Chapter 16 Maternal and Child Health Nursing 7th Edition

Chapter 16  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
When entering the second phase of labor, a patient tells the nurse that the pain is severe and is unsure if pain medication should be used. Which nursing diagnosis should the nurse use to guide the care of the patient at this time?
A)
Pain related to labor contractions
B)
Powerlessness related to the duration and intensity of labor
C)
Decision conflict related to the use of analgesia during labor
D)
Anxiety related to lack of knowledge about normal labor processes
Ans:
C

Feedback:

The patient is in conflict regarding whether or not to use pain medication during labor at this time. This is an example of decisional conflict. The patient’s need is much more than experiencing pain during labor contractions. There is no enough information to support that the patient is experiencing powerlessness. The patient is not demonstrating anxiety related to the labor process.

2.
A patient in labor is prescribed transcutaneous electrical nerve stimulation (TENS) to help with pain relief during labor. How should the nurse explain the process of pain relief with this method?
A)
Counterirritation stimulation blocks pain from traveling to the spinal cord.
B)
Needles are inserted along meridians to release endorphins and control pain.
C)
A machine is used to measure the patient’s ability to relax during contractions.
D)
Small injections of sterile saline reduce are used to reduce the amount of back pain.
Ans:
A

Feedback:

Transcutaneous electrical nerve stimulation (TENS) works to relieve pain by applying counterirritation to nociceptors. Low-intensity electrical stimulation blocks the afferent fibers, preventing pain from traveling to the spinal cord synapses from the uterus. Needles being inserted along meridians to release endorphins explain acupuncture. A machine to measure the patient’s ability to relax during contractions explains biofeedback. Small injections of saline to reduce back pain explain intracutaneous nerve stimulation.

3.
The health care provider is reluctant to provide pain medication to a patient delivering a preterm fetus. What should the nurse explain to the patient as the reason for the preterm fetus being more affected by medication?
A)
Affinity of the preterm fetus to fat-soluble drugs
B)
Inability of the immature liver to metabolize or inactivate drugs
C)
Affinity of the preterm fetus to drugs that are strongly bound to protein
D)
Inability of the preterm fetus to use drugs with a molecular weight over 1,000
Ans:
B

Feedback:

A preterm fetus, which has an immature liver and is unable to metabolize or inactivate drugs, is generally more affected by drugs than a term fetus. A preterm fetus does not have an affinity to drugs that are fat soluble or strongly bound to protein. The preterm fetus is not able to metabolize drugs because of an immature liver, which has nothing to do with the molecular weight of the medication.

4.
When teaching the pregnant patient about self-medicating for pain during labor, why did the nurse instruct the patient to avoid taking acetylsalicylic acid?
A)
Development of respiratory depression in the newborn
B)
Interference with the ability to concentrate on contractions
C)
Interference with blood coagulation with increased risk of bleeding in mother or infant
D)
Competition with bilirubin-binding sites in fetal circulation increases risk of kernicterus.
Ans:
C

Feedback:

The nurse should caution the pregnant patient not to take acetylsalicylic acid (aspirin) for pain in labor because aspirin interferes with blood coagulation, increasing the risk for bleeding in the newborn or patient. Aspirin does not cause respiratory depression in the newborn, interfere with contractions, or compete with bilirubin-binding cites in fetal circulation.

5.
The nurse is preparing materials to instruct a pregnant patient about the use of a local anesthetic to block specific nerve pathways. About which type of pain reduction technique will the nurse instruct the patient?
A)
General anesthesia
B)
Pressure anesthesia
C)
Regional anesthesia
D)
Pudendal nerve block
Ans:
C

Feedback:

Regional anesthesia is the injection of a local anesthetic to block specific nerve pathways. This achieves pain relief by blocking sodium and potassium transport in the nerve membrane so the nerve is unable to conduct sensations. General anesthesia is rarely used and is not referred to as being general anesthesia. Pressure anesthesia results from the fetal head pressing against the stretched perineum. A pudendal nerve block is the injection of a local anesthetic through the vagina to anesthetize the pudendal nerve.