Ch 33: The Postpartum Family: Needs and Care
29) The nurse is preparing teaching material for a new mother. What should the nurse include when instructing on areas to include when observing the infant? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Touch 2. Vision 3. Hearing 4. Diaper care 5. General appearance
Answer: 1, 2, 3, 5 Explanation: When teaching on observing the baby, the nurse should include general appearance and the five senses - vision, hearing, touch, smell, and taste. Diaper care is included when teaching about the skin. Page Ref: 886
32) A new mother is planning to bottle feed her infant and wants helps with suppressing lactation. What should the nurse suggest to help this new mother? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Wear a 24-hour support bra 2. Apply cabbage leaves to the breast tissue 3. Apply warm compresses every 4 to 6 hours 4. Massage lotion on the breasts 3 times a day 5. Avoid all nipple stimulation for 7 to 10 days
Answer: 1, 2, 5 Explanation: Nurses should advise the non-breastfeeding mother to avoid any stimulation of her breasts and nipples by her baby, herself, breast pumps, or her sexual partner until the sensation of fullness has passed (usually in 7 to 10 days). Such stimulation will increase milk production and delay the suppression process. Heat is avoided for the same reason. The wearing of a 24-hour support bra and the use of cabbage leaves and/or cold compresses should be helpful during this period of time. Page Ref: 894
33) A postpartum patient who received epidural morphine prior to a cesarean birth is concerned about a severe headache that has persisted for several days. What should the nurse suggest to this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Ingest fluids with caffeine 2. Engage in moderate exercise 3. Increase the intake of all fluids 4. Lie in bed in a quiet dark room 5. Restrict the intake of warm fluids
Answer: 1, 3, 4 Explanation: For a spinal headache the nurse should instruct the patient to engage in bed rest in a quiet dark room. Caffeine and hydration are also helpful. Moderate exercise could exacerbate the headache. There is no reason to restrict the intake of warm fluids. Page Ref: 905
30) The nurse is monitoring a postpartum patient receiving methylergonovine maleate (Methergine). Which assessment findings should the nurse identify as being expected adverse effects of this medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Nausea 2. Leg pain 3. Headache 4. Hypertension 5. Uterine cramping
Answer: 1, 3, 4, 5 Explanation: Common adverse effects of methylergonovine maleate (Methergine) include nausea, headache, hypertension, and uterine cramping. Leg pain is not an identified adverse effect of this medication. Page Ref: 889
31) The nurse is preparing to administer a sitz bath to a postpartum patient. In which order should the nurse perform the steps of this procedure? 1. Open the clamp on the tubing 2. Anchor the infusion bag to the sitz bath basin, with the tube facing upward 3. Fill the drainage bag with warm or cool water up to the top line as indicated on the bag 4. Close the clamp on the tubing, dry perineum with a clean towel, and apply new peri-pad 5. Secure the drainage bag from a hook over the toilet or from the handle used to flush the toilet
Answer: 2, 3, 5, 1, 4 Explanation: When providing a sitz bath the nurse should: insert the large infusion bag or tube into the back of the sitz bath basin, anchoring it to the bottom of the basin with the small opening at the end of the tubing facing upward, toward the ceiling; fill the drainage bag with warm or cool water up to the top line as indicated on the bag; secure the drainage bag from a hook over the toilet or from the handle used to flush the toilet if it is a few feet higher than the toilet; open the clamp on the tubing; once the sitz bath is complete, instruct the woman to close the clamp on the tubing, dry perineum with a clean towel, and apply new peri-pad. Page Ref: 892
27) The nurse is performing discharge teaching for a newly delivered first-time mother and her infant on the 2nd postpartum day. Which statement by the mother indicates that teaching has been successful? A) "Taking baths will help my perineum feel less sore each day." B) "If I develop heavy bleeding, I should take my temperature." C) "My bowel movements should resume in a week." D) "I will go back to the doctor in 4 days for my RhoGAM shot."
