Pain Management During Childbirth

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Maternity and Women’s Health Care Today
Social, Ethical, and Legal Issues
Reproductive Anatomy and Physiology
Hereditary and Environmental Influences on Childbearing
Conception and Prenatal Development
Maternal Adaptations to Pregnancy
Antepartum Assessment, Care, and Education
Nutrition for Childbearing
Assessing the Fetus
Complications of Pregnancy
The Childbearing Family with Special Needs
Processes of Birth
Pain Management During Childbirth
Intrapartum Fetal Surveillance
Nursing Care During Labor and Birth
Intrapartum Complications
Postpartum Adaptations and Nursing Care
Postpartum Maternal Complications
Normal Newborn: Processes of Adaptation
Assessment of the Normal Newborn
Care of the Normal Newborn
Infant Feeding
High-Risk Newborn: Complications Associated with Gestational Age and Development
High-Risk Newborn: Acquired and Congenital Conditions
Family Planning
Infertility
Women’s Health

All Questions

Question 1

Free

Multiple Choice

Childbirth preparation can be considered successful if which of the following outcomes is achieved?

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Labor was pain-free.

The birth experiences of friends and families were ignored.

Only nonpharmacologic methods for pain control were used.

The patient rehearsed labor and practiced skills to master pain.

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Question 2

Free

Multiple Choice

A woman with a known heroin habit is admitted in early labor. Which drug is contraindicated with opiate-dependent patients?

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Nalbuphine (Nubain)

Hydroxyzine (Vistaril)

Promethazine (Phenergan)

Diphenhydramine (Benadryl)

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Question 3

Free

Multiple Choice

A patient is admitted to the labor and birth room in active labor; contractions are 4 to 5 minutes apart and last for 30 seconds. The nurse needs to perform a detailed assessment. When is the best time to ask questions or perform procedures?

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After the contraction is over

When it is all right with the coach

During the increment of the next contraction

After administration of analgesic-anesthetic

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Question 4

Free

Multiple Choice

Childbirth pain is different from other types of pain in that it is

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less intense.

associated with a physiologic process.

more responsive to pharmacologic management.

designed to make one withdraw from the stimulus.

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Question 5

Free

Multiple Choice

Excessive anxiety during labor heightens the patient's sensitivity to pain by increasing

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muscle tension.

the pain threshold.

blood flow to the uterus.

rest time between contractions.

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Question 6

Multiple Choice

Which fetal position may cause the laboring patient increased back discomfort?

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Left occiput anterior

Left occiput posterior

Right occiput anterior

Right occiput transverse

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Question 7

Multiple Choice

A major advantage of nonpharmacologic pain management is

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a more rapid labor is likely.

more complete pain relief is possible.

the woman remains fully alert at all times.

there are no side effects or risks to the fetus.

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Question 8

Multiple Choice

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

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Latent phase

Active phase

Second stage

Transition phase

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Question 9

Multiple Choice

The primary side effect of maternal narcotic analgesia in the newborn is

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tachypnea.

bradycardia.

acrocyanosis.

respiratory depression.

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Question 10

Multiple Choice

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

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local.

epidural.

pudendal.

spinal block.

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Question 11

Multiple Choice

The nurse is teaching a childbirth education class. Which information regarding excessive pain in labor should the nurse include in the session?

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It usually results in a more rapid labor.

It has no effect on the outcome of labor.

It is considered to be a normal occurrence.

It may result in decreased placental perfusion.

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Question 12

Multiple Choice

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

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Gravida 2 who refused any medication

Gravida 2 who delivered a stillborn baby last year

Gravida 1 who did not attend prepared childbirth classes

Gravida 3 who has two children younger than 3 years

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Question 13

Multiple Choice

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

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Narcotics

Spinal block

Epidural anesthesia

Breathing and relaxation techniques

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Question 14

Multiple Choice

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

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imagery.

effleurage.

distraction.

dissociation.

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Question 15

Multiple Choice

When administering a narcotic to a laboring patient, which statement explains why the nurse should inject the medication at the beginning of a contraction?

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The medication will be rapidly circulated.

Less medication will be transferred to the fetus.

The maternal vital signs will not be adversely affected.

Full benefit of the medication is received during that contraction.

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Question 16

Multiple Choice

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

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epidural block.

pudendal block.

local infiltration.

spinal (subarachnoid) block.

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Question 17

Multiple Choice

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

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give the woman oxygen.

turn the woman to the right side.

decrease the intravenous infusion rate.

place a wedge under the woman's right hip.

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Question 18

Multiple Choice

Which physiologic effect may occur in the presence of increased maternal pain perception during labor?

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Increase in uterine contractions in response to catecholamine secretion

Decrease in blood pressure in response to alpha receptors

Decreased perfusion to the placenta in response to catecholamine secretion

Increased uterine blood flow, causing increase in maternal blood pressure

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Question 19

Multiple Choice

Which of the following factors would affect pain perception or tolerance for the laboring patient?

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Right occiput posterior fetal position during labor

Bishop score of 10 prior to the induction of labor

Gynecoid pelvis

Absence of Ferguson's reflex

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Question 20

Multiple Choice

A patient in labor is approaching the transition stage and already has an epidural in place. An additional dose of medication has been prescribed and administered to the patient. Which priority intervention should be performed in order to evaluate the clinical response to treatment?

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Obtain a pain scale response from the patient based on a 0 to 10 scale.

Document maternal blood pressure and fetal heart rates following medication administration and observe for any variations.

Document intake and output on the electronic health record (EHR).

Increase the flow rate of prescribed parenteral fluid to maintain hydration.

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