A nurse in a clinic is caring for a client who is antepartum. The client expresses concern about preparing their preschooler for a new sibling.
Which of the following responses should the nurse make?
Avoid bringing your preschooler to prenatal visits.
Move your preschooler from their crib to a bed the day before the baby comes home.
Plan to spend individual time with your preschooler.
Ensure that your preschooler sees you holding the baby during the initial encounter.
The Correct Answer is C
Choice A rationale
Avoiding the preschooler's presence at prenatal visits can inadvertently promote feelings of exclusion and resentment, suggesting the new sibling is an unwelcome disruption. In contrast, involving the older child in the pregnancy experience, like listening to the fetal heartbeat, helps normalize the upcoming change and prepares them for the new family dynamic, fostering a positive adjustment. This inclusion is crucial for emotional security.
Choice B rationale
Making a significant change, such as moving the preschooler from a crib to a bed, immediately before or the day the new baby arrives, associates the loss of their comfortable sleeping arrangement with the sibling's arrival. This can be viewed as a punishment, increasing stress and anxiety and potentially fueling sibling rivalry and regression. Major changes should be made several weeks before the birth.
Choice C rationale
Planning and dedicating specific, high-quality individual time ("special time") with the preschooler reassures them of their continued importance and secures their parent-child bond. This counteracts the potential feeling of being displaced or replaced by the newborn, which is critical for maintaining their self-esteem and emotional well-being during the family transition.
Choice D rationale
Insisting the initial encounter be a visual of the parent holding the baby can immediately trigger jealousy and a sense of loss of parental attention, as the parent is focused elsewhere. Instead, the parent should greet the preschooler first with open arms and allow the child to approach the baby on their own terms, promoting a gentler, more positive introduction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"C"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"C"},"F":{"answers":"B"}}
Explanation
🧾 Explanation
- Moderate lochia rubra
- Normal up to 1–2 weeks postpartum. Not related to mastitis.
- Temperature 38.4°C
- Still febrile after 24 hrs of antibiotics → infection not yet controlled.
- Purulent nipple discharge
- New finding. Indicates possible breast abscess or worsening mastitis.
- Hemoglobin 12 g/dL
- Stable and within normal range. Not relevant to mastitis progression.
- WBC 35,000/mm³
- Increased from 28,000 → worsening systemic inflammatory response.
- Decreased pain
- Symptomatically better, but this may reflect partial relief from antibiotics/analgesics rather than full resolution. Still, it’s a positive sign.
Summary:
- Improving: Pain relief.
- Unrelated: Lochia rubra, hemoglobin.
- Worsening: Persistent fever, purulent nipple discharge, rising WBC.
This mixed picture suggests partial response but possible complication (breast abscess). The nurse should notify the provider promptly, anticipate breast ultrasound to rule out abscess, and continue close monitoring.
Correct Answer is C
Explanation
Choice A rationale
The car seat harness straps should be positioned at or slightly below the baby's shoulders when the car seat is installed rear-facing. Positioning the straps above the shoulders could allow the baby to slide up and out of the harness in a crash due to the forces involved, compromising the restraint system's effectiveness and increasing injury risk.
Choice B rationale
The retainer clip, also called the chest clip, must be positioned at the level of the armpits across the center of the chest or sternum, not the abdomen. This critical placement ensures that the harness straps are kept correctly positioned over the baby's shoulders, preventing the straps from slipping off during a collision and maintaining optimal force distribution across the torso.
Choice C rationale
A 45-degree recline angle for a rear-facing car seat is generally recommended to prevent the infant's head from falling forward, which can compromise the airway, particularly in newborns or infants with poor head control. This specific angle is crucial for maintaining a safe and open airway and is often achieved using built-in level indicators on the car seat base.
Choice D rationale
Current safety recommendations advise keeping a child in a rear-facing car seat as long as possible, typically until they reach the maximum weight or height limit allowed by the car seat manufacturer, which often extends well beyond 12 months of age, frequently up to 2 to 4 years of age, for maximum spinal protection.
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