Question 1

The nurse,who has been calling postpartum clients,learns that one client reports having no appetite and wants to sleep all day.What does this information suggest to the nurse?

Accepted Answer

A) Lack of appetite and the desire to sleep are symptoms of developing postpartum depression. The client could be developing postpartum depression and not just "the blues." The client would need to have more acute symptoms such as hearing voices to consider postpartum psychosis. The nurse has no way of knowing what the client's sleep-wake cycle is, so this choice is incorrect.
B) Lack of appetite and the desire to sleep are symptoms of developing postpartum depression. The client could be developing postpartum depression and not just "the blues." The client would need to have more acute symptoms such as hearing voices to consider postpartum psychosis. The nurse has no way of knowing what the client's sleep-wake cycle is, so this choice is incorrect.
C) Lack of appetite and the desire to sleep are symptoms of developing postpartum depression. The client could be developing postpartum depression and not just "the blues." The client would need to have more acute symptoms such as hearing voices to consider postpartum psychosis. The nurse has no way of knowing what the client's sleep-wake cycle is, so this choice is incorrect.
D) Lack of appetite and the desire to sleep are symptoms of developing postpartum depression. The client could be developing postpartum depression and not just "the blues." The client would need to have more acute symptoms such as hearing voices to consider postpartum psychosis. The nurse has no way of knowing what the client's sleep-wake cycle is, so this choice is incorrect.

Question 2

A nurse manager working in labor and delivery is providing educational material to staff nurses regarding postpartum depression and the maternal role attainment (MRA)process.Which information is true regarding the MRA process?

Accepted Answer

A) Maternal role attainment occurs in four stages. During the formal stage of the MRA process, the woman is still influenced by the guidance of others and tries to act as she believes others expect her to act. During the anticipatory stage of the MRA process, the woman looks to role models, especially her own mother, for examples of how to mother. The informal stage of the MRA process begins when the mother starts making her own choices about mothering.
B) Maternal role attainment occurs in four stages. During the formal stage of the MRA process, the woman is still influenced by the guidance of others and tries to act as she believes others expect her to act. During the anticipatory stage of the MRA process, the woman looks to role models, especially her own mother, for examples of how to mother. The informal stage of the MRA process begins when the mother starts making her own choices about mothering.
C) Maternal role attainment occurs in four stages. During the formal stage of the MRA process, the woman is still influenced by the guidance of others and tries to act as she believes others expect her to act. During the anticipatory stage of the MRA process, the woman looks to role models, especially her own mother, for examples of how to mother. The informal stage of the MRA process begins when the mother starts making her own choices about mothering.
D) Maternal role attainment occurs in four stages. During the formal stage of the MRA process, the woman is still influenced by the guidance of others and tries to act as she believes others expect her to act. During the anticipatory stage of the MRA process, the woman looks to role models, especially her own mother, for examples of how to mother. The informal stage of the MRA process begins when the mother starts making her own choices about mothering.

Question 3

A nurse working in labor and delivery is assessing a client's risk for developing postpartum depression.Which is a risk factor for this disorder?

Accepted Answer

A) A history of bipolar disorder is a risk factor for the development of postpartum depression. Primiparity (first pregnancy) is a risk factor, not multiparity. A lack of family support, not overwhelming family support, is a risk factor for the development of postpartum depression.
B) A history of bipolar disorder is a risk factor for the development of postpartum depression. Primiparity (first pregnancy) is a risk factor, not multiparity. A lack of family support, not overwhelming family support, is a risk factor for the development of postpartum depression.
C) A history of bipolar disorder is a risk factor for the development of postpartum depression. Primiparity (first pregnancy) is a risk factor, not multiparity. A lack of family support, not overwhelming family support, is a risk factor for the development of postpartum depression.
D) A history of bipolar disorder is a risk factor for the development of postpartum depression. Primiparity (first pregnancy) is a risk factor, not multiparity. A lack of family support, not overwhelming family support, is a risk factor for the development of postpartum depression.

Question 4

The postpartum client states that she cannot understand why she does not enjoy being with her baby.Based on this data,which does the nurse suspect the client is experiencing?

Accepted Answer

A) Postpartum depression is characterized by feelings of failure and self-accusation, among others. Postpartum psychosis is more severe, and includes hallucinations and irrationality, which are not represented in this situation. Postpartum infection has nothing to do with this situation. Postpartum blues is characterized by mild depression interspersed with happier feelings, and is self-limiting.
B) Postpartum depression is characterized by feelings of failure and self-accusation, among others. Postpartum psychosis is more severe, and includes hallucinations and irrationality, which are not represented in this situation. Postpartum infection has nothing to do with this situation. Postpartum blues is characterized by mild depression interspersed with happier feelings, and is self-limiting.
C) Postpartum depression is characterized by feelings of failure and self-accusation, among others. Postpartum psychosis is more severe, and includes hallucinations and irrationality, which are not represented in this situation. Postpartum infection has nothing to do with this situation. Postpartum blues is characterized by mild depression interspersed with happier feelings, and is self-limiting.
D) Postpartum depression is characterized by feelings of failure and self-accusation, among others. Postpartum psychosis is more severe, and includes hallucinations and irrationality, which are not represented in this situation. Postpartum infection has nothing to do with this situation. Postpartum blues is characterized by mild depression interspersed with happier feelings, and is self-limiting.

