Question 1

The nurse is working with a laboring woman who has a known intrauterine fetal demise. To facilitate the family's acceptance of the fetal loss, after delivery the nurse should do which of the following?

Accepted Answer

Offering the parents the choice of holding the infant in their arms can be a crucial step in the grieving process, allowing them to acknowledge the reality of the loss and begin to say goodbye. This approach respects the parents' autonomy in deciding how they wish to grieve and can facilitate emotional healing.

Question 2

A 15-year-old client has delivered a 22-week stillborn fetus. What does the nurse understand?

Accepted Answer

D

Question 3

A couple requests to see their stillborn infant. How should the nurse prepare the infant?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

The nurse should prepare the stillborn infant in a way that respects the dignity of the infant and the emotional needs of the parents. Wrapping the infant in a blanket and placing a hat on the infant can help present the infant in a more comforting and dignified manner, which can be important for the parents during their grieving process.

Question 4

The community nurse has identified that the mother who gave birth to a stillborn baby last week is an intuitive griever. Which behavior has the nurse encountered that would lead to this assessment?

Accepted Answer

Intuitive grieving is characterized by a strong focus on expressing emotions and talking about one's feelings and experiences related to the loss. The mother's behavior of repeatedly talking about her thoughts, feelings, and emotions about losing her child aligns with this grieving style.

Question 5

Which of the following may lead to the development of disseminated intravascular coagulation (D I C), also called consumption coagulopathy, in the mother?

Accepted Answer

The answer of Which of the following may lead to...

Question 6

The nurse is planning an in-service presentation about perinatal loss. Which statements should the nurse include in this presentation?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

The answer of The nurse is planning an in-service presentation...

Question 7

It is confirmed that a 14-week fetus has died. The patient has an unfavorable cervix. Which approaches to deliver the fetus should be reviewed with the patient?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

Options A (Oxytocin), B (Misoprostol), C (Prostaglandins), and D (Laminaria tent) are all methods used to induce labor in cases of fetal demise, especially when the cervix is unfavorable. Oxytocin can stimulate uterine contractions, Misoprostol and other Prostaglandins can help ripen the cervix and induce labor, and Laminaria tents are used for cervical dilation. Cesarean section (E) is generally not the preferred method for delivering a deceased fetus, especially in the context of an unfavorable cervix and the absence of maternal health indications for a surgical delivery.

Question 8

The community nurse is planning care for a family that experienced the loss of twins at 20 weeks. Which of these steps should be part of the nurse's care of this family?

Accepted Answer

Expressing belief in the family's ability to get through the experience shows support and empathy, acknowledging their resilience and capacity to cope with their loss. It's important to provide individualized care rather than basing it on reactions of others (A), as grief is a very personal experience. Encouraging the couple to keep their feelings to themselves (C) can be harmful, as expressing and sharing grief is a crucial part of the healing process. Telling the couple their babies are happy in heaven (D) may not align with their beliefs or may be perceived as minimizing their loss.

Question 9

The nurse is supervising care by a new graduate nurse who is working with a couple who have experienced a stillbirth. Which statement made by the new nurse indicates that further instruction is necessary?

Accepted Answer

Staying out of the room as much as possible is not appropriate as it may be interpreted as neglect or discomfort with the situation. The nurse should offer support and presence, acknowledging the family's grief and providing care as needed.

Question 10

As the couple and their families begin to confront the pain of their loss, many normal manifestations of grief may be present. Which of the following would indicate an emotional response to the loss?

Accepted Answer

The answer of As the couple and their families begin...

Question 11

The nurse is present when a mother and her partner are told that their 35-week fetus has died. Which nursing intervention should the nurse perform first?

Accepted Answer

Encouraging open communication with the family and the healthcare team is crucial in this situation. It allows the family to express their feelings, ask questions, and receive the support they need during this difficult time. The other options do not prioritize the immediate emotional needs of the family or involve actions that are premature or inappropriate for the nurse to initiate first.

Question 12

The nurse has returned from working as a maternal-child nurse volunteer for a non-governmental organization. After completing a community presentation about this experience, the nurse knows that learning has occurred when a participant states which of the following?

Accepted Answer

Group B streptococci (GBS) can indeed cause serious infections in newborns, including pneumonia, meningitis, and sepsis, and can lead to fetal death if the infection occurs before or during birth. This understanding indicates that learning about the impact of maternal infections on fetal outcomes has occurred.

Question 13

The nurse is anticipating the arrival of a couple in the labor unit. It has been determined that the 37-week fetus has died in utero from unknown causes. What should the nurse include in the plan of care for this couple?

Accepted Answer

Placing the couple in a labor room at the end of the hall with an empty room next door is a sensitive approach that provides privacy and quiet away from the activity and sounds of other births, which can be emotionally distressing under these circumstances.

Question 14

The nurse is a caring for a patient who is recovering from the loss of her 24-week fetus. Which observations should the nurse identify as being the patient's behavioral responses to this loss?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

Crying, fear of being alone, and absent-mindedness are all behavioral responses to the loss of a child.

Question 15

The client at 37 weeks' gestation calls the clinic nurse to report that neither she nor her partner has felt fetal movement for the past 48 hours. The nurse anticipates that the physician will order which test to assess fetal viability?

Accepted Answer

An ultrasound is the most appropriate and immediate test to assess fetal viability when there is a concern about fetal movement, especially after 48 hours of no perceived movement. It provides direct visualization of the fetus, allowing for assessment of fetal life, movement, and development.

Question 16

The nurse is caring for a client who experienced the birth of a stillborn son earlier in the day. The client is from a culture where a woman's status is dominated by themes of motherhood and childrearing. What behavior would the nurse expect in this client?

Accepted Answer

In cultures where a woman's status is heavily tied to motherhood, the loss of a child may lead to feelings of failure as a woman, as motherhood is a significant aspect of her identity and societal role.

Question 17

The postpartum unit nurse is caring for a client who delivered a term stillborn infant yesterday. The mother is heard screaming at the nutrition services worker, "This food is horrible! You people are incompetent and can't cook a simple edible meal!" The nurse understands this as which of the following?

Accepted Answer

The mother's behavior is indicative of the anger phase of grief. It is common for individuals grieving a significant loss, such as the death of a child, to express anger and frustration, sometimes directed at unrelated issues or individuals, as part of their grieving process.

Question 18

The mother of a client who has experienced a term stillbirth arrives at the hospital and goes to the nurses' desk. The mother asks what she should say to her daughter in this difficult time. What is the nurse's best response?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

Expressing sadness and being present, as well as encouraging the daughter to talk about the baby, are supportive actions that validate her feelings and help her process the loss.

Question 19

The labor and delivery nurse is caring for a client whose labor is being induced due to fetal death in utero at 35 weeks' gestation. In planning intrapartum care for this client, which nursing diagnosis is most likely to be applied?

Accepted Answer

The most appropriate nursing diagnosis for a client experiencing labor induction due to fetal death in utero is "Powerlessness." This diagnosis addresses the emotional and psychological impact of the situation, recognizing the client's likely feelings of loss of control and helplessness in the face of an adverse pregnancy outcome.

Question 20

The nurse is working with a family who experienced the stillbirth of a son 2 months ago. Which statement by the mother would be expected?

Accepted Answer

Grieving the loss of a child can manifest in various ways, including persistent sadness and crying. This is a normal part of the grieving process, indicating that the mother is experiencing expected emotional responses to her profound loss.

Quiz 36: Grief and Loss in the Child-Bearing Family