Obstetric Nurse Test Obstetric Nurse Pain Management in Labor 3

Question 1

The gate control theory of pain, as applied to labor analgesia, explains how non-pharmacological methods reduce pain by:

Accepted Answer

Activating large sensory nerve fibers that inhibit pain signal transmission in the dorsal horn

Answer

Blocking oxytocin receptors in uterine smooth muscle

Answer

Relaxing uterine smooth muscle to reduce contraction intensity

Answer

Increasing endogenous cortisol release

Question 2

A patient at 39 weeks receives IV morphine for labor pain. The nurse should monitor the newborn most closely for:

Accepted Answer

Neonatal respiratory depression, especially if delivery occurs within 1–4 hours of administration

Answer

Neonatal hypertension

Answer

Neonatal hypoglycemia

Answer

Neonatal seizures

Question 3

A patient develops a severe positional headache 12 hours after receiving a spinal block during labor. This presentation is most consistent with:

Accepted Answer

Post-dural puncture headache (PDPH)

Answer

Hypertensive crisis

Answer

Allergic reaction to local anesthetic

Answer

Epidural abscess

Question 4

Which maternal position during labor is most effective for relieving back pain associated with an occiput posterior fetal position?

Accepted Answer

Hands-and-knees (all-fours) position

Answer

Supine with legs elevated on pillows

Answer

Left lateral Sims position

Answer

Semi-Fowler's with knees extended

Question 5

A patient develops a temperature of 38.6°C after 8 hours of epidural analgesia with no other signs of infection. The nurse's best understanding of this finding is:

Accepted Answer

Epidural-associated fever can occur without infection and requires evaluation with clinical context

Answer

This indicates an epidural abscess requiring immediate catheter removal

Answer

This is an expected side effect requiring no action

Answer

The epidural must be discontinued to resolve the fever

Question 6

TENS (transcutaneous electrical nerve stimulation) reduces labor pain primarily through which mechanism?

Accepted Answer

Stimulating endorphin release and activating gate control mechanisms in the spinal cord

Answer

Blocking uterine prostaglandin synthesis

Answer

Relaxing the cervix to speed dilation

Answer

Increasing maternal blood pressure to counter hypotension

Question 7

Which patterned breathing technique taught in childbirth education classes (such as Lamaze) is primarily used to help manage contraction pain during labor?

Accepted Answer

Paced rhythmic breathing synchronized with contractions

Answer

Valsalva maneuver with prolonged breath-holding

Answer

Deliberate hyperventilation to induce mild alkalosis

Answer

Apneic intervals between contractions