Question 1

Hearing impaired parents face- many challenges in caregiving and parenting, particularly if their deafness dates back to infancy or early childhood. In order to ensure that the learning needs of these families are met, legislation has been passed that directs hospitals to use various communication techniques and resources with their deaf patients.

Accepted Answer

Section 504 of the Rehabilitation Act of 1973 requires that hospitals or other institutions that receive funding from the U.S. Department of Health and Human Services use a variety of communication techniques and resources with their deaf patients. This includes providing certified interpreters who are proficient in sign language.

Question 2

When dealing with parents who have some form of sensory impairment, nurses should realize that all of these statements are true except:
A) One of the major difficulties visually impaired parents experience is the skepticism of health care professionals.
B) Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact.
C) The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities.
D) Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information.

Accepted Answer

This statement is not true. Visually impaired mothers can develop other ways to bond with their infants, such as through touch and sound.

Question 3

The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, about one-half million women in America experience a more severe syndrome known as postpartum depression (PPD). Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?
A) PPD symptoms are consistently severe.
B) This syndrome affects only new mothers.
C) PPD can easily go undetected.
D) Only mental health professionals should teach new parents about this condition.

Accepted Answer

PPD can easily go undetected, as its symptoms may be dismissed as normal postpartum adjustment or attributed to other causes, such as exhaustion or the demands of new parenthood. It is important for nurses to be aware of this possibility and to screen new mothers for PPD symptoms. The other options (A, B, D) are not accurate statements about PPD. PPD symptoms can range from mild to severe, affect both mothers and fathers, and nurses can educate and support new parents in learning about and coping with PPD.

Question 4

New parents express concern that, because of the mother's emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. The nurse's response should convey to the parents that:
A) Attachment, or bonding, is a process that occurs over time and does not require early contact.
B) The time immediately after birth is a critical period for people.
C) Early contact is essential for optimum parent-infant relationships.
D) They should just be happy that the infant is healthy.

Accepted Answer

Attachment or bonding is a process that occurs over time and does not require immediate contact after birth.

Question 5

The nurse can help a father in his transition to parenthood by:
A) Pointing out that the infant turned at the sound of his voice.
B) Encouraging him to go home to get some sleep.
C) Telling him to tape the infant's diaper a different way.
D) Suggesting that he let the infant sleep in the bassinet.

Accepted Answer

Pointing out the infant's response to his voice can help the father feel more connected to the baby and recognize the importance of his presence and involvement in the infant's life.

Question 6

The nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dad's chin. This woman's statement reflects:
A) Mutuality.
B) Synchrony.
C) Claiming.
D) Reciprocity.

Accepted Answer

The woman's statement reflects claiming, as she is identifying a physical trait that her son shares with his father. Claiming is a process in which parents and family members identify physical and personality traits that are shared among family members, and it is an important part of establishing a sense of family identity. Mutuality refers to the reciprocal relationship between parents and infants, synchrony refers to the coordination of behaviors between parent and infant, and reciprocity refers to the mutual exchange of behaviors between parent and infant. While these concepts are all related to parent-child interactions, they do not apply to the specific scenario described in the question.

Question 7

The nurse notes that a Vietnamese woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed. In evaluating the woman's behavior with her infant, the nurse realizes that:
A) What appears to be a lack of interest in the newborn is in fact the Vietnamese way of demonstrating intense love by attempting to ward off evil spirits.
B) The woman is inexperienced in caring for newborns.
C) The woman needs a referral to a social worker for further evaluation of her parenting behaviors once she goes home with the newborn.
D) Extra time needs to be planned for assisting the woman in bonding with her newborn.

Accepted Answer

In Vietnamese culture, it is believed that newborns are vulnerable to evil spirits, and excessive attention from parents or others may attract these spirits to the infant, causing harm. Therefore, it is common for Vietnamese parents to limit their interactions with their newborns, with the belief that this will protect them from harm. This behavior does not indicate a lack of love or affection for the child.

Question 8

With regard to parents' early and extended contact with their infant and the relationships built, nurses should be aware that:
A) Immediate contact is essential for the parent-child relationship.
B) Skin-to-skin contact is preferable to contact with the body totally wrapped in a blanket.
C) Extended contact is especially important for adolescents and low-income women because they are at risk for parenting inadequacies.
D) Mothers need to take precedence over their partners and other family matters.

Accepted Answer

Nurses should encourage any activity that optimizes family extended contact.Immediate contact facilitates the attachment process but is not essential;otherwise,adopted infants would not establish the affectionate ties they do.The mode of infant-mother contact does not appear to have any important effect.Mothers and their partners are considered equally important.

Question 9

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which is a facilitating behavior?
A) The parents have difficulty naming the infant.
B) The parents hover around the infant, directing attention to and pointing at the infant.
C) The parents make no effort to interpret the actions or needs of the infant.
D) The parents do not move from fingertip touch to palmar contact and holding.

Accepted Answer

Hovering around the infant, directing attention to and pointing at the infant helps to create a positive and nurturing environment for the infant, which can facilitate attachment. Difficulty naming the infant, making no effort to interpret the actions or needs of the infant, and not moving from fingertip touch to palmar contact and holding can all inhibit attachment.

Question 10

After birth a crying infant may be soothed by being held in a position in which the newborn can hear the mother's heartbeat. This phenomenon is known as:
A) Entrainment.
B) Reciprocity.
C) Synchrony.
D) Biorhythmicity.

Accepted Answer

The newborn is in rhythm with the mother.The infant develops a personal biorhythm with the parents' help over time.Entrainment is the movement of newborns in time to the structure of adult speech.Reciprocity is body movement or behavior that gives cues to the person's desires.These take several weeks to develop with a new baby.Synchrony is the fit between the infant's behavioral cues and the parent's responses.

