Introduction To Maternity And Pediatric Nursing 8th Edition Leifer Test Bank Chapter 07: Nursing Management of Pain During Labor and Birth

Introduction To Maternity And Pediatric Nursing 8th Edition Leifer Test Bank Chapter 07: Nursing Management of Pain During Labor and Birth MULTIPLE CHOICE 1. A nurse is teaching a childbirth preparation class. The group is discussing individual expression of labor pain. What statement is accurate about a patients expression of pain? a. It reduces the patients perception of pain. b. It is intensified by the vertex position of the fetus. c. It is influenced by culture. d. It can be completely controlled by nonpharmacological techniques. ANS: C Culture influences how women feel about birth and what is an acceptable response to pain. DIF: Cognitive Level: Comprehension REF: Page 168 TOP: Cultural Influences on Pain KEY: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. What chemical substance(s) produced in the body acts as a natural pain reliever? a. Endorphins b. Morphine c. Codeine d. Atropine ANS: A Endorphins are natural body substances that are similar to morphine and may explain why laboring women need smaller doses of analgesia. DIF: Cognitive Level: Knowledge REF: Page 167 TOP: Endorphins KEY: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. A nurse instructs a womans labor coach to comfort her by firmly pressing on her lower back. What is this technique? a. Sacral pressure b. Distraction c. Effleurage d. Conscious relaxation ANS: A Sacral pressure refers to firm pressure against the lower back to relieve some of the pain of back labor. DIF: Cognitive Level: Knowledge REF: Page 167 OBJ: 6 TOP: Nonpharmacological Pain Management KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 4. A woman who is 6 cm dilated has the urge to push. What will the nurse instruct the woman to do during the contraction? a. Use slow-paced breathing. b. Hold her breath and push. c. Blow in short breaths. d. Use rapid-paced breathing. ANS: C If a laboring woman feels the urge to push before the cervix is fully dilated, then she is taught to blow in short breaths to avoid bearing down. DIF: Cognitive Level: Application REF: Page 170 TOP: Stair-Step Breathing Pattern KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Several hours into labor, a woman complains of dizziness, numbness, and tingling of her hands and mouth. What does the nurse recognize these symptoms signify? a. Hypertension b. Anxiety c. Anoxia d. Hyperventilation ANS: D Hyperventilation is sometimes a problem if a woman is breathing rapidly. DIF: Cognitive Level: Comprehension REF: Page 171 OBJ: 4 TOP: Hyperventilation KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 6. What is the most appropriate nursing action to take when a laboring woman hyperventilates? 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. ANS: A Measures to combat hyperventilation include breathing into cupped hands or a paper bag or holding breath for a few seconds. All of these techniques decrease PCO2. DIF: Cognitive Level: Application REF: Page 171 OBJ: 4 TOP: Nonpharmacological Pain Management KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk 7. A woman in the transition phase of labor requests a narcotic analgesic medication for pain relief. What should the nurse explain regarding giving a narcotic analgesic medication at this stage of labor? a. It can cause medication given at later stages to be ineffective. b. It will have no complications for the mother or infant. c. It may result in respiratory depression to the newborn. d. It will speed up labor and increase pain. ANS: C The risk of narcotic analgesics is that they cross the placenta and can cause fetal respiratory depression. DIF: Cognitive Level: Comprehension REF: Page 171 OBJ: 7 TOP: Opioids KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: Reduction of Risk 8. What would the nurse guide a labor coach to do to comfort a woman tensing her muscles with contractions? 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. ANS: B Panting relaxes the abdominal wall and distracts the patient. It would not be helpful to offer fluids or to attempt conversation during contractions. Walking intensifies contractions. DIF: Cognitive Level: Application REF: Page 170 TOP: Panting KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 9. A woman in labor will receive general anesthesia prior to cesarean section. The nurse reminds the patient that food and fluids need to be restricted for several hours prior to delivery. What will this prevent? a. Nausea and vomiting b. Vomiting and aspiration c. Abdominal cramping d. Intestinal obstruction ANS: B The major adverse effect of general anesthesia is aspiration of stomach contents. DIF: Cognitive Level: Comprehension REF: Page 173 OBJ: 7 TOP: General Anesthesia KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity: Reduction of Risk 10. What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman? a. Bladder for distention b. Blood pressure c. Sensation in the lower extremities d. Intravenous fluid flow rate ANS: B Blood pressure is checked every 5 minutes when the epidural block is first begun. Bladder assessment is also important but not an initial assessment. DIF: Cognitive Level: Application REF: Page 173 OBJ: 6 TOP: Epidural Block KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk 11. A woman in labor has had an epidural block for pain relief. The nurse will be assessing carefully for what associated side effect of this type of regional anesthesia? a. Reduced fetal heart rate b. Long, intense contractions c. Sudden leg cramps d. Bladder distention ANS: D A side effect of an epidural block is urine retention because the anesthesia interferes with the womans ability to have an urge to void. The patient may have to be catheterized. DIF: Cognitive Level: Knowledge REF: Page 173 OBJ: 7 TOP: Epidural Block KEY: Nursing Process Step: Data Col