The correct answer is choice A. Encourage the client to express her feelings.This is an appropriate nursing intervention for postpartum depression (PPD) because it helps to relieve tension and improve mood. It also shows empathy and support for the client.

Choice B is wrong because telling the client that she will feel better soon is dismissive and unrealistic. It does not address the underlying causes of PPD or offer any coping strategies.

Choice C is wrong because advising the client to ignore her feelings is harmful and counterproductive.It may worsen the symptoms of PPD and increase the risk of complications.

Choice D is wrong because telling the client that she is overreacting is insensitive and judgmental. It may make the client feel guilty and ashamed of her feelings and discourage her from seeking help.

Normal ranges for PPD are not applicable because it is a psychological condition that varies from person to person.However, some signs and symptoms of PPD include overall feeling of sadness, extreme fatigue, inability to stop crying, and increased anxiety.PPD usually occurs within the first year after delivery.

The correct answer is choice A.“I am looking forward to holding my baby.” This statement indicates an understanding of the anticipatory stage of maternal role attainment, which is the social and psychological adaptation to the maternal role and learning expectations.This stage can involve fantasizing about the role and visualizing oneself as a mother.

Choice B. “I am worried about how I will cope with being a mother.” is wrong because it reflects anxiety and uncertainty about the maternal role, which may interfere with the bonding process.

Choice C. “I am not sure if I am ready to be a mother.” is wrong because it shows a lack of confidence and commitment to the maternal role, which may affect the development of maternal identity.

Choice D. “I am excited about decorating the nursery.” is wrong because it focuses on the external aspects of preparing for the baby, rather than the internal process of adapting to the maternal role.

The correct answer is choice C.“I am starting to feel like myself again.” This statement indicates an understanding of the formal stage of maternal role attainment, which is characterized by the acquisition of the maternal function at birth.In this stage, the mother learns to care for her baby by following the cues and guidance of others, such as nurses, family members, or friends.She may feel uncertain or anxious about her abilities and rely on external validation.

Choice A is wrong because it reflects the anticipatory stage of maternal role attainment, which occurs during pregnancy.In this stage, the woman experiences social and psychological adaptation to the maternal role and prepares for the birth of her baby.

Choice B is wrong because it reflects the informal stage of maternal role attainment, which occurs after the formal stage.

In this stage, the mother develops confidence and competence in caring for her baby by following her own instincts and preferences.She may modify or reject the advice of others and become more independent.

Choice D is wrong because it reflects a lack of understanding of any stage of maternal role attainment.It suggests that the mother has low self-esteem and self-efficacy in her maternal role and may need more support and education.

The correct answer is choice A. “I feel like I have finally found my own way of being a mother.” This statement indicates that the client is in the personal stage of maternal role attainment, which is the final stage of the process.In this stage, the mother has developed a sense of harmony and confidence in her maternal role and has integrated it into her identity.

Choice B is wrong because it reflects feelings of guilt and inadequacy, which are common in the formal stage of maternal role attainment.In this stage, the mother follows the rules and expectations of others and may feel overwhelmed by the demands of motherhood.

Choice C is wrong because it expresses a sense of competence and flexibility, which are characteristic of the informal stage of maternal role attainment.In this stage, the mother adapts to the needs and cues of her baby and develops her own style of mothering.

Choice D is wrong because it shows doubt and uncertainty, which are typical of the anticipatory stage of maternal role attainment.In this stage, the mother prepares for the maternal role during pregnancy and learns from various sources.

The correct answer is choice C. “My income level can determine how well I perform my maternal duties.” This statement indicates a need for further teaching because it implies that the woman’s financial status is the only factor that affects her maternal role attainment.Maternal role attainment is a complex process that involves many factors, such as age, culture, gender, support system, self-esteem, and health status.

Choice A is wrong because age can influence how a woman feels about being a mother.Younger mothers may face more challenges and stress than older mothers, while older mothers may have more health risks and less energy than younger mothers.

Choice B is wrong because the baby’s gender can affect how a woman bonds with him or her.

