A nurse is observing bonding between a client and her newborn. Which of the following actions by the client requires the nurse to intervene?
Holding the newborn in an en face position
Asking the father to change the newborn's diaper
Viewing the newborn's actions to be uncooperative
Requesting the nurse take the newborn to the nursery so she can rest
The Correct Answer is C
A. Holding the newborn in an en face position: This action promotes bonding between the mother and the newborn and is a positive interaction.
B. Asking the father to change the newborn's diaper: Involving the father in caregiving tasks fosters family involvement and bonding.
C. Viewing the newborn's actions to be uncooperative: This suggests a negative perception of the newborn's behavior, which could indicate potential issues with bonding or misunderstanding
infant cues, requiring the nurse's intervention.
D. Requesting the nurse take the newborn to the nursery so she can rest: While rest is important for the mother, separating the newborn from the mother could disrupt bonding and breastfeeding, so this action should be discussed further with the client to explore other options.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A.
A. Early decelerations are typically benign and occur due to head compression during
contractions. They mirror the uterine contraction pattern and are not usually associated with fetal compromise.
B. Fetal hypoxia is not typically associated with early decelerations, as they are considered a normal response to head compression during labor.
C. Abruptio placentae refers to the premature separation of the placenta from the uterine wall and is not directly related to early decelerations.
D. Postmaturity refers to a pregnancy that extends beyond 42 weeks gestation and is not directly related to early decelerations.
Correct Answer is B
Explanation
A. A fundal height of 2 fingerbreadths below the umbilicus in a client who is 2 days postpartum is within the expected range for that time frame and does not require immediate assessment.
B. A client who is 1 day postpartum and has not voided in 8 hours may be at risk for urinary retention, which can lead to complications such as bladder distension or urinary tract infection. Prompt assessment and intervention are needed.
C. Not having a bowel movement since prior to admission is not an urgent concern in the
immediate postpartum period, especially if the client is otherwise stable and not experiencing discomfort or other symptoms.
D. Lochia serosa, which is the normal vaginal discharge that occurs 3 to 10 days postpartum, is not an urgent concern and does not require immediate assessment.
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