Question 1

A nurse is performing a postpartum assessment during the first home visit to a patient 3 days postdelivery. Which actions will the nurse perform?

Accepted Answer

The nurse will palpate the breasts to check for engorgement or mastitis, check vaginal discharge to assess lochia, assess the extremities for signs of thrombosis, and inspect the perineum for healing and signs of infection. Auscultating the carotid is not typically part of a postpartum assessment.

Question 2

Characteristics of a caring relationship that the nurse cultivates when interacting with the patient in the home include:

Accepted Answer

Regard for the patient, genuineness, empathy, and rapport are all important characteristics of a caring relationship that the nurse cultivates when interacting with the patient in the home. These qualities help to establish trust and open communication, which are essential for effective patient care. While attachment may develop over time, it is not necessarily a characteristic that the nurse should actively cultivate in a professional relationship with a patient.

Question 3

The homecare nurse is visiting a newborn-and-mother couplet. Which nursing action has the highest priority?

Accepted Answer

A

Question 4

Which safety device is most appropriate for the nurse making home visits?

Accepted Answer

A cell phone is the most appropriate safety device for a nurse making home visits as it allows for easy communication with emergency services or other healthcare professionals if needed. Personal handguns and cans of mace are not appropriate as they can escalate dangerous situations and put the nurse and others at risk. While having a map of the area may be helpful, it is not a safety device.

Question 5

The nurse is planning a home visit for a new mother and newborn who were discharged prior to 48 hours after delivery. In preparation for the home visit, the nurse should:

Accepted Answer

The answer of The nurse is planning a home visit...

Question 6

A new mother is concerned about spoiling her newborn. The home care nurse teaches the mother that:

Accepted Answer

Meeting the infant's needs develops a trusting relationship. Spoiling a newborn is not possible, as their needs for food, comfort, and care should be met promptly. Meeting these needs helps to develop a secure relationship between the baby and the caregiver, which can promote healthy emotional development. Newborns are not capable of manipulation, as they only have basic needs that require attention and care. Crying is a communication of a baby's needs, and it is important to respond to their cries promptly. Rocking a baby to sleep is a normal and soothing practice that can help babies fall asleep faster.

Question 7

During a postpartum home visit, which step should the nurse take to establish a caring relationship?

Accepted Answer

Asking family members how they want to be addressed demonstrates respect and acknowledges their individuality. It can also help establish a sense of trust and comfort in the nurse-client relationship.

Question 8

The homecare nurse is examining a newborn who is sleeping in a basket on a pillow, covered with a fluffy blanket. There is also a stuffed animal in the basket. The most important nursing action is to:

Accepted Answer

The most important nursing action is to educate the parents about the risks associated with SIDS from soft items in the infant's bed. Stuffed animals and fluffy blankets increase the risk of suffocation and should be avoided in a newborn's sleeping environment. Option A is not the priority action, as removing the stuffed animal alone may not address other potential hazards in the baby's sleeping area. Option C is important, but not the most important action in this scenario. Option D is not a priority nursing action at this time as it does not concern the safety of the baby.

Question 9

A postpartum patient calls the telephone triage nurse and reports that her 2-month-old infant has a fever. She asks the nurse what to give the baby. The nurse should suggest:

Accepted Answer

Tylenol (acetaminophen) is the only medication recommended for infants under the age of 6 months to lower a fever, as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil and Motrin can increase the risk of a rare but serious condition called Reye's syndrome. Therefore, the nurse should suggest Tylenol to the mother in this scenario.

Question 10

To prevent sudden infant death syndrome (SIDS), the nurse encourages the parents of a term infant to place the infant in which position when the infant is sleeping?

Accepted Answer

Placing the infant on their back to sleep has been identified as the single most effective way to reduce the risk of SIDS. Infants should not be placed on their stomach or side for sleep, and sleeping in a waterbed or infant swing can also increase the risk of SIDS.

