Foundations Of Maternal Newborn And Women’s Health Nursing 6th Edition By Sharon – Test Bank
Chapter 11: Perinatal Education
MULTIPLE CHOICE
1. The birth educator is discussing the advantages and disadvantages of birthing options. Which disadvantage is common with epidural anesthesia?
a. Effective pushing is optimized.
b. The risk of catheterization is decreased.
c. The length of labor and birth may be decreased.
d. The use of forceps and oxytocin administration is increased.
ANS: D
Administration of oxytocic drugs and the use of forceps are more likely with epidural anesthesia. Epidural anesthesia can cause less effective pushing because the woman cannot feel the contractions. Catheterizing the patient is common because the woman does not have the urge to empty her bladder. Epidural anesthesia usually removes most pain but may increase the length of labor.
PTS: 1 DIF: Cognitive Level: Application REF: 186
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Health Promotion and Maintenance
2. What is covered by early pregnancy classes offered in the first and second trimesters?
a. Methods of pain relief
b. The phases and stages of labor
c. Coping with common discomforts of pregnancy
d. Prebirth and postbirth care of a client having a cesarean birth
ANS: C
Early pregnancy classes focus on the first two trimesters and cover information on adapting to pregnancy, dealing with early discomforts, and understanding what to expect in the months ahead. Methods of pain relief are discussed in a childbirth preparation class. The phases and stages of labor are usually covered in a childbirth preparation class. Cesarean birth preparation classes discuss prebirth and postbirth of a client having a cesarean birth.
PTS: 1 DIF: Cognitive Level: Understanding REF: 185
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance
3. Which client is most likely to experience pain during labor?
a. Gravida 1 whose fetus is in a breech presentation
b. Gravida 3 who is using Lamaze breathing techniques
c. Gravida 2 who is anxious because her last labor was difficult
d. Gravida 2 who has not attended childbirth preparation classes
ANS: C
Anxiety affects a woman’s perception of pain. Tension during labor causes tightening of abdominal muscles, impeding contractions and increasing pain by stimulation of nerve endings. A breech presentation does not mean that the woman will experience a painful labor. Lamaze breathing techniques use the mind to prevent pain; they involve concentration and conditioning to help the woman respond to contractions with relaxation to decrease pain. Childbirth preparation classes can help a woman prepare for the pain but will not prevent the woman from experiencing pain during labor.
PTS: 1 DIF: Cognitive Level: Analysis REF: 188
OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Health Promotion and Maintenance
4. When reading a new client’s birth plan, the nurse notices that the client will be bringing a doula to the hospital during labor. What does the nurse think that this means?
a. The client will have her grandmother as a support person.
b. The client will bring a paid, trained labor support person with her during labor.
c. The client will have a special video she will play during labor to assist with relaxation.
d. The client will have a bag that contains all the approved equipment that may help with the labor process.
ANS: B
A doula is a trained labor support person who is employed by the mother to provide labor support. She gives physical support such as massage, helps with relaxation, and provides emotional support and advocacy throughout labor. A doula is usually not a relative of the woman. A doula is a trained labor support person.
PTS: 1 DIF: Cognitive Level: Understanding REF: 184
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. Which is the method of childbirth that helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor?
a. Bradley
b. Lamaze
c. Leboyer
d. Dick-Read
ANS: D
The Dick-Read method helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor. The Lamaze method involves concentration and conditioning to help the woman respond to contractions with relaxation to decrease pain. Viewing childbirth as a traumatic experience, the Leboyer method uses decreased light and noise to help the newborn adapt to extrauterine life more easily. The Bradley method teaches women to use abdominal muscles to increase relaxation and breath control; it emphasizes avoidance of all medications and interventions.
PTS: 1 DIF: Cognitive Level: Understanding REF: 188, 189
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance
6. Which type of cutaneous stimulation involves massage of the abdomen?
a. Imagery
b. Effleurage
c. Mental stimulation
d. Thermal stimulation
ANS: B
Effleurage is massage usually performed on the abdomen during contractions. Imagery exercises enhance relaxation by teaching the woman to imagine herself in a relaxing setting. Mental stimulation is a group of methods to decrease pain by increasing mental stimulation. Thermal stimulation decreases pain by using applications of heat and cold.
PTS: 1 DIF: Cognitive Level: Understanding REF: 190
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity
7. What does a birth plan help the parents accomplish?
a. Avoidance of an episiotomy
b. Determining the outcome of the birth
c. Assuming complete control of the situation
d. Taking an active part in planning the birth experience
ANS: D
The birth plan helps the woman and her partner look at the available options and plan the birth experience to meet their personal needs. A birth plan cannot dictate the need for or avoidance of an episiotomy. The outcome of the birth is not an absolute determinant. A birth plan does not assume complete control of the situation; it allows for expanding communication.
PTS: 1 DIF: Cognitive Level: Understanding REF: 192
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance
8. Which client could safely be cared for by a certified nurse-midwife?
a. Gravida 3, para 2, with no complications
b. Gravida 1, para 0, with mild hypertension
c. Gravida 2, para 1, with insulin-dependent diabetes
d. Gravida 1, para 0, with borderline pelvic measurements
ANS: A
A certified nurse-midwife (CNM) cares for women who are at low risk for complications. The CNM would not care for a woman with hypertension. The CNM would not care for a woman with insulin-dependent diabetes. The CNM would not care for a woman with borderline pelvic measurements.
PTS: 1 DIF: Cognitive Level: Analysis REF: 184
OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Health Promotion and Maintenance
9. Martha is a gravida 3, para 2, whose last child was born 5 years ago. She attended childbirth preparation classes with her first pregnancy. Which class would be most appropriate for her?
a. Refresher course
b. Infant care classes
c. Postpartum classes
d. Early pregnancy classes
ANS: A
When 2 or more years elapse between a prepared childbirth class and a subsequent pregnancy, a refresher course is recommended to provide couples with an update on new developments and to review techniques. Infant care classes cover the basics of infant care, with which she is familiar. She has experienced the postpartum period so this class would not be as beneficial as a refresher class. Early pregnancy classes cover information on adapting to pregnancy, dealing with discomforts such as morning sickness and fatigue, and understanding what to expect in the months ahead.
PTS: 1 DIF: Cognitive Level: Analysis REF: 186
OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Health Promotion and Maintenance
10. A client asks, “What can I do to help decrease the amount of pain with labor?” What should be the nurse’s best response?
a. “Nothing. That is the way God intended it to be.”
b. “We can give you medications to help with the pain.”
c. “You should not worry about the pain; leave that concern up to the staff.”
d. “By trying to relax, the contractions will be more efficient and the pain may be less.”
ANS: D
Anxiety and tension will make the uterine contractions less effective and increase the length of labor. Relaxation will help the contractions to be more effective and the labor will be less painful. Stating nothing is demeaning and does not answer the woman’s questions. The woman may not want medications but instead is looking for alternatives. “You should not worry about the pain; leave that concern up to the staff” does not answer the woman’s questions and would not alleviate her concern about pain control.
PTS: 1 DIF: Cognitive Level: Application REF: 188
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
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