Deck 18: Postpartum Psychosocial Adaptations

Question 1

A new mother states, "My mother-in-law will be here from out of town for a few weeks. I'm afraid she will take over the care of the baby." Which response should the nurse make?

A) Tell the client that everything will be okay.
B) Tell the client how lucky she is to have someone to help her.
C) Encourage the client to allow her mother-in-law to take care of the newborn.
D) Encourage the client to tell her mother-in-law that she (the new mother) wants to care for her infant.

Answer 1

Encourage the client to tell her mother-in-law that she (the new mother) wants to care for her infant.

Question 2

While the nurse is demonstrating a baby bath, the client states, "The other nurse told me to do it a different way." Which response should the nurse make?

A) Tell her to do the procedure whichever way works best for her.
B) Confront the other nurse about her knowledge of the procedure.
C) Reassure her that procedures are based on standard principles and may vary.
D) Tell her that the other nurse does not have much experience in caring for newborns.

Answer 2

Reassure her that procedures are based on standard principles and may vary.

Question 3

A husband calls the nurse's station stating that his wife, who delivered last week, is happy one minute and crying the next. He says, "She was never like this before the baby was born." Which should be the nurse's initial response?

A) Reassure him that this behavior is normal.
B) Advise him to get immediate psychological help for her.
C) Tell him to ignore the mood swings because they will go away.
D) Instruct him in the signs, symptoms, and duration of postpartum blues.

Answer 3

Reassure him that this behavior is normal.

Question 4

During which stage of role attainment do the parents become acquainted with their baby and combine parenting activities with cues from the infant?

A) Formal
B) Informal
C) Personal
D) Anticipatory

Question 5

To promote bonding and attachment immediately after birth, which action should the nurse take?

A) Assist the mother in feeding her baby.
B) Allow the mother quiet time with her infant.
C) Teach the mother about the concepts of bonding and attachment.
D) Assist the mother in assuming an en face position with her newborn.

Question 6

The postpartum nurse is reviewing dietary practices for an Asian client. Which should the nurse expect to observe as a dietary practice for this culture?

A) Food brought from home
B) Preference for fresh fruits
C) Preference for "cold" foods
D) Request for ice water instead of hot water

Question 7

The postpartum client who continually repeats the story of her labor, birth, and recovery experiences is doing which?

A) Making the birth experience "real"
B) Accepting her response to labor and birth
C) Providing others with her knowledge of events
D) Taking hold of the events leading to her labor and birth

Question 8

The nurse observes a client on her first postpartum day sitting in bed while her newborn lies awake in the bassinet. Which appropriate action should the nurse take?

A) Hand the baby to the woman.
B) Explain "taking-in" to the woman.
C) Offer to hand the baby to the woman.
D) No action, because this situation is perfectly acceptable.

Question 9

A postpartum client who is a gravida 4, para 4, comes to the office for her 6-week postpartum checkup. Her presentation is untidy and unkempt. The client states that she is not sleeping well and relates that she feels overwhelmed at times. According to the client, family members' responses have been nonsupportive. What recommendations would you advise to help the client at this time?

A) Tell the client that this is a normal reaction to an increase in family size and that listening to music can help relieve anxiety.
B) Tell the client to increase her exercise pattern because that will promote a sense of well-being.
C) Make appropriate referrals for psychological intervention counseling because the client is exhibiting high-risk symptoms.
D) Record the client's vital signs as part of the ongoing assessment and offer relaxation strategies as a method of support.

Question 10

During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby?

A) Letting-go
B) Taking-in
C) Taking-on
D) Taking-hold

Question 11

Which client is most likely to have the least stress adjusting to her role as a mother?

A) A 26-year-old woman who is returning to work in 10 weeks
B) A 35-year-old anxious mother who has had no contact with babies or children
C) A 16-year-old teenager who lives with her parents and has a strained relationship with her mother
D) A 25-year-old woman who knew at 16 weeks of gestation that she was pregnant with twins, who were delivered by cesarean birth

Question 12

A postpartum nurse is observing a client holding the baby she delivered less than 24 hours ago. Her husband is watching his wife and asking questions about newborn care. The 4-year-old big brother is punching his mother on the back. Which action should the nurse should take?

A) Report the incident to the social services department.
B) Advise the parents that the older son needs to be reprimanded.
C) No action; this is a normal family adjusting to family change.
D) Report to oncoming staff that the mother is probably not a good disciplinarian.

Question 13

Which action should the nurse do to provide support and encouragement to the new postpartum client?

A) Recount how she solved her own problems.
B) Correct the new mother at every opportunity.
C) Praise the mother's early attempts at infant care.
D) Explain to the new mother that everything will be fine.

Question 14

A 25-year-old gravida 1, para 1, who had an emergency cesarean birth 3 days ago is scheduled for discharge. As you prepare her for discharge, she begins to cry. Which should be your initial action?

