Chapter 07: Nursing Management of Pain
During Labor and Birth
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. The nurse is preparing a teaching plan for a woman receiving a subarachnoid block before
delivery. What nursing action will be included in this plan to prevent the associated side effect of
this type of anesthesia?
a. Restrict oral fluids.
b. Keep legs flexed.
c. Walk with assistance as soon as possible.
d. Lie flat for several hours.
ANS: D
The woman would be advised to remain flat for several hours after the block to decrease the
chance of postspinal headache.
DIF: Cognitive Level: Application REF: p. 175 OBJ: 7 | 8
TOP: Subarachnoid Block KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. A woman requests a pudendal block to manage her labor pain. What statement by the woman
indicates a need for further explanation about the pudendal block?
a. “I‘m having a contraction. Can I get the pudendal block now?”
b. “I‘ll get the pudendal block right before I deliver.”
c. “The nurse-midwife will insert the needles into my vagina.”
d. “It takes a few minutes after the medicine is administered to make me feel numb.”
ANS: A
The pudendal block does not block pain from contractions and is given just before birth.
DIF: Cognitive Level: Comprehension REF: p. 176 OBJ: 7 | 8
, TOP: Pudendal Block KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart. She
received little prenatal care and had no childbirth preparation. She is crying loudly and shouting,
“Please give me something for the pain. I can‘t take the pain!” What is the priority nursing
diagnosis?
a. Pain related to uterine contractions
b. Knowledge deficit related to the birth experience
c. Ineffective coping related to inadequate preparation for labor
d. Risk for injury related to lack of prenatal care
ANS: A
The most important issue for this woman, at this time, is effective pain management.
DIF: Cognitive Level: Analysis REF: p. 177, Nursing Care Plan 7.1
OBJ: 4 TOP: Pain as a Priority
KEY: Nursing Process Step: Nursing Diagnosis
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. The nurse who encourages the gate control theory of pain control would advise a woman in labor
and her partner to use which nonpharmacological method of pain management?
a. Slow abdominal breathing
b. Guided relaxation
c. Listening to music
d. Massage
ANS: D
According to the gate control theory, stimulating large-diameter nerve fibers temporarily
interferes with conduction of impulses through small-diameter fibers. Massage is a technique
that stimulates large-diameter fibers and “closes the gate.”
DIF: Cognitive Level: Analysis REF: p. 166 OBJ: 6
TOP: Gate Control KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
During Labor and Birth
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. The nurse is preparing a teaching plan for a woman receiving a subarachnoid block before
delivery. What nursing action will be included in this plan to prevent the associated side effect of
this type of anesthesia?
a. Restrict oral fluids.
b. Keep legs flexed.
c. Walk with assistance as soon as possible.
d. Lie flat for several hours.
ANS: D
The woman would be advised to remain flat for several hours after the block to decrease the
chance of postspinal headache.
DIF: Cognitive Level: Application REF: p. 175 OBJ: 7 | 8
TOP: Subarachnoid Block KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Reduction of Risk
2. A woman requests a pudendal block to manage her labor pain. What statement by the woman
indicates a need for further explanation about the pudendal block?
a. “I‘m having a contraction. Can I get the pudendal block now?”
b. “I‘ll get the pudendal block right before I deliver.”
c. “The nurse-midwife will insert the needles into my vagina.”
d. “It takes a few minutes after the medicine is administered to make me feel numb.”
ANS: A
The pudendal block does not block pain from contractions and is given just before birth.
DIF: Cognitive Level: Comprehension REF: p. 176 OBJ: 7 | 8
, TOP: Pudendal Block KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. An 18-year-old primigravida is 4 cm dilated and her contractions are 5 minutes apart. She
received little prenatal care and had no childbirth preparation. She is crying loudly and shouting,
“Please give me something for the pain. I can‘t take the pain!” What is the priority nursing
diagnosis?
a. Pain related to uterine contractions
b. Knowledge deficit related to the birth experience
c. Ineffective coping related to inadequate preparation for labor
d. Risk for injury related to lack of prenatal care
ANS: A
The most important issue for this woman, at this time, is effective pain management.
DIF: Cognitive Level: Analysis REF: p. 177, Nursing Care Plan 7.1
OBJ: 4 TOP: Pain as a Priority
KEY: Nursing Process Step: Nursing Diagnosis
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. The nurse who encourages the gate control theory of pain control would advise a woman in labor
and her partner to use which nonpharmacological method of pain management?
a. Slow abdominal breathing
b. Guided relaxation
c. Listening to music
d. Massage
ANS: D
According to the gate control theory, stimulating large-diameter nerve fibers temporarily
interferes with conduction of impulses through small-diameter fibers. Massage is a technique
that stimulates large-diameter fibers and “closes the gate.”
DIF: Cognitive Level: Analysis REF: p. 166 OBJ: 6
TOP: Gate Control KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
