Exam 3 INDIVIDUAL 6

13. The nurse is interested in promoting coparenting because of the high likeability that at some point, both parents will be working outside the home. After reading research by Davis, Schoppe-Sullivan, Mangelsdorf, and Brown (2009), the nurse learns that which factor impacts coparenting the most? 1 . Infant temperament 2. Father's interest 3. Strength of support systems 4. Mother's expectations

1 This is correct. Infant temperament difficulty reported by fathers at 3.5 months was associated with a decrease in supportive coparenting behavior. Early interventions to enhance coparenting are essential for families with temperamentally difficult infants.

4. The nurse on a postpartum unit is focused on providing care that will assist the mother and father in making the transition to parenthood. For which reason does the nurse review the prenatal and labor records? 1. Pregnancy and birth experiences, which can either enhance or impede the process of becoming a mother. 2. Awareness of prenatal classes that will help identify and focus on learning needs of both parents. 3. Identification of preexisting maternal conditions that may interfere with parenting transitions. 4. Knowledge regarding questions and concerns the mother and father may have about neonate issues.

1 This is correct. The nurse reviews the maternal prenatal and labor records because pregnancy and birth experiences can either enhance or impede the process of becoming a mother. The nurse is looking for factors such as complications during pregnancy, labor, and birth.

8. The nurse on a postpartum unit focuses on how to assist the father in identifying his role with the neonate. Which intervention by the nurse is most helpful? 1. Encourage the couple to identify mutual expectations of the fathering role. 2. Critique the father's methods of providing physical care for the neonate. 3. Provide written materials about the physical and emotional role of a father. 4. Observe for a competitive attitude between the parents about providing baby care

1 This is correct. Mutually agreed-upon fathering expectations, shared by the couple, can decrease the level of stress within the relationship.

1. Loutzenhiser, McAuslan, and Sharpe (2015) performed a study regarding maternal and paternal fatigue and factors associated with fatigue across the transition to parenthood. Which evidence-based conclusion is made regarding fatigue and the transitioning parents? 1. Levels of prenatal and postnatal fatigue are associated. 2. Postnatal fatigue remains consistent for a period of 1 year. 3. Poor sleep quality in fathers is related to depressive symptoms. 4. The length of couple relationship strongly impacts parenteral fatigue

1 This is correct. The evidence-based conclusion for the study indicates that high levels of prenatal fatigue were associated with higher levels of postpartum fatigue for both the mother and father

15. The nurse on a postpartum unit is acutely aware that cultural influences impact the patient's process of "becoming a mother." For which cultural influences does the nurse assess? Select all that apply. 1. What amount of time the mother spends in each phase 2. Differences in the mother's expectation related to ability to rest 3. How the mother physically recovers from labor and delivery 4. Mother's involvement in decision making for the first few months 5. Whether the mother seems interested in how to care for her baby

15. ANS: 1, 2, 4, 5 1 This is correct. The amount of time the mother spends in each phase of "becoming a mother" can be influenced by culture. 2 This is correct. The expectation of some cultures is that the mother should rest in the postpartum period or longer rather than be focused on care of the baby. 4 This is correct. The expectation of some cultures is that the mother does not need to be focused on decision making about the baby for the first few months of the infant's life. 5 This is correct. Whether a mother is interested in learning how to care for her neonate may be culturally influenced. In some cultures, the mother's mother and other family members will provide care for the infant for several months. The nurse does need to assess whether the lack of interest is culturally based or a sign of other issues.

16. The nurse is counseling a lesbian couple who have decided to have a child. Which considerations does the nurse present with regard to which partner will become pregnant? Select all that apply. 1. Consider the age and health of each partner. 2. Evaluate each partner's career goals. 3. Decide which partner has better insurance. 4. Determine who will be on the birth certificate. 5. Identify which woman desires to be pregnant.

16. ANS: 1, 2, 3, 5 1 This is correct. A lesbian couple needs to consider the age and overall health of each partner before deciding on who will be the biological mother of their child. 2 This is correct. It is important to evaluate each partner's career goals before deciding who will be the biological mother of a lesbian couple's child. More defined goals may indicate a stronger need to be a coparent instead of the biological mother. 3 This is correct. A consideration about which partner has the best health insurance coverage for the pregnancy and birth, and for the child, is a necessary financial consideration 5 This is correct. An important decision for the lesbian couple is determining which partner desires to be pregnant. If both want to be pregnant, it may be a matter of which partner will become pregnant first.

17. The nurse in a postpartum unit evaluates new parents for risk factors that can indicate problems with bonding/attachment. Which situations does the nurse recognize as a cause for bonding/attachment problems? Select all that apply. 1. The mother experienced eclampsia in the third trimester of pregnancy. 2. The neonate is being treated for meconium aspiration syndrome. 3. The mother experienced dystocia in the second phase of labor. 4. The father of the neonate is in the military and not yet home on leave. 5. The mother's mother lives next door and is available to help with the baby.

17. ANS: 1, 2, 3 1 This is correct. The nurse recognizes the mother who experienced eclampsia in the third trimester of pregnancy as being at risk for bonding/attachment problems. 2 This is correct. The nurse recognizes the mother whose neonate is being treated for meconium aspiration syndrome as being at risk for bonding/attachment problems. The mother is likely to be separated from the neonate. 3 This is correct. The nurse recognizes the parents of a neonate may experience bonding/attachment problems if the mother experienced dystocia in the second stage of labor. The condition is likely to have caused a long and exhaustive labor for both parents.