Some women may have a preference for a certain gender or feel more comfortable with one gender over another.Gender may also influence the expectations and roles that the woman and her partner have for the child.

Choice D is wrong because the cultural background can shape the woman’s expectations of motherhood.

Different cultures may have different beliefs, values, practices, and norms regarding pregnancy, childbirth, and parenting.The woman may face conflicts or challenges if her culture differs from the dominant culture or her partner’s culture.

The correct answer is choice C. Interdependent.According to Mercer’s theory of maternal role attainment, the interdependent phase is when the mother has integrated the maternal role into her other roles and responsibilities and has established a reciprocal relationship with her baby.She also seeks social support and validation from others.

Choice A.Dependent is wrong because it refers to the first phase of maternal role attainment, when the mother is focused on her own needs and recovery after childbirth and relies on others for guidance and assistance.

Choice B.Dependent-independent is wrong because it refers to the second phase of maternal role attainment, when the mother begins to take charge of her own and her baby’s care and learns the skills and behaviors of mothering.

Choice D.Independent is wrong because it refers to the fourth phase of maternal role attainment, when the mother has achieved a sense of harmony and confidence in her maternal role and has developed a unique style of mothering.

The correct answer is A. Infant characteristics. The nurse should identify that the client is at risk for impaired maternal role attainment due to the infant’s characteristics, such as having Down syndrome, which can affect the mother’s bonding and attachment process. The mother may experience feelings of guilt, sadness, disappointment, or rejection toward the infant.

B. Social support is incorrect. The nurse should identify that the client’s social support is a protective factor for maternal role attainment, not a risk factor. The client may benefit from the emotional and practical support of her family, friends, health care providers, or support groups.

C. Maternal characteristics is incorrect. The nurse should identify that the client’s maternal characteristics are not a risk factor for impaired maternal role attainment in this scenario. Maternal characteristics that can affect maternal role attainment include age, parity, education, socioeconomic status, and mental health. There is no indication that the client has any of these factors that would interfere with her ability to bond with her baby.

D. Cultural norms is incorrect. The nurse should identify that the client’s cultural norms are not a risk factor for impaired maternal role attainment in this scenario. Cultural norms can affect maternal role attainment by influencing the mother’s expectations, beliefs, values, and practices regarding motherhood and childrearing. There is no indication that the client has any cultural barriers that would prevent her from bonding with her baby.

The correct answer is choice B. The program should be flexible to accommodate individual needs and preferences.This is because antenatal education aims to help prospective parents prepare for childbirth and parenthood, and different cultural backgrounds may have different beliefs, values and expectations about these topics.

A flexible program can tailor the content and delivery to suit the diverse needs of the participants and promote maternal role attainment.

Choice A is wrong because a standardized program may not address the specific concerns or questions of the pregnant women from different cultural backgrounds.It may also ignore the cultural diversity and sensitivity that is needed to provide effective antenatal education.

Choice C is wrong because having a single instructor may limit the perspectives and expertise that can be shared with the participants.A team of instructors with different backgrounds and specialties may be more beneficial and engaging for the pregnant women.

Choice D is wrong because focusing on the medical aspects of pregnancy and childbirth may neglect the emotional, social and psychological aspects that are also important for maternal role attainment.Antenatal education should cover a range of topics that are relevant and meaningful for the participants.

The correct answer is choices A, B and C. These behaviors indicate optimal bonding because they show that the parents are attentive, affectionate and communicative with their baby.

They also demonstrate that the parents recognize the baby as a unique individual with needs and preferences.

Choice D is wrong because expressing concern about the baby’s weight and appearance may indicate anxiety, insecurity or dissatisfaction with the baby.

These feelings may interfere with bonding and attachment.

Choice E is wrong because allowing other family members to feed and change the baby may indicate detachment, indifference or resentment towards the baby.

These feelings may also hinder bonding and attachment.

The normal range for newborn weight is 2.5 to 4 kg (5.5 to 8.8 lb) and for newborn length is 45 to 55 cm (18 to 22 in).

