A nurse is collecting data from a client who is 6 weeks postpartum. The client tells the nurse, "I am not a good mother. My baby doesn't like me.” Which of the following actions should the nurse take?
Advise the client that most new mothers experience these feelings.
Ask the client if they have had thoughts about harming their infant.
Explain to the client they are experiencing the "baby blues.”
Take the client to the emergency department.
The Correct Answer is B
Choice B reason: The nurse should ask the client if they have had thoughts about harming their infant. This is a crucial action because the client's statement suggests they may be experiencing feelings of inadequacy and self-doubt as a mother, which could potentially lead to more serious thoughts or actions. By directly asking about thoughts of harming the baby, the nurse can assess the client's mental and emotional state more thoroughly and determine if there is a risk of harm to the infant.
Choice A reason:
The nurse should advise the client that most new mothers experience these feelings. This response acknowledges the client's feelings of inadequacy and normalizes their experience, letting them know that it is common for new mothers to have doubts and insecurities. This validation can help the client feel less alone and more understood, promoting a therapeutic nurse-client relationship.
Choice C reason:
The nurse should explain to the client that they are experiencing the "baby blues.” This is a valid option because the client's statement indicates they may be experiencing mood swings, sadness, and emotional sensitivity, which are typical symptoms of the baby blues. Providing this information can help the client understand that these feelings are transient and often related to hormonal changes after childbirth.
Choice D reason:
Taking the client to the emergency department is not warranted based solely on the information provided. The client's statement does not indicate an immediate danger to themselves or their baby. However, if during the assessment (including choice B), the nurse identifies any signs of potential harm to the infant or the client, further action may be necessary, such as involving appropriate mental health professionals or support services.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Following the rupture of membranes, delivery is imminent and administration of glucocorticoids may not take effect to benefit the baby.
Choice B reason:
Monitoring the client's temperature (Choice B) is important as the client is at risk of chorioamnionitis which may increase the risk of severe early neonatal sepsis. Changes in temperature as they may warrant anibiotic therapy and immediate delivery.
Choice C reason:
Giving calcium gluconate (Choice C) is not indicated in this situation. Calcium gluconate is typically administered in cases of magnesium sulfate toxicity or to treat hypocalcemia, neither of which is mentioned in the scenario. Therefore, it is not the appropriate action for the nurse to take at this time.
Choice D reason:
Preparing the client for an amniocentesis (Choice D) is not the correct action in this situation. An amniocentesis is a procedure in which a small amount of amniotic fluid is withdrawn for various diagnostic reasons, such as genetic testing or assessing fetal lung maturity. However, in this scenario, the priority is to administer glucocorticoids to promote fetal lung maturity, and an amniocentesis does not address this immediate concern.
Correct Answer is B
Explanation
Choice A reason:
One cup of oatmeal - Oatmeal is a nutritious food, but it does not contain as high a protein content as some other options. While it offers some protein, it is not the best choice for a high-protein diet during pregnancy. Oatmeal is primarily known for its fiber content and complex carbohydrates, which provide sustained energy.
Choice B reason:
One cup of tofu - Tofu is an excellent source of protein and is a suitable choice for a high- protein diet during pregnancy. Tofu is made from soybeans and is rich in plant-based proteins, making it an ideal option for individuals following a vegetarian or vegan diet as well. Additionally, tofu contains essential amino acids, iron, calcium, and other nutrients beneficial for both the mother and the developing fetus.
Choice C reason:
One cup of brown rice - While brown rice is a healthy whole grain and provides some protein, it does not have as high a protein content as tofu. Brown rice is a good source of complex carbohydrates, fiber, vitamins, and minerals, but it may not meet the high protein requirements of a pregnant woman's diet.
Choice D reason:
One cup of kale - Kale is a nutritious leafy green vegetable, but it does not offer a significant amount of protein compared to tofu. It is rich in vitamins, minerals, and antioxidants, making it a valuable addition to a balanced diet. However, for a high-protein diet during pregnancy, other options like tofu are more suitable.
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