Deck 11: Perinatal Education

Question 1

A primipara client asks about possible support options for her during the labor process. She is apprehensive that her family members will not be prepared to assist her during this time. Which option would be most effective for this client?

A) Reassure the client that the labor and birth staff consists of highly trained nurses who are well educated to take care of laboring clients, so that should be sufficient.
B) Encourage the client to take prepared childbirth classes with her husband because that should provide the best support by a family member.
C) Provide information to the client about obtaining a doula during the labor process.
D) Tell the client that this is a normal feeling based on fear of the unknown and that it will subside once she starts the labor process.

Answer 1

Provide information to the client about obtaining a doula during the labor process.

Question 2

The support person for your labor client has been applying gentle massage to the client's upper back frequently over the past hour. Now, the labor client states that "it just isn't helping anymore." Both the support person and labor client are becoming frustrated with each other's inability to make things less stressful during the labor process. What would be the best nursing response at this time?

A) Have the client change position and tell the support person to take a break.
B) Discuss the effects of habituation and suggest alternate measures that could be used to relieve pain.
C) Advise the client that this may be the best time to ask for an epidural.
D) Tell the client and support person that she must be progressing further and you will do a vaginal exam to determine progress.

Answer 2

Discuss the effects of habituation and suggest alternate measures that could be used to relieve pain.

Question 3

The labor nurse is reviewing breathing techniques with a primipara admitted for induction of labor. When is the best time to encourage the laboring patient to use slow, deep chest breathing with contractions?

A) During labor, when she can no longer talk through contractions
B) During the first stage of labor, when the contractions are 3 to 4 minutes apart
C) Between contractions, during the transitional phase of the first stage of labor
D) Between her efforts to push to facilitate relaxation between contractions

Answer 3

During labor, when she can no longer talk through contractions

Question 4

The nurse is reviewing the option of childbirth classes with a patient in her second trimester. Which statement indicates to the nurse that the patient has understood the teaching?

A) "My labor will likely be shorter if I go to classes."
B) "I will likely perceive less pain during labor if I go to classes."
C) "I will likely be more satisfied with my labor if I go to classes."
D) "I will likely use fewer medications during labor if I go to classes."

Question 5

Which client could safely be cared for by a certified nurse-midwife?

A) Gravida 3, para 2, with no complications
B) Gravida 1, para 0, with mild hypertension
C) Gravida 2, para 1, with insulin-dependent diabetes
D) Gravida 1, para 0, with borderline pelvic measurements

Question 6

When reading a new client's birth plan, the nurse notices that the client will be bringing a doula to the hospital during labor. What does the nurse think that this means?

A) The client will have her grandmother as a support person.
B) The client will bring a paid, trained labor support person with her during labor.
C) The client will have a special video she will play during labor to assist with relaxation.
D) The client will have a bag that contains all the approved equipment that may help with the labor process.

Question 7

A client asks, "What can I do to help decrease the amount of pain with labor?" What should be the nurse's best response?

A) "Nothing. That is the way God intended it to be."
B) "We can give you medications to help with the pain."
C) "You should not worry about the pain; leave that concern up to the staff."
D) "By trying to relax, the contractions will be more efficient and the pain may be less."

Question 8

A pregnant client is anticipating a vaginal birth without complications. During the course of her labor, complications arise and the fetus has to be delivered via cesarean section. The client is visibly upset and wants to know why this has happened to her because she did everything right during her pregnancy. Which priority nursing diagnosis would apply?

A) Risk for injury
B) Pain
C) Impaired skin integrity
D) Anxiety

Question 9

What does a birth plan help the parents accomplish?

A) Avoidance of an episiotomy
B) Determining the outcome of the birth
C) Assuming complete control of the situation
D) Taking an active part in planning the birth experience

Question 10

Which statement is incorrect regarding prepared childbirth education?

A) No use of anesthetics or drugs is to be administered to clients so they can have a natural childbirth experience.
B) Clients can take refresher courses if they have delivered within the last 2 years.
C) Prepared childbirth classes may differ slightly based on the available resources of health care facilities.
D) Prepared childbirth classes are aimed at increasing awareness of the childbirth experience for parents and significant others to promote better control of pain and decrease anxiety.

Question 11

Which phrase best describes neuromuscular dissociation?

A) Loosening taut muscles when touched by another person
B) Contracting and consciously releasing different muscle groups
C) Relaxing while someone is applying pressure against a tendon or large muscle
D) Relaxing the rest of the body while one group of muscles is strongly contracted

Question 12

Which type of cutaneous stimulation involves massage of the abdomen?

A) Imagery
B) Effleurage
C) Mental stimulation
D) Thermal stimulation

Question 13

The birth educator is discussing the advantages and disadvantages of birthing options. Which disadvantage is common with epidural anesthesia?

