CPM CPM Postpartum Care and Recovery 2 — Questions and Answers
Question 1: Which hormone is primarily responsible for triggering milk ejection (let-down) during breastfeeding?
- Prolactin
- Estrogen
- Oxytocin (Correct answer)
- Progesterone
Correct answer: Oxytocin
Oxytocin, released from the posterior pituitary in response to nipple stimulation, causes myoepithelial cells around alveoli to contract and eject milk.
Question 2: A postpartum client at 6 weeks has not resumed menses. She is fully breastfeeding and has no signs of pregnancy. What is the most likely explanation?
- Postpartum hypothyroidism
- Lactational amenorrhea (Correct answer)
- Premature menopause
- Asherman syndrome
Correct answer: Lactational amenorrhea
Lactational amenorrhea results from elevated prolactin suppressing GnRH and LH, which inhibits ovulation and menstruation in fully breastfeeding women.
Question 3: When counseling a postpartum client about the Edinburgh Postnatal Depression Scale (EPDS), a midwife should explain that a score of 10 or above indicates what?
- Normal postpartum mood
- Possible postpartum depression requiring follow-up (Correct answer)
- Definitive diagnosis of major depression
- Need for immediate hospitalization
Correct answer: Possible postpartum depression requiring follow-up
An EPDS score of 10 or above is a positive screen that warrants further evaluation but is not itself a diagnosis; the midwife should conduct additional assessment and arrange follow-up.
Question 4: Which postpartum complication is most associated with a history of operative vaginal delivery or prolonged second stage?
- Endometritis
- Perineal hematoma (Correct answer)
- Deep vein thrombosis
- Retained placenta
Correct answer: Perineal hematoma
Perineal hematomas result from trauma to blood vessels in the vulvar or vaginal area and are more common after operative delivery or prolonged pushing.
Question 5: What is the recommended minimum duration of exclusive breastfeeding according to the American Academy of Pediatrics?
- 3 months
- 4 months
- 6 months (Correct answer)
- 12 months
Correct answer: 6 months
The AAP recommends exclusive breastfeeding for approximately 6 months, followed by continued breastfeeding alongside complementary foods for at least 1 year.
Question 6: A postpartum client on day 10 develops a red, warm, wedge-shaped area on one breast with fever and flu-like symptoms. What is the most likely diagnosis?
- Breast engorgement
- Plugged milk duct
- Mastitis (Correct answer)
- Breast abscess
Correct answer: Mastitis
Mastitis presents with a localized, red, warm, tender area (often wedge-shaped following a ductal segment) along with systemic symptoms such as fever and myalgia.
CPM CPM Postpartum Care and Recovery 2
Which hormone is primarily responsible for triggering milk ejection (let-down) during breastfeeding?