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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A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has the condition. The couple tells the nurse that they are having a second baby. Because their daughter has PKU, they are certain that this baby will not be affecteWhich response by the nurse is the most accurate?
- A. Good planning. You need to take advantage of the odds that are in your favor.
- B. I think you'd better first check with your physician.
- C. You are both carriers; therefore, each baby has a 25% chance of being affected.
- D. The ultrasound indicates a boy, and boys are not affected by PKU.
Correct Answer: C
Rationale: Each child conceived by this couple has a one-in-four chance of being affected with the PKU disorder. This couple still has an increased likelihood of having a child with PKU; having one child already with PKU does not guarantee that they will not have another. These parents need to discuss their options with their physician. However, an opportune time has presented itself for the couple to receive correct teaching about inherited genetic risks. No correlation exists between gender and inheritance of the disorder, because PKU is an autosomal recessive disorder.
A couple asks the nurse about the procedure for surrogate parenting. Which correct responses should the nurse provide for this couple? (Select all that apply.)
- A. Donated embryos can be implanted into the surrogate mother.
- B. The surrogate mother needs to have carried one previous birth to term.
- C. You both need to be infertile to be eligible for surrogate parenting.
- D. Conception can take place outside the surrogate mother’s body and then implanted.
Correct Answer: A
Rationale: A. Donated embryos can be implanted into the surrogate mother: This is a common method in surrogate parenting where embryos from either the intended parents or donors are implanted into the surrogate mother's uterus.
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 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.
A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion?
- A. Contraction frequency every 3 min
- B. Contraction duration of 100 seconds
- C. Fetal heart rate with moderate variability
- D. Fetal heart rate of 118/min
Correct Answer: B
Rationale: Contractions lasting longer than 90 seconds (tachysystole) can lead to fetal distress by reducing uteroplacental blood flow. Oxytocin should be discontinued if contractions become excessive. Moderate variability and normal fetal heart rate do not indicate distress.