Test Bank for Maternity and Pediatric
Nursing 4th Edition Ricci Kyle Carman| Test
Bank Already 100% Verified Answers
A nurse is observing a postpartum client interacting with her newborn and notes that the
mother is engaging with the newborn in the en face position. Which of the following
would the nurse be observing?
A) Mother placing the newborn next to bare breast.
B) Mother making eye-to-eye contact with the newborn
C) Mother gently stroking the newborns face
D) Mother holding the newborn upright at the shoulder - B
The en-face position is characterized by the mother interacting with the newborn
through eye-to-eye contact while holding the newborn. Bonding is a vital component of
the attachment process for establishing parent-infant attachment and a healthy, loving
relationship. During this early period of acquaintance, mothers touch their infants in a
characteristic manner. Mothers visually and physically "explore" their infants, initially
using their fingertips on the infant's face and extremities and progressing to massaging
and stroking the infant with their fingers. This is followed by palm contact on the trunk.
Eventually, mothers draw their infant toward them and hold the infant. Kangaroo care
refers to skin-to-skin contact between the mother and newborn.
When reviewing the medical record of a postpartum client, the nurse notes that the
client has experienced a third-degree laceration. The nurse understands that the
laceration extends to which of the following?
A) Superficial structures above the muscle
B) Through the perineal muscles
C) Through the anal sphincter muscle
D) Through the anterior rectal wall - C
A third-degree laceration extends through the anal sphincter muscle. A first-degree
laceration involves only the skin and superficial structures above the muscle. A second-
degree laceration extends through the perineal muscles. A fourth-degree laceration
continues through the anterior rectal wall
The nurse is assessing a postpartum client's lochia and finds that there is about a 4-inch
stain on the perineal pad. The nurse documents this finding as which of the following?
A) Scant
B) Light
C) Moderate
D) Large - B
, The amount of lochia is described as light or small for an approximately 4-inch stain.
Scant refers to a 1- to 2-inch stain of lochia; moderate refers to a 4- to 6-inch stain; and
large or
heavy refers to a pad that is saturated within 1 hour after changing.
A nurse is completing a postpartum assessment. Which finding would alert the
nurse to a potential problem?
A) Lochia rubra with a fleshy odor
B) Respiratory rate of 20 breaths per minute
C) Temperature of 101 F
D) Pain rating of 4 on a scale from 0 to 10 - C
Typically, the new mother's temperature during the first 24 hours postpartum is within
the normal range. Some women experience a slight fever, up to 100.4º F (38º C), during
the first 24 hours. A temperature above 100.4º F (38º C) at any time or an abnormal
temperature after the first 24 hours may indicate infection and must be reported. Foul-
smelling lochia or lochia with an unexpected change in color or amount, shortness of
breath, or respiratory rate below 16 or above 20 breaths per minute would also be a
cause for concern. The goal of pain management is to have the woman's pain scale
rating maintained between 0 to 2 points at all times, especially after
breast-feeding
A nurse is reviewing the medical record of a postpartum client. The nurse
identifies that the woman is at risk for a postpartum infection based on which of the
following? (Select all that apply.)
A) History of diabetes
B) Labor of 12 hours
C) Rupture of membranes for 16 hours
D) Hemoglobin level 10 mg/dL
E) Placenta requiring manual extraction - A, D, E
Risk factors for postpartum infection include history of diabetes, labor over 24 hours,
hemoglobin less than 10.5 mg/dL, prolonged rupture of membranes (more than 24
hours), and manual extraction of the placenta
After teaching parents about their newborn, the nurse determines that the
teaching was successful when they identify the development of a close
emotional attraction to a newborn by parents during the first 30 to 60 minutes
after birth as which of the following?
A) Reciprocity
B) Engrossment
C) Bonding
D) Attachment - C
The development of a close emotional attraction to the newborn by parents during the
first 30 to 60 minutes after birth describes bonding. Reciprocity is the process by which
the infant's capabilities and behavioral characteristics elicit a parental response.
Engrossment refers to the intense interest during early contact with a newborn.
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