Deck 7: Nursing Management of Pain During Labor and Birth

Question 1

A woman in the transition phase of labor requests a narcotic analgesic medication for pain relief. The nurse explains that giving a narcotic analgesic medication at this stage of labor will:

A) Cause medication given at later stages ineffective
B) Have no complications for the mother or baby
C) Result in respiratory depression to the newborn
D) Speed up labor and increase pain

Answer 1

Result in respiratory depression to the newborn

Question 2

The nurse who is instructing a Lamaze class on abdominal breathing tells a patient that because her baseline respiratory rate is 22, her rate while performing slow breathing should be no lower than:

A) 9
B) 10
C) 15
D) 20

Answer 2

10

Question 3

A woman requests a pudendal block to manage her labor pain. The nurse realizes that the woman needs further explanation about the pudendal block when she says:

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."

Answer 3

"I'm having a contraction. Can I get the pudendal block now?"

Question 4

While teaching the child birth preparation class, the nurse explains to the class that labor pains:

A) Lower a woman's tolerance for pain
B) Are intensified by the vertex position of the fetus
C) Are influenced by cultural factions
D) Can be completely controlled by nonpharmacological techniques

Question 5

Chemical substances produced in the body that act as natural pain relievers are:

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

Question 6

The nurse explains that the Dick-Read method of childbirth preparation is based on:

A) Mild sedation throughout labor
B) Relaxation techniques
C) Slow abdominal breathing
D) Deep massage

Question 7

An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart. She received little prenatal care. She 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 8

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 9

A narcotic antagonist used to reverse narcotic-induced respiratory depression is:

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

Question 10

The nurse coaches the primigravida not to bear down until the cervix is completely dilated because premature bearing down can cause:

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

Question 11

Several hours into labor, a woman complains of blurred vision, numbness, and tingling of her hands and mouth. The nurse recognizes these as symptoms of:

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

Question 12

A woman in labor has had an epidural block for pain relief. The nurse will be assessing carefully for the associated side effect of:

A) Drop in fetal heart rate
B) Long, intense contractions
C) Sudden leg cramps
D) Marked hypotension

Question 13

A woman received a subarachnoid block before delivery. In order to prevent the associated side effect of this type of anesthesia, the nurse would include in the teaching plan that the patient should:

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

Question 14

The initial nursing action immediately after an epidural block is initiated for a laboring woman would be to:

A) Palpate the bladder for distention
B) Measure the woman's blood pressure
C) Assess sensation in the lower extremities
D) Decrease intravenous fluid flow rate

Question 15

When a pregnant woman arrives at the labor suite, she tells the nurse that she wants to have an epidural for delivery. The nurse is aware that the factor that would be a contraindication to an epidural block is:

A) A low platelet count
B) Previous cesarean delivery
C) A history of migraine headaches
D) A history of diabetes mellitus

Question 16

After the physician discussed general anesthesia with a woman in labor, the nurse determines the woman understood the explanation when she says food and fluids are restricted for several hours prior to delivery to prevent:

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

Question 17

A nurse instructs a woman's labor coach to comfort her by firmly pressing on her lower back. This technique is called:

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

Question 18

A woman who is 6 cm dilated has the urge to push. The nurse would instruct the woman to:

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

Question 19

To comfort a woman who is tensing her muscles with contractions, the nurse would guide the labor coach to:

A) Offer warm liquids to the patient
B) Encourage patient to pant
C) Engage the patient in conversation
D) Direct the patient in progressive relaxation

Question 20

The appropriate nursing action to take when a laboring woman hyperventilates is to:

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

Question 21

The nurse clarified that the amount of pain a person is willing to endure is referred to as _____ ______________.

Question 22

The nurse encourages the women in the childbirth preparation class to practice various positions and exercises that will be beneficial in combating discomfort in the later stages of pregnancy. Those exercises are: Select all that apply.

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

Question 23

The nurse points out that the major advantages of nonpharmacological pain control methods are that they do not: Select all that apply.

A) Sedate the mother
B) Slow labor
C) Dull the excitement of the birth experience
D) Have allergy potential
E) Have to be delayed until labor is well established
F) None of the above

Question 24

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

Question 25

The nurse discussing nonpharmacological forms of pain relief will focus on methods of: Select all that apply.

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