Answer: A Explanation: A) A sitz bath or tub bath promotes healing and provides relief from perineal discomfort during the initial weeks following birth. B) If heavy bleeding begins, the client should call her healthcare provider immediately, not take her temperature. Postpartum hemorrhage can be life-threatening. C) Bowel movements should resume in 2 to 3 days after birth. A week is too long a time frame, and indicates constipation. D) When RhoGAM is needed, it is given within 72 hours of birth, while still at the hospital. Page Ref: 891
6) A variety of drugs are used either alone or in combination to provide relief of postpartum pain. Which of the following would be an option for pain relief? A) Nonsteroidal anti-inflammatory agents B) Proquad C) Methergine D) Intravenous oxytocin
Answer: A Explanation: A) A variety of drugs are used alone or in combination to provide relief of postpartum pain. An option would include nonsteroidal anti-inflammatory agents such as ibuprofen and ketorolac. B) Proquad is a measles, mumps, rubella, and varicella live virus vaccine. C) Methergine is prescribed to promote uterine contractions. D) Intravenous oxytocin (Pitocin) remains the first-line drug for excessive bleeding related to postpartum uterine atony. Page Ref: 897
28) The nurse is assessing clients after delivery. For which client is early discharge at 24 hours after delivery appropriate? A) Woman and baby who have had two successful breastfeedings B) Woman who is bottle-feeding her infant and has not voided since delivery C) Twins delivered at 35 weeks, bottle-feeding D) Cesarean birth performed for fetal distress
Answer: A Explanation: A) Early discharge may be advantageous if mother and baby are doing well, help is available for the mother at home, and the family and physician/CNM agree that both clients are healthy and ready for discharge. Feeding successfully is one of the physiologic needs of the infant and both mother and infant appear to be doing well. B) Early discharge may be advantageous if mother and baby are doing well. Voiding is a physiologic need of the mother and has not yet been accomplished. C) Preterm infants are not appropriate for early discharge. D) Infants who experienced distress in labor are not appropriate for early discharge. Page Ref: 882
9) A client who delivered 2 hours ago tells the nurse that she is exhausted and feels guilty because her friends told her how euphoric they felt after giving birth. How should the nurse respond? A) "Everyone is different, and both responses are normal." B) "Most mothers do feel euphoria; I don't know why you don't." C) "It's good for me to know that because it might indicate a problem." D) "Let me bring your baby to the nursery so that you can rest."
Answer: A Explanation: A) Following birth, some women feel exhausted and in need of rest. Other women are euphoric and full of psychic energy, ready to retell their experience of birth repeatedly. B) The nurse should not imply that a mother's emotional response is not expected. C) Both euphoria and exhaustion are normal feelings after birth. Fatigue after birth is not indicative of a problem. D) The client might want to be with her newborn, and the nurse should not encourage unnecessary separation of mother and child. Page Ref: 898
1) The nurse assesses the postpartum client to have moderate lochia rubra with clots. Which nursing intervention would be appropriate? A) Assess fundus and bladder status. B) Catheterize the client. C) Administer Methergine IM per order. D) Contact the physician immediately.
Answer: A Explanation: A) The amount, consistency, color, and odor of the lochia are monitored on an ongoing basis. Increased bleeding is most often related to uterine atony and responds to fundal massage, expression of any clots, and emptying the bladder. B) Catheterizing the client might be an intervention if the bladder is full and the client is unable to void, but it is not the initial intervention. C) It is not necessary to administer Methergine IM per order; the situation does not warrant this intervention. D) It is not necessary to contact the physician immediately; the situation does not warrant this intervention. Page Ref: 888
21) The nurse is planning care for three newly delivered adolescents and their babies. What should the nurse keep in mind when planning their care? A) The baby's father should be encouraged to participate when the nurse is providing instruction. B) A class for all the adolescents would decrease teaching effectiveness. C) The schools that the adolescents attend will provide teaching on bathing. D) Adolescents understand the danger signals in newborns.
