Phases of Maternal Role Attainment > Maternal & Newborn
Exam Review
More questions on this topic
Total Questions : 18
Showing 18 questions, Sign in for moreA nurse is caring for a postpartum client who has decided not to breastfeed her infant and has chosen formula feeding instead.
The nurse should instruct the client that:
Explanation
Formula feeding increases risk for infection in infants.This is because breast milk contains antibodies and other germ-fighting factors that help protect the baby from infections, such as ear infections, diarrhea, respiratory infections and meningitis.Breast milk also provides ideal nutrition and is easily digested by the baby.
A nurse is caring for a postpartum client who has been diagnosed with postpartum depression (PPD).
Which of the following interventions should be included in her plan of care?
Explanation
Encourage her to participate in support groups.This is because support groups can help the postpartum client to share her feelings, learn coping skills, and receive emotional and social support from other mothers who have experienced postpartum depression.Support groups can also reduce the sense of isolation and stigma that some women with postpartum depression may feel.
Encourage her to sleep as much as possible is wrong because sleeping too much can be a sign of depression and can interfere with the mother’s ability to bond with her baby and perform daily activities.Sleeping too little can also worsen symptoms or increase the likelihood of postpartum depression due to sleep deprivation. Therefore, the mother should be encouraged to follow a healthy sleep routine and get help from others if needed.
Encourage her to avoid talking about her feelings is wrong because talking about feelings is an important part of psychotherapy, which is a recommended treatment for postpartum depression.Talking about feelings can help the mother to express her emotions, identify negative thoughts, and receive feedback and guidance from a mental health professional. Avoiding talking about feelings can lead to further isolation and distress.
Encourage her to spend time alone as much as possible is wrong because spending time alone can also increase the sense of isolation and loneliness that some women with postpartum depression may experience. Spending time alone can also prevent the mother from receiving help and support from others, such as her partner, family, friends, or healthcare providers. The mother should be encouraged to seek social support and engage in enjoyable activities with others.
A client is concerned about the risk factors for pre-term labor.
Which of the following factors should the nurse include in the discussion?
Explanation
Advanced maternal age is a risk factor for preterm labor, which occurs when regular contractions begin to open the cervix before 37 weeks of pregnancy.
Preterm labor can lead to premature birth, which can have serious health consequences for the baby.
Choice B is wrong because full-term gestation is not a risk factor for preterm labor.Full-term gestation means that the pregnancy lasts between 39 and 40 weeks, which is the ideal duration for the baby’s development.
Choice C is wrong because absence of medical or obstetric complications is not a risk factor for preterm labor.Some medical or obstetric complications that can increase the risk of preterm labor include urinary tract infections, high blood pressure, bleeding from the vagina, placenta previa, diabetes and blood clotting problems.
Choice D is wrong because lack of uterine contractions before 37 weeks of gestation is not a risk factor for preterm labor.Uterine contractions are a sign of preterm labor, not a cause of it.
Some other risk factors for preterm labor that the nurse should include in the discussion are:
• Previous preterm delivery or preterm labor
• Multiple gestation (twins, triplets or more)
• Abnormalities of the reproductive organs, such as a short cervix
• Ethnicity (African American and American Indian/Alaska Native mothers have higher rates of preterm birth than white mothers)
• Age of the mother (women younger than 18 are more likely to have a preterm delivery)
• Tobacco use and substance abuse
• Short time period between pregnancies (less than 18 months)
A nurse is evaluating the effectiveness of antenatal education on a group of expectant mothers.
Which of the following outcomes would indicate a positive effect of the education?
Explanation
The correct answer is choice A. Increased self-confidence levels.
This outcome would indicate that the expectant mothers have gained knowledge and skills to cope with the challenges of pregnancy and childbirth, and feel more confident in their abilities to perform the maternal role.
Antenatal education aims to prepare women for pregnancy, labor, delivery, and postnatal care, and to enhance their self-confidence and satisfaction.
Choice B is wrong because decreased childbirth attitudes would indicate that the expectant mothers have developed negative or fearful perceptions of childbirth, which could affect their coping and decision-making abilities.
Antenatal education should promote positive attitudes and expectations towards childbirth.
Choice C is wrong because increased maternal role strain would indicate that the expectant mothers are experiencing difficulties or conflicts in adapting to the maternal role, which could affect their well-being and bonding with the baby.
Antenatal education should help women to adjust to the changes and demands of motherhood.
