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Question 1:

A nurse is planning care for a postpartum client who has postpartum depression.

Which of the following interventions should the nurse include in the plan? (Select all that apply.)

Explanation

The normal ranges for postpartum depression are: • Edinburgh Postnatal Depression Scale (EPDS): a score of 10 or higher indicates possible PPD. • Patient Health Questioaire-9 (PHQ-9): a score of 5 or higher indicates mild depression, 10 or higher indicates moderate depression, 15 or higher indicates moderately severe depression, and 20 or higher indicates severe depression.

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Question 2:

A nurse is caring for a postpartum client who delivered her third infant 2 days ago.

The nurse recognizes that which of the following findings are suggestive of postpartum depression? (Select all that apply.)

Explanation

The correct answer is choice B and D.Fatigue and flat affect are two symptoms of postpartum depression, which is a type of mood disorder that affects some people after giving birth.Postpartum depression can cause feelings of sadness, anxiety, guilt, irritability and difficulty bonding with the baby.

Choice A is wrong because fatigue is not a normal part of the postpartum period.It can indicate a lack of sleep, physical exhaustion or depression.

Choice C is wrong because euphoria is not a symptom of postpartum depression.It can be a sign of postpartum psychosis, which is a rare and severe condition that requires emergency medical attention.

Choice E is wrong because crying is not necessarily a symptom of postpartum depression.

It can be a normal reaction to the hormonal and emotional changes that occur after childbirth.However, if crying is excessive, prolonged or accompanied by other signs of depression, it may indicate a problem.


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Question 3:

A nurse is caring for a postpartum client who delivered their third infant two days ago.

Which of the following manifestations could indicate postpartum depression? (Select all that apply.)

Explanation

The correct answer is choice B and D. Postpartum depression is a type of mood disorder that affects some people after giving birth.It can cause symptoms such asdepressed mood, insomnia, fatigue, anxiety, irritability, difficulty bonding with the baby and flat affect.Flat affect means having a lack of emotional expression or showing little interest in anything.

Choice A is wrong because fatigue is a common symptom of postpartum depression, not an indication of it.

Choice C is wrong because euphoria is the opposite of depression.It means feeling extremely happy or excited.

Choice E is wrong because delusions are a sign of postpartum


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Question 4:

A nurse is assessing a postpartum client who is exhibiting tearfulness, insomnia, lack of appetite and a feeling of let down.

Which of the following conditions are associated with these manifestations?

Explanation

The correct answer is choice D. Postpartum blues.According toand, postpartum blues is a self-limited syndrome of mood lability, tearfulness, feeling of inadequacies, lack of appetite, sleep pattern disturbances, and feeling of letdown that affects 85-90% of women in the postpartum period

Choice A is wrong because postpartum fatigue results from the work of labor and does not include tearfulness or feeling of letdown

Choice B is wrong because postpartum psychosis is a severe mental health condition that involves pronounced sadness, disorientation, confusion, paranoia, hallucinations, delusions, and risk of harming oneself or the infant


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Question 5:

A nurse is assessing a postpartum client who is exhibiting tearfulness, insomnia, lack of appetite and a feeling of let down.

Which of the following conditions are associated with these manifestations?

Explanation

The correct answer is choice B.The client should take sertraline at bedtime to prevent insomnia, which is a common adverse effect of this medication.

Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class of drugs.

Choice A is wrong because sertraline is compatible with breastfeeding and does not pose a significant risk to the infant.

Choice C is wrong because sertraline may take several weeks to show improvement in the client’s mood.The nurse should advise the client to continue taking the medication as prescribed and report any adverse effects or suicidal thoughts.

Choice D is wrong because weight gain is a possible adverse effect of sertraline, but it is not a reason to stop taking the medication abruptly.

The nurse should instruct the client to monitor their weight and report any significant changes to the provider.Abrupt discontinuation of sertraline can cause withdrawal symptoms such as nausea, dizziness, headache, and irritability.


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Question 6:

A nurse is planning care for a client who has postpartum depression with suicidal ideation.

Which of the following interventions should be included in the plan of care?

Explanation

Answer and explanation

The correct answer is choice A. Encourage the client to express her feelings and concerns.This is an appropriate intervention for a client who has postpartum depression with suicidal ideation because it allows the client to vent their emotions and feel supported by the nurse.

It also helps the nurse assess the client’s risk of self-harm and provide appropriate referrals if needed.


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Question 7:

A nurse is conducting a home visit for a client who has postpartum depression and is taking paroxetine.

Which of the following statements by the client indicates an understanding of the medication?

Explanation

The correct answer is choice D. Paroxetine is an antidepressant that belongs to the class of selective serotonin reuptake inhibitors (SSRIs).

It can cause withdrawal symptoms if stopped abruptly, such as nausea, dizziness, headache, and anxiety.Therefore, it is recommended to taper off this medication gradually when feeling better, under the guidance of a doctor.