Answer: A Explanation: A) The father, if he is involved, should be included as much as possible. If classes are offered in the hospital during the postpartum stay, the adolescent mother and father should be strongly encouraged to attend and participate. B) If classes are offered in the hospital during the postpartum stay, the adolescent mother and father should be strongly encouraged to attend and participate. C) The nurse should never assume that basic newborn care education will be provided to a client elsewhere. D) Group classes for adolescent mothers should include infant care skills, information about growth and development, infant feeding, well-baby care, and danger signals in the ill newborn. Page Ref: 907
3) The nurse is preparing to administer postpartum neuraxial morphine to a client who is morbidly obese. For which side effect related to morbid obesity should the nurse monitor? A) Respiratory depression B) Confusion C) Constipation D) Hypotension
Answer: A Explanation: A) Women who are morbidly obese are at increased risk for respiratory depression, which is managed by administration of naloxone (Narcan), mask ventilation, and endotracheal intubation with mechanical ventilation, if necessary. B) The client is not at increased risk of confusion, as this is not affected by postpartum neuraxial morphine administration in the context of morbid obesity. C) The client is not at increased risk of constipation, as this is not affected by postpartum neuraxial morphine administration in the context of morbid obesity. D) The client is not at increased risk of hypotension, as this is not affected by postpartum neuraxial morphine administration in the context of morbid obesity. Page Ref: 905
5) The incidence of complications and discomforts in the first year postpartum is common and women may experience which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Pain B) Excess energy C) Urinary incontinence D) Changes in mental health status E) Sleep deprivation
Answer: A, C, D, E Explanation: A) Pain can be a discomfort in the first year postpartum. B) Fatigue, not excess energy, can be a discomfort in the first year postpartum. C) Urinary incontinence can be a complication in the first year postpartum. D) Changes in mental health status can be a complication in the first year postpartum. E) Sleep deprivation can be a complication in the first year postpartum. Page Ref: 884
8) The nurse is caring for a client who had a cesarean birth 4 hours ago. Which interventions would the nurse implement at this time? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Administer analgesics as needed. B) Encourage the client to ambulate to the bathroom to void. C) Encourage leg exercises every 2 hours. D) Encourage the client to cough and deep-breathe every 2 to 4 hours. E) Encourage the use of breathing, relaxation, and distraction.
Answer: A, C, D, E Explanation: A) The nurse continues to assess the woman's pain level and provide relief measures as needed. B) Ambulation should begin no later than 24 hours postoperatively and should be encouraged at least 2 to 3 times a day, but not in the first 4 hours. C) Within the first 12 hours postoperatively, unless medically contraindicated, the woman should be assisted to dangle her legs off the side of the bed. D) The woman is encouraged to cough and breathe deeply and to use incentive spirometry every 2 to 4 hours while awake for the first few days following cesarean birth. E) The nurse should encourage the use of breathing, relaxation, and distraction techniques. Page Ref: 904
14) A new grandmother comments that when her children were born, they stayed in the nursery. The grandmother asks the nurse why her daughter's baby stays mostly in the room instead of the nursery. How should the nurse respond? A) "Babies like to be with their mothers more than they like to be in the nursery." B) "Contact between parents and babies increases attachment." C) "Budget cuts have decreased the number of nurses in the nursery." D) "Why do you ask? Do you have concerns about your daughter's parenting?"
Answer: B Explanation: A) Although most newborns cry less when held than when in their cribs, this is not the most important reason for encouraging mothers to spend time with their babies. B) In a mother-baby unit, the newborn's crib is placed near the mother's bed, where she can see her baby easily; this is conducive to an on-demand feeding schedule for both breastfeeding and formula-feeding infants. C) Budget cuts are not a reason for babies' being in the nursery less than in the past. D) It is not therapeutic to use the word "why." The grandmother has not indicated that she has any concerns about her daughter's parenting. Page Ref: 900
18) A multiparous client delivered her first child vaginally 2 years ago, and delivered an infant by cesarean yesterday due to breech presentation. Which statement would the nurse expect the client to make? A) "I can't believe how much more tired I was with the first baby." B) "I'm having significantly more pain this time than with my last birth." C) "It is disappointing that I can't breastfeed because of the cesarean." D) "Getting in and out of bed feels more comfortable than last time."