The correct answer is choice D. Learning about motherhood from various sources.This is because the anticipatory stage of maternal role attainment involves the social and psychological adaptation to the maternal role.The women in this stage learn about motherhood from various sources such as books, media, family, friends, and health professionals.

Choice A is wrong because following rules and routines for infant care is part of the formal stage of maternal role attainment, which occurs after birth.The women in this stage follow the guidelines and expectations of others for infant care.

Choice B is wrong because developing one’s own style of mothering is part of the informal stage of maternal role attainment, which occurs after the formal stage.The women in this stage become more confident and flexible in their maternal role and develop their own style of mothering.

Choice C is wrong because achieving harmony and satisfaction in the maternal role is part of the personal stage of maternal role attainment, which occurs after the informal stage.The women in this stage have a strong sense of maternal identity and feel comfortable and satisfied with their maternal role.

Personal stage.This stage is characterized by the integration of the maternal role into the woman’s identity and the development of a unique parenting style.The woman is confident and comfortable in her maternal role and enjoys mothering.

Choice A is wrong because theanticipatory stageis the stage before birth, when the woman prepares for motherhood and learns about infant care from various sources.

Choice B is wrong because theformal stageis the stage right after birth, when the woman follows the instructions and expectations of others (such as nurses and doctors) for infant care and seeks validation and reassurance from them.

Choice C is wrong because theinformal stageis the stage when the woman begins to rely on her own intuition and experience for infant care and adapts to the infant’s cues and needs.

Personal stage.According to the Maternal Role Attainment Theory, the personal stage is when the woman is adapting to the infant’s needs and preferences and is becoming more confident and competent in infant care.This stage usually occurs around six weeks after birth.

Choice A is wrong because the anticipatory stage is when the woman experiences social and psychological acclimatization to maternal duties during pregnancy.

Choice B is wrong because the formal stage is when the woman acquires the maternal function at birth and follows the guidelines of health professionals and family members.

Choice C is wrong because the informal stage is when the woman develops her own style of mothering based on trial and error and feedback from the infant.

The correct answer is choice D. Personal stage.According to Mercer’s theory of maternal role attainment, the personal stage is when the woman feels a strong attachment with her infant and develops a sense of identity as a mother.She also feels confident and competent in her maternal role and is ready for another child.

Choice A is wrong because the anticipatory stage is when the woman experiences social and psychological adaptation to the maternal role during pregnancy.She learns about motherhood from various sources and forms expectations about her role.

Choice B is wrong because the formal stage is when the woman acquires the maternal function at birth and follows the guidelines of health professionals and family members.She imitates the behaviors of other mothers and tries to meet the needs of her infant.

Choice C is wrong because the informal stage is when the woman adapts her maternal role to fit her own style and preferences.She learns from her own experiences and responds to the cues of her infant.

The correct answer is choiceCandE.The personal stage of maternal role attainment involves forming a strong attachment with the infant and developing a sense of identity as a mother.This stage occurs after the birth and is characterized by the mother’s confidence and comfort in her maternal role.

ChoiceAis wrong because expressing joy and pleasure in motherhood is part of the anticipatory stage, which occurs during pregnancy and involves social and psychological adaptation to the maternal role.

ChoiceBis wrong because coping with physical and emotional changes after delivery is part of the formal stage, which occurs at birth and involves learning the maternal function from others.

ChoiceDis wrong because preparing for the birth and the postpartum period is also part of the anticipatory stage.

The correct answer is choice D. I should avoid using a pacifier until my baby is at least 6 months old.This statement indicates a need for further teaching because there is no evidence that pacifier use in the newborn period interferes with breastfeeding.Pacifiers may have benefits for infant comfort, safe sleep, and maternal postpartum experience.However, pacifiers may also have risks for dental development and reliance if used for too long.

Therefore, postpartum patient counseling should include information on both the potential benefits and risks of pacifiers.

Choice A is wrong because breastfeeding on demand or at least every 2 to 3 hours helps to establish milk supply and prevent engorgement.

