Blueprints Obstetrics & Gynecology 7th Edition Callahan Test Bank

Chapter 1 Pregnancy and Prenatal Care

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.

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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 womans 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 clients 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.

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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?

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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

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