Answer: B Explanation: A) Mothers who have experienced cesareans, particularly unanticipated ones that follow lengthy labors, may be fatigued, sleep deprived, and under the influence of medications that alter their level of consciousness. B) Women with cesarean births have special needs: increased need for rest and sleep; incisional care; self-care; and relief of pain and discomfort. C) Breastfeeding is not contraindicated by cesarean birth. D) Getting in and out of bed is more painful after cesarean birth than after vaginal birth. The nurse can assist the woman in identifying interventions to relieve discomfort or pain. The woman should be encouraged to take pain medication regularly, engage in frequent rest periods, avoid prolonged activity, and observe for signs of "overdoing it." Page Ref: 904
11) The postpartum client expresses concern about getting back to her prepregnant shape, and asks the nurse when she will be able to run again. Which statement by the client indicates that teaching was effective? A) "I can start running in 2 weeks, and can breastfeed as soon as I am done." B) "I should see how my energy level is at home, and increase my activity slowly." C) "Running is not recommended for breastfeeding women." D) "If I am getting 8 hours of sleep per day, I can start running."
Answer: B Explanation: A) Running should not be initiated until after 6 weeks postpartum or with medical approval. The nurse can provide the new mother with suggestions for resuming her normal level of activity. Breastfeeding should take place prior to running to minimize chest discomfort. B) Women should be encouraged to limit the number of activities to prevent excessive fatigue, increase in lochia, and negative psychologic reactions, such as feeling overwhelmed. A regular exercise program including vigorous activities such as running, weight lifting, or competitive sports can usually be initiated after the 6-week postpartum examination or when approved by the client's physician/CNM. C) This statement is not true. It is more comfortable to nurse prior to running, but running is not contraindicated and can usually be initiated after the 6-week postpartum examination or when approved by the client's physician/CNM. D) This response does not address a more important factor, which is encouraging the client to assess her own energy level and to gradually return to previous activity levels. Page Ref: 899
4) A postpartum client has just received a rubella vaccination. The client demonstrates understanding of the teaching associated with administration of this vaccine when she states which of the following? A) "I will need another vaccination in 3 months." B) "I must avoid getting pregnant for 1 month." C) "This will prevent me from getting chickenpox." D) "This will protect my newborn from getting the measles."
Answer: B Explanation: A) The client will not need another vaccination in 3 months. B) The client must avoid pregnancy for at least 1 month after receiving the rubella vaccine. C) The vaccination prevents measles, not chickenpox. D) The vaccination will only protect the client receiving it; therefore, the newborn will not be protected until the child receives his own vaccination. Page Ref: 895
13) Which statement by a nursing student preparing to care for a postpartum lesbian mother would indicate that the student is prepared for the teaching? A) "I can't let the client know I've never worked with lesbian mothers." B) "I will have to adjust some of my discharge instruction for this mother." C) "I don't need to include the partner when I provide care and instruction." D) "Discharge teaching is exactly the same for lesbian mothers as for all others."
Answer: B Explanation: A) The nurse should ask the patient for guidance regarding any special needs or requests that she or her partner may have. B) The nurse should be aware that standardized postpartum instructions, particularly those related to intercourse and contraception, might need to be individualized and amended. C) Providing quality patient-centered care for any postpartum woman involves acknowledging, welcoming, and involving her intimate partner in care and decision making. D) The nurse should be aware that standardized postpartum instructions, particularly those related to intercourse and contraception, might need to be individualized and amended. Page Ref: 908
16) The client having her second child is scheduled for a cesarean birth because the baby is in a breech presentation. The client states, "I'm wondering what will be different this time compared with my first birth, which was vaginal." What response is best? A) "We'll take good care of you and your baby. You'll be home before you know it." B) "You'll be wearing a sequential compression device until you start walking." C) "You will have a lot of pain, but there are medications that we give when it gets really bad." D) "You won't be able to nurse until the baby is 12 hours old, because of your epidural."
