Chapter 22: Postpartum Mood Disorders

Question 1

A postpartum patient reports experiencing mood swings, tearfulness, and feelings of being overwhelmed. Which of the following symptoms is most characteristic of postpartum blues?

A) Severe depressive symptoms
B) Emotional lability
C) Persistent insomnia lasting over a month
D) Lack of interest in infant care

Answer 1

B) Emotional lability

Rationale: Emotional lability, or rapid cycling mood symptoms, is the most prominent feature of postpartum blues.

Question 2

Which of the following is the primary intervention for a woman experiencing postpartum blues?

A) Prescribing antidepressants
B) Encouraging social isolation for rest
C) Reassurance and validation of the woman’s experience
D) Immediate hospitalization

Answer 2

C) Reassurance and validation of the woman’s experience

Rationale: Postpartum blues typically require reassurance and support, not formal medical treatment.

Question 3

A nurse is educating a new mother about postpartum blues. Which statement by the mother would indicate the need for further education?

A) “I am feeling tearful and overwhelmed, but I know this is temporary.”
B) “My mood swings are making it hard to care for my baby.”
C) “I’m feeling exhausted, but I can still take care of my baby.”
D) “I should expect these symptoms to resolve in about a week or two.”

Answer 3

B) “My mood swings are making it hard to care for my baby.”

Rationale: Rationale: Postpartum blues typically do not interfere with the mother’s ability to care for her infant. Persistent difficulty may indicate a need for further evaluation for postpartum depression.

Question 4

Which of the following factors is most likely to contribute to postpartum blues?

A) Lack of familial support
B) History of severe psychiatric disorders
C) Biologic, psychological, and social factors
D) Prior history of postpartum depression

Answer 4

C) Biologic, psychological, and social factors

Rationale: These are the hypothesized factors contributing to postpartum blues, although no specific studies have validated the exact cause.

Question 5

Which of the following is a typical course for postpartum blues?

A) Symptoms worsen progressively over time
B) Symptoms usually resolve by postpartum day 10
C) Symptoms last for more than six weeks
D) Symptoms are permanent and require long-term therapy

Answer 5

B) Symptoms usually resolve by postpartum day 10

Rationale: Postpartum blues usually resolve by postpartum day 10, though the symptoms may peak on days 4 and 5.

Question 6

A postpartum woman experiences symptoms of irritability, anxiety, and fatigue. She reports that these symptoms have been present since delivery. The nurse should:

A) Immediately refer the patient for psychiatric evaluation
B) Initiate antidepressant therapy
C) Advise the patient to avoid interacting with the infant
D) Provide reassurance and validate the woman’s experience

Answer 6

D) Provide reassurance and validate the woman’s experience

Rationale: These symptoms are common in postpartum blues, and reassurance, validation, and support are the recommended interventions.

Question 7

Which of the following is most important for the nurse to assess in a woman with postpartum blues?

A) The woman’s ability to bond with her infant
B) The woman’s symptoms of severe depression
C) The woman’s level of physical activity
D) The woman’s history of psychiatric disorders

Answer 7

A) The woman’s ability to bond with her infant

Rationale: While postpartum blues do not typically impair infant care, monitoring the woman’s bonding with her infant is important for early detection of any issues.

Question 8

Which of the following postpartum symptoms would most likely indicate a need for further evaluation for postpartum depression rather than postpartum blues?

A) Tearfulness
B) Anxiety
C) Difficulty thinking clearly
D) Persistent sadness and lack of interest in the baby

Answer 8

D) Persistent sadness and lack of interest in the baby

Rationale: Persistent sadness and lack of interest in the baby may indicate postpartum depression, which requires further evaluation.

Question 9

A nurse is assessing a postpartum woman who reports feelings of being overwhelmed and experiencing irritability and mood swings. The nurse should:

A) Offer reassurance that these feelings are typical and self-limiting
B) Refer the woman for psychiatric treatment immediately
C) Recommend isolation to reduce external stressors
D) Suggest starting medication to address her symptoms

Answer 9

A) Offer reassurance that these feelings are typical and self-limiting

Rationale: Postpartum blues are self-limiting and do not usually require medication or psychiatric intervention, but reassurance and support are appropriate.

Question 10

A postpartum patient is experiencing mood swings, guilt, and feelings of worthlessness. Which of the following signs would most strongly suggest that the patient is experiencing postpartum depression (PPD) rather than postpartum blues?