A) Assess her for pain.
B) Allow her time to express her feelings.
C) Point out how lucky she is to have a healthy baby.
D) Explain that she is experiencing postpartum blues.

Question 15

An example of binding in during the postpartum period is a:

A) new mother telling her friends all about her labor and birth experience.
B) father looking at his newborn and stating that he "looks like I did when I was a baby."
C) mother reporting increasing anxiety during the postpartum period because she feels like she is all alone.
D) mother wanting some time alone so that she can catch up on needed sleep.

Question 16

The nurse is teaching new parents about behavior cues that indicate their infant has had enough stimulation. Which cues should the nurse include in the teaching session?

A) The infant kicks his legs.
B) The infant is quiet and alert.
C) The infant splays his fingers.
D) The infant looks at their faces.

Question 17

Which should the nurse do to provide support to a new client who must return to full-time employment 6 weeks after a vaginal birth?

A) Discuss child care arrangements with her.
B) Allow her to solve the problem on her own.
C) Reassure her that she'll get used to leaving her baby.
D) Allow her to express her positive and negative feelings freely.

Question 18

A new father states, "I know nothing about babies," but he seems to be interested in learning. The nurse should take which action?

A) Include him in teaching sessions.
B) Tell him when he does something wrong.
C) Show no concern because he will learn on his own.
D) Continue to observe his interaction with the newborn.

Question 19

The term reciprocal attachment behavior refers to which of the following?

A) Behavior during the sensitive period when the infant is in the quiet alert stage
B) Positive feedback an infant exhibits toward parents during the attachment process
C) Unidirectional behavior exhibited by the infant, initiated and enhanced by eye contact
D) Behavior by the infant during the sensitive period to elicit feelings of "falling in love" from the parents

Question 20

Which anticipatory guidance action by the nurse makes role transition to parenthood easier?

A) Helps the new parents identify resources
B) Recommends employing babysitters frequently
C) Tells the parents about the realities of parenthood
D) Offers a home phone number and tells parents to call if they have a question

Question 21

Match each term with the correct definition of maternal adaptation stages.

Taking-in

A)Passive, dependent
B)Begins to see self as a mother
C)Autonomous, seeking information

Question 22

Match each term with the correct definition of maternal adaptation stages.

Letting-go

A)Passive, dependent
B)Begins to see self as a mother
C)Autonomous, seeking information

Question 23

Which are nursing measures that can promote parent-infant bonding and attachment? (Select all that apply.)

A) Provide comfort and ample time for rest.
B) Keep the baby wrapped to avoid cold stress.
C) Position the infant face to face with the mother.
D) Point out the characteristics of the infant in a positive way.
E) Limit the amount of modeling so the mother doesn't feel insecure.

Question 24

Which of the following behaviors would be applicable to a nursing diagnosis of risk for impaired parenting?

A) En face behavior is observed between father and infant.
B) Mother relates that she feels exhilarated postbirth.
C) Mother states that she feels excessive fatigue as a result of the childbirth experience.
D) Father displays finger tipping behavior toward infant.

Question 25

Match each term with the correct definition of maternal adaptation stages.

Taking-hold

A)Passive, dependent
B)Begins to see self as a mother
C)Autonomous, seeking information

Question 26

A family is concerned about how their 2-year-old son is going to react to the new baby. What intervention would help facilitate sibling attachment?

A) Have the mother and father spend individual time with their son to allay potential anxiety over the new baby coming in and displacing his position in the family as the only child.
B) Make sure that their son is supervised at all times when the baby is brought home from the hospital and is in his presence.
C) Include the son in helping to take care of the baby and reinforce the label of "big brother" as a special role.
D) Observe the son's reaction to the baby and let him decide when he wants to be introduced to his new sibling.

Question 27

A postpartum patient calls the clinic and reports to the nurse feelings of fatigue, tearfulness, and anxiety. What is the nurse's best response?

A) "When did these symptoms begin?"
B) "Sounds like normal postpartum depression."
C) "Are you having trouble getting enough sleep?"
D) "Are you able to get out of bed and provide care for your baby?"

Question 28

Which strategies should the nurse suggest to a postpartum client to promote stress reduction during the first weeks at home? (Select all that apply.)

A) Limiting coffee, tea, cola, and any caffeinated beverages
B) Maintaining a rigid schedule
C) Sleeping when the infant sleeps
D) Inviting visitors and friends to stop by frequently
E) Using learned breathing techniques from childbirth classes for relaxation

Question 29

The nurse is developing a plan of care for the patient's fourth stage of labor. One nursing intervention is to promote bonding. Specifically, which nursing action will facilitate the bonding process?

A) Encourage the patient to call the baby by his or her first name.
B) Stimulate the grasp reflex by placing the patient's finger in the infant's palm.
C) Ask the patient if she wants her baby placed on her chest immediately after birth.
D) Assess for familial characteristics and remark on the resemblance to the patient or the father.