Question 5

A client of Eastern European descent who gave birth to her third child on the previous shift tells the nurse that she wants to get cleaned up and have something to eat so that she can be ready to go home in the morning.Which action by the nurse is appropriate?

Accepted Answer

A) To provide culturally sensitive care, the nurse should assist the client with self-care requests and check on when the meals will be delivered because clients of European descent often want to ambulate, shower, dress, and plan to go home quickly. The nurse should not suggest that the discharge is dependent upon the physician. Telling the client to pace herself or to take advantage of rest because she has other children at home who will also need her care does not allow for cultural differences surrounding childbirth.
B) To provide culturally sensitive care, the nurse should assist the client with self-care requests and check on when the meals will be delivered because clients of European descent often want to ambulate, shower, dress, and plan to go home quickly. The nurse should not suggest that the discharge is dependent upon the physician. Telling the client to pace herself or to take advantage of rest because she has other children at home who will also need her care does not allow for cultural differences surrounding childbirth.
C) To provide culturally sensitive care, the nurse should assist the client with self-care requests and check on when the meals will be delivered because clients of European descent often want to ambulate, shower, dress, and plan to go home quickly. The nurse should not suggest that the discharge is dependent upon the physician. Telling the client to pace herself or to take advantage of rest because she has other children at home who will also need her care does not allow for cultural differences surrounding childbirth.
D) To provide culturally sensitive care, the nurse should assist the client with self-care requests and check on when the meals will be delivered because clients of European descent often want to ambulate, shower, dress, and plan to go home quickly. The nurse should not suggest that the discharge is dependent upon the physician. Telling the client to pace herself or to take advantage of rest because she has other children at home who will also need her care does not allow for cultural differences surrounding childbirth.

Question 6

The nurse is instructing a new mother on the strategies to prevent the development of postpartum depression.Which instructions will the nurse include in the teaching session with the client? Select all that apply.

Accepted Answer

A) The nurse should instruct the client on the signs and symptoms of postpartum depression with the direction to phone her health care provider if this occurs. The nurse should also encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood. It is not normal to feel depressed for months after delivering a baby. Not having children is not the only way to avoid postpartum depression. Restricting fluids and eating a low-fat diet will not prevent postpartum depression and could harm the new mother's physiological status.
B) The nurse should instruct the client on the signs and symptoms of postpartum depression with the direction to phone her health care provider if this occurs. The nurse should also encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood. It is not normal to feel depressed for months after delivering a baby. Not having children is not the only way to avoid postpartum depression. Restricting fluids and eating a low-fat diet will not prevent postpartum depression and could harm the new mother's physiological status.
C) The nurse should instruct the client on the signs and symptoms of postpartum depression with the direction to phone her health care provider if this occurs. The nurse should also encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood. It is not normal to feel depressed for months after delivering a baby. Not having children is not the only way to avoid postpartum depression. Restricting fluids and eating a low-fat diet will not prevent postpartum depression and could harm the new mother's physiological status.
D) The nurse should instruct the client on the signs and symptoms of postpartum depression with the direction to phone her health care provider if this occurs. The nurse should also encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood. It is not normal to feel depressed for months after delivering a baby. Not having children is not the only way to avoid postpartum depression. Restricting fluids and eating a low-fat diet will not prevent postpartum depression and could harm the new mother's physiological status.
E) The nurse should instruct the client on the signs and symptoms of postpartum depression with the direction to phone her health care provider if this occurs. The nurse should also encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood. It is not normal to feel depressed for months after delivering a baby. Not having children is not the only way to avoid postpartum depression. Restricting fluids and eating a low-fat diet will not prevent postpartum depression and could harm the new mother's physiological status.

Question 7

The home care nurse determines that a client being treated for postpartum depression is improving.Which assessment data supports the nurse's conclusion?

Accepted Answer

A) The nurse who observes the client in casual wear, holding the baby while rocking in a chair, should determine that treatment for postpartum depression has been effective because these are signs the client is improving. The other choices would indicate disinterest in child care and care of the home. The client who is sleeping while the spouse is making dinner and watching the baby would indicate treatment has not been effective at all.
B) The nurse who observes the client in casual wear, holding the baby while rocking in a chair, should determine that treatment for postpartum depression has been effective because these are signs the client is improving. The other choices would indicate disinterest in child care and care of the home. The client who is sleeping while the spouse is making dinner and watching the baby would indicate treatment has not been effective at all.
C) The nurse who observes the client in casual wear, holding the baby while rocking in a chair, should determine that treatment for postpartum depression has been effective because these are signs the client is improving. The other choices would indicate disinterest in child care and care of the home. The client who is sleeping while the spouse is making dinner and watching the baby would indicate treatment has not been effective at all.
D) The nurse who observes the client in casual wear, holding the baby while rocking in a chair, should determine that treatment for postpartum depression has been effective because these are signs the client is improving. The other choices would indicate disinterest in child care and care of the home. The client who is sleeping while the spouse is making dinner and watching the baby would indicate treatment has not been effective at all.