A) Rapid cycling mood changes
B) Symptoms resolve within 10 days
C) Persistent feelings of sadness and guilt
D) Mild irritability and tearfulness

Answer 10

C) Persistent feelings of sadness and guilt

Rationale: Unlike postpartum blues, PPD involves persistent and more severe symptoms, including feelings of sadness, guilt, and hopelessness.

Question 11

A nurse is assessing a new mother who reports feeling overwhelmed and disconnected from her baby. Which of the following findings would be most concerning and indicate the need for immediate intervention?

A) The mother expresses a lack of interest in the baby
B) The mother has mild mood swings
C) The mother exhibits tearfulness after visiting with family
D) The mother reports difficulty sleeping but feels generally well

Answer 11

A) The mother expresses a lack of interest in the baby

Rationale: A lack of interest in the baby is a major red flag for postpartum depression and requires immediate evaluation for further intervention.

Question 12

Which of the following is the most common risk factor for developing postpartum depression (PPD)?

A) Having a history of high blood pressure during pregnancy
B) Experiencing unresolved feelings about the pregnancy
C) Receiving inadequate assistance from a partner
D) Delivering a healthy infant

Answer 12

B) Experiencing unresolved feelings about the pregnancy

Rationale: Unresolved feelings about the pregnancy are one of the most common risk factors for developing PPD.

Question 13

A postpartum patient exhibits symptoms of hopelessness, moodiness, and guilt. Which of the following is the most appropriate action for the nurse to take?

A) Provide reassurance that these feelings are normal and will pass
B) Refer the patient for psychiatric evaluation and treatment
C) Suggest that the patient avoid interacting with the infant for a few days
D) Encourage the patient to focus on regaining her physical appearance

Answer 13

B) Refer the patient for psychiatric evaluation and treatment

Rationale: PPD requires treatment, including psychiatric evaluation, and is not self-limiting like postpartum blues.

Question 14

Which of the following is a potential consequence of untreated postpartum depression (PPD) on the mother-infant bond?

A) Increased maternal sensitivity and responsiveness to the infant
B) Enhanced mother-infant attachment
C) Difficulty forming an emotional attachment to the infant
D) Improved infant health outcomes

Answer 14

C) Difficulty forming an emotional attachment to the infant

Rationale: Untreated PPD can impair the mother’s ability to form a strong emotional bond with her infant, affecting attachment.

Question 15

A nurse is caring for a postpartum patient who has been diagnosed with PPD. Which of the following interventions is most appropriate for supporting this patient?

A) Encourage the patient to focus on her appearance and weight loss
B) Provide education on the self-limiting nature of the condition
C) Offer emotional support and encourage open communication with the partner
D) Discourage contact with the infant until the patient feels better

Answer 15

C) Offer emotional support and encourage open communication with the partner

Rationale: Emotional support and encouragement of communication with the partner are essential in helping the patient cope with PPD.

Question 16

Which of the following hormonal changes is most likely to contribute to the development of postpartum depression?

A) Increased estrogen levels
B) Decreased progesterone and estrogen levels
C) Increased thyroid hormone levels
D) Decreased serotonin level

Answer 16

B) Decreased progesterone and estrogen levels

Rationale: A sharp decrease in estrogen and progesterone levels in the immediate postpartum period is believed to contribute to the development of PPD.

Question 17

A postpartum mother reports crying often, feeling sad, and unable to make decisions. These symptoms have persisted for more than two weeks. Which of the following is the most appropriate nursing diagnosis?

A) Risk for impaired parenting
B) Ineffective coping
C) Postpartum depression
D) Acute grief

Answer 17

C) Postpartum depression

Rationale: The symptoms described are characteristic of postpartum depression, especially when they persist beyond two weeks.

Question 18

Which of the following factors is most likely to increase the risk for postpartum depression (PPD)?

A) A supportive partner and social network
B) Previous history of depression or anxiety
C) A positive and planned pregnancy
D) An uncomplicated childbirth experience

Answer 18

B) Previous history of depression or anxiety

Rationale: A history of depression or anxiety is one of the most significant risk factors for developing PPD.

Question 19

Which of the following is an example of a psychosocial factor that may contribute to postpartum depression (PPD)?