Choice A is wrong because paroxetine does not usually cause nausea and does not need to be taken with food.Choice B is wrong because paroxetine does not cause constipation, but rather diarrhea as a common side effect.Choice C is wrong because paroxetine does not interact with grapefruit juice, unlike some other medications that are metabolized by the same enzyme.Grapefruit juice can increase or decrease the blood levels of some drugs, causing adverse effects or reduced efficacy.


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Question 8:

A nurse is reviewing the medical record of a client who has postpartum depression.

Which of the following factors should the nurse identify as a risk factor for this condition?

Explanation

Answer and explanation..

The correct answer is choice B. The client has a family history of bipolar disorder.According to the American Psychological Association, a family history of depression or mental illness is one of the risk factors for postpartum depression.Postpartum depression is a mood disorder that affects some women after giving birth and can cause symptoms such as sadness, anxiety, irritability, guilt, and difficulty bonding with the baby.

Choice A is wrong because an uncomplicated vaginal delivery is not a risk factor for postpartum depression.In fact, complications during childbirth can increase the risk of developing this condition.

Choice C is wrong because being 25 years old and primiparous (having given birth for the first time) is not a risk factor for postpartum depression.However, age can be a factor if the mother is very young or older than average.

Choice D is wrong because planning and desiring the pregnancy is not a risk factor for postpartum depression.On the contrary, having an unplanned or unwanted pregnancy can increase the risk of developing this condition.


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Question 9:

A nurse is evaluating a client who has postpartum depression after 4 weeks of treatment with cognitive behavioral therapy (CBT).

Which of the following outcomes indicates that CBT is effective?

Explanation

The correct answer is choice D. All of the above outcomes indicate that CBT is effective for postpartum depression.CBT is a psychological treatment that helps women identify and change unhelpful thoughts, feelings, and behaviors that contribute to depression.CBT can improve self-esteem, confidence, social interest, and positive thoughts and beliefs about oneself.

Choice A is wrong because it only covers one aspect of CBT effectiveness.

Self-esteem and confidence are important outcomes, but they are not the only ones.

Choice B is wrong because it only covers one aspect of CBT effectiveness.

Social interest is an indicator of reduced isolation and increased support, but it is not the only one.

Choice C is wrong because it only covers one aspect of CBT effectiveness.

Positive thoughts and beliefs are a key component of CBT, but they are not the only one.


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Question 10:

A nurse is educating a group of pregnant women about postpartum depression.

Which of the following statements by one of the participants indicates a need for further teaching?

 

Explanation

The correct answer is D. “Postpartum depression is caused by poor parenting skills.” This statement indicates a need for further teaching because it is false and stigmatizing.Postpartum depression is not caused by poor parenting skills, but by a combination of hormonal, physical, emotional, financial and social changes that happen after having a baby.

Postpartum depression can affect anyone regardless of their parenting skills or experience.

The other statements are correct and show an understanding of postpartum depression:

• A.“Postpartum depression can affect my ability to bond with my baby.” This statement is true because postpartum depression can cause feelings of guilt, anxiety and inability to care for the baby or oneself.

These feelings can interfere with the attachment and bonding process between the parent and the baby.

• B.“Postpartum depression can occur anytime within the first year after giving birth.” This statement is true because postpartum depression can appear within a week of delivery or gradually, even up to a year later.

The onset and duration of postpartum depression can vary depending on the individual and their circumstances.

• C.“Postpartum depression can be treated with medication, therapy, or both.” This statement is true because postpartum depression is a treatable condition that can be managed with medication and counseling.

Depending on the type and severity of the symptoms, different treatment options may be recommended by the healthcare provider.

The most important thing is to seek help and support if one is experiencing postpartum depression.


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Question 11:

A nurse is caring for a postpartum client who delivered her third infant 2 days ago.

The nurse recognizes that which of the following findings are suggestive of postpartum depression? (Select all that apply.).

Explanation

The correct answer is choice B and D.Fatigue and flat affect are two symptoms of postpartum depression, which is a type of mood disorder that affects some people after giving birth.Postpartum depression can cause feelings of sadness, anxiety, guilt, irritability and difficulty bonding with the baby.

Choice A is wrong because fatigue is not a normal part of the postpartum period.It can indicate a lack of sleep, physical exhaustion or depression.

Choice C is wrong because euphoria is not a symptom of postpartum depression.It can be a sign of postpartum psychosis, which is a rare and severe condition that requires emergency medical attention.

Choice E is wrong because crying is not necessarily a symptom of postpartum depression.It can be a normal reaction to the hormonal and emotional changes after childbirth, also known as the baby blues.However, if the crying is frequent, prolonged or for no apparent reason, it may indicate postpartum depression.


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Question 12:

A nurse is assessing a postpartum client who is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown.

The nurse knows these findings are characteristics of.