Choice D is wrong because decreased social support would indicate that the expectant mothers have less access to or use of resources and assistance from their family, friends, or health professionals, which could affect their coping and satisfaction.
Antenatal education should encourage women to seek and utilize social support during pregnancy and postpartum.
A nurse is assessing a postpartum client who delivered her second baby 3 days ago.
The client says, “I feel sad that my older child will not get as much attention from me as before.” The nurse recognizes that the client is in which phase of maternal role attainment?
Explanation
The correct answer is choice C. Interdependent.According to Mercer’s theory of maternal role attainment, the interdependent phase is when the mother redefines her relationship with her older child and integrates the new baby into the family.She also reestablishes her role in society and resumes her pre-pregnancy activities.
Choice A is wrong because dependent is the first phase of maternal role attainment, when the mother is focused on her own needs and recovery after childbirth.She relies on others for support and guidance.
Choice B is wrong because dependent-independent is the second phase of maternal role attainment, when the mother begins to take charge of her own care and learns how to care for the baby.She seeks information and validation from health professionals and experienced mothers.
Choice D is wrong because independent is the fourth and final phase of maternal role attainment, when the mother has a strong sense of identity and competence in her maternal role.She develops her own style of mothering and feels confident and comfortable with her baby.
A nurse is providing discharge teaching to a postpartum client who had a vaginal delivery with an episiotomy.
The client asks, “How can I take care of myself at home?” Which of the following responses should the nurse give?
Explanation
The correct answer is choice C. You should drink plenty of fluids and eat high-fiber foods.This will help you prevent constipation and ease your bowel movements, which can be painful after an episiotomy.
Choice A is wrong because you should not avoid taking sitz baths until your stitches dissolve.Sitz baths can help reduce the pain, swelling, and bruising around the wound area.
However, you should consult your doctor before taking a sitz bath.
Choice B is wrong because you should not change your perineal pad from back to front.This can introduce bacteria into your wound and increase the risk of infection.You should change your perineal pad from front to back and use a squirt bottle filled with warm water to cleanse the area every time you use the bathroom.
Choice D is wrong because you should not resume sexual intercourse as soon as you feel comfortable.You should wait until your wound is fully healed and your bleeding has stopped, which may take several weeks.You should also use a lubricant and a condom to prevent irritation and infection.
A nurse is caring for a postpartum client who had a difficult labor and delivery. The client expresses frustration and disappointment with her birth experience. Which of the following actions should the nurse take?
Explanation
The correct answer is choice B. Encourage the client to talk about her feelings and listen empathetically.
This action shows respect for the client’s emotions and helps her process her experience.
It also allows the nurse to provide support and reassurance.
Choice A is wrong because it dismisses the client’s feelings and implies that she should not be upset.
This can make the client feel guilty or invalidated.
Choice C is wrong because it blames the client for having unrealistic and unachievable expectations.
This can make the client feel ashamed or defensive.
Choice D is wrong because it suggests that the client needs professional counselling to cope with her emotions.
This can make the client feel stigmatized or abnormal.
Normal ranges for postpartum emotions vary depending on the individual and the circumstances.
However, some signs of postpartum depression or post-traumatic stress disorder include persistent sadness, anxiety, anger, guilt, flashbacks, nightmares, insomnia, loss of interest, difficulty bonding with the baby, or thoughts of harming oneself or the baby.
These symptoms should be reported to a healthcare provider as soon as possible.
A nurse is caring for a woman who gave birth three hours ago. The nurse observes that the woman is holding her infant close to her chest and is talking softly to him. The nurse interprets this behaviour as:
Explanation
The correct answer is choice B. Attachment.
Attachment is the process of developing a strong emotional bond between the mother and the infant.
It is influenced by factors such as maternal hormones, infant cues, and environmental support.
Attachment behaviors include holding, touching, talking, and gazing at the infant.
Choice A is wrong because bonding is the initial attraction felt by the parents for their infant.
It usually occurs within the first few minutes or hours after birth and is facilitated by skin-to-skin contact.
Choice C is wrong because engrossment is the term used to describe the father’s absorption, preoccupation, and interest in the infant.
It involves visual awareness, tactile awareness, perception of newborn as perfect, strong attraction, awareness of distinct features, extreme elation, and increased sense of self-esteem.
Choice D is wrong because entrainment is the term used to describe the infant’s movement in response to speech.
The infant synchronizes his or her movements with the rhythm and pitch of the adult’s voice.
A nurse is assessing a woman who gave birth four days ago. The nurse notes that the woman has a positive mood, expresses confidence in her ability to care for her infant, and reports adequate support from her partner and family. The nurse identifies these findings as indicators of:
Explanation
The correct answer is choice D. Postpartum adaptation.
This is the process of adjusting to the physical, emotional, and social changes that occur after childbirth.The woman in the question shows signs of positive mood, confidence, and adequate support, which are indicators of successful postpartum adaptation.
Choice A is wrong because postpartum blues are characterized by mild depressive symptoms, such as mood swings, crying spells, irritability, and anxiety, that usually occur within the first few days after delivery and resolve within two weeks.
Choice B is wrong because postpartum depression is a more severe and persistent form of depression that affects 10-15% of women after childbirth.
It can cause symptoms such as sadness, hopelessness, guilt, loss of interest, insomnia, appetite changes, and suicidal thoughts.It usually requires treatment with psychotherapy and/or medication.
Choice C is wrong because postpartum psychosis is a rare but serious psychiatric emergency that affects 1-2 in every 1000 women after childbirth.
It can cause symptoms such as delusions, hallucinations, paranoia, confusion, agitation, and attempts to harm oneself or the baby.It usually requires hospitalization and treatment with mood stabilizers and antipsychotics.
The nurse is palpating a patient’s uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?
Explanation
The correct answer is choice D. To stabilize the lower uterine segment.Palpating the uterus after delivery helps to determine its size, firmness and rate of descent, which are indicators of its involution.The nurse places one hand just above the symphysis pubis to support the lower uterine segment and prevent it from being pushed down by the pressure of the other hand on the fundus.This prevents complications such as uterine inversion or prolapse.
Choice A is wrong because uterine prolapse is not prevented by placing one hand above the symphysis pubis, but by supporting the lower uterine segment with that hand.
Choice B is wrong because uterine hemorrhage is not prevented by placing one hand above the symphysis pubis, but by massaging the fundus to make it firm and contract the blood vessels.
Choice C is wrong because uterine inversion is not prevented by placing one hand above the symphysis pubis, but by stabilizing the lower uterine segment with that hand and avoiding excessive traction on the umbilical cord.
The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient’s uterus?
Explanation
The correct answer is choice C. Ask the patient to void.This is because a full bladder can displace the uterus and interfere with its contraction, which can lead to postpartum hemorrhageThe nurse should assess the patient’s uterus after ensuring that the bladder is empty.
Choice A is wrong because placing the patient on the left side does not affect the uterus assessment.It may help with blood circulation and oxygenation, but it is not necessary before checking the uterus.
Choice B is wrong because assessing the passage of lochia is part of the uterus assessment, not a prerequisite.Lochia is the vaginal discharge after giving birth, containing blood, mucus, and uterine tissueIt has three stages: lochia rubra (red), lochia serosa (pinkish brown), and lochia alba (yellowish white)
Choice D is wrong because administering a dose of oxytocin is not required before assessing the uterus.
Oxytocin is a hormone that stimulates uterine contractions and reduces bleeding.It may be given during or after labor to prevent or treat postpartum hemorrhage, but it is not a routine procedure.
What is the most common cause of subinvolution?
Explanation
The correct answer is choice A.Retained placental fragments are the most common cause of subinvolution.Subinvolution is a condition where the uterus does not return to its normal size after childbirth.Retained placental fragments prevent the uterus from contracting properly and cause prolonged bleeding and infection.
Choice B is wrong because infection is not the most common cause of subinvolution, but it can be an aggravating factor.Infection can cause inflammation and interfere with the healing of the uterine lining.
Choice C is wrong because uterine fibroids are not the most common cause of subinvolution, but they can be a predisposing factor.Uterine fibroids are benign tumors that can distort the shape of the uterus and impair its contraction.
Choice D is wrong because multiparity is not the most common cause of subinvolution, but it can be a predisposing factor.Multiparity means having given birth more than once, which can weaken the uterine muscles and reduce their ability to contract.
Normal ranges for uterine involution are as follows:
• Uterus weight: decreases from about 1000 g at delivery to about 60 g at six weeks postpartum.
• Uterus height: decreases from about 20 cm above the pubic bone at delivery to about 12 cm at one week postpartum, and then descends into the pelvis by six weeks postpartum.
• Uterus size: decreases from about 20 times its normal size at delivery to about its normal size at six weeks postpartum.