A) Hormonal fluctuations
B) Sleep deprivation
C) History of sexual abuse
D) Increased serotonin levels

Answer 19

C) History of sexual abuse

Rationale: A history of sexual or physical abuse is a psychosocial factor that can increase the risk for developing PPD.

Question 20

What is the recommended starting point for prophylactic intervention of Postpartum Depression (PPD)?

A. Immediate antidepressant therapy
B. A prenatal risk assessment and education
C. Inpatient psychiatric care
D. Immediate marriage counseling

Answer 20

B. A prenatal risk assessment and education

Rationale: Prophylactic intervention begins with a prenatal risk assessment and education, which can help identify women at risk for PPD.

Question 21

Which is the most common treatment approach for Postpartum Depression (PPD)?

A. Antidepressant medication combined with psychotherapy and adequate rest
B. Antidepressant medication alone
C. Antidepressant medication combined with antipsychotic medication
D. Only psychotherapy

Answer 21

A. Antidepressant medication combined with psychotherapy and adequate rest

Rationale: The management of PPD mirrors that of major depression, typically involving a combination of antidepressant medication, antianxiety medication, sleep/rest, and psychotherapy.

Question 22

Which of the following behaviors is commonly seen in a partner with PPD?

A. Excessive sleep and lethargy
B. Withdrawal, irritability, and anger
C. Increased affection towards the infant
D. Overwhelming joy and excitement

Answer 22

B. Withdrawal, irritability, and anger

Rationale: Partners with PPD often display behaviors like irritability, anger, withdrawal, and even substance use, which can be mistaken for other issues.

Question 23

What is one of the highest rates for paternal depression observed postpartum?

A. 1-2 weeks postpartum
B. 3-6 months postpartum
C. 6-12 months postpartum
D. 12-18 months postpartum

Answer 23

B. 3-6 months postpartum

Rationale: The highest rates of depression among fathers occur between 3 and 6 months postpartum.

Question 24

Which of the following is a commonly used screening tool for Postpartum Depression (PPD)?

A. Edinburgh Postnatal Depression Scale (EPDS)
B. Beck Depression Inventory (BDI)
C. Postpartum Anxiety Scale (PAS)
D. Generalized Anxiety Disorder Scale (GAD-7)

Answer 24

A. Edinburgh Postnatal Depression Scale (EPDS)

Rationale: The EPDS is one of the commonly used tools for screening PPD in women.

Question 25

What is the cutoff score on the Edinburgh Postnatal Depression Scale (EPDS) that indicates possible PPD?

A. 5 or 6
B. 7 or 8
C. 9 or 10
D. 15 or 16

Answer 25

C. 9 or 10

Rationale: The cutoff score for identifying potential PPD with the EPDS is 9 or 10, with a sensitivity of 86%.

Question 26

Which of the following is a domain included in the Postpartum Depression Screening Scale (PDSS)?

A. Emotional liability
B. Suicidal thoughts
C. Cognitive impairment
D. All of the above

Answer 26

D. All of the above

Rationale: The PDSS includes multiple domains such as emotional liability, suicidal thoughts, and cognitive impairment.

Question 27

Which of the following can help reduce the risk of negative outcomes from PPD?

A. Early recognition and treatment of PPD
B. Ignoring symptoms until they improve on their own
C. Excessive financial stress management
D. Ignoring the importance of sleep and rest

Answer 27

A. Early recognition and treatment of PPD

Rationale: Early identification and treatment can significantly improve outcomes for both mother and infant.

Question 28

Which group is typically least likely to be screened for Postpartum Depression (PPD)?

A. Women with a history of depression
B. Women who are self-reported as emotionally well
C. Women with strong social support systems
D. All of the above

Answer 28

B. Women who are self-reported as emotionally well

Rationale: Women who appear emotionally well or deny symptoms may be less likely to be screened for PPD.

Question 29

What is one factor that can increase the likelihood of paternal PPD?

A. Supportive relationship with the mother
B. High job satisfaction
C. Lack of parental leave
D. No history of mental health issues

Answer 29

C. Lack of parental leave

Rationale: Lack of parental leave is one of the factors that can increase the risk of paternal PPD.

Question 30

Which of the following is true regarding the resolution of Postpartum Depression (PPD) without treatment?

