Chapter 22: Trition to Parenthood Lowdermilk: Maternity & Women’s Health Care, 11th Edition

TEST BANK FOR MATERNITY & WOMEN’S HEALTH CARE 11TH EDITION BY LOWDERMILK Chapter 22: Trition to Parenthood Lowdermilk: Maternity & Women’s Health Care, 11th Edition MULTIPLE CHOICE 1. After giving birth to a healthy infant boy, a primiparous client, 16 years of age, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is ―Deficient knowledge of infant care.‖ What should the nurse be certain to include in the plan of care as he or she prepares the client for discharge? a. Teach the client how to feed and bathe her infant. b. Give the client written information on bathing her infant. c. Advise the client that all mothers instinctively know how to care for their infants. d. Provide time for the client to bathe her infant after she views a demonstration of infant bathing. CORRECT ANSWER: D Having the mother demonstrate infant care is a valuable method of assessing the client‘s understanding of her newly acquired knowledge, especially in this age group, because she may inadvertently neglect her child. Although verbalizing how to care for the infant is a form of client education or providing written information might be useful, neither is the most developmentally appropriate teaching method for a teenage mother. Advising the young woman that all mothers instinctively know how to care for their infants is inappropriate; it is belittling and false. DIF: Cognitive Level: Apply REF: p. 520 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 2. A 30-year-old multiparous woman has a boy who is years old and has recently delivered an infant girl. She tells the nurse, ―I don‘t know how I‘ll ever manage both children when I get home.‖ Which suggestion would assist this new mother in alleviating sibling rivalry? a. Tell the older child that he is a big boy now and should love his new sister. b. Let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the newborn. c. Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him. d. Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time. CORRECT ANSWER: D The older child may regress in habits or behaviors (e.g., toileting, sleep habits) as a method of seeking attention. Parents need to distribute their attention in an equitable manner. Telling the older child that he should love his new sister is a negative approach to facilitating sibling acceptance of the new infant. Reactions of siblings may result from temporary separation from the mother. Removing the older child from the home when the new infant arrives may enhance negative behaviors from the older child caused by a separation from the mother. Providing small gifts from the infant to the older child is a strategy for facilitating sibling acceptance of the new infant. DIF: Cognitive Level: Analyze REF: p. 517 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 3. The nurse observes that a first-time mother appears to ignore her newborn. Which strategy should the nurse use to facilitate mother-infant attachment? a. Tell the mother she must pay attention to her infant. b. Show the mother how the infant initiates interaction and attends 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. CORRECT ANSWER: B Pointing out the responsiveness of the infant is a positive strategy for facilitating parent-infant attachment. Telling the mother that she must pay attention to her infant may be perceived as derogatory and is not appropriate. Educating the young mother in infant care is important, but pointing out the responsiveness of her baby is a better tool for facilitating mother-infant attachment. Videos are an educational tool that can demonstrate parent-infant attachment, but encouraging the mother to recognize the infant‘s responsiveness is more appropriate. DIF: Cognitive Level: Apply REF: p. 502 TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 4. A nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dad‘s. This statement is most descriptive of which process? a. Mutuality b. Synchrony c. Claiming d. Reciprocity CORRECT ANSWER: C Claiming refers to the process by which the child is identified in terms of likeness to other family members. Mutuality occurs when the infant‘s behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics. Synchrony refers to the ―fit‖ between the infant‘s cues and the parent‘s responses. Reciprocity is a type of body movement or behavior that provides the observer with cues. DIF: Cognitive Level: Understand REF: pp. 502, 504 TOP: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity 5. New parents express concern that because of the mother‘s emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. Which information should the nurse‘s response convey? a. Attachment, or bonding, is a process that occurs over time and does not require early contact. b. Time immediately after birth is a critical period for humCORRECT ANSWER. c. Early contact is essential for optimal parent-infant relationships. d. These new parents should just be happy that the infant is healthy. CORRECT ANSWER: A Attachment occurs over time and does not require early contact. Although a delay in contact does not necessarily mean that attachment is inhibited, additional psychologic energy may be necessary to achieve the same effect. The formerly accepted definition of bonding held that the period immediately after birth was critical for bonding to occur. Research since has indicated that parent-infant attachment occurs over time. A delay does not inhibit the process. Parent-infant attachment involves activities such as touching, holding, and gazing; it is not exclusively eye contact. Telling the parents that they should be happy that the infant is healthy is inappropriate; it may be received as derogatory and belittling.