The nurse checks on a patient and her baby in the middle of the night.
The patient and her baby are both asleep in the bed, with the baby lying beside the patient.
What should the nurse do next?
Tell the patient that the baby must be returned to the nursery for safety reasons.
Remind the patient about infant safety and assist her to place the infant in the crib.
Wake the patient and remind her that keeping the baby in bed with her is unsafe.
Pick up the baby and return it to the crib while letting the patient sleep.
The Correct Answer is B
Choice A rationale
Sending the baby back to the nursery is generally contraindicated unless medically necessary, as it disrupts the desired maternal-infant bonding and rooming-in model of care. The recommended approach is to correct the unsafe sleeping situation while supporting the family's desire for the infant to remain at the bedside and promoting safe practices.
Choice B rationale
The safest and most therapeutic intervention is to first remind the mother about the risks of co-sleeping, which include suffocation, sudden infant death syndrome (SIDS), and overlaying. Then, the nurse should gently assist the mother in placing the infant back into a safe sleep environment, such as a crib, without alarming her or taking the baby away.
Choice C rationale
Waking the patient abruptly solely to deliver a safety lecture is often perceived as confrontational and intrusive, which can negatively impact the nurse-patient relationship. The goal is to correct the immediate hazard and educate, but in a calm, supportive, and non-judgmental manner, prioritizing safety first, then education.
Choice D rationale
Picking up the baby while the mother is sleeping, without an immediate, life-threatening emergency, can be perceived as an invasion of privacy and a lack of respect for the mother-infant dyad. It's best practice to involve the mother in the intervention to ensure she is aware and understands the reasoning for the safety action being taken. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The regression in habits and behaviors, like a return to thumb-sucking or wetting the bed, is a common manifestation of sibling rivalry and is the older child's unconscious attempt to regain parental attention by acting like the infant. The best approach is to affirm the older child's need for extra love and attention and acknowledge that these feelings are typical, validating his emotional response to the newborn's presence and minimizing punitive reactions.
Choice B rationale
Telling the older child he is a "big boy" and instructing him to "love his new sister" invalidates his complex emotional response to the change, which often includes feelings of resentment or displacement. This statement creates an unrealistic expectation and can intensify feelings of inadequacy or hostility toward the newborn, rather than alleviating the underlying causes of sibling rivalry which require emotional support.
Choice C rationale
Asking friends and relatives not to bring gifts for the older sibling removes a crucial opportunity to help the older child feel included and valued amidst the focus on the newborn. Bringing the older child gifts, especially those "from the baby," helps mitigate feelings of being overlooked and reinforces the message that he is still important to the family, thereby reducing rivalry.
Choice D rationale
Allowing the older child to stay away from the home for 6 weeks during the newborn period may intensify the child's feeling of being displaced or abandoned by the parents. Rather than promoting adjustment, this absence can create further distance and difficulty reintegrating the older child into the new family dynamic, increasing the risk of more severe sibling rivalry upon return. —.
Correct Answer is D
Explanation
Choice A rationale
Loose bedding poses a significant risk for sudden infant death syndrome (SIDS) because it can accidentally cover the infant's face, leading to suffocation or rebreathing of exhaled air, which increases carbon dioxide levels (hypercapnia). The proper intervention is to educate parents to ensure a safe sleep environment with a firm mattress and no loose objects.
Choice B rationale
Exposure to secondhand smoke (SHS) is a major respiratory hazard for newborns, as the numerous toxins and particulate matter directly impair the developing pulmonary system. SHS damages the cilia lining the airways, increasing the risk for acute respiratory infections, asthma, and SIDS. Avoiding exposure protects lung health.
Choice C rationale
Newborns possess an immature immune system with limited capacity to mount a robust defense against pathogens. Exposure to individuals with upper respiratory tract infections (URIs), even common colds, increases the risk of the newborn developing serious lower respiratory tract infections, such as bronchiolitis or pneumonia, necessitating protective isolation.
Choice D rationale
Placing the infant in the prone position (on the belly) for sleep significantly increases the risk of SIDS and is contraindicated. The safest sleep position for newborns to prevent SIDS and aspiration is the supine position (on the back). The gag reflex and anatomical relationship of the trachea and esophagus better prevent aspiration in the supine position.
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