PERRY’S MATERNAL CHILD
NURSING CARE (MAXIMIZING
COMFORT FOR THE LABORING
WOMAN) EXAM QUESTIONS AND
WELL EXPLAINED REVIEWED
COMPLETE SOLUTIONS
1. An 18-year-old pregnant woman, gravida 1, is
admitted to the labor and birth unit with moderate
contractions every 5 minutes that last 40 seconds.
The woman states, "My contractions are so strong
that I don't know what to do with myself." The nurse
should:
a. assess for fetal well-being.
b. encourage the woman to lie on her side.
c. disturb the woman as little as possible.
d. recognize that pain is personalized for each
individual.
ANS: D
Each woman's pain during childbirth is unique and is
influenced by a variety of physiologic, psychosocial, and
environmental factors. A critical issue for the nurse is how
support can make a difference in the pain of the woman
during labor and birth. Assessing for fetal well-being
includes no information that would indicate fetal distress or
a logical reason to be overly concerned about the well-
,being of the fetus. The left lateral position is used to
alleviate fetal distress, not maternal stress. The nurse has
an obligation to provide physical, emotional, and
psychosocial care and support to the laboring woman.
This patient clearly needs support.
2. Nursing care measures are commonly offered to
women in labor. Which nursing measure reflects
application of the gate-control theory?
a. Massaging the woman's back
b. Changing the woman's position
c. Giving the prescribed medication
d. Encouraging the woman to rest between
contractions
ANS: A
According to the gate-control theory, pain sensations
travel along sensory nerve pathways to the brain, but only
a limited number of sensations, or messages, can travel
through these nerve pathways at one time. Distraction
techniques such as massage or stroking, music, focal
points, and imagery reduce or completely block the
capacity of nerve pathways to transmit pain. These
distractions are thought to work by closing down a
hypothetic gate in the spinal cord and thus preventing pain
signals from reaching the brain. The perception of pain is
thereby diminished. Changing the woman's position, giving
prescribed medication, and encouraging rest do not
reduce or block the capacity of nerve pathways to transmit
pain using the gate-control theory.
3. A laboring woman received an opioid agonist
(meperidine) intravenously 90 minutes before she
gave birth. Which medication should be available to
, reduce the postnatal effects of Demerol on the
neonate?
a. Fentanyl (Sublimaze)
b. Promethazine (Phenergan)
c. Naloxone (Narcan)
d. Nalbuphine (Nubain)
ANS: C
An opioid antagonist can be given to the newborn as one
part of the treatment for neonatal narcosis, which is a state
of central nervous system (CNS) depression in the
newborn produced by an opioid. Opioid antagonists such
as naloxone (Narcan) can promptly reverse the CNS
depressant effects, especially respiratory depression.
Fentanyl, promethazine, and nalbuphine do not act as
opioid antagonists to reduce the postnatal effects of
Demerol on the neonate. Although meperidine (Demerol)
is a low-cost medication and readily available, the use of
Demerol in labor has been controversial because of its
effects on the neonate.
4. A woman in labor has just received an epidural
block. The most important nursing intervention is to:
a. limit parenteral fluids.
b. monitor the fetus for possible tachycardia.
c. monitor the maternal blood pressure for possible
hypotension.
d. monitor the maternal pulse for possible
bradycardia.
ANS: C
The most important nursing intervention for a woman who
has received an epidural block is to monitor the maternal
blood pressure frequently for signs of hypotension.
NURSING CARE (MAXIMIZING
COMFORT FOR THE LABORING
WOMAN) EXAM QUESTIONS AND
WELL EXPLAINED REVIEWED
COMPLETE SOLUTIONS
1. An 18-year-old pregnant woman, gravida 1, is
admitted to the labor and birth unit with moderate
contractions every 5 minutes that last 40 seconds.
The woman states, "My contractions are so strong
that I don't know what to do with myself." The nurse
should:
a. assess for fetal well-being.
b. encourage the woman to lie on her side.
c. disturb the woman as little as possible.
d. recognize that pain is personalized for each
individual.
ANS: D
Each woman's pain during childbirth is unique and is
influenced by a variety of physiologic, psychosocial, and
environmental factors. A critical issue for the nurse is how
support can make a difference in the pain of the woman
during labor and birth. Assessing for fetal well-being
includes no information that would indicate fetal distress or
a logical reason to be overly concerned about the well-
,being of the fetus. The left lateral position is used to
alleviate fetal distress, not maternal stress. The nurse has
an obligation to provide physical, emotional, and
psychosocial care and support to the laboring woman.
This patient clearly needs support.
2. Nursing care measures are commonly offered to
women in labor. Which nursing measure reflects
application of the gate-control theory?
a. Massaging the woman's back
b. Changing the woman's position
c. Giving the prescribed medication
d. Encouraging the woman to rest between
contractions
ANS: A
According to the gate-control theory, pain sensations
travel along sensory nerve pathways to the brain, but only
a limited number of sensations, or messages, can travel
through these nerve pathways at one time. Distraction
techniques such as massage or stroking, music, focal
points, and imagery reduce or completely block the
capacity of nerve pathways to transmit pain. These
distractions are thought to work by closing down a
hypothetic gate in the spinal cord and thus preventing pain
signals from reaching the brain. The perception of pain is
thereby diminished. Changing the woman's position, giving
prescribed medication, and encouraging rest do not
reduce or block the capacity of nerve pathways to transmit
pain using the gate-control theory.
3. A laboring woman received an opioid agonist
(meperidine) intravenously 90 minutes before she
gave birth. Which medication should be available to
, reduce the postnatal effects of Demerol on the
neonate?
a. Fentanyl (Sublimaze)
b. Promethazine (Phenergan)
c. Naloxone (Narcan)
d. Nalbuphine (Nubain)
ANS: C
An opioid antagonist can be given to the newborn as one
part of the treatment for neonatal narcosis, which is a state
of central nervous system (CNS) depression in the
newborn produced by an opioid. Opioid antagonists such
as naloxone (Narcan) can promptly reverse the CNS
depressant effects, especially respiratory depression.
Fentanyl, promethazine, and nalbuphine do not act as
opioid antagonists to reduce the postnatal effects of
Demerol on the neonate. Although meperidine (Demerol)
is a low-cost medication and readily available, the use of
Demerol in labor has been controversial because of its
effects on the neonate.
4. A woman in labor has just received an epidural
block. The most important nursing intervention is to:
a. limit parenteral fluids.
b. monitor the fetus for possible tachycardia.
c. monitor the maternal blood pressure for possible
hypotension.
d. monitor the maternal pulse for possible
bradycardia.
ANS: C
The most important nursing intervention for a woman who
has received an epidural block is to monitor the maternal
blood pressure frequently for signs of hypotension.