A) Effective pushing is optimized.
B) The risk of catheterization is decreased.
C) The length of labor and birth may be decreased.
D) The use of forceps and oxytocin administration is increased.

Question 14

During the course of labor, a client has been having her labor coach rub her lower back to relieve pain. After 30 minutes, the client complains that this method is no longer working and becomes increasingly frustrated with the labor coach. The vaginal exam is 2 to 3 cm, 80% effaced, and -1 station, membranes intact. Which option would you recommend to decrease the client's perceived pain?

A) Have the labor coach change the touch location and begin gently massaging another area on the back.
B) Perform a vaginal exam to determine progress.
C) Have the labor coach step outside the room (LDR) and take a break because it is best to try and defuse the confrontation.
D) Suggest to the client that perhaps the use of a narcotic opioid will relieve her pain and facilitate the labor process.

Question 15

Which client is most likely to experience pain during labor?

A) Gravida 1 whose fetus is in a breech presentation
B) Gravida 3 who is using Lamaze breathing techniques
C) Gravida 2 who is anxious because her last labor was difficult
D) Gravida 2 who has not attended childbirth preparation classes

Question 16

Which technique would provide the best pain relief for a pregnant woman with an occiput posterior position?

A) Neuromuscular disassociation
B) Effleurage
C) Psychoprophylaxis
D) Sacral pressure

Question 17

Martha is a gravida 3, para 2, whose last child was born 5 years ago. She attended childbirth preparation classes with her first pregnancy. Which class would be most appropriate for her?

A) Refresher course
B) Infant care classes
C) Postpartum classes
D) Early pregnancy classes

Question 18

What is covered by early pregnancy classes offered in the first and second trimesters?

A) Methods of pain relief
B) The phases and stages of labor
C) Coping with common discomforts of pregnancy
D) Prebirth and postbirth care of a client having a cesarean birth

Question 19

Which is the method of childbirth that helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor?

A) Bradley
B) Lamaze
C) Leboyer
D) Dick-Read

Question 20

A relaxation technique that can be used during the childbirth experience to decrease maternal pain perception is:

A) using increased environmental stimulation as a method of distraction.
B) restricting family and friends from visiting during the labor period to keep the client focused on breathing techniques.
C) medicating the client frequently to reduce pain perception.
D) assisting the client in breathing methods aimed at taking control of pain perception based on the contraction pattern.

Question 21

The prenatal nurse educator is teaching couples the technique of using sacral pressure during labor. Which should be included in the teaching session? (Select all that apply.)

A) The technique can be combined with heat to the area.
B) A jiggling motion should be used while applying the pressure.
C) Tennis balls may be used to apply the pressure to the sacral area.
D) The pressure against the sacrum should be intermittent during the contraction.
E) The hand may be moved slowly or remain positioned directly over the sacrum.

Question 22

The nurse assesses a patient in active labor and determines that the fetus is in the left occiput posterior position. The patient indicates to the nurse that she does not want an epidural. Which is the best technique for the nurse to include in the patient's plan of care?

A) Effleurage
B) Sacral pressure
C) Progressive relaxation
D) Rapid, paced breathing

Question 23

Match each term with the correct definition.

Lamaze childbirth education

A)Includes the father as a support person and a coach
B)Psychoprophylaxis class that uses the mind to prevent pain
C)Classes focus on breathing to prevent the fear-tension-pain cycle

Question 24

Match each term with the correct definition.

Dick-Read childbirth education

A)Includes the father as a support person and a coach
B)Psychoprophylaxis class that uses the mind to prevent pain
C)Classes focus on breathing to prevent the fear-tension-pain cycle

Question 25

A couple asks the nurse to explain the use of breathing techniques during the labor process. Which should the nurse include in the response? (Select all that apply.)

A) Start to use the focused breathing as soon as labor begins.
B) The use of complex breathing patterns should start during early labor.
C) The breathing pattern chosen to use during labor should be practiced frequently.
D) Focused or controlled breathing techniques are considered just one of many coping strategies.
E) One helpful technique with breathing is to visualize oxygen entering on inhalation and tension leaving on exhalation.

Question 26

In a prenatal education class, the nurse is reviewing the importance of using relaxation techniques during labor. Which client statement will the nurse need to correct?

A) "We will practice relaxation techniques only in a quiet setting so I can focus."
B) "Relaxation is important during labor because it will help me conserve my energy."
C) "If I relax in between contractions, my baby will get more oxygen during labor."
D) "My partner and I will practice relaxation throughout the remainder of my pregnancy."

Question 27

Match each term with the correct definition.

Bradley childbirth education

A)Includes the father as a support person and a coach
B)Psychoprophylaxis class that uses the mind to prevent pain
C)Classes focus on breathing to prevent the fear-tension-pain cycle