Chapter 13: Transition to Parenthood Nursing School Test Banks

Chapter 13: Transition to Parenthood

Multiple Response

1. 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.)
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 to have her family bring her food to eat.

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

KEY: Integrated Process: Caring | Cognitive Level: Application | Content Area: Maternity | Client Need: Psychosocial Integrity | Difficulty Level: Moderate

2. The nurse is caring for a postpartum woman who gave birth to a healthy, full-term baby girl. She has a 2-year-old son. She voices concern about her older childs adjustment to the new baby. Nursing actions that will facilitate the older sons adjustment to having a new baby in the house would include which of the following? (Select all that apply.)
a. Explain to the mother that she can have her son lie in bed with her when he is visiting her in the hospital.
b. Teach her son how to change the babys diapers.
c. Assist her son in holding his new baby sister.
d. Recommend that she spend time reading to her older son while he sits in her lap.

ANS: a, c, d
Two-year-olds enjoy being close to their mothers, including lying next to their mothers or being held. Changing diapers is not viewed as a pleasurable experience and is not developmentally appropriate for a 2-year-old. Children enjoy being able to hold their sibling and feeling grown up.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Application | Content Area: Maternity | Client Need: Psychosocial Integrity | Difficulty Level: Easy

3. Which of the following nursing actions are directed at assisting men in their transition to fatherhood? (Select all that apply.)
a. Encourage the woman to take on the major responsibility for infant care.
b. Talk to the man, away from his partner, about his expectations of the fathering role.
c. Praise the father for his interactions with his infant.
d. Provide information on infant care and behavior to both parents.

ANS: c, d
It is important to first have the couple discuss with each other their expectations of the fathering role. Once this has occurred, then the woman and nurse need to support the man in his role of infant care. Both parents need to receive information about infant care and infant behaviors, and both parents need to be praised for their interactions with their baby.

KEY: Integrative Process: Teaching and Learning | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Moderate

4. Which of the following nursing actions are directed at promoting bonding? (Select all that apply.)
a. Providing opportunity for parents to hold their newborn as soon as possible following the birth.
b. Providing opportunities for the couple to talk about their birth experience and about becoming parents.
c. Promoting rest and comfort by keeping the newborn in the nursery at night.
d. Providing positive comments to parents regarding their interactions with their newborn.

ANS: a, b, d
Parent bonding can be delayed by prolonged periods of separation from their child. The other three actions support parent bonding with their newborn.

KEY: Integrative Process: Caring | Cognitive Level: Application | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Moderate

5. Which of the following factors place a new mother at risk for parenting? (Select all that apply.)
a. She is 17 years old.
b. Family income is below the average income.
c. Her parents live in the same city and are perceived as helpful.
d. She dropped out of school at age 13.

ANS: a, b, d
Adolescent parents may have a more difficult transition to parenthood because they have not made the transition to adulthood. Financial concerns can hamper the transition to parenthood because the focus of attention may be on where to get money to pay for daily living expenses versus on the care of their newborn. Decreased ability to read and comprehend information regarding child care may hamper the ability to gain knowledge about the care of their child.

KEY: Integrative Process: Safe and Effective Care Environment | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Moderate

6. Which of the following nursing actions can assist a man in his transition to fatherhood? (Select all that apply.)
a. Ask the man to share his ideas of what it means to be a father.
b. Demonstrate infant care such as diapering and feeding.
c. Engage couple in a discussion regarding each others expectations of the fathering role.
d. Provide the man with information on infant care.

ANS: a, b, c, d
Each of these actions can assist the father in his transition. It is important for the man to be able to learn and practice infant care skills in a nonthreatening environment. It is also important for the man to be able to openly talk about his feelings regarding fatherhood and for the couple to identify mutual expectations of the fathering role.

KEY: Integrative Process: Safe and Effective Care Environment | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Moderate

Multiple Choice

7. A 16-year-old woman delivers a healthy, full-term male infant. The nurse notes the following behaviors 2 hours after the birth: Woman holds baby away from her body; woman refers to baby as he; woman verbalizes she wanted a baby girl; woman requests that baby be placed in the bassinet so she can eat her lunch. The most appropriate nursing diagnosis for this woman is:
a. At risk for impaired parenting related to disappointment with baby as evidenced by verbalizing she wanted a girl
b. At risk for impaired parenting related to nonnurturing behaviors as evidenced by holding baby away from body
c. At risk for impaired motherinfant attachment as evidenced by woman requesting baby being placed in bassinet
d. At risk for impaired motherinfant attachment related to disappointment as evidenced by calling baby he

