Psycho-social-cultural aspects of antepartum period

12. The labor and delivery nursing staff is conducting research to determine the benefits of childbirth education (CBE). Which finding does evidence-based practice support? 1. Women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery. 2. Women who are considered to be at high risk had fewer complications if CBE or a birth plan was used. 3. Women of color, younger in age, and who are multipara respond best to CBE and/or a birth plan. 4. Women with a previous cesarean delivery are more likely to have a vaginal delivery after CBE

ANS: 1 This is correct. According to Afshar et al., 2017, and Gagnon, 2011, women who participated in CBE and/or had a birth plan had higher odds of a vaginal delivery.

4. The nurse is providing care in a school clinic established for the care of adolescent mothers. When assessing a patient who is 11 years of age and pregnant, which deduction regarding the patient's psychosocial development will the nurse recognize? 1. The adolescent is self-centered and oriented toward the present. 2. At this age, pregnancy is likely a result of attachment to a first love. 3. Moving into the mothering role will be nearly impossible at this age. 4. The role of the grandmother will be as the baby's primary caretaker.

ANS: 1 This is correct. Pregnancy in early adolescence is difficult because the adolescent is self-centered and oriented toward the present, which makes maternal adaptation to pregnancy difficult and interferes with mothering

7. A couple announces to their parents that the couple is pregnant. One expectant grandmother says, "Grandchildren will call me by my first name. I am not ready to be a grandmother." Which feelings are being expressed by the grandmother? 1. The pregnancy presents undeniable evidence the grandmother is growing older. 2. The grandmother has specific wishes about how she is to be addressed as a person. 3. The grandmother is most likely teasing and actually feels overwhelming delight. 4. The grandmother has never thought of herself in this role and will adapt with time.

ANS: 1 This is correct. The feelings expressed in the grandmother's comment is in response to undeniable evidence that the grandmother is growing older.

6. A patient in the second trimester of pregnancy seems distressed. With encouragement, the patient states, "I have been totally avoiding physical contact with my husband to avoid prompting any sexual activity." Which statement by the nurse is the best response? 1. "Nonsexual expressions of affection are important for both of you." 2. "Be honest and tell your husband the reason you are avoiding him." 3. "You need to agree to sex in order to prevent infidelity from occurring." 4. "Sex during pregnancy is a healthy and normal display of affection."

ANS: 1 This is correct. The nurse needs to inform the patient that nonsexual expressions are important during pregnancy to both partners.

16. A patient is experiencing pregnancy complications. Which factors will affect the client's ability to manage this situation? Select all that apply. 1. Current health status 2. Perceived threat to self or fetus 3. Previously used coping skills 4. Existence of a support network 5. Implemented nursing interventions

ANS: 1, 2, 3, 4, 5 1 This is correct. The patient's physical condition will impact the patient's ability to manage this situation. 2 This is correct. The patient's perceived threat to herself or the fetus will affect the patient's ability to manage this situation. 3 This is correct. The patient's previously used coping skills will affect the patient's ability to manage this situation. 4 This is correct. The existence of a support network will assist the patient in her ability to manage this situation. 5 This is correct. The recognition of patient needs and the implementation of appropriate nursing interventions will increase that patient's ability to manage this situation.

17. The nurse works in a prenatal clinic located in a multicultural city. It is important for the nurse to recognize which cultural beliefs as prescriptive? Select all that apply. 1. The mother will aid the baby's circulation by remaining active during pregnancy. 2. The satisfaction of pregnancy cravings will prevent birthmarks on the baby. 3. The mother invites harm to the fetus during the night by sleeping on her back. 4. A safety pin attached to an undergarment will prevent fetal facial deformities. 5. Drinking too much tea will stimulate the fetus and cause a premature birth.

ANS: 1, 2, 4 1 This is correct. The belief of improving the baby's circulation by the mother remaining active during pregnancy is a prescriptive belief. 2 This is correct. It is a prescriptive belief that satisfying a mother's cravings will prevent birthmarks on the baby. 3 This is incorrect. It is a prescriptive belief that the mother will protect the fetus from harm by sleeping on her back, and not invite harm during the night if in this position. 4 This is correct. It is a prescriptive belief that if a mother attaches a safety pin to an undergarment, the baby will be protected from having a cleft lip or palate. 5

15. The nurse is encouraging cultural sensitivity among the nonmedical personnel in a prenatal clinic. Which type of family does the nurse identify as including children? Select all that apply. 1. Nuclear family 2. Extended family 3. Cohabitating family 4. Dyad family 5. Blended family

ANS: 1, 2, 5 1 This is correct. A nuclear family includes a father, mother, and child. 2 This is correct. An extended family includes three generations, including married brothers and sisters and their children. Extended families do not necessarily live together. 3 This is incorrect. A cohabitating family is an unmarried couple living together, which may or may not include children. 4 This is incorrect. A dyad family is a couple living alone without children. 5 This is correct. A blended family is a combination of two families with children from one or both families and sometimes children of the newly married couple.