Answer: B Explanation: A) This response focuses on the nurse, and does not provide specific information to answer the client's question. B) The use of sequential compression devices (SCDs) and early ambulation are essential to the prevention of deep vein thrombosis, especially if the client had a cesarean birth. C) Focusing on the pain is a negative emphasis and pain can also be a factor in a vaginal birth. D) Epidural anesthesia prevents leg function, and therefore ambulation, but does not impact a mother's ability to breastfeed. Page Ref: 906
17) The nurse is caring for a client who delivered by cesarean birth. The client received a general anesthetic. To prevent or minimize abdominal distention, which of the following would the nurse encourage? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Increased intake of cold beverages B) Leg exercises every 2 hours C) Abdominal tightening D) Ambulation E) Using a straw when drinking fluids
Answer: B, C, D Explanation: A) The woman should avoid carbonated or very hot or cold beverages, as they would increase the distention through the increase of gas and constipation. B) Immobility increases the risk of abdominal distention and discomfort. Leg exercises serve to prevent or minimize abdominal distention in a surgical client who received a general anesthetic. C) Abdominal tightening serves to prevent or minimize abdominal distention in a surgical client who received a general anesthetic. D) Early ambulation prevents abdominal distention that can occur with excess accumulation of gas in the intestines. E) The woman should avoid the use of straws to avoid increasing the distention through increase of gas and constipation. Page Ref: 903
23) The nurse is caring for a client who plans to relinquish her baby for adoption. The nurse would implement which approach to care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Encourage the client to see and hold her infant. B) Encourage the client to express her emotions. C) Respect any special requests for the birth. D) Acknowledge the grieving process in the client. E) Allow access to the infant, if the client requests it.
Answer: B, C, D, E Explanation: A) Encouraging the client to see and hold her infant does not respect the client's right to refuse interaction. The amount of contact she chooses to have with her newborn should be respected. B) The mother who decides to relinquish her baby needs emotional support and validation of her loss. C) The woman should decide whether to see and hold her baby and should have any special requests regarding the birth honored. D) Perinatal nurses should be aware that relinquishing mothers are at risk for disenfranchised grief, in which they are unable to proceed through the grieving process and come to resolution with the loss. The nurse should acknowledge the woman's loss and support her decision. E) The amount of contact she chooses to have with her newborn should be respected. Page Ref: 908
7) On the 3rd day postpartum, a client who is not breastfeeding experiences engorgement. To relieve her discomfort, the nurse should encourage the client to do which of the following? A) Remove her bra B) Apply heat to the breasts C) Apply cold packs to the breasts D) Use a breast pump to release the milk
Answer: C Explanation: A) A support bra is recommended. B) Applying heat would stimulate milk production. C) Applying cold packs to the breasts relieves discomfort and helps suppress lactation. D) Using a breast pump would stimulate milk production and delay the suppression process. Page Ref: 894
20) The nurse is caring for a 15-year-old client who gave birth to her first child yesterday. What action is the best indicator that the nurse understands the parenting adolescent? A) The client's mother is included in all discussions and demonstrations. B) The father of the baby is encouraged to change a diaper and give a bottle. C) The nurse explains the characteristics and cues of the baby when assessing him. D) A discussion on contraceptive methods is the first topic of teaching.
