Chapter 22: Transition to Parenthood
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 is “Lack of understanding
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.
ANS: 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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: PlN
anUnR g INGTB.COM
inS
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.
ANS: 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.
, PTS: 1 DIF: Cognitive Level: Applying
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.
ANS: 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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
4. A nurse hears a primiparouN s wRomaI
Sn N
taG
like his dad’s. This statementUis most
lkinBg.toCheM
r son and telling him that his chin is just
descriptive of which process?
a. Mutuality
b. Synchrony
c. Claiming
d. Reciprocity
ANS: 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.
PTS: 1 DIF: Cognitive Level: Understand
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 humans.
c. Early contact is essential for optimal parent-infant relationships.
, d. These new parents should just be happy that the infant is healthy.
ANS: 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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
6. During a telephone follow-up conversation with a woman who is 4 days postpartum, the
woman tells the nurse, “I don’t know what’s wrong. I love my son, but I feel so let down. I
seem to cry for no reason!” Which condition might this new mother be experiencing?
a. Letting-go
b. Postpartum depression (PPD)
c. Postpartum blues
d. Attachment difficulty
ANS: C
During the postpartum blues, women are emotionally labile, often crying easily and for no
apparent reason. This lability seems to peak around the fifth postpartum day. The letting-go
NUs R
phase is the period that occur seS IN
veral G
wT B.aftOer childbirth. During this phase the woman
eeks
wants to move forward as a family unit with all members, appropriately interacting to their
new roles. PPD is an intense, pervasive sadness marked by severe, labile mood swings; it is
more serious and persistent than the postpartum blues. Crying is not a maladaptive
attachment response; it indicates postpartum blues.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment | Nursing Process: Diagnosis
MSC: Client Needs: Psychosocial Integrity
7. Which statement by the nurse can assist a new father in his transition to parenthood?
a. Pointing out that the infant turned at the sound of his voice
b. Encouraging him to go home to get some sleep
c. Telling him to tape the infant’s diaper a different way
d. Suggesting that he let the infant sleep in the bassinet
ANS: A
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 is “Lack of understanding
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.
ANS: 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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: PlN
anUnR g INGTB.COM
inS
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.
ANS: 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.
, PTS: 1 DIF: Cognitive Level: Applying
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.
ANS: 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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
4. A nurse hears a primiparouN s wRomaI
Sn N
taG
like his dad’s. This statementUis most
lkinBg.toCheM
r son and telling him that his chin is just
descriptive of which process?
a. Mutuality
b. Synchrony
c. Claiming
d. Reciprocity
ANS: 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.
PTS: 1 DIF: Cognitive Level: Understand
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 humans.
c. Early contact is essential for optimal parent-infant relationships.
, d. These new parents should just be happy that the infant is healthy.
ANS: 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.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
6. During a telephone follow-up conversation with a woman who is 4 days postpartum, the
woman tells the nurse, “I don’t know what’s wrong. I love my son, but I feel so let down. I
seem to cry for no reason!” Which condition might this new mother be experiencing?
a. Letting-go
b. Postpartum depression (PPD)
c. Postpartum blues
d. Attachment difficulty
ANS: C
During the postpartum blues, women are emotionally labile, often crying easily and for no
apparent reason. This lability seems to peak around the fifth postpartum day. The letting-go
NUs R
phase is the period that occur seS IN
veral G
wT B.aftOer childbirth. During this phase the woman
eeks
wants to move forward as a family unit with all members, appropriately interacting to their
new roles. PPD is an intense, pervasive sadness marked by severe, labile mood swings; it is
more serious and persistent than the postpartum blues. Crying is not a maladaptive
attachment response; it indicates postpartum blues.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment | Nursing Process: Diagnosis
MSC: Client Needs: Psychosocial Integrity
7. Which statement by the nurse can assist a new father in his transition to parenthood?
a. Pointing out that the infant turned at the sound of his voice
b. Encouraging him to go home to get some sleep
c. Telling him to tape the infant’s diaper a different way
d. Suggesting that he let the infant sleep in the bassinet
ANS: A