14. A pregnant patient tells the nurse that her spouse has been diagnosed with Couvade syndrome. Which manifestations does the nurse suspect the spouse is experiencing? Select all that apply. 1. Nausea from unidentifiable causes 2. Physical rejection of sexual advances 3. Significant recent weight gain 4. Unexplainable abdominal pains 5. Self-imposed social isolation

ANS: 1, 3, 4 1 This is correct. Couvade syndrome is diagnosed when the male experiences some of the same manifestations of pregnancy as a pregnant partner. Nausea is a symptom of Couvade syndrome. 2 This is incorrect. The rejection of sexual advances by the male of a pregnant couple is not a manifestation of Couvade syndrome. Some causes may be fear hurting the woman and/or the fetus, or lack of interest related to the physical changes of pregnancy. 3 This is correct. Couvade syndrome is diagnosed when the male experiences some of the same manifestations of pregnancy as a pregnant partner. Weight gain is a symptom of Couvade syndrome. 4 This is correct. Couvade syndrome is diagnosed when the male experiences some of the same manifestations of pregnancy as a pregnant partner. Abdominal pains are a symptom of Couvade syndrome

13. The nurse notes that a patient in the third trimester of pregnancy feels unable to "mother" her unborn child. Which information about the patient helps the nurse identify the sources of the patient's ambivalence? Select all that apply. 1. The patient is estranged from her mother. 2. The patient asks about classes for baby care. 3. The patient expresses a loss of independence. 4. The patient's partner is excited about a baby. 5. The patient expresses disgust about body changes

ANS: 1, 3, 5 1 This is correct. Women who have a positive relationship with their own mothers more easily identify with the role of motherhood. A source of ambivalence for this patient is likely related to her estranged relationship from her own mother. 2 This is incorrect. Asking about classes for baby care is not a sign of ambivalence. 3 This is correct. When the patient expresses unresolved conflict about her loss of independence, which may relate to the demands of motherhood, the nurse identifies a source of ambivalence. 4 This is incorrect. One of the tasks of motherhood is ensuring social acceptance of the baby by significant others; it is unlikely the excitement about the baby by the patient's partner is a source of ambivalence. 5 This is correct. Acceptance of a pregnancy includes acceptance of the related body changes. The patient's expressed disgust about body changes is a likely source of ambivalence.

18. The nurse works in a prenatal clinic that serves a multicultural population. The nurse is culturally aware, and so, which behaviors by a patient are expected due to common restrictive beliefs? Select all that apply. 1. A pregnant woman denies sexual intercourse during her third trimester. 2. A pregnant woman allows a clinic staff member to take a photo of her. 3. A pregnant woman reaches to an overhead shelf to collect her belongings. 4. A pregnant woman avoids sitting in front of a fan or air conditioner. 5. A pregnant woman refuses to watch a televised eclipse of the moon.

ANS: 1, 5 1 This is correct. The nurse expects a pregnant woman to deny sexual intercourse in the last trimester of pregnancy; it is a restrictive belief aimed at preventing respiratory distress in a newborn. 5 This is correct. A restrictive belief states that a pregnant woman should not see an eclipse of the moon; to do so will cause the baby to have a cleft lip or palate

3. The nurse works in a prenatal clinic and interacts with multiple patients from various socioeconomic backgrounds. Which patient does the nurse assess most carefully for a mental health issue? 1. A woman who chooses single parenthood 2. A military veteran who was deployed twice 3. The pregnant partner of a lesbian relationship 4. The mother who is multigestational with triplets

ANS: 2 This is correct. A military veteran who was deployed twice is at greater risk for depression. The nurse ascertains if the patient was treated for PTSD and any signs of mental health issues.

11. The nurse is counseling a couple in the third trimester of pregnancy and recommends the couple attend childbirth education classes. For which reason is the nurse least likely to recommend the classes? 1. The classes will affirm the normalcy of birth. 2. The techniques will enable a medication-free delivery. 3. The classes acknowledge a woman's ability to inherently give birth. 4. The classes explore ways to find strength and comfort during labor

ANS: 2 This is correct. Childbirth classes do not focus on teaching techniques that enable a medication-free delivery. However, the classes may enable the mother to require less medication because of greater understanding of the birthing process.