Answer: C Explanation: A) Although the grandmother or another family member may plan to assist with or provide much of the newborn care in some cases, the nurse should always ensure that the adolescent mother has the knowledge and demonstrates the skills to provide care for her newborn before discharge. B) The father, if he is involved, should be included as much as possible, but having the mother learn more about her new baby is a higher priority. C) A newborn physical examination performed at the bedside gives the parent(s) immediate feedback about the newborn's health and demonstrates methods of handling an infant. This action helps the client learn about her baby as an individual and facilitates maternal-infant attachment. This is the highest priority. D) The nurse should offer detailed teaching on contraception, as the young woman may have no prior experience with it and may not feel comfortable requesting this information, but establishing rapport and facilitating understanding of and attachment to the newborn is a higher priority. Page Ref: 907
23) The nurse is preparing a teaching brochure for Spanish-speaking postpartum clients. Which topics are critical for this population? A) Baby baths and birth certificates B) Hygiene practices C) When and how to contact their healthcare provider D) Pain-relief options in labor and after birth
Answer: C Explanation: A) Baby baths and birth certificates are necessary information, but not critical. B) It is important to consider cultural practices and realize that some women may prefer not to shower in the first few days following birth. Some Hispanic women prefer to delay showering. Hygiene practices are important, but not critical. C) Knowing how to contact their healthcare provider at all times is critical so that clients receive appropriate advice and care in case of a problem or emergency. Knowing what to watch for and when to call the healthcare provider also facilitates safety. These are the highest priorities. D) Pain relief is important, but not critical. Page Ref: 899
19) The nurse is supervising a student nurse who is working with a 14-year-old client who delivered her first child yesterday. Which statement indicates that the nursing student understands the particular needs of an adolescent client? A) "This client will need less teaching, because she will have gotten the right information in school." B) "Because of her age, this client will require less frequent fundal checks to assess for postpartal hemorrhage." C) "Because of her age, this client will probably need extra teaching about the terminology for her anatomy." D) "This client will need to have her grandmother provide day care and help raise the baby."
Answer: C Explanation: A) Public or private education likely does not cover the extent of the information that the adolescent needs to know about pregnancy and delivery. The nurse has many opportunities for teaching adolescent parents about their newborn in the postpartum unit and serves as a role model for new parents when responding to and caring for the newborn. B) Adolescent mothers have the same basic physical care needs as older mothers. C) Some adolescents may not have a working knowledge of their own anatomy and physiology or the related terminology, and they may require special assistance with postpartum hygiene and care. D) Although the client will require day care to continue with her education, the assistance does not have to come from her grandmother. Page Ref: 907
10) The breastfeeding client asks the nurse about appropriate contraception. What is the nurse's best response? A) "Breastfeeding has many effects on sexual intercourse." B) "IUDs are easy to use and easy to insert prior to sexual intercourse." C) "It's possible to get pregnant before your menstrual period returns. Let's talk about some different options for contraception." D) "Breastfeeding hampers ovulation, so no contraception is needed."
Answer: C Explanation: A) This answer does not address the client's question about contraception. B) IUDs can only be placed by a healthcare provider in a clinic situation. C) The nurse should discuss the importance of contraception during the early postpartum period and provide information on the advantages and disadvantages of different methods, including special considerations for breastfeeding mothers. The woman's body needs adequate time to heal and recover from the stress of pregnancy and childbirth. D) Breastfeeding hampers ovulation, but to be safe, breastfeeding women should use a contraceptive. The nurse should discuss the importance of contraception during the early postpartum period and provide information on the advantages and disadvantages of different methods, including special considerations for breastfeeding mothers. Page Ref: 902
2) The nurse is providing education to the new family. Which question by the nurse is best? A) "Do you know how to give the baby a bath?" B) "You have diapers and supplies at home, right?" C) "How have your breastfeedings been going?" D) "How much formal education do you have?"
