ATI RN
Promoting Client Comfort During Labor and Delivery Questions
Question 1 of 5
Which method of pain management would be safest for a gravida 3, para 2, admitted at 8 cm cervical dilation?
Correct Answer: C
Rationale: The correct answer is C: Epidural anesthesia. At 8 cm cervical dilation, the patient is in active labor and close to delivery. Epidural anesthesia is the safest method as it provides effective pain relief without affecting the baby's central nervous system. Narcotics can pass through the placenta and affect the baby's breathing. Spinal block may cause a sudden drop in blood pressure. Breathing and relaxation techniques may not be sufficient at 8 cm dilation. Epidural anesthesia is the most appropriate for pain management in this scenario.
Question 2 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 3 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 4 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.
Question 5 of 5
A pregnant woman in labor is quite anxious and has been breathing rapidly during contractions. She now complains of a tingling sensation in her fingers. What is the priority nursing intervention at this time?
Correct Answer: B
Rationale: The correct answer is B: Reposition the patient to a side lying position. This is the priority intervention because the tingling sensation in the fingers could be a sign of hyperventilation, which can lead to respiratory alkalosis. Repositioning the patient to a side lying position can help optimize oxygenation and reduce the risk of hyperventilation by promoting better breathing mechanics. Performing a vaginal exam (A) is not necessary at this time and could increase the patient's anxiety. Instructing the patient to breathe into her cupped hands (C) may not address the underlying issue of hyperventilation. Notifying the physician (D) is important but repositioning the patient should be done first to address the immediate physiological need.