Question 1

A 25-year-old gravida 1 para 1 who had an emergency cesarean birth 3 days ago is scheduled for discharge.As you prepare her for discharge,she begins to cry.Your initial action should be to

Accepted Answer

Although many women experience transient postpartum blues,they need assistance in expressing their feelings.This condition affects 50% to 80% of new mothers.There should be no assumption that the patient is in pain,when in fact she may have no pain whatsoever.This is "blocking" communication and inappropriate in this situation.The patient needs the opportunity to express her feelings first; patient teaching can occur later.

Question 2

Which concerns about parenthood are often expressed by visually impaired mothers (Select all that apply)?

Accepted Answer

Concerns expressed by visually impaired mothers include infant safety,extra time needed for parenting activities,transportation,handling other people's reactions,providing proper discipline,and missing out visually.Blind people sense reluctance on the part of others to acknowledge that they have a right to be parents; however,blind parents are fully capable of caring for their infants.

Question 3

The postpartum woman who continually repeats the story of her labor,delivery,and recovery experience is:

Accepted Answer

Reliving the birth experience makes the event real and helps the mother realize that the pregnancy is over and that the infant is born and is now a separate individual.The retelling of the story is to satisfy her needs,not the needs of others.This new mother is in the taking-in phase,trying to make the birth experience seem real and separate the infant from herself.

Question 4

A new father states,"I know nothing about babies," but he seems to be interested in learning.This is an ideal opportunity for the nurse to:

Accepted Answer

The nurse must be sensitive to the father's needs and include him whenever possible.As fathers take on their new role,the nurse should praise every attempt,even if his early care is awkward.It is important to note the bonding process of the mother and the father; however,that does not satisfy the expressed needs of the father.The new father should be encouraged in caring for his baby by pointing out the things that he does right.Criticizing him will discourage him.

Question 5

To promote bonding and attachment immediately after delivery,the most important nursing intervention is to:

Accepted Answer

Assisting the mother in assuming an en face position with her newborn will support the bonding process.The mother should be given as much privacy as possible; however,nursing assessments must still be continued during this critical time.The mother has just delivered and is more focused on the infant; she will not be receptive to teaching at this time.This is a good time to initiate breastfeeding; however,the mother first needs time to explore the new infant and begin the bonding process.

Question 6

During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby?

Accepted Answer

Accepting the real infant and relinquishing the fantasy infant occurs during the letting-go phase of maternal adjustment.During the taking-hold phase the mother assumes responsibility for her own care and shifts her attention to the infant.In the taking-in phase the mother is primarily focused on her own needs.There is no taking-on phase of maternal adjustment.

Question 7

A man calls the nurse's station and states that his wife,who delivered 2 days ago,is happy one minute and crying the next.The man says,"She was never like this before the baby was born." The nurse's initial response could be to:

Accepted Answer

Before providing further instructions,inform family members of the fact that postpartum blues are a normal process.Telling her partner to "ignore the mood swings" does not encourage further communication and may belittle the husband's concerns.Postpartum blues are usually short-lived; no medical intervention is needed.Client teaching is important; however,the new father's anxieties need to be allayed before he will be receptive to teaching.

Question 8

On observing a woman on her first postpartum day sitting in bed while her newborn lies awake in the bassinet,the nurse should:

Accepted Answer

During the "taking-in" phase of maternal adaptation (the mother may be passive and dependent),the nurse should encourage bonding when the infant is in the quiet alert stage.This is done best by simply giving the baby to the mother.The patient is exhibiting expected behavior during the taking-in phase; however,interventions by the nurse can facilitate infant bonding.The patient will learn best during the taking-hold phase.

Question 9

A nurse is observing a family.The mother is holding the baby she delivered less than 24 hours ago.Her husband is watching his wife and asking questions about newborn care.The 4-year-old brother is punching his mother on the back.The nurse should:

Accepted Answer

The observed behaviors are normal variations of families adjusting to change.There is no need to report this one incident.Giving advice at this point would make the parents feel inadequate.

Question 10

A parent who has a hearing impairment is presented with a number of challenges in parenting.Which nursing approaches are appropriate for working with hearing-impaired new parents (Select all that apply)?

Accepted Answer

Section 504 of the Rehabilitation Act of 1973 requires that hospitals use various communication techniques and resources with the deaf and hard of hearing patient.This includes devices such as door alarms,cry alarms,and amplifiers.Before initiating communication,the nurse needs to be aware of the parents' preferences for communication.Not all hearing-impaired patients know sign language.Do they wear a hearing aid? Do they read lips? Do they wish to have a sign language interpreter? If the parent relies on lip reading,the nurse should sit close enough so that the parent can visualize lip movements.The nurse should speak clearly in a regular voice volume,in short,simple sentences.Written messages such as on a black or white erasable board can be useful.Written materials should be reviewed with the parents before discharge.

Question 11

The best way for the nurse to promote and support the maternal-infant bonding process is to:

Accepted Answer

Close and frequent interaction between mother and infant,which is facilitated by rooming-in,is important in the bonding process.This is often referred to as the mother-baby care or couplet care.Having the mother express her feelings is important; however,it is not the best way to promote bonding.The mother needs time to rest and recuperate; she should not be expected to do all of the care.The patient needs to observe the infant during all stages so she will be aware of what to anticipate when they go home.

Question 12

The mother-baby nurse is able to recognize reciprocal attachment behavior.This refers to:

Accepted Answer

In this definition,"reciprocal" refers to the feedback from the infant during the attachment process.This is a good time for bonding; however,it does not define reciprocal attachment.Reciprocal attachment applies to feedback behavior and is not unidirectional.

Quiz 20: Transition to Parenthood