Choice B is wrong because placing the baby on his back to sleep reduces the risk of sudden infant death syndrome (SIDS).

Choice C is wrong because washing the baby’s face with a mild soap and water every day helps to prevent skin infections and rashes.

The correct answer is choice A, B and C. These actions demonstrate empathy and support for the client who is experiencing stress and anxiety.

The nurse should encourage the client to express her feelings and concerns, validate the client’s emotions and reassure her that they are normal, and suggest the client to join a support group or seek counseling if needed.

Choice D is wrong because advising the client to rest as much as possible and avoid visitors may isolate the client and worsen her emotional state.

The client may benefit from social support and interaction with others who can provide comfort and assistance.

Choice E is wrong because helping the client identify coping strategies and relaxation techniques is not enough to address the underlying causes of stress and anxiety.

The nurse should also explore the client’s feelings and concerns, validate her emotions, and offer referrals to mental health services if needed.

The correct answer is choice A, B, C, D and E. All of these benefits can be explained by the nurse to the client.

Choice A is correct because skin-to-skin contact helps regulate the newborn’s body temperature and blood glucose levels by providing warmth and stimulating digestion.

Choice B is correct because skin-to-skin contact stimulates the release of oxytocin and reduces postpartum bleeding by promoting uterine contractions and preventing hemorrhage.

Choice C is correct because skin-to-skin contact enhances maternal-infant bonding and attachment by facilitating eye contact, touch, smell and vocalization.

Choice D is correct because skin-to-skin contact increases the production of colostrum and milk supply by stimulating the baby’s interest in feeding and the mother’s hormonal

The correct answer is choice D. Respect the client’s preferences and choices regarding her care and her baby’s care.This is because this intervention promotes maternal involvement in decision making and problem solving by honoring the client’s autonomy and individuality.

Some possible explanations for the other choices are:

• Choice A is wrong because providing information and education about infant care and development does not necessarily encourage maternal involvement in decision making and problem solving.It may be helpful for increasing the client’s knowledge and confidence, but it does not address the client’s feelings of being overwhelmed by her new role.

• Choice B is wrong because asking open-ended questions and listening actively to the client’s responses does not directly encourage maternal involvement in decision making and problem solving.It may be useful for establishing rapport and assessing the client’s needs, but it does not empower the client to make her own decisions or solve her own problems.

• Choice C is wrong because offering practical suggestions and guidance based on evidence-based practice does not foster maternal involvement in decision making and problem solving.It may be beneficial for providing support and advice, but it does not respect the client’s preferences and choices or allow her to explore her own options.

The correct answer is choice A. Assess the client’s needs, interests, and goals for postpartum care.This is because the nurse should tailor the social support and referrals to the client’s individual preferences and needs, rather than imposing a generic list of resources or contacting others without the client’s consent.

Choice B is wrong because providing a list of local agencies, organizations, and programs that offer services for postpartum women is not enough to facilitate social support networks and referrals.The nurse should also assess the client’s needs, interests, and goals for postpartum care and help the client access and utilize the appropriate resources.

Choice C is wrong because contacting the client’s family, friends, or neighbors and asking them to visit or help with household chores is not appropriate without the client’s permission and involvement.The nurse should respect the client’s privacy and autonomy and collaborate with the client to identify potential sources of social support.

The correct answer is choice A.“I feel like I have known this baby forever.” This statement indicates optimal maternal role attainment, which is a developmentally, interactive, adaptive, and committed multi-dimensional process based on the discovery of pregnancy, characteristics of the mother, receiving social support, which leads to maternal identity, formation of maternal skills, resiliency, development of newborn, improvement of mother-newborn interactions and increased well-being of the mother.

Choice B is wrong because it shows doubt and insecurity about the maternal role, which may hinder the attachment and bonding process with the infant.

Choice C is wrong because it reflects a preoccupation with the birth mother, which may interfere with the development of a strong maternal identity and relationship with the adopted infant.

Choice D is wrong because it implies a lack of readiness and acceptance of the maternal role, which may delay the acquisition of competence and joy in mothering.

The correct answer is choice D. Involve the mother in the infant’s care as much as possible.This is because maternal role attainment is adevelopmental, interactive, adaptive, and committed multi-dimensional processthat leads to maternal identity, formation of maternal skills, resiliency, development of newborn, improvement of mother-newborn interactions and increased well-being of the mother.By involving the mother in the infant’s care, the nurse can facilitate this process and help the mother accept and play the motherhood role more quickly and confidently.

Choice A is wrong because visiting the neonatal intensive care unit as often as possible is not enough to promote maternal role attainment.The mother needs to have active participation and interaction with her infant, not just passive observation.

Choice B is wrong because explaining the medical procedures and equipment used for the infant’s care is not sufficient to promote maternal role attainment.The mother needs to have emotional and physical contact with her infant, not just cognitive understanding of the infant’s condition.

Choice C is wrong because providing positive feedback and reassurance to the mother about her abilities is not adequate to promote maternal role attainment.The mother needs to have practical experience and competence in taking care of her infant, not just verbal encouragement.

Answer and explanation..

The correct answer is choice C. Increased development and attachment of their infants.

Maternal role attainment is the process by which a woman learns to identify and perform the behaviors expected of a mother.

This process enhances the mother-infant bond and promotes the infant’s physical, emotional, and cognitive development.

Choice A is wrong because increased security and trust in their infants is an outcome of maternal role attainment, not a benefit for the mothers.

Choice B is wrong because increased self-esteem and happiness in their lives are possible benefits for the mothers, but they are not directly related to maternal role attainment.

Choice D is wrong because increased resilience and fulfillment in their roles are also possible benefits for the mothers, but they are not specific to maternal role attainment.

They could apply to any role that a woman assumes in her life.

The correct answer is choice C. The mother avoids eye contact and turns away from her infant.

This observation would indicate impaired bonding after a cesarean delivery because it shows a lack of interest, affection, and attachment to the infant.According to some studies, cesarean delivery can affect parent-infant bonding and the birth experience can mediate this association.

Choice A is wrong because the mother expresses concern about her infant’s well-being.

This observation would indicate a positive and caring attitude toward the infant, which is a sign of healthy bonding.

Choice B is wrong because the mother holds her infant close to her chest and talks softly.

This observation would indicate a warm and nurturing behavior toward the infant, which is a sign of strong bonding.

Choice D is wrong because the mother asks questions about her infant’s appearance and behavior.

This observation would indicate a curious and attentive attitude toward the infant, which is a sign of normal bonding.

Normal ranges for parent-infant bonding are not well defined, but some factors that can influence it are the mode of delivery, the birth experience, the prenatal attachment, the maternal mental health, and the infant’s health and temperament.

The correct answer is D. Assisting the client with feeding, bathing, and diapering her infant. The nurse should provide opportunities for the client to interact with her infant and learn basic caregiving skills, which can enhance maternal role attainment. The nurse should also provide positive feedback and encouragement to the client as she develops confidence and competence in her maternal role.

A. Referring the client to a social worker for counseling and support is incorrect. Although this intervention may be helpful for the client’s psychosocial needs and substance abuse issues, it does not directly promote maternal role attainment. The nurse should collaborate with the social worker and other members of the interdisciplinary team to provide comprehensive care for the client.

B. Educating the client about the effects of substance abuse on her infant is incorrect. Although this intervention may be important for the client’s awareness and motivation to change her behavior, it does not directly promote maternal role attainment. The nurse should provide education in a nonjudgmental and supportive manner and assess the client’s readiness to change.

C. Providing opportunities for the client to interact with other teenage mothers is incorrect. Although this intervention may be beneficial for the client’s social support and peer learning, it does not directly promote maternal role attainment. The nurse should facilitate group activities that foster positive interactions between mothers and their infants.

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.

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.

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)

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.

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.

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.

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.

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.

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 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 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.

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.

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.

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.

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.

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.

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 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.