Question 11

The postpartum homecare patient asks the nurse why the visit is taking place. Which response is best? "We make homecare visits to:

Accepted Answer

The best response is choice B, as it accurately describes the purpose of a postpartum homecare visit. The nurse's visit is to ensure both the mother and the baby are safe and doing well in the home environment. This includes assessing the mother's physical and emotional recovery, as well as assessing the baby's growth and development. While the other choices may also be objectives of the visit, they do not provide the most complete and accurate explanation for why the visit is taking place.

Question 12

A mother and her newborn have been discharged after a hospital stay of less than 48 hours. What are essential components the nurse must include in the first postpartum home visit?

Accepted Answer

The nurse should assess the newborn's color to check for jaundice or cyanosis, measure weight to ensure proper growth, observe mother-newborn interaction to support bonding and identify any issues, and reinforce information about feeding and sleep patterns to support the mother's understanding and confidence in caring for her newborn. Height measurement is not typically essential in the immediate postpartum period.

Question 13

The nurse is planning a homecare visit to a mother who just recently delivered. The neighborhood is known to have a significant crime rate. What should the nurse do when planning this visit to facilitate personal safety?

Accepted Answer

Putting personal possessions, such as expensive jewelry, in the trunk before leaving the office reduces the risk of becoming a target for theft or robbery. Planning the visit at nighttime would likely increase the risk of danger, and waiting until arrival to find the location could also increase the risk of becoming lost or encountering unsafe individuals. Wearing flashy jewelry may also increase the risk of theft or robbery.

Question 14

The nurse is at the home of a postpartum patient for an initial assessment. The patient gave birth by cesarean section 1 week earlier. Which statements should the nurse include?

Accepted Answer

The nurse should assess the incision due to the cesarean section and inquire about the patient's rest to evaluate recovery.

Question 15

The nurse is making a postpartum home visit in the summer. The new father asks about taking the baby to a family outing this weekend. The nurse should encourage the father to:

Accepted Answer

Keeping the infant in the shade is the best choice as it will protect the infant's delicate skin from the harmful effects of the sun's rays. Dark blankets may cause overheating and uncovering the infant's head may increase the risk of hyperthermia. It is not necessary to avoid taking the infant outdoors for 6 months, but adequate precautions must be taken to protect the infant's health.

Question 16

The nurse is meeting with a new mother for the first time during a home visit. The patient delivered her first child 3 days ago. She had a normal pregnancy and a vaginal delivery. The infant is breastfeeding. Which statements by the mother indicate that she needs more information about the home visit?

Accepted Answer

The answer of The nurse is meeting with a new...

Question 17

The nurse is conducting several home visits over the course of a week. Which action is appropriate to maintain safety?

Accepted Answer

Providing a daily schedule of visits to supervisors, including patient addresses and phone numbers, ensures that someone is aware of the nurse's location and can respond in case of an emergency, enhancing safety.

Question 18

The nurse is teaching experienced postpartum nurses about homecare visits. Which statements indicate that teaching was effective?

Accepted Answer

If a nurse encounters a crime in progress, leaving the area is the safest action. Trusting one's instincts or "gut" feelings is important for personal safety, as ignoring them might lead to unsafe situations.

Question 19

The nurse is speaking to a community group about the controversy regarding the length of the hospital stay for postpartum patients. Which statement indicates that a participant needs additional information?

Accepted Answer

While the statement regarding current length-of-stay laws and newborns receiving recommended follow-up care is accurate, the other statements could use clarification or elaboration. Statement A only mentions insurance requirements for uncomplicated births, while statement B points to insurance companies as the reason for shortened stays without providing further context. Statement C implies that early discharge was designed solely as an alternative to home birth, which is not entirely accurate.

Question 20

The nurse is performing a postpartum homecare visit. Which teaching has the highest priority?

Accepted Answer

The highest priority is ensuring the baby is adequately hydrated and healthy, indicated by the number of wet diapers daily. This reflects the baby's fluid intake and kidney function, which are critical in the early postpartum period.

Quiz 37: Home Care of the Postpartum Family