A nurse is assessing a postpartum client who received Rho (D) immune globulin (RhoGAM) before discharge.
Which statement by the client indicates a need for further teaching?
Explanation
The correct answer is choice D. “I will need to avoid contact with anyone who has rubella.” This statement indicates a need for further teaching because RhoGAM has nothing to do with rubella, which is a viral infection that can cause birth defects if contracted during pregnancy.
RhoGAM is given to prevent Rh incompatibility, which is a condition where the mother’s immune system attacks the baby’s blood cells if they have different Rh factors.
Choice A is wrong because the client will need another dose of RhoGAM only if she gets pregnant again with an Rh-positive baby.
Choice B is wrong because the client does not need to use contraception for at least three months after receiving RhoGAM.
Choice C is wrong because the client’s blood type does not change after receiving RhoGAM and does not need to be checked again.
A nurse is caring for a postpartum client who had a vaginal delivery with an episiotomy.
Which action would help prevent infection of the perineal area?
Explanation
The correct answer is C. Spraying warm water over the perineum after each voiding or bowel movement.This action would help prevent infection of the perineal area by keeping it clean and reducing the risk of bacterial contamination.
A is wrong because ice packs can only help reduce swelling and pain, but not prevent infection.
B is wrong because changing the pad from back to front can introduce bacteria from the rectum to the vagina and perineum, increasing the risk of infection. The correct way is to change the pad from front to back.
D is wrong because an inflatable ring or pillow can increase blood flow to the perineal area and delay healing, which can increase the risk of infection.
A firm surface is better for sitting after delivery.
Some other preventive measures for postpartum infections include washing hands before touching the perineal area, using only maxi pads and not tampons for postpartum bleeding, taking preventive antibiotics if prescribed, and contacting a doctor if symptoms of infection appear.
A nurse is planning care for a client who has postpartum psychosis and is experiencing hallucinations.
Which of the following interventions should the nurse include in the plan?
Explanation
Normal ranges for postpartum psychosis are not applicable, as it is a rare and severe psychiatric disorder that affects 1-2 per 1,000 women.It usually occurs within the first 2 weeks after delivery, but can occur up to 12 months postpartum.
A nurse is reviewing the laboratory results of a postpartum client who had a hemorrhage due to uterine atony. Which finding would be expected in this client?
Explanation
The correct answer is A. Decreased hematocrit and hemoglobin levels.This is because postpartum hemorrhage can lead to hypovolemia which can cause a decrease in hematocrit and hemoglobin levels.Increased white blood cell and platelet counts (option B) are not expected findings in postpartum hemorrhage.Decreased prothrombin time and partial thromboplastin time (option C) are not expected findings in postpartum hemorrhage.Increased fibrinogen and fibrin degradation products (option D) are not expected findings in postpartum hemorrhage.
A nurse is caring for a client who is in the informal stage of maternal role attainment.
Which of the following statements by the client indicates an understanding of this stage?
Explanation
The correct answer is choice C. “I am starting to feel like I can handle being a mother.” This statement indicates that the client is in the informal stage of maternal role attainment, which is characterized by a sense of confidence and competence in the maternal role.
The client develops her own style of mothering and integrates feedback from others.
Choice A is wrong because it reflects the initial stage of maternal role attainment, which is marked by a strong emotional attachment to the newborn.
Choice B is wrong because it suggests that the client is in the formal stage of maternal role attainment, which involves learning the skills and behaviors of mothering from external sources such as healthcare providers and family members.
Choice D is wrong because it implies that the client is in the anticipatory stage of maternal role attainment, which occurs during
A nurse is reviewing the medical records of four clients who are pregnant and planning to have a vaginal birth after cesarean (VBAC).
Which of the following clients has the highest risk of uterine rupture during labor?
Explanation
A client who had a vertical incision on her uterus but a low transverse incision on her skin for her previous cesarean delivery has the highest risk of uterine rupture during labor.This is because a vertical incision on the uterus weakens the uterine wall and increases the risk of rupture during contractions.
Normal ranges for uterine rupture during labor are 0.2% to 1.5% for women who have had one previous cesarean delivery with a low transverse incision and 0.9% to 3.7% for women who have had two or more previous cesarean deliveries with low transverse incisions.
Sign Up or Login to view all the 18 Questions on this Exam
Join over 100,000+ nursing students using Nursingprepexams’s science-backend flashcards, practice tests and expert solutions to improve their grades and reach their goals.
Sign Up Now
