The nurse is making a home visit three weeks postpartum. The nurse suspects the client is experiencing postpartum depression when she makes which of the following statements?
“I am really tired, and look forward to someday sleeping all night again.”.
“I have been getting a headache every once in a while, but it subsides when I take Tylenol.”.
“I feel like I am crying for no apparent reason, and I feel sad every day.”.
“I am feeling restless a lot lately.”.
The Correct Answer is C
Choice A rationale
Feeling tired and wanting to sleep longer postpartum is common due to disrupted sleep from infant care, but it doesn't specifically indicate postpartum depression, which involves significant mood and emotional changes.
Choice B rationale
Occasional headaches postpartum can result from hormonal changes or stress, resolving with analgesics like Tylenol, and are not indicative of postpartum depression without associated mood disturbances like sadness or crying episodes.
Choice C rationale
Persistent crying and daily sadness are hallmark signs of postpartum depression, linked to hormonal imbalances, disrupted serotonin regulation, and social or emotional factors affecting maternal mental health postpartum.
Choice D rationale
Restlessness may be attributed to anxiety, but it alone doesn't conclusively diagnose postpartum depression, which involves deeper and more pervasive mood changes such as sadness or emotional withdrawal.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A respiratory rate of 75 breaths per minute exceeds the normal range of 30 to 60 breaths per minute in neonates. Tachypnea indicates distress, which necessitates immediate intervention to prevent complications.
Choice B rationale
A temperature of 96.5°F is below the normal neonatal range of 97.7°F to 99.5°F, suggesting hypothermia. This can impair enzyme activity, oxygen delivery, and thermoregulatory functions, requiring prompt warming measures.
Choice C rationale
Sucking or licking of the nipples reflects a positive response in kangaroo care, indicative of improved thermoregulation and bonding. This natural behavior also suggests a healthy neonate capable of initiating feeding.
Choice D rationale
Nasal flaring is a sign of respiratory distress, typically indicating increased effort to meet oxygen demands. This would not be considered a positive outcome and requires immediate evaluation and intervention.
Correct Answer is C
Explanation
Choice A rationale
Respiratory depression is less common in myelomeningocele unless secondary to severe neurological anomalies. It is not the primary risk mediator in this congenital condition.
Choice B rationale
Decreased cardiac output is not directly associated with myelomeningocele. This condition primarily affects the spinal cord and surrounding tissues rather than cardiovascular function.
Choice C rationale
Infection risk is high due to exposed neural tissue, making it the most significant concern. Infection can lead to meningitis, sepsis, and neurological deterioration if not properly managed.
Choice D rationale
Neurological damage is inherent to myelomeningocele but does not act as an external risk mediator. The focus is on preventing additional risks like infections to improve outcomes.
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