Question 8

A client who is breastfeeding has been diagnosed with postpartum depression after delivering her first child.Which medications might be prescribed for this client? Select all that apply.

Accepted Answer

A) Sertraline is recommended to be the first-line treatment for postpartum depression. Paroxetine is the alternative first-line treatment for postpartum depression. Fluoxetine is not recommended for lactating women because of the long half-life and the risk of the medication crossing into the breast milk. Diazepam and phenytoin are not used to treat postpartum depression.
B) Sertraline is recommended to be the first-line treatment for postpartum depression. Paroxetine is the alternative first-line treatment for postpartum depression. Fluoxetine is not recommended for lactating women because of the long half-life and the risk of the medication crossing into the breast milk. Diazepam and phenytoin are not used to treat postpartum depression.
C) Sertraline is recommended to be the first-line treatment for postpartum depression. Paroxetine is the alternative first-line treatment for postpartum depression. Fluoxetine is not recommended for lactating women because of the long half-life and the risk of the medication crossing into the breast milk. Diazepam and phenytoin are not used to treat postpartum depression.
D) Sertraline is recommended to be the first-line treatment for postpartum depression. Paroxetine is the alternative first-line treatment for postpartum depression. Fluoxetine is not recommended for lactating women because of the long half-life and the risk of the medication crossing into the breast milk. Diazepam and phenytoin are not used to treat postpartum depression.
E) Sertraline is recommended to be the first-line treatment for postpartum depression. Paroxetine is the alternative first-line treatment for postpartum depression. Fluoxetine is not recommended for lactating women because of the long half-life and the risk of the medication crossing into the breast milk. Diazepam and phenytoin are not used to treat postpartum depression.

Question 9

The nurse caring for a postpartum client would consider the nursing diagnosis of ineffective individual coping when the client demonstrates which behavior?

Accepted Answer

A) The postpartum client who is lying in bed in a darkened room and not wanting to spend time with the new baby is demonstrating signs of ineffective individual coping. The other behaviors would not indicate ineffective copying but rather effective coping and are incorrect.
B) The postpartum client who is lying in bed in a darkened room and not wanting to spend time with the new baby is demonstrating signs of ineffective individual coping. The other behaviors would not indicate ineffective copying but rather effective coping and are incorrect.
C) The postpartum client who is lying in bed in a darkened room and not wanting to spend time with the new baby is demonstrating signs of ineffective individual coping. The other behaviors would not indicate ineffective copying but rather effective coping and are incorrect.
D) The postpartum client who is lying in bed in a darkened room and not wanting to spend time with the new baby is demonstrating signs of ineffective individual coping. The other behaviors would not indicate ineffective copying but rather effective coping and are incorrect.

Question 10

The home care nurse is planning care for a client with a history of postpartum depression after the births of all her children.Based on this data,which will the nurse include in the client's plan of care? Select all that apply.

Accepted Answer

A) Because the client has a history of postpartum depression with other children, the nurse needs to plan prevention strategies for the client. By taking advantage of those who want to help and maintaining outside interests, the client may prevent the onset of postpartum depression. Instructing to eat a healthful diet with limited alcohol intake is another strategy to prevent postpartum depression. The other interventions would not help prevent postpartum depression.
B) Because the client has a history of postpartum depression with other children, the nurse needs to plan prevention strategies for the client. By taking advantage of those who want to help and maintaining outside interests, the client may prevent the onset of postpartum depression. Instructing to eat a healthful diet with limited alcohol intake is another strategy to prevent postpartum depression. The other interventions would not help prevent postpartum depression.
C) Because the client has a history of postpartum depression with other children, the nurse needs to plan prevention strategies for the client. By taking advantage of those who want to help and maintaining outside interests, the client may prevent the onset of postpartum depression. Instructing to eat a healthful diet with limited alcohol intake is another strategy to prevent postpartum depression. The other interventions would not help prevent postpartum depression.
D) Because the client has a history of postpartum depression with other children, the nurse needs to plan prevention strategies for the client. By taking advantage of those who want to help and maintaining outside interests, the client may prevent the onset of postpartum depression. Instructing to eat a healthful diet with limited alcohol intake is another strategy to prevent postpartum depression. The other interventions would not help prevent postpartum depression.
E) Because the client has a history of postpartum depression with other children, the nurse needs to plan prevention strategies for the client. By taking advantage of those who want to help and maintaining outside interests, the client may prevent the onset of postpartum depression. Instructing to eat a healthful diet with limited alcohol intake is another strategy to prevent postpartum depression. The other interventions would not help prevent postpartum depression.

Quiz 28: Mood and Affect