Question 11

In the United States the en face position is preferred immediately after birth. Nurses can facilitate this process by all of these actions except:
A) Washing both the infant's face and the mother's face.
B) Placing the infant on the mother's abdomen or breast with their heads on the same plane.
C) Dimming the lights.
D) Delaying the instillation of prophylactic antibiotic ointment in the infant's eyes.

Accepted Answer

As newborns become functionally able to sustain eye contact with their parents,they spend time in mutual gazing,often in the en face position,a position in which the parent's and infant's faces are approximately 20 cm apart and on the same plane.Washing the infant's or mother's face is not necessary at this time and would interrupt the process.Nurses and physicians or midwives can facilitate eye contact immediately after birth by placing the infant on the mother's abdomen or breasts with the mother's and the infant's faces on the same plane.Dimming the lights encourages the infant's eyes to stay open.To promote eye contact,instillation of prophylactic antibiotic ointment into the infant's eyes can be delayed until after the infant and parents have had some time together in the first hour after birth.

Question 12

Of the many factors that influence parental responses, nurses should be aware that all of these statements regarding age are true except:
A) An adolescent mother's egocentricity and unmet developmental needs interfere with her ability to parent effectively.
B) An adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mothers.
C) Adolescent mothers have a higher documented incidence of child abuse.
D) Mothers older than 35 often deal with more stress related to work and career issues and decreasing libido.

Accepted Answer

There is no conclusive evidence that adolescent mothers have a higher documented incidence of child abuse compared to other age groups.

Question 13

The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, would the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?
A) Talks and coos to her son
B) Seldom makes eye contact with her son
C) Cuddles her son close to her
D) Tells visitors how well her son is feeding

Accepted Answer

Infrequent eye contact with her son may indicate a lack of interest or difficulty in forming an emotional connection, which can be maladaptive to the development of a secure parent-infant attachment. A, C, and D are all positive behaviors that promote bonding and attachment between the mother and her new son.

Question 14

After giving birth to a healthy infant boy, a primiparous woman, 16, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is risk for impaired parenting related to deficient knowledge of newborn care. In planning for the woman's discharge, what should the nurse be certain to include in the plan of care?
A) Tell the woman how to feed and bathe her infant.
B) Give the woman written information on bathing her infant.
C) Advise the woman that all mothers instinctively know how to care for their infants.
D) Provide time for the woman to bathe her infant after she views an infant bath demonstration.

Accepted Answer

Providing a demonstration for the woman to view and then allowing time for her to practice with guidance is the best way to help her gain knowledge and confidence in caring for her newborn. Simply telling her or giving her written information may not be as effective in ensuring she has the necessary skills. It is also important to avoid assuming all mothers instinctively know how to care for their infants, as this can lead to inadequate support and education for those who may need it.

Question 15

With regard to the adaptation of other family members, mainly siblings and grandparents, to the newborn, nurses should be aware that:
A) Sibling rivalry cannot be dismissed as overblown psychobabble; negative feelings and behaviors can take a long time to blow over.
B) Participation in preparation classes helps both siblings and grandparents.
C) In the United States paternal and maternal grandparents consider themselves of equal importance and status.
D) Since 1990 the number of grandparents providing permanent care to their grandchildren has been declining.

Accepted Answer

Preparing older siblings,as well as grandparents,helps with everyone's adaptation.Sibling rivalry should be expected initially,but the negative behaviors associated with it have been overemphasized and stop in a comparatively short time.In the United States,in contrast to other cultures,paternal grandparents frequently consider themselves secondary to maternal grandparents.The number of grandparents providing permanent child care has been rising.

Question 16

In addition to eye contact, early sensual contacts between infant and mother involve sound and smell. Nurses should be aware that, despite what folk wisdom might say:
A) High-pitched voices irritate newborns.
B) Infants can learn to distinguish their mother's voice from others soon after birth.
C) All babies in the hospital smell alike.
D) A mother's breast milk has no distinctive odor.

Accepted Answer

Infants can learn to distinguish their mother's voice from others soon after birth. This is due to the fact that they have been exposed to her voice while in the womb.

Answer: C
 This statement is false. Newborns can distinguish the scent of their mother from that of other mothers or people in close proximity.

The other choices are incorrect. High-pitched voices are actually preferred by infants, as they are similar to the tones heard in the womb. Breast milk does have a distinctive odor, which can vary based on the mother's diet and overall health.

Quiz 15: Transition to Parenthood

When dealing with parents who have some form of sensory impairment, nurses should realize that all of these statements are true except:

New parents express concern that, because of the mother's emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. The nurse's response should convey to the parents that:

The nurse can help a father in his transition to parenthood by:

The nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dad's chin. This woman's statement reflects:

The nurse notes that a Vietnamese woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed. In evaluating the woman's behavior with her infant, the nurse realizes that:

With regard to parents' early and extended contact with their infant and the relationships built, nurses should be aware that:

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which is a facilitating behavior?

After birth a crying infant may be soothed by being held in a position in which the newborn can hear the mother's heartbeat. This phenomenon is known as:

In the United States the en face position is preferred immediately after birth. Nurses can facilitate this process by all of these actions except:

Of the many factors that influence parental responses, nurses should be aware that all of these statements regarding age are true except:

The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, would the nurse identify as a possible maladaptive behavior regarding parent-infant attachment?

With regard to the adaptation of other family members, mainly siblings and grandparents, to the newborn, nurses should be aware that:

In addition to eye contact, early sensual contacts between infant and mother involve sound and smell. Nurses should be aware that, despite what folk wisdom might say: