Chapter 18 Pain Management for Childbirth

Chapter 18  Pain Management for Childbirth

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Childbirth preparation can be considered successful if the outcome is described as follows:

a. Labor and delivery were pain-free.
b. The woman’s partner participated eagerly.
c. The woman rehearsed labor and practiced skills to master pain.
d. Only nonpharmacologic methods for pain control were used.

ANS: 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. Childbirth preparation does not guarantee a
pain-free labor. A woman should be prepared for pain and anesthesia/analgesia realistically.
The partner’s role and participation level should be established by the couple. Women will not
always achieve their desired level of pain control by using nonpharmacologic methods alone.

PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating
REF: p. 356 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
This pain comes from cervical changes, distention of the lower uterine segment, and uterine
ischemia. 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. Second-stage labor pain is intense, sharp, burning, and localized. Third-stage
labor pain is similar to that of the first stage.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 355 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

Childbirth pain is part of a normal process, whereas other types of pain usually signify an
injury or illness. Childbirth pain is not more or less responsive to medication. The pain with
childbirth is a normal process; it is not caused by the type of injury when withdrawal from the
stimuli is seen. Childbirth pain is not less intense than other types of pain.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 354 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
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. It can also decrease blood flow to the uterus, the pain
threshold, and the amount of rest the mother gets between contractions.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 356
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
In the left occiput posterior position, each contraction pushes the fetal head against the
mother’s sacrum, which results in intense back discomfort. The other fetal positions do not
cause more back discomfort.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 358 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance