Deck 37: Home Care of the Postpartum Family

Question 1

A nurse is performing a postpartum assessment during the first home visit to a patient 3 days postdelivery. Which actions will the nurse perform?

A) Palpate the breasts.
B) Ausculate the carotid.
C) Check vaginal discharge.
D) Assess the extremities.
E) Inspect the perineum.

Answer 1

Palpate the breasts.
Check vaginal discharge.
Assess the extremities.
Inspect the perineum.

Question 2

Characteristics of a caring relationship that the nurse cultivates when interacting with the patient in the home include:

A) Regard for the patient.
B) Genuineness.
C) Empathy.
D) Rapport.
E) Attachment.

Answer 2

Regard for the patient.
Genuineness.
Empathy.
Rapport.

Question 3

The homecare nurse is visiting a newborn-and-mother couplet. Which nursing action has the highest priority?

A) Establish rapport with the family members.
B) Review the hospital medical records.
C) Determine the newborn's sleeping arrangements.
D) Examine the umbilical cord stump.

Answer 3

Establish rapport with the family members.

Question 4

Which safety device is most appropriate for the nurse making home visits?

A) Personal handgun
B) Cell phone
C) Can of mace
D) Map of the area

Question 5

The nurse is planning a home visit for a new mother and newborn who were discharged prior to 48 hours after delivery. In preparation for the home visit, the nurse should:

A) Review the patient's records.
B) Gather materials and equipment that might be needed.
C) Make a pre-visit telephone call to determine time and day of visit.
D) Contact the healthcare provider about any special concerns.
E) Schedule additional home visits or follow-up contacts with community agencies.

Question 6

A new mother is concerned about spoiling her newborn. The home care nurse teaches the mother that:

A) Newborns can be manipulative, so caution is advised.
B) Meeting the infant's needs develops a trusting relationship.
C) An infant who is rocked to sleep every night is being spoiled.
D) Crying is good for babies, and letting them cry it out is advised.

Question 7

During a postpartum home visit, which step should the nurse take to establish a caring relationship?

A) Ask family members how they want to be addressed.
B) Do a portion of what the nurse agrees to do for the family, to avoid overwhelming them.
C) Speak directly to the father when asking questions.
D) Present information to the family instead of asking questions.

Question 8

The homecare nurse is examining a newborn who is sleeping in a basket on a pillow, covered with a fluffy blanket. There is also a stuffed animal in the basket. The most important nursing action is to:

A) Remove the stuffed animal from the basket and place it on the floor.
B) Teach the parents the risk of SIDS from soft items in the infant's bed.
C) Make certain that the blanket is firmly tucked under the baby.
D) Ask whether the color of the blanket has cultural significance.

Question 9

A postpartum patient calls the telephone triage nurse and reports that her 2-month-old infant has a fever. She asks the nurse what to give the baby. The nurse should suggest:

A) Tylenol.
B) Aspirin.
C) Advil.
D) Motrin.

Question 10

To prevent sudden infant death syndrome (SIDS), the nurse encourages the parents of a term infant to place the infant in which position when the infant is sleeping?

A) On the parents' waterbed
B) Swaddled in the infant swing
C) On the back
D) On the stomach

Question 11

The postpartum homecare patient asks the nurse why the visit is taking place. Which response is best? "We make homecare visits to:

A) "Reinforce any teaching that you didn't quite grasp in the hospital."
B) "Verify that both you and the baby are safe and doing well."
C) "Provide a service that leads to better statistical outcomes."
D) "Thoroughly assess your baby to make sure he is growing."

Question 12

A mother and her newborn have been discharged after a hospital stay of less than 48 hours. What are essential components the nurse must include in the first postpartum home visit?

A) Assessment of color
B) Measurement of weight
C) Measurement of height
D) Assessment of mother-newborn interaction
E) Reinforcement of information about feeding and sleep patterns

Question 13

The nurse is planning a homecare visit to a mother who just recently delivered. The neighborhood is known to have a significant crime rate. What should the nurse do when planning this visit to facilitate personal safety?

A) Plan the visit at nighttime.
B) Wait to find the exact location until arrival in the neighborhood.
C) Put personal possessions in the trunk when leaving the office.
D) Wear flashy jewelry to garner respect.

Question 14

The nurse is at the home of a postpartum patient for an initial assessment. The patient gave birth by cesarean section 1 week earlier. Which statements should the nurse include?

A) "Because you had a cesarean, I'd like to assess your incision."
B) "You aren't having any problems nursing, right?"
C) "How rested do you feel since you came home?"
D) "Since you are bottle-feeding, I won't assess your breasts."
E) "You should remain at home for the first 3 weeks after delivery."

Question 15

The nurse is making a postpartum home visit in the summer. The new father asks about taking the baby to a family outing this weekend. The nurse should encourage the father to:

A) Cover the infant with dark blankets to block the sun.
B) Keep the infant in the shade.
C) Uncover the infant's head to prevent hyperthermia.
D) Avoid taking the infant outdoors for 6 months.

Question 16

The nurse is meeting with a new mother for the first time during a home visit. The patient delivered her first child 3 days ago. She had a normal pregnancy and a vaginal delivery. The infant is breastfeeding. Which statements by the mother indicate that she needs more information about the home visit?

A) "You are going to check my baby's weight."
B) "You are going to watch me nurse the baby and give me tips."
C) "You are going to teach my mother about the baby."
D) "You are checking for safety issues when my son starts crawling."
E) "You are going to take blood samples from me and my son."

Question 17

The nurse is conducting several home visits over the course of a week. Which action is appropriate to maintain safety?

A) Provide a daily schedule of visits to supervisors, including patient addresses and phone numbers.
B) Maintain distance from threatening pets but do not insist that they be kept out of the room.
C) If an unsafe situation arises, discuss safety concerns with the patient before continuing with the visit.
D) Lock personal belongings in the car trunk prior to entering the patient's home.

Question 18

The nurse is teaching experienced postpartum nurses about homecare visits. Which statements indicate that teaching was effective?

A) "I should tell the family to put any guns or knives away."
B) "It is best to wear professional street clothes on visits."
C) "If I encounter a crime in progress, I should leave the area."
D) "Wearing jewelry is a good way to demonstrate my professionalism."
E) "Ignoring my 'gut' feelings might lead to an unsafe situation."

Question 19

The nurse is speaking to a community group about the controversy regarding the length of the hospital stay for postpartum patients. Which statement indicates that a participant needs additional information?

A) "As of 1998, there's a law that requires insurance to pay for a 48-hour stay after an uncomplicated birth."
B) "The length of stay was shortened by insurance companies to decrease healthcare costs."
C) "Early discharge became more popular in the 1980s as an alternative to having a home birth."
D) "With current length-of-stay laws, newborns have no problems at home, and get recommended follow-up care."

Question 20

The nurse is performing a postpartum homecare visit. Which teaching has the highest priority?

A) Teach or review how to bathe the baby.
B) Teaching how to thoroughly childproof the house
C) How many wet diapers the baby should have daily
D) Prevention of deformational plagiocephaly

Question 21

A new mother inquires about postpartum resources. What resources can the nurse suggest to provide assistance to the new mother?

A) Breastfeeding support groups
B) Meals on Wheels
C) Lactation consultants
D) Postpartal classes
E) Internet sites

Question 22

The postpartum patient has chosen to bottle-feed her infant. Nursing actions that aid in lactation suppression include:

A) Warm showers (b.i.d).
B) Pumping milk t.i.d.
C) Ice packs to the axillary area of each breast q.i.d.
D) Avoiding wearing a bra for 5-7 days.

Question 23

What assessments of the newborn should be completed during the initial home visit?

A) Sleep-wake cycles
B) Parent-infant interaction
C) Fontanelles
D) Umbilical cord status
E) Breast engorgement

Question 24

The postpartum homecare nurse is assessing a new mother, and finds her temperature to be 101.6°F. What is the most important nursing action?

