Obstetric Nurse Test Obstetric Nurse Pain Management in Labor 2

Question 1

Combined spinal-epidural (CSE) analgesia in labor is characterized by:

Accepted Answer

Rapid initial pain relief while preserving the ability to ambulate

Answer

Slower onset than epidural alone

Answer

Higher risk of fetal bradycardia than standard epidural

Answer

Requiring larger total doses of local anesthetic

Question 2

Effleurage as a labor comfort measure is best described as:

Accepted Answer

Light rhythmic stroking of the abdomen during contractions

Answer

Deep sacral massage between contractions

Answer

Cold pack application to the perineum

Answer

Sustained pressure on lumbar trigger points

Question 3

When monitoring a patient using hydrotherapy (water immersion) for labor pain relief, the nurse's priority assessment is:

Accepted Answer

Monitoring water temperature to prevent maternal and fetal hyperthermia

Answer

Limiting immersion to 15-minute intervals

Answer

Restricting use to patients with intact membranes only

Answer

Ensuring the patient is in active labor before entry

Question 4

Which local anesthetic agent is most commonly used in continuous epidural infusions for labor analgesia?

Accepted Answer

Low-concentration bupivacaine or ropivacaine

Answer

Lidocaine 2%

Answer

Tetracaine 0.5%

Answer

Chloroprocaine 3%

Question 5

A patient with an epidural reports a "hot spot" — an area of persistent pain despite the epidural running. The nurse's first action is:

Accepted Answer

Reposition the patient and notify the anesthesia provider

Answer

Discontinue the epidural and switch to IV opioids

Answer

Independently increase the epidural infusion rate

Answer

Administer IV ketorolac for the breakthrough pain

Question 6

Patient-controlled epidural analgesia (PCEA) differs from a standard continuous epidural infusion because it:

Accepted Answer

Allows the patient to self-administer bolus doses within preset safety limits

Answer

Eliminates the need for a background continuous infusion

Answer

Permits the patient to adjust the continuous rate independently

Answer

Requires more total anesthetic medication per hour

Question 7

A patient asks about nitrous oxide (N2O) for labor pain. Which statement by the nurse is most accurate?

Accepted Answer

It reduces pain perception and anxiety without eliminating sensation

Answer

Nitrous oxide completely eliminates labor pain

Answer

It should not be used after 8 cm cervical dilation

Answer

It causes significant respiratory depression in the newborn