Question 1

Nursing care measures are commonly offered to women in labour.Which nursing measure reflects application of the gate-control theory?

Accepted Answer

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 
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 A

Question 2

The nurse should be aware that a plan to achieve adequate pain relief without maternal risk is most effective if which of the following occurs?

Accepted Answer

A)  The mother gives birth without any analgesic or anaesthetic. 
B)  The mother and family's priorities and preferences are incorporated into the plan. 
C)  The primary health care provider determines the best pain relief for the mother and family. 
D)  The nurse informs the family of all alternative methods of pain relief available in the hospital setting. 
A)  The mother gives birth without any analgesic or anaesthetic. 
B)  The mother and family's priorities and preferences are incorporated into the plan. 
C)  The primary health care provider determines the best pain relief for the mother and family. 
D)  The nurse informs the family of all alternative methods of pain relief available in the hospital setting. B

Question 3

To help patients manage discomfort and pain during labour,nurses should be aware of which of the following?

Accepted Answer

A)  The predominant pain of the first stage of labour is the visceral pain located in the lower portion of the abdomen. 
B)  Referred pain is the extreme discomfort between contractions. 
C)  The somatic pain of the second stage of labour is more generalized and related to fatigue. 
D)  Pain during the third stage is a somewhat milder version of the second stage. 
A)  The predominant pain of the first stage of labour is the visceral pain located in the lower portion of the abdomen. 
B)  Referred pain is the extreme discomfort between contractions. 
C)  The somatic pain of the second stage of labour is more generalized and related to fatigue. 
D)  Pain during the third stage is a somewhat milder version of the second stage. A

Question 4

Nurses should be aware of which of the following differences that experience can make in relation to labour pain?

Accepted Answer

A)  Sensory pain for nulliparous women often is greater than for multiparous women during early labour. 
B)  Affective pain for nulliparous women usually is less than that for multiparous women throughout the first stage of labour. 
C)  Women with a history of substance use experience more pain during labour. 
D)  Multiparous women have more fatigue from labour and thus experience more pain. 
A)  Sensory pain for nulliparous women often is greater than for multiparous women during early labour. 
B)  Affective pain for nulliparous women usually is less than that for multiparous women throughout the first stage of labour. 
C)  Women with a history of substance use experience more pain during labour. 
D)  Multiparous women have more fatigue from labour and thus experience more pain.

Question 5

What should the nurse be cognizant of with regard to spinal and epidural anaesthesia?

Accepted Answer

A)  It is commonly used for Caesarean births but is not suitable for vaginal births. 
B)  A high incidence of after-birth headache is seen with spinal blocks. 
C)  Epidural blocks allow the woman to move freely. 
D)  Spinal and epidural blocks are never used together. 
A)  It is commonly used for Caesarean births but is not suitable for vaginal births. 
B)  A high incidence of after-birth headache is seen with spinal blocks. 
C)  Epidural blocks allow the woman to move freely. 
D)  Spinal and epidural blocks are never used together.

Question 6

Nurses with an understanding of cultural differences regarding likely reactions to pain are better able to help patients.Women from which of the following ethnic groups would be most likely to be stoic in response to labour pain?

Accepted Answer

A)  Chinese women 
B)  Arab or Middle Eastern women 
C)  First Nations women 
D)  African-Canadian women 
A)  Chinese women 
B)  Arab or Middle Eastern women 
C)  First Nations women 
D)  African-Canadian women

Question 7

Maternal hypotension is a potential adverse effect of regional anaesthesia and analgesia.Which nursing intervention would you use to raise the patient's blood pressure?

Accepted Answer

A)  Place the woman in a supine position. 
B)  Perform a vaginal examination. 
C)  Increase intravenous (IV) fluids. 
D)  Implement continuous electronic fetal heart monitoring. 
A)  Place the woman in a supine position. 
B)  Perform a vaginal examination. 
C)  Increase intravenous (IV) fluids. 
D)  Implement continuous electronic fetal heart monitoring.

Question 8

An 18-year-old pregnant woman,gravida 1,is admitted to the labour 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." What should the nurse do?

Accepted Answer

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. 
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.

Question 9

After a change-of-shift report the nurse assumes care of a multiparous patient in labour.The woman is complaining of pain that radiates to her abdominal wall,lower back,and buttocks and down her thighs.Before implementing a plan of care,the nurse should understand that this type of pain is referred to as which one of the following?

Accepted Answer

A)  Visceral 
B)  Referred 
C)  Somatic 
D)  Afterpain 
A)  Visceral 
B)  Referred 
C)  Somatic 
D)  Afterpain

Question 10

Which of the following reflects the role of the nurse with regard to informed consent?

Accepted Answer

A)  Inform the patient about the procedure and have her sign the consent form. 
B)  Act as a patient advocate and provide clarification. 
C)  Call the physician to see the patient. 
D)  Witness the signing of the consent form. 
A)  Inform the patient about the procedure and have her sign the consent form. 
B)  Act as a patient advocate and provide clarification. 
C)  Call the physician to see the patient. 
D)  Witness the signing of the consent form.

