Deck 7: Nursing Management of Pain During Labor and Birth

Question 1

A nurse is teaching a childbirth preparation class.The group is discussing individual expression of labor pain.What statement is accurate about a patient's expression of pain?

A) It reduces the patient's perception of pain.
B) It is intensified by the vertex position of the fetus.
C) It is influenced by culture.
D) It can be completely controlled by nonpharmacological techniques.

Answer 1

It is influenced by culture.

Question 2

The nurse is instructing a Lamaze class on abdominal breathing and tells a patient that her baseline respiratory rate is 22 breaths per minute.What should be the patient's rate while performing slow breathing?

A) 9
B) 11
C) 15
D) 20

Answer 2

11

Question 3

A woman in the transition phase of labor requests a narcotic analgesic medication for pain relief.What should the nurse explain regarding giving a narcotic analgesic medication at this stage of labor?

A) It can cause medication given at later stages to be ineffective.
B) It will have no complications for the mother or infant.
C) It may result in respiratory depression to the newborn.
D) It will speed up labor and increase pain.

Answer 3

It may result in respiratory depression to the newborn.

Question 4

The nurse is preparing a teaching plan for a woman receiving a subarachnoid block before delivery.What nursing action will be included in this plan to prevent the associated side effect of this type of anesthesia?

A) Restrict oral fluids.
B) Keep legs flexed.
C) Walk with assistance as soon as possible.
D) Lie flat for several hours.

Question 5

A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back.What is this technique?

A) Sacral pressure
B) Distraction
C) Effleurage
D) Conscious relaxation

Question 6

The nurse who encourages the gate control theory of pain control would advise a woman in labor and her partner to use which nonpharmacological method of pain management?

A) Slow abdominal breathing
B) Guided relaxation
C) Listening to music
D) Massage

Question 7

What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman?

A) Bladder for distention
B) Blood pressure
C) Sensation in the lower extremities
D) Intravenous fluid flow rate

Question 8

A woman in labor will receive general anesthesia prior to cesarean section.The nurse reminds the patient that food and fluids need to be restricted for several hours prior to delivery.What will this prevent?

A) Nausea and vomiting
B) Vomiting and aspiration
C) Abdominal cramping
D) Intestinal obstruction

Question 9

What would the nurse guide a labor coach to do to comfort a woman tensing her muscles with contractions?

A) Offer warm liquids to the patient.
B) Encourage the patient to pant.
C) Engage the patient in conversation.
D) Assist the patient to the knee-chest position.

Question 10

What is the most appropriate nursing action to take when a laboring woman hyperventilates?

A) Help her breathe into her cupped hands.
B) Place her flat on her back.
C) Initiate oxygen at 2 liters via mask.
D) Notify the doctor.

Question 11

A woman in labor has had an epidural block for pain relief.The nurse will be assessing carefully for what associated side effect of this type of regional anesthesia?

A) Reduced fetal heart rate
B) Long, intense contractions
C) Sudden leg cramps
D) Bladder distention

Question 12

A woman who is 6 cm dilated has the urge to push.What will the nurse instruct the woman to do during the contraction?

A) Use slow-paced breathing.
B) Hold her breath and push.
C) Blow in short breaths.
D) Use rapid-paced breathing.

Question 13

Several hours into labor,a woman complains of dizziness,numbness,and tingling of her hands and mouth.What does the nurse recognize these symptoms signify?

A) Hypertension
B) Anxiety
C) Anoxia
D) Hyperventilation

Question 14

Which narcotic antagonist is used to reverse narcotic-induced respiratory depression?

A) Hydroxyzine (Vistaril)
B) Phenobarbital
C) Naloxone (Narcan)
D) Nitrous oxide

Question 15

An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart.She received little prenatal care and had no childbirth preparation.She is crying loudly and shouting,"Please give me something for the pain.I can't take the pain!" What is the priority nursing diagnosis?

A) Pain related to uterine contractions
B) Knowledge deficit related to the birth experience
C) Ineffective coping related to inadequate preparation for labor
D) Risk for injury related to lack of prenatal care

Question 16

When a pregnant woman arrives at the labor suite,she tells the nurse that she wants to have an epidural for delivery.What is a contraindication to an epidural block?

A) Abnormal clotting
B) Previous cesarean delivery
C) History of migraine headaches
D) History of diabetes mellitus

Question 17

A woman requests a pudendal block to manage her labor pain.What statement by the woman indicates a need for further explanation about the pudendal block?

