Question 1

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

Accepted Answer

The gate control theory explains how pain impulses reach the brain for interpretation.It supports several nonpharmacological methods of pain control.According to this theory,pain is transmitted through small-diameter nerve fibers.However,the stimulation of large-diameter nerve fibers temporarily interferes with the conduction of impulses through small-diameter fibers.Techniques to stimulate large-diameter fibers and "close the gate" to painful impulses include massage,palm and fingertip pressure,and heat and cold applications.

Question 2

What typical types of classes are available to help expectant parents prepare for parenthood? (Select all that apply. )
A) Infant care
B) Breastfeeding
C) Gestational diabetes
D) Sources of financial aid
E) Yoga

Accepted Answer

Prenatal classes include such topics as infant care,breastfeeding,gestational diabetes,exercising,and sibling and grandparent preparation.Yoga and financial information are not traditional content for prenatal instruction.

Question 3

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.

Accepted Answer

Childbirth pain differs from other types of pain,because it is part of a normal,natural,and expected process,can be relieved by change of position,declines immediately following birth,and is self-limiting.Childbirth pain requires pharmacological management with narcotics in many cases.

Question 4

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? (Select all that apply. )
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.

Accepted Answer

Fentanyl has a rapid onset and short duration of action.Fentanyl,sufentanil,and alfentanil are not the same drugs.Fentanyl can cause respiratory depression but less than meperidine.It is not administered by mouth.

Question 5

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

Accepted Answer

Pelvic rock,tailor sitting,and shoulder curling are beneficial to the muscles that will have to adapt to the extra weight and changed posture of later pregnancy.Leg lifts and sit-ups are not beneficial,because they both increase intra-abdominal pressure.

Question 6

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.

Accepted Answer

The hypotension that accompanies an epidural block may cause inadequate perfusion of the placenta,leading to fetal hypoxia.

Question 7

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

Accepted Answer

Skin stimulation,diversion and distraction,and breathing techniques are the bases of nonpharmacological pain control.Although exercise and practices such as yoga and Pilates are beneficial,they are not means of pain control.

Question 8

What is the least amount of sensation that one perceives as pain?
A) Tolerance
B) Threshold
C) Level
D) Abatement

Accepted Answer

Pain threshold is the least amount of sensation that one perceives as pain.Thresholds are different for each individual.

Question 9

What breathing techniques 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 paced breathing
E) Patterned paced breathing

Accepted Answer

First-stage breathing includes the techniques of modified paced breathing and patterned paced breathing,which are types of abdominal breathing techniques.These patterns of breathing will help a woman in labor to focus and reduce pain perception.The fourth stage of labor is the woman's recovery stage and does not require a breathing technique.

Question 10

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? (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.

Accepted Answer

All the options mentioned are benefits of nonpharmacological pain control methods with the exception of sedating the mother.

Question 11

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

Accepted Answer

If the fetal occiput is in a posterior pelvic quadrant,each contraction pushes it against the mother's sacrum,resulting in persistent and poorly relieved back pain (back labor).Labor is often longer with this fetal position.

Question 12

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? (Select all that apply. )
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.

Accepted Answer

To prevent the risk for injury related to epidural anesthesia,the nurse should assess for movement,sensation,and leg strength before ambulating,ambulate cautiously with an assistant,assist the woman to change positions regularly,and observe for signs that birth may be near: increase in bloody show,perineal bulging,and/or crowning.

Question 13

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

Accepted Answer

Facial grimacing may be an indicator of unexpressed pain.

Quiz 7: Nursing Management of Pain During Labor and Birth

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

What typical types of classes are available to help expectant parents prepare for parenthood? (Select all that apply. )

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

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? (Select all that apply. )

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 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?

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

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

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

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? (Select all that apply. )

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?

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?