Question 11

A labouring woman received fentanyl citrate (Sublimaze)intravenously 90 minutes before she gave birth.Which medication should be available to reduce the postnatal effects of Sublimaze on the neonate?

Accepted Answer

A)  Meperidine (Demerol) 
B)  Promethazine (Phenergan) 
C)  Naloxone (Narcan) 
D)  Nalbuphine (Nubain) 
A)  Meperidine (Demerol) 
B)  Promethazine (Phenergan) 
C)  Naloxone (Narcan) 
D)  Nalbuphine (Nubain)

Question 12

What should nurses be aware of with regard to systemic analgesics administered during labour?

Accepted Answer

A)  Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. 
B)  Effects on the fetus and newborn can include decreased alertness and delayed sucking. 
C)  Intramuscular ( IM ) administration is preferred over intravenous ( IV ) administration. 
D)  IV patient-controlled analgesia ( PCA ) results in increased use of an analgesic. 
A)  Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. 
B)  Effects on the fetus and newborn can include decreased alertness and delayed sucking. 
C)  Intramuscular ( IM ) administration is preferred over intravenous ( IV ) administration. 
D)  IV patient-controlled analgesia ( PCA ) results in increased use of an analgesic.

Question 13

Maternity nurses often have to answer questions about the many ways people have tried to make the birthing experience more comfortable.Nurses should be aware of which of the following?

Accepted Answer

A)  Music supplied by the support person has to be discouraged because it could disturb others or upset the hospital routine. 
B)  Women in labour can benefit from sitting in a bathtub, but they must limit immersion to no longer than 15 minutes at a time. 
C)  Effleurage is permissible, but counterpressure is almost always counterproductive. 
D)  Electrodes attached to either side of the spine to provide high-intensity electrical impulses facilitate the release of endorphins. 
A)  Music supplied by the support person has to be discouraged because it could disturb others or upset the hospital routine. 
B)  Women in labour can benefit from sitting in a bathtub, but they must limit immersion to no longer than 15 minutes at a time. 
C)  Effleurage is permissible, but counterpressure is almost always counterproductive. 
D)  Electrodes attached to either side of the spine to provide high-intensity electrical impulses facilitate the release of endorphins.

Question 14

A first-time mother is concerned about the type of medications she will receive during labour.She is in a fair amount of pain and is nauseous.In addition,she appears to be very anxious.You explain that opioid analgesics often are used with sedatives for which of the following reasons?

Accepted Answer

A)  "The two together work best for you and your baby." 
B)  "Sedatives help the opioid work better, and they also will help relax you and relieve your nausea." 
C)  "They work better together so you can sleep until you have the baby." 
D)  "This is what the doctor has ordered for you." 
A)  "The two together work best for you and your baby." 
B)  "Sedatives help the opioid work better, and they also will help relax you and relieve your nausea." 
C)  "They work better together so you can sleep until you have the baby." 
D)  "This is what the doctor has ordered for you."

Question 15

A woman in labour has just received an epidural block.What is the most important nursing intervention?

Accepted Answer

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. 
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.

Question 16

When is effleurage most effective?

Accepted Answer

A)  First stage of labour 
B)  Transition phase of labour 
C)  Second stage of labour 
D)  Placental delivery 
A)  First stage of labour 
B)  Transition phase of labour 
C)  Second stage of labour 
D)  Placental delivery

Question 17

Which statement correctly describes the effects of various pain factors?

Accepted Answer

A)  Higher prostaglandin levels arising from dysmenorrhea can blunt the pain of childbirth. 
B)  Upright positions in labour increase the pain factor because they cause greater fatigue. 
C)  Women who move around trying different positions are experiencing more pain. 
D)  Levels of pain-mitigating b-endorphins are higher during a spontaneous, natural childbirth. 
A)  Higher prostaglandin levels arising from dysmenorrhea can blunt the pain of childbirth. 
B)  Upright positions in labour increase the pain factor because they cause greater fatigue. 
C)  Women who move around trying different positions are experiencing more pain. 
D)  Levels of pain-mitigating b-endorphins are higher during a spontaneous, natural childbirth.

Question 18

What should the labouring woman be taught if she is receiving an opioid antagonist?

Accepted Answer

A)  Her pain will decrease. 
B)  Her pain will return. 
C)  She will feel less anxious. 
D)  She will no longer feel the urge to push. 
A)  Her pain will decrease. 
B)  Her pain will return. 
C)  She will feel less anxious. 
D)  She will no longer feel the urge to push.

Question 19

What should the nurse be aware of with regard to a pregnant woman's anxiety and pain experience?