A. PPD rarely resolves without help
B. PPD always resolves within three months without intervention
C. PPD resolves spontaneously in most cases
D. PPD only resolves with the use of medication

Answer 30

B. PPD always resolves within three months without intervention

Rationale: PPD rarely resolves without treatment, and gradual improvement may occur over six months with appropriate intervention.

Question 31

What is commonly added to the treatment plan for moderate to severe cases of Postpartum Depression (PPD)?

A. Sleep therapy
B. Hormonal therapy
C. Antidepressants
D. Hospitalization

Answer 31

C. Antidepressants

Rationale: For moderate to severe cases of PPD, antidepressants (SSRIs), such as Zoloft, are commonly prescribed along with psychotherapy.

Question 32

Which type of treatment is most appropriate for severe cases of Postpartum Depression (PPD)?

A. Psychotherapy alone
B. Hormonal therapy
C. Support groups
D. Hospitalization

Answer 32

D. Hospitalization

Rationale: Severe cases of PPD may require hospitalization to provide intensive care and ensure the safety of both the mother and the baby.

Question 33

Which treatment modality is often used in addition to psychotherapy to help manage Postpartum Depression (PPD)?

A. Antidepressants (SSRIs)
B. Antipsychotic medications
C. Sleep therapy
D. Hormonal therapy

Answer 33

C. Sleep therapy

Rationale: Sleep therapy is one of the treatments used to manage PPD, as inadequate sleep can worsen depressive symptoms.

Question 34

Which class of medications is commonly prescribed for moderate to severe Postpartum Depression (PPD)?

A. Benzodiazepines
B. Antidepressants
C. Antipsychotics
D. Opioids

Answer 34

C. Antidepressants

Rationale: Antidepressants, particularly SSRIs like Zoloft, are commonly prescribed for moderate to severe cases of PPD.

Question 35

Which treatment modality is NOT mentioned as part of the management plan for Postpartum Depression (PPD)?

A. Psychotherapy
B. Support groups
C. Electroconvulsive therapy (ECT)
D. Hormonal therapy

Answer 35

C. Electroconvulsive therapy (ECT)

Question 36

Which of the following is most commonly associated with the onset of postpartum psychosis?

A. Previous history of mental illness
B. Sleep disturbances and fatigue
C. Hormonal fluctuations
D. Previous pregnancies with complications

Answer 36

A. Previous history of mental illness

Rationale: A previous history of mental illness is common in women who experience postpartum psychosis.

Question 37

Which of the following is a potential risk associated with postpartum psychosis?

A. Increased risk for suicide and infanticide
B. Increased risk of severe dehydration
C. Increased risk for chronic fatigue syndrome
D. Increased risk for social isolation

Answer 37

A. Increased risk for suicide and infanticide

Rationale: Postpartum psychosis carries a significant increased risk for suicide and infanticide.

Question 38

What are the early symptoms of postpartum psychosis often similar to?

A. Anxiety disorder
B. Mania
C. Depression
D. Schizophrenia

Answer 38

C. Depression

Rationale: Early symptoms of postpartum psychosis often resemble depression but may escalate to more severe symptoms.

Question 39

Which of the following is NOT typically a symptom of postpartum psychosis?

A. Hallucinations
B. Extreme disorganization of thought
C. Mania
D. Mild fatigue

Answer 39

D. Mild fatigue

Rationale: Mild fatigue is not a defining symptom of postpartum psychosis; the condition involves more severe symptoms such as hallucinations, disorganization, and mania.

Question 40

What is the recommended approach for women with postpartum psychosis?

A. Outpatient therapy and support groups only
B. Immediate hospitalization and psychotropic drug treatment
C. Immediate discharge with follow-up care
D. Bed rest and avoiding interaction with family members

Answer 40

B. Immediate hospitalization and psychotropic drug treatment

Rationale: Women with postpartum psychosis are often hospitalized for several months and treated with psychotropic medications, individual psychotherapy, and support group therapy.

Question 41

Why should women with postpartum psychosis not be left alone with their infants?

A. They may feel overwhelmed by the demands of caring for the baby
B. They may experience a lack of bonding with the infant
C. There is a risk of suicide or infanticide
D. They may develop a fear of harming the baby unintentionally

Answer 41

C. There is a risk of suicide or infanticide

Rationale: Women with postpartum psychosis are at a high risk for suicide or infanticide and should not be left alone with their infants.

