Nursing role in providing comfort during labor and birth

Question 1

1. The nurse is caring for a primigravid client in active labor at 42 weeks’ gestation. The client has had no analgesia or
   anesthesia and has been pushing for 2 hours. The nurse can be most helpful to this client by:
   a. Changing her pushing position every 15 minutes.
   b. Notifying the health care provider of her current status.
   c. Continuing with current pushing technique.
   d. Assessing the client’s current pain and fetal status

Answer 1

B. Notify the health care provider of her current status

Question 2

2. The physician has ordered prostaglandin gel to be administered vaginally to a newly admitted primigravid client. Which
   of the following indicate that the client has had a therapeutic response to the medication?
   a. Resting period of 2 minutes between contractions.
   b. Normal patellar and elbow refl exes for the past 2 hours.
   c. Softening of the cervix and beginning effacement.
   d. Leaking of clear amniotic fl uid in small amounts

Answer 2

C. Softening of the cervix and beginning of effacement

Question 3

3. A 21-year-old primigravid client at 40 weeks’ gestation is admitted to the hospital in active labor. The client’s cervix is 8
   cm and completely effaced at 0 station. During the transition phase of labor, which of the following is a priority nursing
   diagnosis?
   a. Impaired urinary elimination related to nothing-by-mouth status.
   b. Risk for injury related to hyperventilation and dizziness.
   c. Ineffective coping related to lack of confi - dence.
   d. Pain related to increasing frequency and intensity of uterine contractions

Answer 3

A. Impaired urinary elimination related to nothing by mouth status.

Question 4

4. Which of the following would the nurse include in the teaching plan for a 16-year-old primigravid client in early labor
   concerning active relaxation techniques to help her cope with pain?
   a. Relaxing uninvolved body muscles during uterine contractions.
   b. Practicing being in a deep, meditative, sleeplike state.
   c. Focusing on an object in the room during the contractions.
   d. Breathing rapidly and deeply between contractions.

Answer 4

A. Relaxing uninvolved body muscles during uterine contractions.

Question 5

5. The nurse is performing effleurage for a primigravid client in early labor. The nurse should do which of the following?
   a. Deep kneading of superficial muscles.
   b. Secure grasping of muscular tissues.
   c. Light stroking of the skin surface.
   d. Prolonged pressure on specific sites

Answer 5

C. light stroking of the skin surface.

Question 6

6. A 24-year-old primigravid client in active labor requests use of the jet hydrotherapy tub to aid in pain relief. The nurse
   bases the response on the understanding that this therapy is commonly contraindicated for clients with which of the
   following?
   a. Ruptured membranes.
   b. Multifetal gestation.
   c. Diabetes mellitus.
   d. Hypotonic labor patterns

Answer 6

A. Ruptured membranes.

Question 7

7. Assessment of a 23-year-old primigravid client at term who is admitted to the birthing unit in active labor reveals that her cervix is 4 cm dilated and 100% effaced. Contractions are occurring every 4 minutes. The nurse is developing a care
   plan with the client to relieve pain based on the gate-control theory of pain. The nurse should explain which of the following to the client?
   a. Input from the large sensory fibers opens the gate.
   b. Labor pain is a matter of individual perception.
   c. Slow abdominal breathing can open the gate.
   d. The gating mechanism is in the spinal cord

Answer 7

D. The gating mechanism is in the spinal cord.

Question 8

8 The nurse explains to a newly admitted primigravid client in active labor that, according to the gate-control theory of
pain, a closed gate means that the client should experience which of the following?
a. No pain.
b. Sharp pain.
c. Light pain.
d. Moderate pain.

Answer 8

A. No pain

Question 9

9. A primigravid client in active labor has had no anesthesia. The client’s cervix is 7 cm dilated, and she is starting to feel
   considerable discomfort during contractions. The nurse should instruct the client to change from slow chest breathing to
   which of the following?
   a. Rapid, shallow chest breathing.
   b. Deep chest breathing.
   c. Rapid pant-blow breathing.
   d. Slow abdominal breathing

Answer 9

A. Rapid shallow chest breathing

Question 10

10. A 31-year-old multigravid client at 39 weeks’ gestation admitted to the hospital in active labor is receiving intravenous
    lactated Ringer’s solution and a continuous epidural anesthetic. During the first hour after administration of the anesthetic,
    the nurse should monitor the client for:
    a. Hypotension.
    b. Diaphoresis.
    c. Headache.
    d. Tremors

Answer 10

A. Hypotension