Deck 7: Nursing Management of Pain During Labor and Birth

Question 1

The initial nursing action immediately after the anesthesiologist administers epidural block for a laboring woman is to assess:

A) bladder for distention.
B) blood pressure.
C) sensation in the lower extremities.
D) intravenous fluid flow rate.

Answer 1

blood pressure.

Question 2

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 to be ineffective.
B) have no complications for the mother or infant.
C) result in respiratory depression to the newborn.
D) speed up labor and increase pain.

Answer 2

result in respiratory depression to the newborn.

Question 3

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.

Answer 3

sacral pressure.

Question 4

A woman who is 6 cm dilated has the urge to push.The nurse would instruct the woman to __________ 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 5

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 6

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

A) endorphins.
B) morphine.
C) codeine.
D) atropine.

Question 7

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

A) mild sedation throughout labor.
B) relaxation techniques.
C) skin stimulation.
D) deep massage.

Question 8

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

A) hydroxyzine (Vistaril).
B) phenobarbital.
C) naloxone (Narcan).
D) nitrous oxide.

Question 9

While teaching the childbirth preparation class,the nurse explains that the patient's expression of labor pain:

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

Question 10

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

A) hypertension.
B) anxiety.
C) anoxia.
D) hyperventilation.

Question 11

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 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) reduced fetal heart rate.
B) long, intense contractions.
C) sudden leg cramps.
D) bladder distention.

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 for several hours.

Question 14

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 15

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 the patient to pant.
C) engage the patient in conversation.
D) assist the patient to the knee-chest position.

Question 16

After the physician discussed general anesthesia with a woman in labor,the nurse determines that 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) intestinal obstruction.

Question 17

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 a contraindication to an epidural block is:

A) abnormal clotting.
B) previous cesarean delivery.
C) history of migraine headaches.
D) history of diabetes mellitus.

Question 18

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 mask.
D) notify the doctor.

Question 19

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

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

Question 20

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. "

Question 21

How does the pain of childbirth differ from other types of pain? Select all that apply.

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.

Question 22

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

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

Question 23

A sign to alert the nurse to the need of pain relief in an uncomplaining labor patient would be:

A) frequently asking for ice chips.
B) facial grimacing.
C) changing positions in bed.
D) covering her face with her hands.

Question 24

The nurse points out the major advantages of nonpharmacological pain control methods.What are they? Select all that apply.

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 25

What breathing technique(s)would the nurse teach the prenatal patient to help her focus during labor in order to reduce pain? Select all that apply.

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

Question 26

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

Question 27

When the patient who received an epidural block asks why her blood pressure is taken so often,the nurse's best response would be to explain that the frequent blood pressure assessments:

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

Question 28

The nurse defines the least amount of sensation that one perceives as pain as:

A) tolerance.
B) threshold.
C) level.
D) abatement.

Question 29

Which are nonpharmacological forms of pain relief? Select all that apply.

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

Question 30

The nurse reminds the expectant parent that which typical types of classes are available to help prepare for parenthood? Select all that apply.

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

Question 31

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