Question 42

What is one of the main reasons postpartum affective disorders often go unrecognized?

A. Women are not aware of the possibility of depression after birth
B. Healthcare providers do not screen for depression
C. The symptoms of depression are identical to typical postpartum experiences
D. There is a lack of training among nurses

Answer 42

A. Women are not aware of the possibility of depression after birth

Rationale: Many women are unaware that depression can occur postpartum, and some may feel ashamed of negative emotions during this time, preventing them from seeking help.

Question 43

Which of the following is a risk factor for postpartum depression that can be identified during the nursing assessment?

A. High social support network
B. Strong coping skills
C. Previous normal pregnancies
D. Positive family history of psychiatric disorders

Answer 43

D. Positive family history of psychiatric disorders

Rationale: A family history of psychiatric disorders increases a woman’s risk for developing postpartum depression.

Question 44

During a postpartum nursing assessment, what should the nurse pay particular attention to in the woman’s history?

A. Number of children the woman has
B. The woman’s smoking history
C. Previous psychological problems or family history of psychiatric disorders
D. The woman’s work history

Answer 44

C. Previous psychological problems or family history of psychiatric disorders

Rationale: Previous psychological problems or a family history of psychiatric disorders are significant risk factors for postpartum depression and should be assessed.

Question 45

Which of the following physical findings should a nurse assess during the postpartum assessment that could suggest a postpartum affective disorder?

A. Weight gain
B. Increased energy levels
C. Difficulty concentrating
D. Improved sleep quality

Answer 45

C. Difficulty concentrating

Rationale: Difficulty concentrating is a common symptom of postpartum affective disorders, suggesting a potential problem that requires further investigation.

Question 46

What specific prenatal or birth factors increase the risk of postpartum depression?

A. Short labor duration
B. Previous postpartum hemorrhage
C. Birth of a high-risk or infant with special needs
D. Vaginal delivery

Answer 46

C. Birth of a high-risk or infant with special needs

Rationale: The birth of a high-risk or infant with special needs increases the likelihood of postpartum depression, as it can create additional stress and emotional challenges for the mother.

Question 47

Which of the following nonverbal indicators might suggest postpartum depression during a nursing assessment?

A. Smiling and maintaining eye contact
B. Avoiding eye contact and appearing withdrawn
C. Expressing excitement about motherhood
D. Engaging actively in conversation

Answer 47

B. Avoiding eye contact and appearing withdrawn

Rationale: Nonverbal signs such as avoiding eye contact and appearing withdrawn may suggest emotional distress, which could be indicative of postpartum depression.

Question 48

What should the nurse assess in relation to a woman’s sleep during a postpartum assessment?

A. Whether the woman gets adequate rest during the day
B. Whether the woman has issues with insomnia or excessive sleep
C. Whether the woman sleeps through the night without waking
D. Whether the woman naps frequently throughout the day

Answer 48

B. Whether the woman has issues with insomnia or excessive sleep

Rationale: Insomnia or excessive sleep is common in women experiencing postpartum depression and should be assessed.

Question 49

How can a nurse assist a woman identified as high-risk for postpartum depression?

A. Provide medication immediately after the assessment
B. Reassure her that she will recover without professional help
C. Offer individual or family counseling referrals
D. Recommend that she continue her daily activities without any changes

Answer 49

C. Offer individual or family counseling referrals

Rationale: Nurses can assist by referring high-risk women for counseling to help prevent or address postpartum depression and improve overall outcomes.

Question 50

Which of the following is most important for the nurse to emphasize when helping a postpartum woman adjust to the changes she is experiencing?

A. The importance of maintaining unrealistic expectations to avoid disappointment
B. The need for professional help only if symptoms worsen
C. The importance of good nutrition, exercise, and sleep
D. The need to be completely self-sufficient during the postpartum period

Answer 50

C. The importance of good nutrition, exercise, and sleep

Rationale: Good nutrition, exercise, and sleep are crucial for the postpartum recovery process, helping women cope with emotional and physical challenges.

Question 51

A postpartum woman reports feeling “down and hopeless” and is showing signs of difficulty adjusting to her new role. What would be an appropriate nursing response?

