Obstetric Nurse Test Obstetric Nurse Postpartum Maternal Care 4 — Questions and Answers
Question 1: A nurse is caring for a postpartum patient with postpartum depression (PPD). Which statement by the patient is most concerning and requires priority intervention?
- 'I feel sad and cry most of the day.'
- 'I don't feel the bond with my baby I expected.'
- 'I sometimes think everyone would be better off without me.' (Correct answer)
- 'I feel anxious and overwhelmed by caring for my baby.'
Correct answer: 'I sometimes think everyone would be better off without me.'
Passive suicidal ideation ('everyone would be better off without me') indicates severe PPD and requires immediate psychiatric evaluation.
Question 2: The Edinburgh Postnatal Depression Scale (EPDS) is used to screen for postpartum depression. A score of 13 or above indicates what?
- Normal postpartum adjustment
- Possible postpartum depression requiring further evaluation (Correct answer)
- Mild baby blues, no intervention needed
- Confirmed diagnosis of postpartum psychosis
Correct answer: Possible postpartum depression requiring further evaluation
An EPDS score of 13 or above suggests probable postpartum depression and warrants further clinical evaluation and intervention.
Question 3: Which teaching point is most important for a postpartum patient being discharged home regarding her lochia?
- Lochia should stop completely by day 5 postpartum
- Report foul-smelling lochia, which may indicate infection (Correct answer)
- Lochia rubra lasting more than 3 days is abnormal
- Lochia should always be bright red for the first 2 weeks
Correct answer: Report foul-smelling lochia, which may indicate infection
Foul-smelling lochia is a key warning sign of postpartum endometritis and patients should be taught to report it promptly.
Question 4: A postpartum patient asks when she can resume sexual intercourse. What is the standard nursing guidance?
- After her first postpartum menstrual period
- When lochia has completely stopped, usually by week 2
- Typically after the 6-week postpartum visit and provider clearance (Correct answer)
- After sutures from any perineal laceration are removed
Correct answer: Typically after the 6-week postpartum visit and provider clearance
Sexual intercourse is generally recommended to resume after the 6-week postpartum checkup and provider approval to ensure adequate healing.
Question 5: Which nursing action is the priority when caring for a postpartum patient with suspected uterine subinvolution?
- Encourage early ambulation
- Assess for signs of retained placental fragments or infection (Correct answer)
- Apply a cold compress to the fundus
- Restrict oral intake to clear liquids
Correct answer: Assess for signs of retained placental fragments or infection
Uterine subinvolution is commonly caused by retained placental fragments or infection, and these causes must be assessed and addressed promptly.
Question 6: A postpartum patient is prescribed methylergonovine (Methergine). Which condition is a contraindication to this medication?
- Postpartum hemorrhage due to uterine atony
- Hypertension (Correct answer)
- Uterine subinvolution
- Retained placental fragments
Correct answer: Hypertension
Methylergonovine causes vasoconstriction and is contraindicated in patients with hypertension because it can cause severe elevation of blood pressure.
Question 7: A postpartum patient who is not breastfeeding asks when her menstrual cycle will return. What is the most accurate response?
- Menstruation typically returns within 2–3 weeks postpartum
- Menstruation typically returns within 6–8 weeks postpartum (Correct answer)
- Menstruation will not return for at least 6 months
- Menstruation return depends entirely on contraception use
Correct answer: Menstruation typically returns within 6–8 weeks postpartum
In non-breastfeeding women, menstruation typically resumes within 6–8 weeks postpartum as hormone levels return to pre-pregnancy baseline.
Obstetric Nurse Test Obstetric Nurse Postpartum Maternal Care 4
A nurse is caring for a postpartum patient with postpartum depression (PPD).
Which statement by the patient is most concerning and requires priority intervention?