Pharmacological Methods of Pain Relief Sherpath
Exam Questions and Answers
A patient has received fentanyl, and her respiratory status is rapidly declining. Which medication
would the nurse anticipate administering to counteract the effects of this drug?
Naloxone
Naloxone counteracts opioid-induced respiratory depression.
A woman is administered fentanyl during labor and is still experiencing significant pain. Which
prescription from the health care provider would the nurse anticipate for administration?
Nitrous oxide
The nurse anticipates a prescription for nitrous oxide, which can be administered to a woman who is
still experiencing pain after the administration of fentanyl.
During an emergency delivery, which maternal adverse effects would a nurse monitor in a patient
undergoing general anesthesia?
Uterine relaxation
-The nurse should monitor for uterine relaxation, which is an adverse effect of general anesthesia.
Respiratory depression
-The nurse should monitor for respiratory depression, which is an adverse effect of general anesthesia
Maternal aspiration of gastric contents
-The nurse should monitor for maternal aspiration of gastric contents, which is an adverse effect of
general anesthesia
The nurse would question a prescription for spinal anesthesia for a woman with which condition?
Infection at the site of insertion
-Contraindications and precautions include the woman's refusal, coagulation defects, uncorrected
hypovolemia, infection in the area of insertion, systemic infection, allergy, and possibly prior spinal
surgery.
A patient arrives at the labor and delivery unit with steady contractions and is 5 cm dilated. On
assessment, the fetal heart rate is 200 beats/min, and it is determined that a cesarean delivery should
be performed. Which anesthesia method does the nurse anticipate?
Subarachnoid (spinal) block
-The nurse would anticipate a subarachnoid block (SAB), because it is recommended when a quick
cesarean birth is necessary and an epidural catheter is not in place.
A nurse is caring for a patient undergoing an episiotomy repair after birth. Which types of anesthesia
does the nurse anticipate?
Pudendal anesthesia
-The nurse would anticipate pudendal anesthesia for episiotomy repair. Pudendal blocks anesthetize
the lower vagina and part of the perineum.
Local infiltration anesthesia
, -The nurse would anticipate local infiltration, which is routinely used for episiotomy repair. Local
infiltration anesthesia numbs the immediate area of the episiotomy or laceration.
A nurse is caring for a patient in the first stage of labor who received a combined spinal-epidural (CSE)
block with opioid analgesics for pain relief from uterine contractions. The nurse observes for which
common side effects of these drugs?
Nausea
Nausea is a common side effect of intrathecal opioid analgesics. Nalbuphine is one drug that can
counteract nausea from intrathecal opioid administration.
Pruritus
Pruritus is a common side effect of intrathecal opioid analgesics as a result of the release of
histamine. Antihistamines, such as nalbuphine, can counteract pruritus from intrathecal
administration.
Vomiting
Vomiting is a common side effect of intrathecal opioid analgesics. Nalbuphine is one drug that can
counteract nausea from intrathecal opioid administration and will also decrease the incidence of
vomiting.
A nurse is managing the administration of nitrous oxide for a patient in labor. The nurse observes for
which common side effects of nitrous oxide?
Nausea
Nausea is a common side effect of nitrous oxide. Vomiting may also be present with the
administration of nitrous oxide. Nitrous oxide is administered by the labor and delivery nurse, and
side effects should be reported to the health care provider or midwife who prescribed the
medication.
Dizziness
Dizziness is a common side of nitrous oxide. Nitrous oxide is a gas that is inhaled and does not take
away contraction pain but rather helps reduce anxiety and increases a feeling of well-being so that
the labor pain is easier to deal with.
Dysphoria
Dysphoria is a common side effect of nitrous oxide. Because nitrous oxide is an inhalant, it creates a
feeling of dysphoria and reduces anxiety so that labor pain is easier to deal with.
Which prescription would the nurse expect to administer to a patient at high risk for maternal
hypotension before epidural anesthesia?
Intravenous fluids
The nurse would anticipate intravenous fluids, which should be administered before epidural
anesthesia.
Which intervention is most appropriate to increase a laboring woman’s maternal cardiac output?
