OB CH20

During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby? a. Letting go b. Taking hold c. Taking in d. Taking on

a. Letting go

When working with parents who have some form of sensory impairment, nurses should understand that ________ is an inaccurate statement. 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.

b. Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact.

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 counseling 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."

b. "Grandparents can help you with parenting skills and also help preserve family traditions."

To promote bonding and attachment immediately after delivery, the most important nursing intervention is to: a. Allow the mother quiet time with her infant. b. Assist the mother in assuming an en face position with her newborn. c. Teach the mother about the concepts of bonding and attachment. d. Assist the mother in feeding her baby.

b. Assist the mother in assuming an en face position with her newborn.

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

b. Seldom makes eye contact with her son

The best way for the nurse to promote and support the maternal-infant bonding process is to: a. Help the mother identify her positive feelings toward the newborn. b. Encourage the mother to provide all newborn care. c. Assist the family with rooming-in. d. Return the newborn to the nursery during sleep periods.

c. Assist the family with rooming-in.

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.

c. Claiming.

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.

c. PPD can easily go undetected.

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: a. Taking-in. b. Postpartum depression (PPD). c. Postpartum (PP) blues. d. Attachment difficulty.

c. Postpartum (PP) blues.

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 a. Assess her for pain. b. Point out how lucky she is to have a healthy baby. c. Explain that she is experiencing postpartum blues. d. Allow her time to express her feelings.

d. Allow her time to express her feelings.

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

d. An environment that fosters as much privacy as possible should be created.

After giving birth to a healthy infant boy, a primiparous woman, 16 years old, 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. Instruct the patient how to feed and bathe her infant. b. Give the patient written information on bathing her infant. c. Advise the patient that all mothers instinctively know how to care for their infants. d. Provide time for the patient to bathe her infant after she views an infant bath demonstration.

d. Provide time for the patient to bathe her infant after she views an infant bath demonstration.

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: a. Report the incident to the social services department. b. Advise the parents that the toddler needs to be reprimanded. c. Report to oncoming staff that the mother is probably not a good disciplinarian. d. Realize that this is a normal family adjusting to family change.

d. Realize that this is a normal family adjusting to family change.

Which concerns about parenthood are often expressed by visually impaired mothers (Select all that apply)? a. Infant safety b. Transportation c. The ability to care for the infant d. Missing out visually e. Needing extra time for parenting activities to accommodate the visual limitations

a. Infant safety b. Transportation d. Missing out visually e. Needing extra time for parenting activities to accommodate the visual limitations

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.

a. Attachment, or bonding, is a process that occurs over time and does not require early contact.

When the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics, this is called: a. Mutuality. b. Bonding. c. Claiming. d. Acquaintance.

a. Mutuality.

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.

a. Pointing out that the infant turned at the sound of his voice.

The mother-baby nurse is able to recognize reciprocal attachment behavior. This refers to: a. The positive feedback an infant exhibits toward parents during the attachment process. b. Behavior during the sensitive period when the infant is in the quiet alert stage. c. Unidirectional behavior exhibited by the infant, initiated and enhanced by eye contact. d. Behavior by the infant during the sensitive period to elicit feelings of "falling in love" from the parents.

a. The positive feedback an infant exhibits toward parents during the attachment process.

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)? a. Use devices that transform sound into light. b. Assume that the patient knows sign language. c. Speak quickly and loudly. d. Ascertain whether the patient can read lips before teaching. e. Written messages aid in communication.

a. Use devices that transform sound into light. d. Ascertain whether the patient can read lips before teaching. e. Written messages aid in communication.

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.

a. Washing both the infant's face and the mother's face.

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.

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.

Other early sensual contacts between infant and mother involve sound and smell. Nurses should be aware that, despite what folk wisdom may 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.

b. Infants can learn to distinguish their mother's voice from others soon after birth.

The postpartum woman who continually repeats the story of her labor, delivery, and recovery experience is: a. Providing others with her knowledge of events. b. Making the birth experience "real." c. Taking hold of the events leading to her labor and delivery. d. Accepting her response to labor and delivery.

b. Making the birth experience "real."

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. In the past few decades the number of grandparents providing permanent care to their grandchildren has been declining.

b. Participation in preparation classes helps both siblings and grandparents.

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: a. Tell him to ignore the mood swings, as they will go away. b. Reassure him that this behavior is normal. c. Advise him to get immediate psychological help for her. d. Instruct him in the signs, symptoms, and duration of postpartum blues.

b. Reassure him that this behavior is normal.

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

b. Show the mother how the infant initiates interaction and pays attention to her.

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 one 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.

b. The parents hover around the infant, directing attention to and pointing at the infant.

After they are born, 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.

d. Biorhythmicity.

Of the many factors that influence parental responses, nurses should be conscious of negative stereotypes that apply to specific patient populations. Which response could be an inappropriate stereotype of adolescent mothers? 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.

c. Adolescent mothers have a higher documented incidence of child abuse.

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.

c. Extended contact is especially important for adolescents and low-income women because they are at risk for parenting inadequacies.

On observing a woman on her first postpartum day sitting in bed while her newborn lies awake in the bassinet, the nurse should: a. Realize that this situation is perfectly acceptable. b. Offer to hand the baby to the woman. c. Hand the baby to the woman. d. Explain "taking in" to the woman.

c. Hand the baby to the woman.

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: a. Continue to observe his interaction with the newborn. b. Tell him when he does something wrong. c. Show no concern, as he will learn on his own. d. Include him in teaching sessions.

d. Include him in teaching sessions.