ATI RN
Promoting Client Comfort During Labor and Delivery Questions
Question 1 of 5
The nurse is teaching a childbirth education class. Which information regarding excessive pain in labor should the nurse include in the session?
Correct Answer: D
Rationale: The correct answer is D because excessive pain in labor can lead to increased maternal stress, which may result in decreased placental perfusion, compromising oxygen and nutrient delivery to the fetus. This can have serious implications for the baby's well-being. Choices A, B, and C are incorrect because excessive pain in labor does not necessarily lead to a more rapid labor, has an effect on the labor outcome by potentially impacting placental perfusion, and is not considered a normal occurrence that should be disregarded.
Question 2 of 5
The method of anesthesia in labor that is considered the safest for the fetus is
Correct Answer: A
Rationale: The correct answer is A: epidural block. Epidural anesthesia in labor is considered the safest for the fetus because it does not directly affect the baby's central nervous system. It provides effective pain relief for the mother while minimizing the risk of medication passing to the fetus. It also allows for adjustment of the dose as needed during labor. Summary of why other choices are incorrect: B: Pudendal block is a regional anesthesia technique that primarily provides pain relief to the perineum and does not affect the fetus directly. C: Local infiltration anesthesia is limited in its coverage and may not provide adequate pain relief during labor. D: Spinal (subarachnoid) anesthesia may lead to a rapid and significant drop in blood pressure, affecting fetal oxygenation and require careful monitoring.
Question 3 of 5
Which of the following factors would affect pain perception or tolerance for the laboring patient?
Correct Answer: A
Rationale: The correct answer is A: Right occiput posterior fetal position during labor. This position can lead to intense back pain and prolonged labor, affecting pain perception. A posterior position can put pressure on the sacrum and cause increased discomfort. In contrast, choices B, C, and D do not directly impact pain perception during labor. Choice B, Bishop score of 10, indicates favorable conditions for labor progress but does not necessarily affect pain perception. Choice C, Gynecoid pelvis, refers to a common pelvis shape that may facilitate labor but does not directly influence pain tolerance. Choice D, Absence of Ferguson's reflex, is related to the ability to push effectively but is not directly linked to pain perception.
Question 4 of 5
A labor patient, gravida 2, para 1, at term has received meperidine (Demerol) for pain control during labor. Her most recent dose was 15 minutes ago and birth is now imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. Which medication does the nurse anticipate would be required in the birth room for administration?
Correct Answer: A
Rationale: Rationale: The correct answer is A: Oxytocin (Pitocin). Oxytocin is commonly given during the third stage of labor to help with uterine contractions and prevent postpartum hemorrhage. Meperidine can cross the placenta and cause respiratory depression in the newborn. Therefore, the nurse should anticipate needing oxytocin to assist with contractions after birth to minimize bleeding. Summary of other choices: B: Naloxone (Narcan) - This is an opioid antagonist used to reverse the effects of opioids like meperidine. However, it is not typically needed if the newborn does not show signs of respiratory depression. C: Bromocriptine (Parlodel) - This medication is not commonly used during labor and birth and is not indicated in this scenario. D: Oxygen - While oxygen may be needed for the mother or newborn in certain situations, it is not directly related to the administration of meperidine or
Question 5 of 5
A patient presents to the labor and birth area for emergent birth. Vaginal exam reveals that the patient is fully dilated, vertex, +2 station, with ruptured membranes. The patient is extremely apprehensive because this is her first childbirth experience and asks for an epidural to be administered now. What is the priority nursing response based on this patient assessment?
Correct Answer: A
Rationale: The correct answer is A because the patient is fully dilated and at +2 station, indicating imminent birth. Administering an epidural at this stage can be risky due to the potential for rapid progression of labor, making it difficult to safely place the epidural. Contact anesthesia is often used in emergent situations for epidural placement. Additionally, preparing the patient per protocol ensures that all necessary steps are followed for the safety and well-being of the patient and the baby. Choices B and C are incorrect because telling the patient she won't need pain medication is dismissive of her valid request and could lead to unnecessary distress. Assisting with nonpharmacologic methods may not be effective at this point given the patient's extreme apprehension and the advanced stage of labor. Choice D is incorrect as calling the physician for admitting orders is not the priority in this situation. The immediate focus should be on addressing the patient's request for pain management and ensuring her safety during the birth process.