Question 1

The method of anesthesia in labor considered the safest for the fetus is the

Accepted Answer

D

Question 2

One of the greatest risks to the mother during administration of general anesthesia is

Accepted Answer

Aspiration of stomach contents is the greatest risk to the mother during administration of general anesthesia because it can lead to serious complications such as pneumonia, respiratory distress, and death. This risk is increased during pregnancy due to the increased pressure on the stomach from the growing uterus and the decreased tone of the lower esophageal sphincter. Measures such as fasting before surgery, use of medications to reduce stomach acid, and rapid sequence induction can help reduce the risk of aspiration.

Question 3

When providing labor support,the nurse knows that which fetal position might cause the laboring woman more back discomfort?

Accepted Answer

The left occiput posterior position is known to cause more back discomfort during labor as the baby's skull presses against the mother's lower back. This position may also stall labor progress and increase the likelihood of the need for interventions such as cesarean section. The other positions listed may also have their own challenges during labor but do not typically cause as much back discomfort as the left occiput posterior position.

Question 4

The nerve block used in labor that provides anesthesia to the lower vagina and perineum is called a(n)

Accepted Answer

The nerve block used in labor that provides anesthesia to the lower vagina and perineum is called a pudendal block. The other options listed provide anesthesia to different areas of the body, such as the epidural providing relief from contractions throughout the lower body, and the spinal block providing complete numbness from the waist down. A local block is a more general term for anesthesia injected into a specific area, which could include the perineum but is not specific to labor.

Question 5

The best time to teach nonpharmacologic pain control methods to an unprepared laboring woman is during which phase?

Accepted Answer

The latent phase of labor is the beginning phase and typically lasts the longest, providing an opportune time to teach nonpharmacologic pain control methods. During this phase, the woman is typically more alert and receptive to instruction, as the contractions are generally mild and irregular. Teaching pain control methods during this time allows the woman to practice and become comfortable using nonpharmacologic methods to manage pain early in labor.

Question 6

It is important for the nurse to develop a realistic birth plan with the pregnant woman.The nurse can explain that a major advantage of nonpharmacologic pain management is that

Accepted Answer

Nonpharmacologic pain management methods do not involve the use of drugs, which means that there are no side effects or risks to the fetus. This is an important consideration when developing a birth plan, as the health and safety of both the mother and the baby should always be a top priority. Other advantages of nonpharmacologic pain management methods include the woman remaining fully alert at all times and potentially experiencing a quicker labor, although complete pain relief may not always be possible.

Question 7

To improve placental blood flow immediately after the injection of an epidural anesthetic,the nurse should

Accepted Answer

Placing a wedge under the woman's right hip, also known as a left lateral tilt, is recommended to improve placental blood flow after epidural anesthesia. This position helps to decrease the pressure of the uterus on the vena cava and aorta, which leads to an improvement in blood flow to the placenta. Turning the woman to the right side and giving oxygen may also improve placental blood flow, but they are not the best choices in this situation. Decreasing the intravenous infusion rate is not recommended as it may decrease maternal blood pressure and decrease blood flow to the placenta.

Question 8

The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is

Accepted Answer

Maternal narcotic analgesia can cross the placenta and cause respiratory depression in the newborn. This is a potentially life-threatening side effect that the nurse must monitor for during newborn stabilization. Bradycardia and acrocyanosis are possible side effects of narcotic analgesia, but respiratory depression is the primary concern. Tachypnea may also occur as a compensatory mechanism in response to respiratory depression.

Question 9

Which woman will most likely have increased anxiety and tension during her labor?

Accepted Answer

Gravida 2 who delivered a stillborn baby last year is likely to have increased anxiety and tension during her labor due to the traumatic experience of a previous loss.

Question 10

The most important nursing intervention for the patient who has received an epidural narcotic is

Accepted Answer

Monitoring respiratory rate hourly is the most important nursing intervention for a patient who has received an epidural narcotic as these medications can cause respiratory depression. Close monitoring is required to detect any signs of respiratory distress and prevent complications. Administering analgesics as needed, monitoring blood pressure every 4 hours, and assessing the level of anesthesia are also important interventions, but monitoring respiratory rate is the most critical.

Question 11

A woman received 50 mcg of Fentanyl intravenously 1 hour before delivery.What drug should the nurse have readily available?

Accepted Answer

Fentanyl is a potent opioid analgesic that can cause respiratory depression in both the mother and the newborn. Therefore, the nurse should have naloxone, which is an opioid antagonist, readily available to reverse the effects of fentanyl if respiratory depression occurs. Promethazine, nalbuphine, and butorphanol are not directly related to the reversal of opioid effects and may be used for other purposes.

Question 12

Which method of pain management is safest for a gravida 3 para 2 admitted at 8 cm cervical dilation?

Accepted Answer

At 8 cm cervical dilation, it is too late for the safe administration of epidural anesthesia or spinal block. Narcotics can potentially cause respiratory depression in both the mother and the neonate, and should be reserved for cases where other methods of pain management are ineffective. Breathing and relaxation techniques can be safely used at any stage of labor and delivery, and can help the mother cope with the discomfort of labor without risking harm to herself or her baby.

Question 13

Excessive anxiety in labor heightens the woman's sensitivity to pain by increasing

Accepted Answer

Excessive anxiety in labor increases muscle tension, which can increase the sensitivity to pain. This tension can also lead to a longer and more difficult labor process.

Question 14

Which statement is true about the physiologic effects of pain in labor?

Accepted Answer

Pain during labor can cause the release of stress hormones (such as cortisol) which can cause decreased blood flow to the uterus and placenta, resulting in decreased oxygen supply to the fetus. This can potentially lead to fetal distress and compromise the outcome of labor.

Question 15

The most important nursing intervention after the injection of epidural anesthesia is monitoring

Accepted Answer

Monitoring maternal blood pressure is the most important nursing intervention after the injection of epidural anesthesia, as it can cause significant hypotension which can affect the fetal blood supply. Nurses should monitor the maternal blood pressure every 5-10 minutes for the first hour after the injection, and then every 15-30 minutes thereafter. Urinary output, contractions, and intravenous infusion rate are also important to monitor, but they are not the most critical after epidural anesthesia.

Question 16

In order to help patients manage discomfort and pain during labor,nurses should be aware that

Accepted Answer

The predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomen. Nurses should be aware of this type of pain to better assist patients in managing discomfort during this stage of labor.

Question 17

Childbirth preparation can be considered successful if the outcome is described as

Accepted Answer

Childbirth preparation is successful if the woman has practiced skills and techniques to cope with pain during labor.

Answer: D 
 Childbirth preparation can be considered successful if the woman is able to achieve her desired level of pain control using only nonpharmacologic methods. However, this option is not as comprehensive as option C, which focuses on a broader goal of preparing for labor and mastering pain management skills. Options A and B are not appropriate outcomes to measure success in childbirth preparation.

Question 18

The laboring woman who imagines her body opening to let the baby out is using a mental technique called

Accepted Answer

The woman is using imagery, which involves using mental images or visualizations to focus or distract the mind. She is using this technique to help cope with the pain and intensity of labor. Dissociation involves mentally detaching from the experience, Effleurage refers to light stroking movements used in massage, and Distraction involves focusing the mind on something else to reduce pain perception.

Question 19

The nurse caring for women in labor understands that childbirth pain is different from other types of pain in that it is

Accepted Answer

Childbirth pain is associated with a physiologic process, specifically the process of the uterus contracting and the cervix dilating during labor. This type of pain is different from other types of pain, which may be caused by injury or illness.

Question 20

When giving a narcotic to a laboring woman,the nurse should inject the medication at the beginning of a contraction so that

Accepted Answer

Injecting the medication at the beginning of a contraction reduces the amount of medication transferred to the fetus because uterine blood flow is reduced during contractions, limiting fetal exposure.

Quiz 18: Pain Management for Childbirth