10. A couple is planning for the birth of their first child and is discussing the difference between a physician and a midwife. Which information presented by the couple does the nurse validate as being true? 1. Midwives are commonly self-taught without formal training. 2. Physicians provide care for both low- and high-risk patients. 3. Midwives primarily deliver babies in the home setting. 4. Physicians rely on the use of technological procedures for birth.

ANS: 2 This is correct. It is true that physicians are able to manage both low- and high-risk patients during childbirth

8. A mother has a child who is 4 years of age, and she is expecting another child. The mother expresses concern to the nurse about how the older sibling will receive the newborn. Which intervention shared by the mother does the nurse discourage? 1. "I plan to let him hear the baby's heartbeat at the next prenatal visit." 2. "I think that I will just bring the new baby home as a surprise." 3. "I have enrolled him in a sibling preparation class at the hospital." 4. "I let him pick out a gift for the baby, and have one for him from the baby."

ANS: 2 This is correct. The nurse will discourage the mother from bringing a newborn home as a surprise. The older sibling needs time to adjust to the prospect of having a new baby. This action is likely to create a greater lack of acceptance in the older sibling.

19. A couple informs the nurse they have decided to make arrangements for a home birth. Which criteria will the nurse share with the couple regarding a safe home birth? Select all that apply. 1. The couple must be trained on how to be in control of the birth. 2. The pregnant woman must be in good health with a normal pregnancy. 3. The birthing home must be within a 1-hour drive of a hospital. 4. Adequate medical supplies and resuscitation equipment is available. 5. The birthing room needs to be sterile prior to labor and delivery.

ANS: 2, 4 2 This is correct. The nurse is correct in informing the couple that the woman must be in good health with a normal pregnancy. High-risk pregnancies are not suitable for home births 4 This is correct. The nurse needs to inform the couple that in addition to being attended by a well-trained health care provider, adequate medical supplies and resuscitation equipment need to be in the home

5. The nurse is providing care for a patient who is 42 years of age and in the first trimester of her pregnancy. For which possible complication will the nurse closely monitor the patient and fetus? 1. Elevated blood pressure and proteinuria 2. Indications of maladaptation to pregnancy 3. Alterations in fetal chromosomal studies 4. Subtle indicators of menopause occurring

ANS: 3 This is correct. Due to the patient's age, the nurse will closely monitor for chromosomal alterations in the fetus. Older mothers are a greater risk for fetal chromosome defects.

1. The nurse at a prenatal clinic is aware of the important tasks that each expectant mother will need to address. When an expectant mother states, "I will give up everything I have to make sure this baby is safe and well-cared for," which task is the mother addressing? 1. Expressing an attachment to the child 2. Ensuring safe birth for mother and child 3. Stating a willingness to give of oneself 4. Ensuring social acceptance of the child

ANS: 3 This is correct. The mother's statement specifically addresses the mother's willingness and efforts to make personal sacrifices for the child. The task is that of giving oneself to the demands of motherhood.

2. The nurse is providing prenatal care for a patient who is pregnant with a second child. Which understanding about complexity of a second pregnancy does the nurse use to assist the patient with the acceptance of this pregnancy? 1. Point out that the financial obligation is always less with a second child. 2. Make suggestions of how the first child will be a "helper" with the new baby. 3. Recommend career decisions needed because of additional parenting tasks. 4. Offer strategies for working out a new relationship with the first child

ANS: 4 This is correct. Pregnancy tasks are more complex for the multipara due to the relationship between the mother and the first child. The nurse can offer strategies for remodeling this relationship and help the mother with feelings associated with the needed change.

9. A pregnant patient and her spouse live in the same home as the spouse's family who is not supportive of the pregnancy. The patient feels the family is ruining the happiness about the pregnancy. Which is the most important determination for the nurse to make? 1. What the potential for improving the current support network is 2. Who will provide the patient the greatest amount of support 3. Whether the couple's finances support moving into a separate location 4. If threatened or actual abuse from household members occur toward the patient

ANS: 4 This is correct. The most important determination for the nurse to make in this scenario is whether the patient is experiencing a threat or actual abuse from the family members.

20. The more prepared a pregnant woman feels for the birth of her baby will lower her anxiety and fear. The behavior is referred to as ____________________.

ANS: nesting behavior The nurse recognizes that completing preparations for the birth of a child can lower the anxiety and fear a pregnant woman feels about the impending birth. The flurry of activity the woman initiates to finish preparations for the arrival of the neonate is referred to as nesting behavior.