18. The nurse uses research from Greenberg and Morris (1974) as a guideline for identifying the presence of engrossment in a new baby by the father. Which behaviors exhibit paternal-infant bonding related to engrossment? Select all that apply. 1. Seeing the baby as attractive 2. Perceiving the baby as being perfect 3. Having a desire to touch the baby 4. Indicating an increasing sense of self-esteem 5. Positively commenting about the baby's features

18. ANS: 1, 2, 3, 4, 5 1 This is correct. Evidence of paternal engrossment involves a visual awareness of the baby and seeing their baby as attractive. 2 This is correct. Evidence of paternal engrossment involves a perception that their baby is perfect. 3 This is correct. Evidence of paternal engrossment involves a tactile awareness of the baby and having a desire to touch the baby. 4 This is correct. Evidence of paternal engrossment involves an increase of self-esteem. 5 This is correct. Evidence of paternal engrossment involves an awareness of and positive comments about their infant's distinct features.

5. The nurse is researching for evidence-based practice related to a mother's response during the postpartum period. Based on research by Rubin and Mercer, which finding will the nurse be able to easily implement to change the culture of the unit? 1. Satisfaction questionnaires 2. Alterations in terminology 3. Decrease nurse/patient ratios 4. Soliciting paternal expectations

2 This is correct. Rubin and Mercer have addressed the terminology used regarding the mother during early postpartum. From "maternal phases" and "maternal touch" (Rubin), terminology was changed by Mercer to "maternal role attainment" and finally to "becoming a mother." This change can be easily implemented by the nurse and promote a change in the unit culture

10. Which behavior does the nurse identify as a demonstration of unidirectional bonding between a parent and infant? 1. The parents respond to the baby's cry. 2. The parents call the baby by name. 3. The baby responds to comforting measures. 4. The parents stimulate and entertain the baby.

2 This is correct. When the parents call the baby by name, they are demonstrating unidirectional bonding.

11. The nurse is observing a new mother interact with her baby and notices the mother holding the baby close to her body. However, the nurse also notices that the mother does not hold the baby in an enface position. Which question is most appropriate for the nurse to ask? 1. "Can I help you with a nice position in which to hold your baby?" 2. "What can you tell me about your family's beliefs with new babies?" 3. "Is there some reason that I have not seen you look into your baby's eyes?" 4. "Your baby is so expressive, have you looked into his eyes yet?"

2 This is correct. Asking the mother about her family's beliefs with new babies allows the mother to provide cultural information that may be influencing the mother's interactions with her baby

__ 3. The nurse is aware that some parenting skills are acquired through the process of intentional learning. Which activity does the nurse associate with intentional learning? 1. The couple observes other individuals who are mothers and fathers. 2. The couple attends hospital classes addressing newborn and infant care. 3. The couple discusses with each other how they were parented. 4. The couple watches media containing parenting roles

2 This is correct. The couple who attends hospital classes addressing newborn and infant care is experiencing intentional learning.

7. Dayton et al. (2016) performed qualitative research regarding expectant fathers' beliefs and expectations. The nurse identifies which theme as emerging from this research? 1. Men felt that the role of being a father can be learned. 2. Men described fathering as an extremely difficult task. 3. Men rely on other men to support the fathering role. 4. Men believe that the nurturing role is always the mother's.

2 This is correct. The referenced research did result in men describing fathering as being an extremely difficult task. Fathers felt the task included being responsible for another life and the importance of providing financial and concrete support to their children.

6. The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother-infant bonding? 1. The mother is pleased to have the nurse visit her home and baby. 2. The baby's grandmother is present and involved with mother/baby care. 3. The mother focuses the visit on her physical recovery and concerns. 4. The baby's father is on "paternity leave" and involved with the baby.

3 This is correct. After the first 48 hours postpartum, the mother moves into the "taking hold" phase when the mother's focus moves from self to the infant. When the mother focuses the nurse's attention on the mother's physical recovery and concerns, the nurse needs to assess for problems with mother-infant bonding.

14. The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause? 1. Fatigue related to a "fussy" baby 2. Frustration over physical appearance 3. Changes in hormonal levels 4. Stress related to new mother role

3 This is correct. Although the other options can contribute to postpartum blues, the most likely cause is changes in hormone levels

12. A new mother expresses frustration about how to know what her baby wants. The mother states, "I don't know what I expect, but then, the baby doesn't know either." Which situation does the nurse use as an example of neonate communication? 1. The baby is content to lie still on the mother's abdomen. 2. The baby is easily awakened if irritated by loud noises. 3. The baby resists eye contact if bored or disinterested. 4. The baby roots for the breast when the cheek is stroked.

4 This is correct. Rooting is an initial interaction that elicits the desire/need to eat. When a neonate's cheek is stroked, the neonate turns the head toward the touch and begins to root for the breast. The mother needs to understand this is the neonate's method of communication.

9. The nurse is providing postpartum care for an adolescent mother and her family. Which factor is most important for the nurse to consider when planning teaching about neonatal care? 1. The grandparents decided they want to be involved. 2. The parents need to discuss their expectations of each other. 3. The mother is determined the father should be involved. 4. Information must be presented on an age-appropriate level.

4 This is correct. Learning styles and teaching strategies are different for young teens and older teens. Information needs to be provided in a manner that will engage the adolescent parent in the learning process. This is the most important factor for the nurse to consider.

2. As a result of the previously mentioned research study, the nurses in a postpartum facility will implement which evidence-based change? 1. Continue to assess the level of fatigue for the mother during postpartum period. 2. Assist fathers in recognizing and managing stress and depressive symptoms. 3. Encourage the father to go home and rest while the mother is hospitalized. 4. Promote strategies to decrease fatigue during both prenatal and postnatal periods.

4 This is correct. Nurses will provide information on strategies to decrease fatigue during the prenatal period and postnatal periods