A. Tell her to focus on her new responsibilities and avoid discussing feelings
B. Encourage her to verbalize her feelings and provide information on support resources
C. Suggest that her feelings are normal and should pass with time
D. Dismiss her concerns as typical postpartum changes

Answer 51

B. Encourage her to verbalize her feelings and provide information on support resources

Rationale: Encouraging the woman to discuss her feelings and providing information about available resources helps in early identification of potential postpartum affective disorders.

Question 52

A nurse is assessing a postpartum woman who has been struggling with feelings of depression. What is an important factor for the nurse to explore when assessing her ability to cope with the changes of the postpartum period?

A. The woman’s history of substance abuse
B. The woman’s current level of social support and willingness to seek help
C. The woman’s financial status and work schedule
D. The woman’s preference for medication versus therapy

Answer 52

B. The woman’s current level of social support and willingness to seek help

Rationale: A strong social support network and willingness to seek help are important factors in coping with the emotional challenges of the postpartum period.

Question 53

A nurse is assessing a postpartum client who is at home. Which statement by the client would lead the nurse to suspect that the client may be developing postpartum depression?

A) I just feel so overwhelmed and tired.

B) I’m feeling so guilty and worthless lately.

C) It’s strange, one minute I’m happy, the next I’m sad.

D) I keep hearing voices telling me to take my baby to the river.

Answer 53

B) I’m feeling so guilty and worthless lately.

Question 54

A nurse suspects that a postpartum client is experiencing postpartum psychosis.
Which of the following would most likely lead the nurse to suspect this condition?

A) Delirium

B) Feelings of anxiety

C) Sadness

D) Insomnia

Answer 54

A) Delirium

Question 55

As part of an inservice program, a nurse is describing a transient, self-limiting mood disorder that affects mothers after childbirth. The nurse correctly identifies this as postpartum:

A) Depression

B) Psychosis

C) Bipolar disorder

D) Blues

Answer 55

D) Blues

Question 56

A nurse is educating a postpartum client diagnosed with moderate depression about the use of selective serotonin reuptake inhibitors (SSRIs) for treatment. Which of the following should be included in the education?

A. SSRIs are not recommended during breastfeeding.
B. SSRIs may take several weeks to show therapeutic effects.
C. SSRIs can be discontinued suddenly without side effects.
D. SSRIs are not effective for postpartum depression.

Answer 56

B. SSRIs may take several weeks to show therapeutic effects.

Rationale: SSRIs, like Zoloft, are commonly used to treat postpartum depression and may take several weeks to demonstrate therapeutic effects.

Question 57

A woman diagnosed with postpartum depression has been prescribed Zoloft (sertraline). Which of the following is the most important nursing consideration when educating the patient?

A. Zoloft can cause immediate relief of symptoms.
B. Zoloft should be taken only if symptoms of depression are severe.
C. Zoloft is contraindicated during breastfeeding.
D. The client should monitor for any signs of worsening depression or suicidal ideation.

Answer 57

D. The client should monitor for any signs of worsening depression or suicidal ideation.

Rationale: Zoloft and other SSRIs carry a risk of increased suicidal ideation, especially in the initial stages of treatment.

Question 58

Which of the following medications is commonly prescribed for postpartum psychosis and is classified as an antipsychotic agent?

A. Haloperidol
B. Diazepam
C. Zoloft
D. Lithium

Answer 58

A. Haloperidol

Rationale: Haloperidol is an antipsychotic medication often used in the treatment of severe postpartum psychosis.

Question 59

A postpartum client has been prescribed lorazepam (Ativan) for anxiety related to postpartum blues. Which of the following teaching points is most important?

A. Lorazepam is a long-term solution for postpartum anxiety.
B. Avoid alcohol while taking lorazepam.
C. Lorazepam should be taken with food to enhance absorption.
D. Lorazepam can be abruptly discontinued without any withdrawal symptoms.

Answer 59

B. Avoid alcohol while taking lorazepam.

Rationale: Lorazepam is a benzodiazepine, and alcohol can increase its sedative effects, leading to dangerous side effects.

Question 60

A postpartum woman with a history of depression is being treated with a combination of psychotherapy and fluoxetine (Prozac). Which of the following should be included in her education regarding the medication?

A. Prozac should be taken only during the first month after delivery.
B. Prozac will cause immediate improvement in mood.
C. Therapy may enhance the effects of Prozac, and continued participation in counseling is essential.
D. Prozac is contraindicated during breastfeeding.

