Question 1

What is the term used when the infant's behaviours and characteristics call forth a corresponding set of maternal behaviours and characteristics?
A) Mutuality
B) Bonding
C) Claiming
D) Acquaintance

Accepted Answer

Mutuality extends the concept of attachment to include this shared set of behaviours.Bonding is the process over time of parents forming an emotional attachment to their infant.Mutuality refers to a shared set of behaviours that is a part of the bonding process.Claiming is the process by which parents identify their new baby in terms of likeness to other family members and their differences and uniqueness.Like mutuality,acquaintance is part of attachment.It describes how parents get to know their baby during the immediate postpartum period through eye contact,touching,and talking.

Question 2

Which statement regarding postpartum mood disorder ( PPMD )is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?
A) PPMD symptoms are consistently severe.
B) This syndrome affects only new mothers.
C) PPMD can easily go undetected.
D) Only mental health providers should teach new parents about this condition.

Accepted Answer

PPMD can go undetected because parents do not voluntarily admit to this type of emotional distress out of embarrassment,fear,or guilt.PPMD symptoms range from mild to severe,with women having both good and bad days.Both mothers and fathers should be screened.PPMD in new fathers can also occur.The nurse should include information on PPMD and how to differentiate this from the baby blues for all patients on discharge.Nurses also can urge new parents to report symptoms and seek follow-up care promptly if they occur.

Question 3

With regard to parents' early and extended contact with their infant and the relationships built,what should nurses be aware of?
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 4

After birth a crying infant may be soothed by being held in a position in which the newborn can hear the mother's heartbeat.What is this phenomenon 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 behaviour 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 behavioural cues and the parent's responses.

Question 5

New parents express concern that,because of the mother's emergency Caesarean birth under general anaesthesia,they did not have the opportunity to hold and bond with their daughter immediately after her birth.What should the nurse's response convey to the parents?
A) Attachment 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 is a process that occurs over time and does not require early contact.The formerly accepted definition of bonding held that the period immediately after birth was a critical time for bonding to occur.Research since has indicated that parent-infant attachment occurs over time.A delay does not inhibit the process.Parent-infant attachment involves activities such as touching,holding,and gazing; it is not exclusively eye contact.A response that conveys that the parents should just be happy that the infant is healthy is inappropriate because it is derogatory and belittling.

Question 6

Many first-time parents do not plan on their parents' help immediately after the newborn arrives.What statement by the nurse is the most appropriate when counselling new parents about the involvement of grandparents?
A) "You should tell your parents to leave you alone."
B) "Grandparents can help you with parenting skills and also help preserve family traditions."
C) "Grandparent involvement can be very disruptive to the family."
D) "They are getting old. You should let them be involved while they can."

Accepted Answer

"Grandparents can help you with parenting skills and also help preserve family traditions" is the most appropriate response.Intergenerational help may be perceived as interference,but a statement of this sort is not therapeutic to the adaptation of the family.Not only is the statement "Grandparent involvement can be very disruptive to the family" invalid,it also is not an appropriate nursing response.Regardless of age,grandparents can help with parenting skills and preserve family traditions.Talking about the age of the grandparents is not the most appropriate statement,and it does not demonstrate sensitivity on the part of the nurse.

Question 7

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

Accepted Answer

Claiming refers to the process by which the child is identified in terms of likeness to other family members.Mutuality occurs when the infant's behaviours and characteristics call forth a corresponding set of maternal behaviours and characteristics.Synchrony refers to the "fit" between the infant's cues and the parent's responses.Reciprocity is a type of body movement or behaviour that provides the observer with cues.

Question 8

During a phone follow-up conversation with a woman who is 4 days' postpartum,the woman tells the nurse,"I don't know what's wrong.I love my son,but I feel so let down.I seem to cry for no reason!" The nurse would recognize that the woman is experiencing which of the following?
A) Taking-in
B) Postpartum depression ( PPD )
C) Postpartum ( PP ) blues
D) Attachment difficulty

Accepted Answer

During the PP blues women are emotionally labile,often crying easily and for no apparent reason.This lability seems to peak around the fifth PP day.The taking-in phase is the period after birth when the mother focuses on her own psychological needs.Typically this period lasts 24 hours.PPD is an intense,pervasive sadness marked by severe,labile mood swings; it is more serious and persistent than the PP blues.Crying is not a maladaptive attachment response; it indicates PP blues.

