Chapter 18 Postpartum Psychosocial Adaptations

Chapter 18  Postpartum Psychosocial Adaptations

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. 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

ANS: B
In this definition, reciprocal refers to the feedback from the infant during the attachment process. The quiet alert state is a good time for bonding but does not define reciprocal attachment. Reciprocal attachment deals with feedback behavior and is not unidirectional.

PTS: 1 DIF: Cognitive Level: Understanding REF: 352
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. 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

ANS: A
Reliving the birth experience makes the event real and helps the mother realize that the pregnancy is over and that the infant is born and is now a separate individual. She is in the taking-in phase, trying to make the birth experience seem real. This is to satisfy her needs, not the needs of others. She is trying to make the event real and is trying to separate the infant from herself.

PTS: 1 DIF: Cognitive Level: Understanding REF: 353
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

3. 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

ANS: A
A major task of the formal stage of role attainment is getting acquainted with the infant. The informal stage begins once the parents have learned appropriate responses to their infant’s cues. The personal stage is attained when parents feel a sense of harmony in their role. The anticipatory stage begins during the pregnancy when the parents choose a physician and attend childbirth classes.

PTS: 1 DIF: Cognitive Level: Understanding REF: 354
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

4. 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.

ANS: A
During the taking-in phase of maternal adaptation, in which the mother may be passive and dependent, the nurse should encourage bonding when the infant is in the quiet alert stage. This is done best by simply giving the baby to the mother. She learns best during the taking-hold phase. The woman is dependent and passive at this stage and may have difficulty making a decision. This is expected behavior during the taking-in phase. However, interventions can facilitate infant bonding.

PTS: 1 DIF: Cognitive Level: Application REF: 353
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Psychosocial Integrity

5. 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.

ANS: C
The observed behaviors are normal variations of families adjusting to change. There is no need to report this one incident. Giving advice at this point would make the parents feel inadequate as parents. This is normal for an adjusting family.

PTS: 1 DIF: Cognitive Level: Analysis REF: 366
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity