Chapter 22

Question 1

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

Answer 1

D

Question 2

The nurse observes several interactions between a postpartum woman and her new son. What behaviour, if exhibited by this woman, would the nurse identify as a possible maladaptive behaviour regarding parent–infant attachment?
a.
She talks and coos to her son.
b.
She seldom makes eye contact with her son.
c.
She cuddles her son close to her.
d.
She tells visitors how well her son is feeding.

Answer 2

B

Question 3

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

Answer 3

B

Question 4

The nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dad’s chin. What does this woman’s statement reflect?
a.
Mutuality
b.
Synchrony
c.
Claiming
d.
Reciprocity

Answer 4

C

Question 5

New parents express concern that, because of the mother’s emergency Caesarean birth under general anaesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. What should the nurse’s response convey to the parents?
a.
Attachment 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.

Answer 5

A

Question 6

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 which of the following?
a.
Taking-in
b.
Postpartum depression (PPD)
c.
Postpartum (PP) blues
d.
Attachment difficulty

Answer 6

C

Question 7

Which of the following can the nurse do to help a father in his transition to parenthood?
a.
Point out that the infant turned at the sound of his voice.
b.
Encourage him to go home to get some sleep.
c.
Tell him to tape the infant’s diaper a different way.
d.
Suggest that he let the infant sleep in the bassinet

Answer 7

A

Question 8

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 behaviour with her infant, the nurse realizes which of the following?
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 behaviours once she goes home with the newborn.
d.
Extra time needs to be planned for assisting the woman in bonding with her newborn.

Answer 8

A

Question 9

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 counselling 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.”

Answer 9

B

Question 10

What is the term used when the infant’s behaviours and characteristics call forth a corresponding set of maternal behaviours and characteristics?
a.
Mutuality
b.
Bonding
c.
Claiming
d.
Acquaintance

Answer 10

A

Question 11

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviours that can either facilitate or inhibit attachment. What is a facilitating behaviour?
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.

Answer 11

B

Question 12

With regard to parents’ early and extended contact with their infant and the relationships built, what should nurses be aware of?
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.

Answer 12

C

Question 13

The en face position is preferred immediately after birth. Which of the following would not facilitate this process?
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

Answer 13

A

Question 14

Other early sensual contacts between infant and mother involve sound and smell. Nurses should be aware of which one of the following points?
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 odour.

Answer 14

B

Question 15

After birth a crying infant may be soothed by being held in a position in which the newborn can hear the mother’s heartbeat. What is this phenomenon known as?
a.
Entrainment
b.
Reciprocity
c.
Synchrony
d.
Biorhythmicity

Answer 15

D

Question 16

Of the many factors that influence parental responses, nurses should be aware that which of the following statements regarding age is not true?
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.

Answer 16

C

Question 17

When dealing with parents who have some form of sensory impairment, nurses should realize that which of the following statements is not true?
a.
One of the major difficulties that visually impaired parents experience is the skepticism of health care providers.
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.
Technological advances, including the Internet, can provide deaf parents with a full range of parenting activities and information.

Answer 17

B

Question 18

What should the nurse be aware of with regard to the adaptation of other family members, mainly siblings and grandparents, to the newborn?
a.
Sibling rivalry cannot be dismissed as overblown psychobabble; negative feelings and behaviours can take a long time to blow over.
b.
Participation in preparation classes helps both siblings and grandparents.
c.
In Canada, 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.

Answer 18

B

Question 19

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

Answer 19

D

Question 20

Which statement regarding postpartum mood disorder (PPMD) is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis?
a.
PPMD symptoms are consistently severe.
b.
This syndrome affects only new mothers.
c.
PPMD can easily go undetected.
d.
Only mental health providers should teach new parents about this condition.

Answer 20

C

Question 21

Which concern about parenthood is often expressed by visually impaired mothers?
a.
Skepticism of nurse
b.
Lack of direct eye contact
c.
The ability to care for the infant
d.
Inability to care for themselves postpartally

Answer 21

A