disease (PCOD)
- D. Luteal phase inadequacy
Correct Answer: B
Rationale: Leuprolide acetate is used to treat endometriosis and uterine fibroids, not anovulatory cycles or PCOD.
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Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?
- A. Moderate bright red lochial flow
- B. Breasts firm and tender
- C. Fundus below the symphysis and nonpalpable
- D. Episiotomy slightly red and puffy
Correct Answer: C
Rationale: By postpartum day 14, the fundus should be below the symphysis and nonpalpable, indicating normal involution.
Which statement regarding human trafficking is correct?
- A. Human trafficking is a multibillion-dollar business that primarily exists in the United States.
- B. Victims often experience the Stockholm syndrome.
- C. Vast majority of the victims are young boys and girls.
- D. Human trafficking primarily refers to commercial sex work.
Correct Answer: B
Rationale: The Stockholm syndrome is a common response where the victim develops feelings for their captor. Victims of trafficking can be forced into sex work, labor, or organ donation.
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.
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.
The National Quality Forum has issued a list of 'never events' specifically pertaining to maternal and child health. These include all of the following except:
- A. Infant discharged to the wrong person.
- B. Kernicterus associated with the failure to identify and treat hyperbilirubinemia.
- C. Artificial insemination with the wrong donor sperm or egg.
- D. Foreign object retained after surgery.
Correct Answer: D
Rationale: Although a foreign object retained after surgery is a never event, it does not specifically pertain to obstetric clients.