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Exam (elaborations)

Chapter 18 Pain Management for Childbirth

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Chapter 18 Pain Management for Childbirth

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  • August 22, 2024
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  • 2024/2025
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Chapter 18: Pain Management for Childbirth
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MULTIPLE CHOICE

1. Childbirth preparation can be considered successful if the outcome is described as
a. Labor was pain-free.
b. Birth experiences of friends and families were discredited.
c. The woman rehearsed labor and practiced skills to master pain.
d. Only nonpharmacologic methods for pain control were used.
ANS: C


Feedback
A Childbirth preparation does not guarantee a pain-free labor. A woman should be
prepared for pain and anesthesia/analgesia realistically.
B Friends and families can be an important source of support if they convey
realistic information about labor pain.
C Preparation allows the woman to rehearse for labor and to learn new skills to
cope with the pain of labor and the expected behavioral changes.
D Women will not always achieve their desired level of pain control by using
nonpharmacologic methods alone.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 388
OBJ: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity

2. In order to help patients manage discomfort and pain during labor, nurses should be aware
that
a. The predominant pain of the first stage of labor is the visceral pain located in the
lower portion of the abdomen.
b. Somatic pain is the extreme discomfort between contractions.
c. The somatic pain of the second stage of labor is more generalized and related to
fatigue.
d. Pain during the third stage is a somewhat milder version of the second stage.
ANS: A


Feedback
A This pain comes from cervical changes, distention of the lower uterine segment,
and uterine ischemia.
B Somatic pain is a faster, sharp pain. Somatic pain is most prominent during late
first-stage labor and during second-stage labor as the descending fetus puts
direct pressure on maternal tissues.
C Second-stage labor pain is intense, sharp, burning, and localized.
D Third-stage labor pain is similar to that of the first stage.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 389

, OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. The nurse caring for women in labor understands that childbirth pain is different from other
types of pain in that it is
a. More responsive to pharmacologic management
b. Associated with a physiologic process
c. Designed to make one withdraw from the stimulus
d. Less intense
ANS: B


Feedback
A Pain management during labor may affect the course and length of labor.
B Childbirth pain is part of a normal process, whereas other types of pain usually
signify an injury or illness.
C The pain with childbirth is a normal process; it is not caused by the type of
injury when withdrawal from the stimuli is seen.
D Childbirth pain is not less intense than other types of pain.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 388
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

4. Excessive anxiety in labor heightens the woman’s sensitivity to pain by increasing
a. Muscle tension
b. Blood flow to the uterus
c. The pain threshold
d. Rest time between contractions
ANS: A


Feedback
A Anxiety and fear increase muscle tension, diverting oxygenated blood to the
woman’s brain and skeletal muscles. Prolonged tension results in general
fatigue, increased pain perception, and reduced ability to use coping skills.
B Anxiety can decrease blood flow to the uterus.
C Anxiety will decrease the pain threshold.
D Anxiety will decrease the amount of rest the mother gets between contractions.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 390
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

5. When providing labor support, the nurse knows that which fetal position might cause the
laboring woman more back discomfort?
a. Right occiput anterior
b. Left occiput anterior
c. Right occiput transverse
d. Left occiput posterior
ANS: D

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