A nurse is caring for a client who is 2 weeks postpartum. The client tells the nurse, "I feel really down and sad lately. I have no energy and I feel like I'm going to cry." Which of the following actions should the nurse take first?
Reinforce teaching about ways to increase rest and sleep.
Arrange for counseling to help the client cope with the stress of being a parent.
Request a prescription for antidepressant medication.
Use a postpartum depression screening tool with the client.
The Correct Answer is D
Choice A rationale: While adequate rest and sleep are essential postpartum, the client's symptoms of feeling down and sad may be indicative of postpartum depression and should be further evaluated.
Choice B rationale: Counseling may be helpful, but the priority is to first assess and screen for postpartum depression before making additional recommendations.
Choice C rationale: While antidepressant medications might be necessary for postpartum depression, the initial step should be to assess and screen for depression using the appropriate tool.
Choice D rationale: The client's statement and symptoms raise concerns about possible postpartum depression. Using a postpartum depression screening tool will help the nurse assess the severity of the client's symptoms and determine the appropriate course of action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
A newborn can lose up to 10% of their birth weight in the first few days after birth, which is considered normal. By 7-14 days of age, the baby should have regained their birth weight if breastfeeding effectively.
Choice B rationale:
Gaining 0.25 oz (7 grams) per day after the fourth day of life is not a standard guideline for assessing effective breastfeeding.
Choice C rationale:
Expecting the baby to have less than 5 wet diapers per day after the fourth day of life may indicate dehydration or inadequate breastfeeding, which is not a sign of effective breastfeeding.
Choice D rationale:
Expecting the baby to feed constantly during the first week of life is not necessarily an indicator of effective breastfeeding. While frequent feeding is normal in the early days, the baby should be able to effectively feed and show signs of satiety after nursing.
Correct Answer is B
Explanation
Choice A rationale:
Administering the hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen is not the appropriate treatment for a newborn whose mother is positive for the hepatitis B surface antigen. Immediate intervention is required to prevent transmission.
Choice B rationale:
The newborn of a mother who is positive for the hepatitis B surface antigen should receive hepatitis B immune globulin (HBIG) and the hepatitis B vaccine within 12 hours of birth. HBIG provides passive immunity to the baby while the vaccine stimulates active immunity.
Choice C rationale:
Administering hepatitis B immune globulin for 1 week followed by the hepatitis B vaccine monthly for 6 months is not the correct treatment plan. Immediate intervention is necessary to prevent transmission to the newborn.
Choice D rationale:
Administering the hepatitis B vaccine at 24 hours followed by hepatitis B immune globulin every 12 hours for 3 days is not the appropriate treatment. Hepatitis B immune globulin should be given within 12 hours of birth, not over several days.
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