CH 22: Transition to Parenthood

4. A nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dads. This statement is most descriptive of which process? a. Mutuality b. Synchrony c. Claiming d. Reciprocity

ANS C

6. During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, I dont know whats wrong. I love my son, but I feel so let down. I seem to cry for no reason! Which condition might this new mother be experiencing? a. Letting-go b. Postpartum depression (PPD) c. Postpartum blues d. Attachment difficulty

ANS C

1. After giving birth to a healthy infant boy, a primiparous client, 16 years of age, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is Deficient knowledge of infant care. What should the nurse be certain to include in the plan of care as he or she prepares the client for discharge? a. Teach the client how to feed and bathe her infant. b. Give the client written information on bathing her infant. c. Advise the client that all mothers instinctively know how to care for their infants. d. Provide time for the client to bathe her infant after she views a demonstration of infant bathing.

ANS D

10. In follow-up appointments or visits with parents and their new baby, it is useful if the nurse can identify infant behaviors that can either facilitate or inhibit attachment. What is an inhibiting behavior? a. The infant cries only when hungry or wet. b. The infants activity is somewhat predictable. c. The infant clings to the parents. d. The infant seeks attention from any adult in the room.

ANS D

12. After birth, a crying infant may be soothed by being held in a position in which the newborn can hear the mothers heartbeat. This phenomenon is known as what? a. Entrainment b. Reciprocity c. Synchrony d. Biorhythmicity

ANS D

14. While providing routine mother-baby care, which activities should the nurse encourage to facilitate the parent-infant attachment? 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 discharge of the mother and baby. d. An environment that fosters as much privacy as possible should be created.

ANS D

2. A 30-year-old multiparous woman has a boy who is years old and has recently delivered an infant girl. She tells the nurse, I dont know how Ill ever manage both children when I get home. Which suggestion would assist this new mother in alleviating sibling rivalry? a. Tell the older child that he is a big boy now and should love his new sister. b. Let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the newborn. c. Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him. d. Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time.

ANS D

21. 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. How should the nurse react to this situation? 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 unit adjusting to a major family change.

ANS D

23. A 25-year-old gravida 1 para 1 who had an emergency cesarean birth 3 days ago is scheduled for discharge. As the nurse prepares her for discharge, she begins to cry. The nurses next action should be what? 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.

ANS D

24. A new father states, I know nothing about babies; however, he seems to be interested in learning. How would the nurse best respond to this father? a. Continue to observe his interaction with the newborn. b. Tell him when he does something wrong. c. Show no concern; he will learn on his own. d. Include him in teaching sessions.

ANS D

17. When the infants behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics, what is the correct term for this behavior? a. Mutuality b. Bonding c. Claiming d. Acquaintance

ANS A

22. 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

ANS A

5. New parents express concern that because of the mothers emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. Which information should the nurses response convey? a. Attachment, or bonding, is a process that occurs over time and does not require early contact. b. Time immediately after birth is a critical period for humans. c. Early contact is essential for optimal parent-infant relationships. d. These new parents should just be happy that the infant is healthy.

ANS A

7. Which statement by the nurse can assist a new father in his transition to parenthood? 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 infants diaper a different way d. Suggesting that he let the infant sleep in the bassinet

ANS A

8. A nurse notes that an Eskimo 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. While evaluating this clients behavior with her infant, what realization does the nurse make? a. What appears to be a lack of interest in the newborn is, in fact, the cultural way of demonstrating intense love by attempting to ward off evil spirits. b. The woman is inexperienced in caring for a newborn. 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

ANS A

Which societal factors have a strong influence on parental response to their infant? (Select all that apply.) a. An adolescent mothers 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 years of age often deal with more stress related to work and career issues, as well as decreasing libido. e. Relationships between adolescent mothers and fathers are more stable than older

ANS A B D

The transition to parenting for same-sex couples can present unique challenges. How can the nurse foster adjustment to parenting for these clients? (Select all that apply.) a. Use a supplemental feeding device to simulate breastfeeding. b. Allow the partner to cut the cord. c. Gay fathers should meet their new infant soon after the birth mother has recovered. d. Understand that strong social sanctions remain. e. Provide information regarding support groups

ANS A B D E

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

ANS A B D E

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. Using devices that transform sound into light b. Assuming that the client knows sign language c. Speaking quickly and loudly d. Ascertaining whether the client can read lips before teaching e. Writing messages that aid in communication

ANS A D E

11. In addition to eye contact, other early sensual contacts between the infant and mother involve sound and smell. What other statement regarding the senses is correct? a. High-pitched voices irritate newborns. b. Infants can learn to distinguish their mothers voice from others soon after birth. c. All babies in the hospital smell alike. d. Mothers breast milk has no distinctive odor.

ANS B

13. The postpartum nurse should be cognizant of what with regard to the adaptation of other family members (primarily siblings and grandparents) to the newborn? 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.

ANS B

15. A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment after childbirth. Recognizing the needs of women during this stage, how should the nurse respond? a. Foster an active role in the babys care. b. Provide time for the mother to reflect on the events of her labor and delivery. c. Recognize the womans limited attention span by giving her written materials to read when she gets home rather than doing a teaching session while she is in the hospital. d. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs.

ANS B

16. 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. The postpartum woman talks and coos to her son. b. She seldom makes eye contact with her son. c. The mother cuddles her son close to her. d. She tells visitors how well her son is feeding.

ANS B

18. 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. Parents have difficulty naming the infant. b. Parents hover around the infant, directing attention to and pointing at the infant. c. Parents make no effort to interpret the actions or needs of the infant. d. Parents do not move from fingertip touch to palmar contact and holding.

ANS B

20. The postpartum woman continually repeats the story of her labor, delivery, and recovery experience. What is this new mother attempting to achieve with this behavior? a. Providing others with her knowledge of events b. Making the birth experience real c. Taking hold of the events leading up to her labor and delivery d. Accepting her response to labor and delivery

ANS B

3. The nurse observes that a first-time mother appears to ignore her newborn. Which strategy should the nurse use to facilitate mother-infant attachment? a. Tell the mother she must pay attention to her infant. b. Show the mother how the infant initiates interaction and attends 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.

ANS B

9. Many first-time parents do not plan on having their parents help immediately after the newborn arrives. Which statement by the nurse is the most appropriate when counseling new parents regarding the involvement of grandparents? a. You should tell your parents to leave you alone. b. Grandparents can help you with parenting skills. c. Grandparent involvement can be very disruptive to the family. d. They are getting old. You should let them be involved while they can.

ANS B

In the United States, the en face position is preferred immediately after birth. Which actions by the nurse can facilitate this process? (Select all that apply.) a. Washing both the infants face and the mothers face b. Placing the infant on the mothers abdomen or breast with their heads on the same plane c. Dimming the lights d. Delaying the instillation of prophylactic antibiotic ointment in the infants eyes e. Placing the infant in the grandmothers arms

ANS B C D

19. 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, approximately 500,000 women in America experience a more severe syndrome known as 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.

ANS C