Maternal Newborn Nursing Test Perinatal Mental Health 2 — Questions and Answers
Question 1: A client with postpartum depression wishes to continue breastfeeding. Which antidepressant is generally considered the safest first-line choice for breastfeeding mothers?
- Paroxetine (Paxil)
- Sertraline (Zoloft) (Correct answer)
- Fluoxetine (Prozac)
- Venlafaxine (Effexor)
Correct answer: Sertraline (Zoloft)
Sertraline (Zoloft) is the preferred SSRI for breastfeeding mothers with PPD due to minimal transfer into breast milk and the most extensive infant safety data.
Question 2: A postpartum client reports intense worry about her baby's health, inability to sleep even when the baby sleeps, and uncontrollable catastrophic thoughts. Which condition does the nurse suspect?
- Postpartum blues
- Postpartum depression
- Postpartum anxiety (Correct answer)
- Postpartum psychosis
Correct answer: Postpartum anxiety
Postpartum anxiety is characterized by excessive worry, intrusive thoughts, and inability to relax, and is clinically distinct from postpartum depression.
Question 3: Which client is at highest risk for postpartum psychosis?
- A primiparous woman with no psychiatric history
- A woman with a history of bipolar disorder (Correct answer)
- A woman who experienced gestational diabetes
- A woman who had an unplanned pregnancy
Correct answer: A woman with a history of bipolar disorder
Women with bipolar disorder have a 25–50% risk of developing postpartum psychosis, making it the strongest known risk factor for this condition.
Question 4: A nurse is providing discharge education to a postpartum client. Which statement by the client indicates correct understanding of perinatal mental health warning signs?
- I should feel back to normal within 24 hours of delivery.
- I should call my provider if I feel sad or overwhelmed for more than 2 weeks. (Correct answer)
- It is normal to hear my baby crying when the baby is not crying.
- Mood swings after birth mean I will definitely develop postpartum depression.
Correct answer: I should call my provider if I feel sad or overwhelmed for more than 2 weeks.
Persistent sadness or overwhelm lasting more than 2 weeks warrants contacting a healthcare provider as it may indicate PPD requiring treatment.
Question 5: A client reports intrusive memories of her traumatic delivery, avoids anything that reminds her of the birth, and is hypervigilant 6 weeks postpartum. Which condition does the nurse suspect?
- Postpartum depression
- Postpartum anxiety
- Postpartum PTSD (Correct answer)
- Postpartum psychosis
Correct answer: Postpartum PTSD
Intrusive memories, avoidance behaviors, and hypervigilance following a traumatic birth experience are hallmark diagnostic symptoms of postpartum PTSD.
Question 6: Which nonpharmacological intervention has the strongest evidence for treating mild-to-moderate postpartum depression?
- Yoga and meditation only
- Cognitive-behavioral therapy (CBT) (Correct answer)
- Dietary supplementation with omega-3 fatty acids
- Increased caffeine intake to reduce fatigue
Correct answer: Cognitive-behavioral therapy (CBT)
Cognitive-behavioral therapy (CBT) has the most robust evidence base among nonpharmacological treatments for mild to moderate postpartum depression.
Question 7: A client reports that her partner has become withdrawn, irritable, and disengaged since their baby's birth 8 weeks ago. What should the nurse recognize?
- This is normal adjustment behavior expected of all new fathers
- Partners can also experience postpartum depression (Correct answer)
- This behavior suggests only financial stress related to the new baby
- Partners require no mental health assessment as PPD only affects birthing parents
Correct answer: Partners can also experience postpartum depression
Research shows approximately 10% of fathers and partners experience postpartum depression, often manifesting as irritability and withdrawal rather than sadness.