Accepted Answer

A)  Even mild anxiety must be acknowledged and treated. 
B)  Severe anxiety increases tension, which increases pain and fear. 
C)  Anxiety increases the perception of pain, but it does not affect the mechanism of labour. 
D)  Women who have had a painful labour will have less anxiety the second time because of increased familiarity. 
A)  Even mild anxiety must be acknowledged and treated. 
B)  Severe anxiety increases tension, which increases pain and fear. 
C)  Anxiety increases the perception of pain, but it does not affect the mechanism of labour. 
D)  Women who have had a painful labour will have less anxiety the second time because of increased familiarity.

Question 20

In assessing a woman for pain and discomfort management during labour,what should the nurse do?

Accepted Answer

A)  Have the woman use a visual analogue scale (VAS) to determine her level of pain. 
B)  Note drowsiness as a sign that the medications were working. 
C)  Interpret a woman's fist-clenching as an indication that she is mad at her physician. 
D)  Evaluate the woman's skin turgor to see whether she needs a gentle oil massage. 
A)  Have the woman use a visual analogue scale (VAS) to determine her level of pain. 
B)  Note drowsiness as a sign that the medications were working. 
C)  Interpret a woman's fist-clenching as an indication that she is mad at her physician. 
D)  Evaluate the woman's skin turgor to see whether she needs a gentle oil massage.

Exam 16: Comfort Measures for Labour

Nursing care measures are commonly offered to women in labour.Which nursing measure reflects application of the gate-control theory?

The nurse should be aware that a plan to achieve adequate pain relief without maternal risk is most effective if which of the following occurs?

To help patients manage discomfort and pain during labour,nurses should be aware of which of the following?

Nurses should be aware of which of the following differences that experience can make in relation to labour pain?

What should the nurse be cognizant of with regard to spinal and epidural anaesthesia?

Nurses with an understanding of cultural differences regarding likely reactions to pain are better able to help patients.Women from which of the following ethnic groups would be most likely to be stoic in response to labour pain?

Maternal hypotension is a potential adverse effect of regional anaesthesia and analgesia.Which nursing intervention would you use to raise the patient's blood pressure?

An 18-year-old pregnant woman,gravida 1,is admitted to the labour 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." What should the nurse do?

Which of the following reflects the role of the nurse with regard to informed consent?

A labouring woman received fentanyl citrate (Sublimaze)intravenously 90 minutes before she gave birth.Which medication should be available to reduce the postnatal effects of Sublimaze on the neonate?

What should nurses be aware of with regard to systemic analgesics administered during labour?

Maternity nurses often have to answer questions about the many ways people have tried to make the birthing experience more comfortable.Nurses should be aware of which of the following?

A first-time mother is concerned about the type of medications she will receive during labour.She is in a fair amount of pain and is nauseous.In addition,she appears to be very anxious.You explain that opioid analgesics often are used with sedatives for which of the following reasons?

A woman in labour has just received an epidural block.What is the most important nursing intervention?

When is effleurage most effective?

Which statement correctly describes the effects of various pain factors?

What should the labouring woman be taught if she is receiving an opioid antagonist?

What should the nurse be aware of with regard to a pregnant woman's anxiety and pain experience?

In assessing a woman for pain and discomfort management during labour,what should the nurse do?

Contemporary Perinatal Nursing in Canada

The Family and Culture

Community Care

Health Promotion

Health Assessment

Reproductive Health

Infertility, contraception, and Abortion

Preconception, genetics, conception, and Fetal Development

Anatomy and Physiology of Pregnancy

Nursing Care During Pregnancy

Maternal and Fetal Nutrition

Pregnancy Risk Factors and Assessment: Maternal and Fetal

Pregnancy at Risk: Gestational Conditions

Pregnancy at Risk: Pre-Existing Conditions

Labour and Birth Processes

Fetal Health Surveillance During Labour

Nursing Care During Labour and Birth

Labour and Birth at Risk

Maternal Physiological Changes

Nursing Care During the Fourth Trimester

Transition to Parenthood

Postpartum Complications

Physiological Adaptations of the Newborn

Nursing Care of the Newborn

Newborn Nutrition and Feeding

Infants With Gestational Age-Related Problems

The Newborn at Risk: Acquired and Congenital Problems

Contemporary Pediatric Nursing in Canada

Community-Based Nursing Care of the Child and Family

Family Influences on Child Health Promotion

Social, cultural, and Religious Influences on Child Health Promotion

Developmental Influences on Child Health Promotion

Communication, history, physical, and Developmental Assessment

Pain Assessment and Management

The Infant and Family

The Toddler and Family

The Preschooler and Family

The School-Age Child and Family

The Adolescent and Family

Chronic Illness, disability, and End-Of-Life Care

Cognitive and Sensory Impairment

Family-Centred Home Care

Reaction to Illness and Hospitalization

Pediatric Variations of Nursing Interventions

Respiratory Dysfunction

Gastrointestinal Dysfunction

Cardiovascular Dysfunction

Hematological and Immunological Dysfunction

Genitourinary Dysfunction

Cerebral Dysfunction

Endocrine Dysfunction

Integumentary Dysfunction

Musculoskeletal or Articular Dysfunction

Neuromuscular or Muscular Dysfunction

Filters