Answer: C Explanation: A) This is a closed question; closed questions should be avoided. Also, bathing is a lower-priority need than is feeding. B) This is a leading question. Leading questions should be avoided. C) This is an open-ended question about an important physiologic issue. A discussion that includes both partners can facilitate an open dialog between them and can provide an opportunity for questions and answers. D) Although the family members' level of educational attainment helps when choosing written materials and words, it is rude to ask outright what education they have had. Page Ref: 888
15) What is the advantage of a client using a patient-controlled analgesia (PCA) following a cesarean birth? A) The client receives a bolus of the analgesia when pressing the button. B) The client experiences pain relief within 30 minutes. C) The client feels a greater sense of control, and is less dependent on the nursing staff. The client can deliver as many doses of the medication as needed
Answer: C Explanation: A) With this approach, the woman is given a bolus of analgesia, often morphine, at the beginning of therapy and is not repeated. B) IV pain medications provide rapid pain relief. C) Using a special intravenous (IV) pump system, the woman presses a button to self-administer small doses of the medication as needed. For safety, the pump is preset with a time lockout so that the pump cannot deliver another dose until a specified time has elapsed. Women using PCA feel less anxious and have a greater sense of control with less dependence on the nursing staff. D) For safety, the pump is preset with a time lockout so that the pump cannot deliver another dose until a specified time has elapsed. Page Ref: 904
24) The nurse is planning discharge teaching for a postpartum woman. What recommendations should the woman receive before being discharged? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) To abstain from sexual intercourse for 6 months B) To avoid showers for 4 weeks C) To avoid overexertion D) To practice postpartum exercises E) To obtain adequate rest
Answer: C, D, E Explanation: A) The client should abstain from sexual intercourse until lochia has ceased. B) The client may take a shower and may continue sitz baths at home if she desires. C) The client should avoid overexertion. D) The client should receive information and instruction on postpartum exercises. E) The client should receive information on the need for adequate rest. Page Ref: 910
22) The nurse is preparing to receive a newly delivered client. The client is a young single mother who is relinquishing custody of her newborn through an open adoption. What action is most important? A) Assign the client a room on the GYN surgical floor instead of on the postpartum floor. B) Prepare to complete teaching in time for discharge at 24 hours post-delivery. C) Make an effort not to bring up the topic of the baby, and discuss the mother's health instead. D) Ask the client how much contact she would like with the baby, and whether she wants to feed it.
Answer: D Explanation: A) Clients relinquishing their newborns should be given options concerning contact with the infant, including where they would feel most comfortable if they opt for contact at all. B) Not all clients who relinquish their infants want early discharge. C) It is up to the client to decide how much she wants to talk about her birth, her newborn, or her decision to relinquish the child. D) Assessing the birth mother's preferences by respectfully asking questions and making no assumptions facilitates a more positive experience. Page Ref: 908
26) To actively involve the postpartal client during discharge teaching, the postpartum nurse applies which learning principle? A) Reprints of magazine articles B) Classroom lectures C) Audiotapes D) Interactive nurse-patient relationships
Answer: D Explanation: A) Providing magazine articles does not actively involve the client in learning. B) Classroom lectures do not actively involve the client in learning. C) Listening to audiotapes does not actively involve the client in learning. D) Effective parent learning requires precise timing of teaching, as well as choice of a teaching method that is effective for the family, such as DVDs and return demonstration. Content on self-care, infant care, and anticipatory guidance is important. Page Ref: 911
12) The hospital is developing a new maternity unit. What aspects should be included in the planning of the new unit to best promote family wellness? A) Normal newborn nursery centrally located to all client rooms B) A kitchen with a refrigerator stocked with juice and sandwiches C) Small, cozy rooms with a client bed and rocking chair D) A nursing care model based on providing couplet care
Answer: D Explanation: A) Rooming-in provides the childbearing family with opportunities to interact with their newborn during the first hours and days of life. B) Although having snacks can be good for postpartum clients, some cultures prohibit drinking cold liquids after birth. C) Small rooms can become overly crowded when siblings and grandparents come to visit. Larger rooms that facilitate family attachment are better. D) Couplet care, which is care of both the mother and her baby, is an important part of the family-centered care approach, in which the infant remains at the mother's bedside and both are cared for by the same nurse. Page Ref: 900