A) "I'm having a contraction. Can I get the pudendal block now?"
B) "I'll get the pudendal block right before I deliver."
C) "The nurse midwife will insert the needles into my vagina."
D) "It takes a few minutes after the medicine is administered to make me feel numb."

Question 18

What chemical substance(s)produced in the body acts as a natural pain reliever?

A) Endorphins
B) Morphine
C) Codeine
D) Atropine

Question 19

What is the Dick-Read method of childbirth preparation based on?

A) Mild sedation throughout labor
B) Relaxation techniques
C) Skin stimulation
D) Deep massage

Question 20

The nurse coaches the primigravida not to bear down until the cervix is completely dilated.What may premature bearing down cause?

A) Increased use of oxygen
B) Cervical laceration
C) Uterine rupture
D) Compression of the cord

Question 21

The ______________ ___________,also called the psychoprophylactic method,is the basis of most childbirth preparation classes in the United States.

Question 22

A patient who received an epidural block asks why her blood pressure is taken so often.What is the nurse's best response to explain the frequent blood pressure assessments?

A) They ensure that unsafe levels of hypertension do not occur.
B) They help assess for the need for further pain relief.
C) They monitor the progress of labor.
D) They ensure adequate placental perfusion.

Question 23

Which position(s)and exercise(s)will the nurse teach as beneficial in combating discomfort in the later stages of pregnancy?

A) Leg lifts
B) Pelvic rock
C) Tailor sitting
D) Sit-ups
E) Shoulder curling

Question 24

The nurse is caring for a laboring patient who is not reporting pain.What sign would alert the nurse of the need for pain relief?

A) Frequently asking for ice chips
B) Facial grimacing
C) Changing positions in bed
D) Covering her face with her hands

Question 25

The nurse is caring for a woman with epidural anesthesia for pain control during a vaginal delivery.A risk for injury related to epidural anesthesia has been identified by the nursing staff.What interventions are appropriate for the nurse to implement related to this diagnosis?

A) Assess leg movement and sensation before ambulating.
B) Administer antibiotic as ordered.
C) Observe for signs of impending birth.
D) Provide sacral pressure as needed.
E) Assess fetal position frequently.

Question 26

What breathing techniques would the nurse teach the prenatal patient to help her focus during labor in order to reduce pain?

A) First stage breathing
B) Abdominal breathing
C) Fourth stage breathing
D) Modified pace breathing
E) Patterned paced breathing

Question 27

The amount of pain a person is willing to endure is referred to as ______________ ______________.

Question 28

What is the least amount of sensation that one perceives as pain?

A) Tolerance
B) Threshold
C) Level
D) Abatement

Question 29

When caring for the laboring patient,the nurse determines that the fetus is located in the right occiput posterior (ROA).What will the nurse anticipate?

A) Urinary retention
B) Severe lower back pain
C) A shorter labor process
D) Nausea

Question 30

Which are nonpharmacological forms of pain relief?

A) Skin stimulation
B) Diversion and distraction
C) Breathing techniques
D) Exercise
E) Yoga

Question 31

What typical types of classes are available to help expectant parents prepare for parenthood?

A) Infant care
B) Breastfeeding
C) Gestational diabetes
D) Sources of financial aid
E) Yoga

Question 32

A laboring patient requests hot and cold applications be applied to her abdomen for pain control.How will this intervention act to control pain?

A) By increasing endorphin production
B) By facilitating effacement and dilation
C) By producing increasing pain tolerance
D) By stimulation of large nerve fibers

Question 33

The physician has ordered Fentanyl (Sublimaze)for a woman in labor and has asked the nurse to provide patient education.What will the nurse include in the educational plan?

A) Onset is slow.
B) Duration is short.
C) Administration is by mouth.
D) No known side effects.
E) It is not the same drug as sufentanil.

Question 34

The massage technique that stimulates the large-diameter fibers in order to block impulses from the small-diameter fibers is ____________________.

Question 35

The nurse is providing a conference on nonpharmacological pain control methods.What major advantages of nonpharmacological pain control methods will the nurse include in the presentation?

A) They sedate the mother.
B) They do not slow labor.
C) They do not dull the excitement of the birth experience.
D) They do not have the potential to cause allergic reactions.
E) They do not have to be delayed until labor is well established.

Question 36

How does the pain of childbirth differ from other types of pain?

A) Childbirth pain is part of a normal process.
B) Childbirth pain seldom needs narcotic relief.
C) Position changes relieve pain and facilitate delivery.
D) Childbirth pain declines following birth.
E) Childbirth pain is self-limited.