A) Ask the mother how often and how well the baby is nursing.
B) Determine the frequency of the mother's voiding and stooling.
C) Verify how many hours of sleep she is getting per day.
D) Assess the odor and color of the lochia and perineum.

Question 25

Before a newborn and mother are discharged from the hospital, the nurse informs the parents about routine screening tests for newborns. What is a good reason for having the screening tests done?

A) The tests prevent infants from developing phenylketonuria.
B) The tests detect such disorders as hypertension and diabetes.
C) The tests detect disorders that cause mental retardation, physical handicaps, or death if left undiscovered.
D) The tests prevent sickle-cell anemia, galactosemia, and homocystinuria.

Question 26

The postpartum nurse is performing a homecare visit to a first-time mother on her third day after delivery. She reports that her nipples are becoming sore. What statement indicates that further teaching is needed?

A) "I should try to keep the baby awake, and not let him stay latched on to the breast when he is asleep."
B) "Watching how much areola is visible will help me see whether he has a good mouthful of breast or not."
C) "My nipples will heal if I switch to bottle feeding for about 3 days while I pump my breasts."
D) "Rotating breastfeeding positions will allow the sore areas of my nipples to have less friction."

Question 27

The homecare nurse is seeing a patient at 6 weeks postpartum. Which statement by the patient indicates the need for immediate intervention?

A) "The baby sleeps 7 hours each night now."
B) "My flow is red, and I need to wear a pad."
C) "My breasts no longer leak between feedings."
D) "I started back on the pill 2 weeks ago."

Question 28

A new mother at 36 hours post-delivery has asked to be discharged to home. The nurse explains that criteria for discharge before the newborn is 48 hours old include:

A) The newborn's respiratory rate is less than 60 breaths/min.
B) Singleton birth at a minimum 37 weeks' gestation.
C) The newborn has passed at least three spontaneous stools.
D) The newborn has normal and stable vital signs for 24 hours before discharge.

Question 29

The postpartum homecare nurse has performed home visits to four breastfeeding mothers. Which mother is experiencing an expected outcome?

A) Breasts are engorged; placing fresh cabbage leaves inside her bra
B) Sore and cracked nipples; using baby oil to facilitate healing
C) Frequent breast leakage; changing breast pads once per day
D) Concerns about milk supply; supplementing with formula

Question 30

The nurse is making an initial visit to a postpartum family's home. The mother states that she is having difficulty with breastfeeding. Which resource should the nurse tell the family about?

A) The lactation consultant at the hospital
B) Free immunizations through the county public health department clinics
C) Sources of free formula at a local food pantry
D) A support group for mothers who are experiencing postpartum depression

Question 31

When making a home visit, the nurse should assess the newborn's sleeping arrangements and the crib. Which finding indicates a safety hazard that should be brought to the attention of the parents?

A) Solid headboard and footboard
B) Crib slats less than 2 inches apart
C) Paint on crib not lead-based
D) Loose-fitting soft mattress

Question 32

The nurse should explain to new parents that their infant's position should be changed periodically during the early months of life to prevent:

A) Muscle contractures.
B) Respiratory distress.
C) Permanently flattened areas of the skull.
D) Esophageal reflux.

Question 33

A breastfeeding postpartum patient reports sore nipples to the nurse during a home visit. The intervention with the highest priority is:

A) Infant positioning.
B) Use of the breast shield.
C) Use of breast pads.
D) Type of soap used.

Question 34

The nurse is assessing a new mother 2 days after a normal vaginal delivery. The mother has chosen not to breastfeed. An abnormal finding would be:

A) Weight loss of 3 pounds.
B) Small amount of breast milk expressed.
C) Pink striae on the abdomen.
D) Lochia serosa.

Question 35

During a home visit, a new mother who is breastfeeding complains that her nipples are sore and cracked. Which measures should the nurse suggest?

A) Alternate the baby's nursing positions throughout the day.
B) Bring the baby close to feed so the baby does not pull on the breast.
C) Avoid placing the areola in the baby's mouth.
D) Insert a finger between the infant's gums to break the latch before removing from the breast.
E) Wash the breasts with warm water, and avoid drying soaps.