TEST BANK FOR MATERNITY & WOMEN’S HEALTH
CARE 11TH EDITION BY LOWDERMILK
Lowdermilk: Maternity & Women’s Health Care, 11th Edition
MULTIPLE CHOICE
1. Breathing patterns are taught to laboring women. Which breathing pattern should the
nurse support for the woman and her coach during the latent phase of the first stage of
labor if thecouple has attended childbirth preparation classes?
a. Slow-paced breathing
b. Deep abdominal breathing
c. Modified-paced breathing
d. Patterned-paced breathing
CORRECT ANSWER: A
Slow-paced breathing is approximately one half the woman‘s normal breathing rate
and is used during the early stages of labor when a woman can no longer walk or talk
through her contractions. No such pattern called deep abdominal breathing exists in
childbirth preparation.Modified-paced breathing is shallow breathing that is twice the
woman‘s normal breathing rate. It is used when labor progresses and the woman can
no longer maintain relaxation through paced breathing. Patterned-pace breathing is a
fast, 4:1 breathe, breathe, breathe, blowpattern that is used during the trCORRECT
ANSWERitional phase of labor just before pushing and delivery.
2. A laboring woman has received meperidine (Demerol) intravenously (IV), 90 minutes
beforegiving birth. Which medication should be available to reduce the postnatal
effects of meperidine on the neonate?
a. Fentanyl (Sublimaze)
b. Promethazine (Phenergan)
c. Naloxone (Narcan)
d. Nalbuphine (Nubain)
CORRECT ANSWER: C
An opioid antagonist can be given to the newborn as one part of the treatment for
neonatal narcosis, which is a state of central nervous system (CNS) depression in the
newborn produced by an opioid. Opioid antagonists, such as naloxone (Narcan), can
promptly reverse the CNS depressant effects, especially respiratory depression.
Fentanyl (Sublimaze), promethazine (Phenergan), and nalbuphine (Nubain) do not act
as opioid antagonists to reducethe postnatal effects of meperidine on the neonate.
DIF: Cognitive Level: Apply REF: p. 395
, TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client
Needs: Physiologic Integrity
3. An 18-year-old pregnant woman, gravida 1, para 0, is admitted to the labor and birth
unit withmoderate contractions every 5 minutes that last 40 seconds. The client states,
―My contractions are so strong, I don‘t know what to do.‖ Before making a plan of
care, what should the nurse‘s first action be?
a. Assess for fetal well-being.
b. Encourage the woman to lie on her side.
c. Disturb the woman as little as possible.
d. Recognize that pain is personalized for each individual.
CORRECT ANSWER: D
Each woman‘s pain during childbirth is unique and is influenced by a variety of
physiologic, psychosocial, and environmental factors. A critical issue for the nurse is
how support can make a difference in the pain of the woman during labor and birth.
This scenario includes no information that would indicate fetal distress or a logical
reason to be overly concerned aboutthe well-being of the fetus. The left lateral
position is used to alleviate fetal distress, not maternal stress. The nurse has an
obligation to provide physical, emotional, and psychosocialcare and support to the
laboring woman. This client clearly needs support.
4. A woman who is pregnant for the first time is dilated 3 cm and having contractions
every 5minutes. She is groaning and perspiring excessively; she states that she did not
attend childbirth classes. What is the optimal intervention for the nurse to provide at
this time?
a. Notify the woman‘s health care provider.
b. Administer the prescribed narcotic analgesic.
c. Assure her that her labor will be over soon.
d. Assist her with simple breathing and relaxation instructions.
CORRECT ANSWER: D
By reducing tension and stress, both focusing and relaxation techniques will allow the
womanin labor to rest and conserve energy for the task of giving birth. For those who
have had no preparation, instruction in simple breathing and relaxation can be given in
early labor and is often successful. The nurse can independently perform many
functions in labor and birth, suchas teaching and support. Pain medication may be an
option for this client. However, the initialresponse of the nurse should include
teaching the client about her options. The length of laborvaries among individuals, but
the first stage of labor is the longest. At 3 cm of dilation with contractions every 5
minutes, this woman has a significant amount of labor yet to experience.
5. Nursing care measures are commonly offered to women in labor. Which nursing
measurereflects the application of the gate-control theory?
a. Massage the woman‘s back.
b. Change the woman‘s position.
c. Give the prescribed medication.
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