During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, "I don't know what's wrong.
I love my son, but I feel so let down.
I seem to cry for no reason!" Which condition might this new mother be experiencing?
Postpartum blues.
Postpartum depression (PPD).
Postpartum delirium.
Attachment difficulty.
The Correct Answer is A
Choice A rationale
Postpartum blues are characterized by labile mood, tearfulness, anxiety, and irritability that typically peak around the third to fifth postpartum day and resolve within two weeks. These feelings are often attributed to hormonal shifts, psychological adjustments, and fatigue experienced after childbirth. The woman's statement of feeling "let down" and crying for no reason, occurring on the fourth postpartum day, aligns with the typical presentation of postpartum blues.
Choice B rationale
Postpartum depression (PPD) involves more intense and persistent symptoms than postpartum blues, including depressed mood, loss of interest or pleasure, changes in appetite and sleep, fatigue, feelings of worthlessness or guilt, and difficulty concentrating. These symptoms typically last longer than two weeks and interfere with daily functioning. The woman's statement alone does not provide enough information to diagnose PPD.
Choice C rationale
Postpartum delirium is a rare but serious psychiatric emergency characterized by rapid onset of confusion, disorientation, hallucinations, delusions, and agitation. It typically occurs within the first few days postpartum. The woman's description of her feelings does not suggest the presence of delirium.
Choice D rationale
Attachment difficulty refers to challenges in forming a secure emotional bond between the mother and her infant. While the woman expresses loving her son, her emotional state of feeling "let down" and crying is not a direct indicator of attachment difficulties, which manifest as a lack of engagement or negative interactions with the baby.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D"}
Explanation
The nurse should first address the client’s calf findings followed by their stress about discharge.
Rationale for correct answers
Calf findings must be addressed first due to the risk of deep vein thrombosis (DVT), which is a known complication of cesarean delivery and postpartum immobility. The presence of unilateral calf edema (3 cm greater than the right) and tenderness, combined with an elevated D-dimer, strongly suggests a thrombotic process requiring urgent evaluation. If DVT is confirmed, anticoagulation therapy should be initiated promptly to prevent progression to pulmonary embolism.
Stress about discharge should be the second priority, as emotional concerns can affect adherence to postpartum care instructions. Addressing anxiety about recovery, follow-up visits, and newborn care can improve the client’s overall well-being and readiness for discharge.
Rationale for incorrect Response 1 options
- Breast engorgement: Although uncomfortable, this is a transient issue that can be managed with cold compresses and supportive bras. It does not pose an immediate health risk.
- Constipation: Postpartum bowel irregularities are expected after cesarean delivery; stool softeners and hydration can alleviate symptoms without urgency.
- Surgical incision pain: Rated only 2/10, indicating mild pain that does not require immediate intervention beyond routine analgesia.
Correct Answer is ["B","F","G"]
Explanation
Choice B rationale
Prostaglandin administration, either vaginally or orally, helps to ripen the cervix by increasing collagenase activity and water content, leading to cervical softening, thinning (effacement), and dilation, which are necessary for labor to begin.
Choice F rationale
Amniotomy, or artificial rupture of membranes (AROM), involves the deliberate rupture of the amniotic sac. This can stimulate labor by releasing prostaglandins, increasing uterine contractility, and allowing the presenting part of the fetus to descend further into the pelvis, putting pressure on the cervix.
Choice G rationale
Oxytocin is a synthetic hormone that mimics the action of endogenous oxytocin, stimulating uterine contractions. It is commonly administered intravenously to initiate or augment labor once cervical ripening has occurred or the cervix is favorable.
Choice A rationale
Epidural anesthesia is a method of pain relief during labor, not a method for inducing labor. It provides regional analgesia by blocking nerve impulses in the lower body.
Choice C rationale
Bed rest is generally not recommended for labor induction and can even be counterproductive. Ambulation and positional changes can help to encourage fetal descent and uterine activity.
Choice D rationale
Vitamin supplementation is important for overall maternal and fetal health during pregnancy but does not directly stimulate uterine contractions or cervical changes necessary for labor induction.
Choice E rationale
Fetal ultrasound is used to assess fetal well-being, presentation, and amniotic fluid volume but does not initiate the process of labor induction. .
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