ANS: a
Feedback
a. The potential is for impaired parenting related to disappointment in the gender of the baby.
b. Holding baby away from her body during the first few hours is part of the maternal touch process.
c. Focusing on eating during the first few hours is a behavior of taking-in and is anticipated during this phase.
d. Some parents have not selected a name for their baby and will refer to their baby as he or she. There is concern if the woman calls her baby it.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychosocial Integrity | Difficulty Level: Moderate

8. 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:
a. Bonding
b. Engrossment
c. Couvade syndrome
d. Attachment

ANS: b
Feedback
a. Bonding is defined as the emotional feelings that begin during pregnancy or shortly after birth between the parent and the newborn. Bonding is unidirectional from parent to newborn.
b. Correct. Characteristics of engrossment are visual awareness of baby, tactile awareness of baby, perception that baby is perfect, strong attraction to baby, feeling of strong elation, and increased self-esteem.
c. Couvade syndrome relates to a set of pregnancy symptoms the father experiences during pregnancy of the woman.
d. Attachment is a connection that forms from parent to infant and infant to parent. Attachment has a lifelong impact on the developing individual.

KEY: Integrated Process: Communication and Documentation | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychosocial Integrity | Difficulty Level: Moderate

9. A woman on the day of discharge from the postpartum unit requests clean towels so she can take a shower, asks a number of questions regarding breastfeeding, and shares that she is nervous about taking her baby home and not being able to remember everything she has been taught. These are behaviors associated with:
a. Bonding
b. Taking in
c. Taking hold
d. Attachment

ANS: c
Feedback
a. Bonding is defined as the emotional feelings that begin during pregnancy or shortly after birth between the parent and the newborn. Bonding is unidirectional from parent to newborn.
b. In the taking-in phase, women are dependent and need assistance with self-care and care of the infant.
c. Correct. These are common behaviors of women in the taking-hold phase. Women during this phase have moved to being more independent and able to initiate self-care. They are highly interested in learning about the care of their baby but can easily become frustrated and discouraged when they do not immediately master a new skill.
d. Attachment is a connection that forms from parent to infant and infant to parent. Attachment has a lifelong impact on the developing individual.

KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychosocial Integrity | Difficulty Level: Moderate

10. The nurse is developing a plan of care for a client who is in the taking-in phase after delivering a healthy baby boy. Which of the following should the nurse include in the plan?
a. Provide the client with a nutritious meal.
b. Teach baby care skills like diapering.
c. Discuss the pros and cons of circumcision.
d. Counsel her regarding future sexual encounters.

ANS: a
Feedback
a. Mothers are very hungry immediately after delivery. The nurse should provide the client with food.
b. Baby care skills should be taught during the taking-hold phase.
c. Baby care needs should be discussed during the taking-hold phase.
d. A discussion of sexual issues should be deferred until the taking-hold phase or the letting go phase.

KEY: Integrated Process: Nursing Process: Implementation; Teaching and Learning | Cognitive Level: Application | Content Area: Health and Wellness; Postpartum Care | Client Need: Health Promotion and Maintenance | Difficulty Level: Difficult

11. 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:
a. Taking in
b. Taking hold
c. Taking charge
d. Taking time

ANS: b
As the mothers 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 motherinfant interactions for signs of poor bonding, and if present, implement actions to facilitate attachment.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy

12. The postpartum nurse caring for a 20-year-old G1 P0 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?
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.

ANS: a
These are classical signs of the initial stage of Rubins maternal touch.

KEY: Integrative Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Moderate

True/False

13. Eye movements are an example of newborn/infant style of communication.

ANS: True
Crying, cooing, facial expressions, eye movements, cuddling, and arm and leg movements are all examples of newborn/infant style of communication.

KEY: Integrative Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Easy

14. Bonding is bidirectional from parent to infant and infant to parent.

ANS: False
Bonding is unidirectional from parent to infant. Attachment is bidirectional.

KEY: Integrative Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Easy

15. 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 babys eyes.
Based on this data, the correct nursing diagnosis is altered parentinfant bonding related to emergency cesarean birth.
Cesarean birth can place the parents at risk for bonding, but based on the observed interaction with their newborn, the parents display positive signs of bonding.

ANS: False

KEY: Integrative Process: Nursing Process | Cognitive Level: Analysis | Content Area: Maternity | Client Need: Psychological Integrity | Difficulty Level: Difficult

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