Maternity Chap 7
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
b
The nurse coaches the primigravida not to bear down until the cervix is completely dilated. What may premature bearing down cause? a. Increased use of oxygen b. Cervical laceration c. Uterine rupture d. Compression of the cord
b
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
b
The nurse is instructing a Lamaze class on abdominal breathing and tells a patient that her baseline respiratory rate is 22 breaths per minute. What should be the patients rate while performing slow breathing? a. 9 b. 11 c. 15 d. 20
b
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
b
What is the Dick-Read method of childbirth preparation based on? a. Mild sedation throughout labor b. Relaxation techniques c. Skin stimulation d. Deep massage
b
What is the least amount of sensation that one perceives as pain? a. Tolerance b. Threshold c. Level d. Abatement
b
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.
b
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
b
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.
b, c, d, e
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
b, c, e
When a pregnant woman arrives at the labor suite, she tells the nurse that she wants to have an epidural for delivery. What is a contraindication to an epidural block? a. Abnormal clotting b. Previous cesarean delivery c. History of migraine headaches d. History of diabetes mellitus
a
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
a, b, c
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
a, b, c
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 pace breathing e. Patterned paced breathing
a, b, d, e
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.
a, c, d, e
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
a, c
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
a
A woman requests a pudendal block to manage her labor pain. What statement by the woman indicates a need for further explanation about the pudendal block? a. Im having a contraction. Can I get the pudendal block now? b. Ill get the pudendal block right before I deliver. c. The nurse midwife will insert the needles into my vagina. d. It takes a few minutes after the medicine is administered to make me feel numb.
a
An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart. She received little prenatal care and had no childbirth preparation. She is crying loudly and shouting, Please give me something for the pain. I cant take the pain! What is the priority nursing diagnosis? a. Pain related to uterine contractions b. Knowledge deficit related to the birth experience c. Ineffective coping related to inadequate preparation for labor d. Risk for injury related to lack of prenatal care
a
What chemical substance(s) produced in the body acts as a natural pain reliever? a. Endorphins b. Morphine c. Codeine d. Atropine
a
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.
a
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.
b, e
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.
c
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.
c
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.
c
Which narcotic antagonist is used to reverse narcotic-induced respiratory depression? a. Hydroxyzine (Vistaril) b. Phenobarbital c. Naloxone (Narcan) d. Nitrous oxide
c
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
d
A patient who received an epidural block asks why her blood pressure is taken so often. What is the nurses 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.
d
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
d
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
d
The nurse is preparing a teaching plan for a woman receiving a subarachnoid block before delivery. What nursing action will be included in this plan to prevent the associated side effect of this type of anesthesia? a. Restrict oral fluids. b. Keep legs flexed. c. Walk with assistance as soon as possible. d. Lie flat for several hours.
d
The nurse who encourages the gate control theory of pain control would advise a woman in labor and her partner to use which nonpharmacological method of pain management? a. Slow abdominal breathing b. Guided relaxation c. Listening to music d. Massage
d