Answer 60

C. Therapy may enhance the effects of Prozac, and continued participation in counseling is essential.

Rationale: Prozac (fluoxetine) may take several weeks to show benefits, and combining it with therapy can enhance overall treatment outcomes.

Question 61

Which of the following medications would be contraindicated for a postpartum woman diagnosed with both depression and a history of mania?

A. Lithium
B. Haloperidol
C. Zoloft
D. Mirtazapine

Answer 61

A. Lithium

Rationale: Lithium is contraindicated in patients with a history of mania because it can trigger a manic episode in those with bipolar disorder.

Question 62

A woman with postpartum depression is taking sertraline (Zoloft). Which of the following adverse effects should the nurse inform the client to report immediately?

A. Insomnia
B. Nausea
C. Suicidal thoughts
D. Weight gain

Answer 62

C. Suicidal thoughts

Rationale: SSRIs, including Zoloft, may increase suicidal thoughts in some individuals, particularly in the early stages of treatment.

Question 63

A postpartum woman is receiving antipsychotic medication for postpartum psychosis. Which of the following adverse effects should the nurse monitor for?

A. Hyperactivity
B. Acute dystonia
C. Constipation
D. Insomnia

Answer 63

B. Acute dystonia

Rationale: Antipsychotic medications, like haloperidol, can cause extrapyramidal symptoms, including acute dystonia, which should be closely monitored.

Question 64

A nurse is educating a postpartum client who has been prescribed fluoxetine (Prozac) about the medication’s potential effects. Which of the following should be included in the teaching?

A. Prozac can cause weight loss and increased appetite.
B. Prozac may cause sedation, especially during the early weeks of treatment.
C. Prozac may take several weeks to show full therapeutic effects.
D. Prozac can be stopped abruptly without any adverse effects.

Answer 64

D. Prozac can be stopped abruptly without any adverse effects.

Rationale: Antidepressants like fluoxetine may take several weeks to achieve their full therapeutic effects.

Question 65

A postpartum client with a history of substance abuse has been prescribed an SSRI for depression. Which of the following is an important consideration for this patient?

A. SSRIs are contraindicated for patients with a history of substance abuse.
B. SSRIs should be used cautiously due to the potential for dependency.
C. Close monitoring for substance abuse relapse is necessary.
D. The SSRI should be taken only as needed for depressive symptoms.

Answer 65

C. Close monitoring for substance abuse relapse is necessary.

Rationale: Although SSRIs are not addictive, women with a history of substance abuse should be closely monitored for relapse while on medication.

Question 66

Which of the following is a potential contraindication for the use of SSRIs in a postpartum woman?

A. History of substance abuse
B. History of a major depressive disorder
C. Use of warfarin (Coumadin)
D. History of breast cancer

Answer 66

C. Use of warfarin (Coumadin)

Rationale: SSRIs can increase the risk of bleeding, especially when taken with anticoagulants like warfarin.

Question 67

A postpartum woman is diagnosed with postpartum blues. Which of the following nonpharmacological treatments is appropriate for her?

A. Cognitive-behavioral therapy
B. Electroconvulsive therapy (ECT)
C. Hormonal therapy
D. Light therapy

Answer 67

A. Cognitive-behavioral therapy

Rationale: Cognitive-behavioral therapy can help with mild postpartum blues and is considered a nonpharmacological intervention.

Question 68

A nurse is caring for a postpartum woman with postpartum psychosis who is prescribed antipsychotic medication. Which of the following is the nurse’s priority intervention?

A. Ensure the patient has adequate fluid intake
B. Monitor for signs of sedation and hypotension
C. Provide education about the potential side effects of the medication
D. Instruct the patient to discontinue the medication once symptoms improve

Answer 68

B. Monitor for signs of sedation and hypotension

Rationale: Antipsychotics can cause sedation and hypotension, so these should be closely monitored in postpartum women receiving treatment.

Question 69

A postpartum woman diagnosed with postpartum psychosis is receiving treatment with haloperidol. Which of the following adverse effects should be monitored closely?

A. Weight gain
B. Insomnia
C. Fatigue
D. Tremors or rigidity

Answer 69

D. Tremors or rigidity

Rationale: Haloperidol can cause extrapyramidal symptoms, such as tremors or rigidity, which need to be monitored closely during treatment.