Question 9

The en face position is preferred immediately after birth.Which of the following would not facilitate this process?
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

Washing the infant's and mother's face does not facilitate the en face position.To facilitate the position in which the parent's and infant's faces are approximately 20 cm apart on the same plane,allowing them to make eye contact,the nurse can place the infant at the proper height on the mother's body,dim the lights so that the infant's eyes open,and delay putting ointment in the infant's eyes.

Question 10

Nursing activities that promote parent-infant attachment are many and varied.One activity that should not be overlooked is the management of the environment.While providing routine mother-baby care,the nurse should ensure which of the following?
A) The baby is able to return to the nursery at night so that the new mother can sleep.
B) Routine times for care are established to reassure the parents.
C) The father should be encouraged to go home at night to prepare for mother-baby discharge.
D) An environment that fosters as much privacy as possible should be created.

Accepted Answer

Care providers need to knock before gaining entry.Nursing care activities should be grouped.Once the baby has demonstrated adjustment to extrauterine life (either in the mother's room or the trAnsweritional nursery),all care should be provided in one location.This important principle of family-centred maternity care fosters attachment by giving parents the opportunity to learn about their infant 24 hours a day.One nurse should provide care to both mother and baby in this couplet care or rooming-in model.It is not necessary for the baby to return to the nursery at night.In fact,the mother will sleep better with the infant close by.Care should be individualized to meet the parents' needs,not the routines of the staff.Teaching goals should be developed in collaboration with the parents.The father or other significant other should be permitted to sleep in the room with the mother.The maternity unit should develop policies that allow for the presence of significant others as much as the new mother desires.

Question 11

In follow-up appointments or visits with parents and their new baby,it may be useful if the nurse can identify parental behaviours that can either facilitate or inhibit attachment.What is a facilitating behaviour?
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 over the infant and obviously paying attention to the baby are facilitating behaviours.Inhibiting behaviours include 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.

Question 12

Which of the following can the nurse do to help a father in his transition to parenthood?
A) Point out that the infant turned at the sound of his voice.
B) Encourage him to go home to get some sleep.
C) Tell him to tape the infant's diaper a different way.
D) Suggest that he let the infant sleep in the bassinet.

Accepted Answer

Infants respond to the sound of voices.Because attachment involves a reciprocal interchange,observing the interaction between parent and infant is very important.Separation of the parent and infant does not encourage parent-infant attachment.Educating the parent in infant care techniques is important,but the manner in which a diaper is taped is not relevant and does not enhance parent-infant interactions.Parent-infant attachment involves touching,holding,and cuddling.It is appropriate for a father to want to hold the infant as the baby sleeps.

Question 13

What should the nurse be aware of with regard to the adaptation of other family members,mainly siblings and grandparents,to the newborn?
A) Sibling rivalry cannot be dismissed as overblown psychobabble; negative feelings and behaviours can take a long time to blow over.
B) Participation in preparation classes helps both siblings and grandparents.
C) In Canada, 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 and grandparents helps everyone to adapt.Sibling rivalry should be expected initially,but the negative behaviours associated with it have been overemphasized and stop in a comparatively short time.In Canada,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 14

The nurse observes that a 15-year-old mother seems to ignore her newborn.What is a strategy that the nurse can use to facilitate mother-infant attachment in this mother?
A) Tell the mother she must pay attention to her infant.
B) Show the mother how the infant initiates interaction and pays attention to her.
C) Demonstrate for the mother different positions for holding her infant while feeding.
D) Arrange for the mother to watch a video on parent-infant interaction.

Accepted Answer

Pointing out the responsiveness of the infant is a positive strategy for facilitating parent-infant attachment.Telling the mother that she must pay attention to her infant may be perceived as derogatory and is not appropriate.Educating the young mother in infant care is important,but pointing out the responsiveness of her baby is a better tool for facilitating mother-infant attachment.Videos are an educational tool that can demonstrate parent-infant attachment,but encouraging the mother to recognize the infant's responsiveness is more appropriate.

