Week 9 Quiz(ch. 12/13)

Bonding is bidirectional from parent to infant and infant to parent. Select one: True False

Answer: False

Eye movements are an example of newborn/infant style of communication. Select one: True False

Answer: True

Which of the following clients is most likely to complain of aftepains during her postpartum period? Select one: a. G1 P1, diagnosed with preeclampsia b. G2 P2, group B streptococci in the vagina c. G3 P2, gave birth to a 4100-gram baby and is breastfeeding d. G4 P1, diagnosed with preterm labor

Answer: C Primiparous women usually do not experience discomfort related to uterine contractions during the postpartum period. Multiparous women or women who are breastfeeding may experience afterpains during the first few postpartum days due to the release of oxytocin during infant suckling.

A nurse is preparing to administer RhoGam to a client who delivered a fetal demise. Which of the following must the nurse check before giving the injection? Select one: a. Verify that the direct Coombs test results are positive. b. Check that the fetus was at least 28 weeks' gestation. c. Make sure that the client is at least 3 days postdelivery. d. Confirm that the woman is Rh negative.

Answer: D RhoGam is given to Rh negative mothers who have given birth to an Rh positive fetus, whether or not the fetus is born alive.

The postpartum nurse is caring for a couple who experienced an unplanned emergency cesarean birth. The nurse observes the following behaviors: Parents are gently touching their newborn. Mother is softly singing to her baby. Father is gazing into his baby's eyes. Based on this data, the correct nursing diagnosis is altered parent-infant bonding related to emergency cesarean birth. Select one: True False

Answer: False

The perinatal nurse teaches the postpartum woman that the most critical time to achieve effectiveness from the application of ice packs to the perineum is during the first 24 hours following birth. Select one: True False

Answer: True

The nurse is working with a 36-year-old, married client, G6 P6, who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for the nurse to recommend to this client? Select one: a. Intrauterine contraceptive device b. Contraceptive patch c. Bilateral tubal ligation d. Birth control pills

Answer: A Intrauterine contraception (IUC) is the recommended method for this patient. IUC has a low failure rate and provides long-term contraception for up to 10 years. Bilateral tubal ligation (BTL) is a surgical procedure which results in sterilization. Due to her history of smoking, neither birth control pills nor contraceptive patch is recommended due to the increased risks for blood clots, heart disease, and strokes, also associated with smoking.

The postpartum nurse caring for a 20-year-old G1 P1 woman who 3 hours ago delivered a healthy full-term infant, observes the woman who is lightly touching her baby girl with her fingertips but who seems to be uncomfortable holding her baby close to her body. Which of the following is an accurate interpretation of these observed behaviors? Select one: a. The woman is in the initial stage of maternal touch. b. The woman is in the taking-in phase. c. The woman is having difficulty in bonding with her baby. d. The woman needs to be medicated for pain.

Answer: A These are classical signs of the initial stage of Rubin's maternal touch.

The perinatal nurse demonstrates for the student nurse the correct technique of postpartum uterine palpation. Support for the lower uterine segment is critical, as without it, there is an increased risk of: Select one: a. Uterine edema b. Uterine inversion c. Incorrect measurement d. Intensifying the patient's level of pain

Answer: B During pregnancy there is stretching of the ligaments that hold the uterus in place. Fundal pressure could result in uterine inversion. Supporting the lower uterine segment may prevent uterine inversion during fundal assessment or massage.

The nurse notes that a new father gazes at his baby for prolonged periods of time and comments that his baby is beautiful and he is very happy having a baby. These behaviors are commonly associated with: Select one: a. Bonding b. Engrossment c. Couvade syndrome d. Attachment

Answer: B Engrossment is defined as an absorption, preoccupation, and interest shown by fathers with their newborns. New fathers gaze at their newborns for prolonged periods of time as if they are in a hypnotic trance. characteristics of engrossment include a perception that the newborn is perfect.

The perinatal nurse observes the new mother watching her baby daughter closely, touching her face, and asking many questions about infant feeding. This stage of mothering is best described as: Select one: a. Taking in b. Taking hold c. Taking charge d. Taking time

Answer: B As the mother's physical condition improves, she begins to take charge and enters the taking-hold phase where she assumes care for herself and her infant. At this time, the mother eagerly wants information about infant care and shows signs of bonding with her infant. During this phase, the nurse should closely observe mother-infant interactions for signs of poor bonding, and if present, implement actions to facilitate attachment.

A 25 year-old woman gave birth to her second child 6 hours ago. She informs the nurse that she is bleeding more than with her previous birth experience. The initial nursing action is to: Select one: a. Explain that this is normal for second-time moms. b. Assess the location and firmness of the fundus. c. Change her pad and return in 1 hour and reassess. d. Give her 10 units of oxytocin as per standing order.

Answer: B Frequent assessment of uterine tone and placement allows for the identification of potential complications such as uterine atony (decreased uterine muscle tone) that may lead to postpartum hemorrhage.

A 35-year-old G1 P1 postpartum woman is Rh negative and has given birth to an Rh positive infant. Rh0(D) immune globulin is to be administered. The most appropriate dose that the perinatal nurse would expect to be ordered would be: Select one: a. 120 mcg b. 250 mcg c. 300 mcg d. 350 mcg

Answer: C Nonsensitized women who are Rh negative and have given birth to an Rh positive infant should receive 300 mcg of Rh(D) immune globulin (RhoGAM) within 72 hours after giving birth. RhoGAM should be given whether or not the mother received RhoGAM during the antepartum period. In some situations, depending on the extent of hemorrhage and exchange of maternal-fetal blood, a larger dose of RhoGAM may be indicated.

The nurse is caring for a recently immigrated Chinese woman in the postpartum unit. Based on cultural beliefs and practices of the woman, the nurse would anticipate which of the following? (Select all that apply.) Select one or more: a. The woman prefers cold water for drinking. b. The woman prefers not to shower. c. The woman prefers to have her female relatives care for her baby. d. The woman prefers a wide variety of foods to eat.

Answer: C In traditional Chinese beliefs and practices, the woman is to rest and female family members take care of the infant. During the first month, the woman is to avoid yin energy by eating specific foods and avoiding drinking or touching cold water.

On day four following the birth of an average size baby, the nurse would expect the fundus to be at: Select one: a. 1 cm below umbilicus b. 2 cm below umbilicus c. 3 cm below umbilicus d. 4 cm below umbilicus

Answer: D After birth, the uterine fundus is palpated midway between the umbilicus and the symphysis pubis. Within 12 hours after birth of the placenta, the fundus is located at the level of the umbilicus. 24 hours after birth of the placenta, the fundus is located at 1 cm below the umbilicus. The uterus descends 1 cm per day; by postpartum day #4, the uterine fundus would be palpated 4 cm below the umbilicus.