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 C
Explanation
Choice A rationale: Placing elbow restraints is not a recommended practice for preterm newborns. Restraints are used in some cases to prevent the baby from pulling on tubes or lines, but it is not primarily for energy conservation.
Choice B rationale: While frequent position changes are important to prevent pressure ulcers and promote comfort, they may not necessarily help conserve energy in a preterm newborn.
Choice C rationale: Preterm newborns have limited energy reserves, and conserving energy is essential for their growth and development. Clustering care activities involves combining nursing care tasks to allow for longer periods of uninterrupted rest for the baby. This approach reduces the baby's energy expenditure and promotes better weight gain and stability.
Choice D rationale: While gentle touch and massage can be beneficial for preterm newborns to promote bonding and relaxation, it may not directly conserve energy as cluster care does.
Correct Answer is A
Explanation
Choice A rationale: The rooting reflex is a natural reflex in newborns that helps them find the nipple for feeding. When the baby's cheek is touched or stroked, they will turn their head in that direction and open their mouth, searching for the breast or bottle.
Choice B rationale: The Babinski reflex is a different reflex, which involves the fanning and curling of the toes when the sole of the foot is stroked. It is not related to sucking or feeding.
Choice C rationale: The Moro reflex, also known as the startle reflex, occurs when a newborn is startled by a sudden noise or movement. The baby reacts by extending their arms and legs and then bringing them back toward the center of their body. It is not related to sucking or feeding.
Choice D rationale: The stepping reflex is observed when a newborn is held upright with their feet touching a solid surface. The baby will make stepping movements, but it is not related to sucking or feeding.

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