Explanation

The correct answer is choice D. Postpartum blues.This condition is characterized by feelings of sadness, lack of appetite, sleep pattern disturbances, feeling of inadequacies, crying easily for no apparent reason, restlessness, insomnia, fatigue, headache, anxiety, anger, sadness.It usually occurs within the first few days after delivery and resolves within 2 weeks.

Choice A is wrong because postpartum fatigue is not a specific condition but a common symptom that many postpartum women experience due to physical and emotional demands of childbirth and caring for a newborn.

Choice B is wrong because postpartum psychosis is a rare and severe mental disorder that affects about 0.1% to 0.2% of postpartum women.It involves symptoms such as pronounced sadness, disorientation, confusion, paranoia, hallucinations, delusions, and thoughts of harming oneself or the infant.It usually develops within the first 2 weeks after delivery and requires immediate medical attention.

Choice C is wrong because the letting-go phase is a psychological stage of postpartum adjustment that occurs around the third week after delivery.It involves accepting the reality of parenthood, relinquishing the fantasy of the ideal child, and establishing a new identity as a mother.

It does not involve tearfulness, insomnia, lack of appetite, or feeling of letdown.


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Question 13:

A nurse is providing discharge teaching to a client who has postpartum depression and a prescription for sertraline (Zoloft).

Which of the following statements by the client indicates an understanding of the teaching?

Explanation

The correct answer is choice B.“I can breastfeed my baby while taking this medication.” Sertraline (Zoloft) is one of the preferred antidepressants to take when breastfeeding and has been used by many breastfeeding mothers without any problemsIt passes into breast milk in very small amounts and has been linked with side effects in very few breastfed babies

Choice A is wrong because sertraline can cause insomnia and taking it at bedtime might worsen this side effect

Choice C is wrong because dry mouth is a common and mild side effect of sertraline that does not require stopping the medication

Choice D is wrong because alcohol can interact with sertraline and increase the risk of side effects such as drowsiness, dizziness, and impaired coordination


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Question 14:

A nurse is providing education and support to a woman with postpartum depression and her family members.

Which of the following statements by the family members indicates a need for further teaching?

Explanation

The correct answer is choice C. Choice C is wrong because it shows a lack of understanding and empathy for the woman with postpartum depression.

Postpartum depression is not a sign of weakness and it is not something that can be easily overcome by willpower.It is a serious mental health condition that affects up to 15% of new parentsand requires professional treatment.

Choice A is correct because it shows support and compassion for the woman with postpartum depression.It also acknowledges that postpartum depression is not her fault and she needs help to recover.

Choice B is correct because it shows awareness of the common symptoms of postpartum depression, such as mood swings, low energy and appetite changes.

These symptoms can affect the woman’s ability to care for herself and her baby.

Choice D is correct because it shows encouragement for the woman to seek help from a support group or a therapist.Psychotherapy, also called talk therapy or counseling, is an effective treatment for postpartum depression.

It can help the woman cope with her feelings, thoughts and challenges.


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Question 15:

A nurse is monitoring medication adherence and potential side effects for a woman with postpartum depression who is taking sertraline (Zoloft).

Which of the following side effects should the nurse report to the healthcare provider immediately?

Explanation

The correct answer is choice D. Serotonin syndrome.

Serotonin syndrome is a rare but serious condition that can occur when taking sertraline or other antidepressants that increase serotonin levels in the brain.It can cause symptoms such as agitation, confusion, muscle rigidity, fever, seizures and coma.

It requires immediate medical attention and can be life-threatening.

Choice A.Nausea is a common side effect of sertraline that usually improves over time or can be managed with anti-nausea medications.

It is not a serious concern unless it interferes with eating or drinking.

Choice B.Headache is another common side effect of sertraline that can be treated with painkillers such as paracetamol or ibuprofen.

It is not a sign of a serious problem unless it is severe or persistent.

Choice C.Insomnia is also a common side effect of sertraline that can be reduced by taking the medication in the morning or by avoiding caffeine and alcohol.

It is not a serious issue unless it affects your daily functioning or mental health.

Normal ranges for serotonin levels in the blood are 101–283 ng/mL.

Serotonin syndrome can occur when serotonin levels are too high, usually above 500 ng/mL.


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Question 16:

A nurse is referring a woman with postpartum depression to specialized services as needed, such as social workers, psychologists, or psychiatrists.

Which of the following factors should the nurse consider when making referrals?

Explanation

The correct answer is choice D. All of the above.

The nurse should consider the woman’s preferences and needs, the availability and accessibility of services, and the cost and insurance coverage of services when making referrals for postpartum depression.

Choice A is wrong because it is not enough to consider only the woman’s preferences and needs.

The nurse should also take into account the practical aspects of accessing and affording the services.

Choice B is wrong because it is not enough to consider only the availability and accessibility of services.

The nurse should also respect the woman’s wishes and needs and help her find services that are suitable for her.

Choice C is wrong because it is not enough to consider only the cost and insurance coverage of services.

The nurse should also ensure that the services are available and accessible, and that they meet the woman’s preferences and needs.


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