Exam Questions and Answers
A patient has received fentanyl, and her respiratory status is rapidly declining. Which medication
would the nurse anticipate administering to counteract the effects of this drug?
Naloxone
Naloxone counteracts opioid-induced respiratory depression.
A woman is administered fentanyl during labor and is still experiencing significant pain. Which
prescription from the health care provider would the nurse anticipate for administration?
Nitrous oxide
The nurse anticipates a prescription for nitrous oxide, which can be administered to a woman who is
still experiencing pain after the administration of fentanyl.
During an emergency delivery, which maternal adverse effects would a nurse monitor in a patient
undergoing general anesthesia?
Uterine relaxation
-The nurse should monitor for uterine relaxation, which is an adverse effect of general anesthesia.
Respiratory depression
-The nurse should monitor for respiratory depression, which is an adverse effect of general anesthesia
Maternal aspiration of gastric contents
-The nurse should monitor for maternal aspiration of gastric contents, which is an adverse effect of
general anesthesia
The nurse would question a prescription for spinal anesthesia for a woman with which condition?
Infection at the site of insertion
-Contraindications and precautions include the woman's refusal, coagulation defects, uncorrected
hypovolemia, infection in the area of insertion, systemic infection, allergy, and possibly prior spinal
surgery.
A patient arrives at the labor and delivery unit with steady contractions and is 5 cm dilated. On
assessment, the fetal heart rate is 200 beats/min, and it is determined that a cesarean delivery should
be performed. Which anesthesia method does the nurse anticipate?
Subarachnoid (spinal) block
-The nurse would anticipate a subarachnoid block (SAB), because it is recommended when a quick
cesarean birth is necessary and an epidural catheter is not in place.
A nurse is caring for a patient undergoing an episiotomy repair after birth. Which types of anesthesia
does the nurse anticipate?
Pudendal anesthesia
-The nurse would anticipate pudendal anesthesia for episiotomy repair. Pudendal blocks anesthetize
the lower vagina and part of the perineum.
Local infiltration anesthesia
, -The nurse would anticipate local infiltration, which is routinely used for episiotomy repair. Local
infiltration anesthesia numbs the immediate area of the episiotomy or laceration.
A nurse is caring for a patient in the first stage of labor who received a combined spinal-epidural (CSE)
block with opioid analgesics for pain relief from uterine contractions. The nurse observes for which
common side effects of these drugs?
Nausea
Nausea is a common side effect of intrathecal opioid analgesics. Nalbuphine is one drug that can
counteract nausea from intrathecal opioid administration.
Pruritus
Pruritus is a common side effect of intrathecal opioid analgesics as a result of the release of
histamine. Antihistamines, such as nalbuphine, can counteract pruritus from intrathecal
administration.
Vomiting
Vomiting is a common side effect of intrathecal opioid analgesics. Nalbuphine is one drug that can
counteract nausea from intrathecal opioid administration and will also decrease the incidence of
vomiting.
A nurse is managing the administration of nitrous oxide for a patient in labor. The nurse observes for
which common side effects of nitrous oxide?
Nausea
Nausea is a common side effect of nitrous oxide. Vomiting may also be present with the
administration of nitrous oxide. Nitrous oxide is administered by the labor and delivery nurse, and
side effects should be reported to the health care provider or midwife who prescribed the
medication.
Dizziness
Dizziness is a common side of nitrous oxide. Nitrous oxide is a gas that is inhaled and does not take
away contraction pain but rather helps reduce anxiety and increases a feeling of well-being so that
the labor pain is easier to deal with.
Dysphoria
Dysphoria is a common side effect of nitrous oxide. Because nitrous oxide is an inhalant, it creates a
feeling of dysphoria and reduces anxiety so that labor pain is easier to deal with.
Which prescription would the nurse expect to administer to a patient at high risk for maternal
hypotension before epidural anesthesia?
Intravenous fluids
The nurse would anticipate intravenous fluids, which should be administered before epidural
anesthesia.
Which intervention is most appropriate to increase a laboring woman’s maternal cardiac output?