Question 15

Of the many factors that influence parental responses,nurses should be aware that which of the following statements regarding age is not true?
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

Adolescent mothers are more inclined to have a number of parenting difficulties that benefit from counselling,but a higher incidence of child abuse is not one of them.Midlife mothers have many competencies but are more likely to have to deal with career and sexual issues than are younger mothers.

Question 16

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

Accepted Answer

The woman should be encouraged to hold her infant in the en face position and make eye contact with the infant.Normal infant-parent interactions include talking and cooing to her son,cuddling her son close to her,and telling visitors how well her son is feeding.

Question 17

Other early sensual contacts between infant and mother involve sound and smell.Nurses should be aware of which one of the following points?
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 odour.

Accepted Answer

Infants know the sound of their mother's voice early.Infants respond positively to high-pitched voices.Each infant has a unique odour.Infants quickly learn to distinguish the odour of their mother's breast milk.

Question 18

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 behaviour with her infant,the nurse realizes which of the following?
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 behaviours 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

The nurse may observe a Vietnamese woman who gives minimal care to her infant and refuses to cuddle or interact with her infant.The apparent lack of interest in the newborn is this cultural group's attempt to ward off evil spirits and actually reflects an intense love and concern for the infant.It is important to educate the woman in infant care,but it is equally important to acknowledge her cultural beliefs and practices.

Question 19

When dealing with parents who have some form of sensory impairment,nurses should realize that which of the following statements is not true?
A) One of the major difficulties that visually impaired parents experience is the skepticism of health care providers.
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) Technological advances, including the Internet, can provide deaf parents with a full range of parenting activities and information.

Accepted Answer

Other sensory output can be provided by the parent,other people can participate,and other coping devices can be used.The skepticism,open or hidden,of health care providers places an additional and unneeded burden on the parents.After the parents' capabilities have been assessed (including some the nurse may not have expected),the nurse can help find ways to assist the parents that play to their strengths.The Internet affords an extra teaching tool for the deaf,as do videos with subtitles or nurses signing.A number of electronic devices can turn sound into light flashes to help pick up a child's cry.Sign language is acquired readily by young children.

Question 20

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

Having the mother demonstrate infant care is a valuable method of assessing the patient's understanding of her newly acquired knowledge,especially in this age group,because she may inadvertently neglect her child.Although verbalizing how to care for the infant is a form of patient education,it is not the most developmentally appropriate teaching for a teenage mother.Although providing written information is useful,it is not the most developmentally appropriate teaching for a teenage mother.Advising the woman that all mothers instinctively know how to care for their infants is an inappropriate statement; it is belittling and false.

Quiz 22: Transition to Parenthood

What is the term used when the infant's behaviours and characteristics call forth a corresponding set of maternal behaviours and characteristics?

Which statement regarding postpartum mood disorder ( PPMD ) is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?

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

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

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

Many first-time parents do not plan on their parents' help immediately after the newborn arrives.What statement by the nurse is the most appropriate when counselling new parents about the involvement of grandparents?

The nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dad's chin.What does this woman's statement reflect?

During a phone follow-up conversation with a woman who is 4 days' postpartum,the woman tells the nurse,"I don't know what's wrong.I love my son,but I feel so let down.I seem to cry for no reason!" The nurse would recognize that the woman is experiencing which of the following?

The en face position is preferred immediately after birth.Which of the following would not facilitate this process?

Nursing activities that promote parent-infant attachment are many and varied.One activity that should not be overlooked is the management of the environment.While providing routine mother-baby care,the nurse should ensure which of the following?

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

Which of the following can the nurse do to help a father in his transition to parenthood?

What should the nurse be aware of with regard to the adaptation of other family members,mainly siblings and grandparents,to the newborn?

The nurse observes that a 15-year-old mother seems to ignore her newborn.What is a strategy that the nurse can use to facilitate mother-infant attachment in this mother?

Of the many factors that influence parental responses,nurses should be aware that which of the following statements regarding age is not true?

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

Other early sensual contacts between infant and mother involve sound and smell.Nurses should be aware of which one of the following points?

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 behaviour with her infant,the nurse realizes which of the following?

When dealing with parents who have some form of sensory impairment,nurses should realize that which of the following statements is not true?