1. A 32-year-old woman presents with persistent feelings of sadness, fatigue, and anhedonia
for the past six weeks. Which of the following symptoms would support a diagnosis of
major depressive disorder?
a. Increased energy and grandiosity
b. Weight loss, insomnia, and suicidal ideation
c. Excessive worry and compulsive behaviors
d. Episodes of rage and hostility
Answer: b. Weight loss, insomnia, and suicidal ideation
Rationale: Major depressive disorder (MDD) is characterized by symptoms such as
depressed mood, anhedonia, changes in weight, sleep disturbances, fatigue, feelings of
worthlessness, difficulty concentrating, and suicidal ideation lasting at least two weeks.
Grandiosity (a), excessive worry (c), and episodes of rage (d) are more indicative of other
mental health disorders.
Substance Use Disorders in Women
2. A pregnant woman admits to frequent alcohol use. Which fetal complication is most
associated with maternal alcohol consumption during pregnancy?
a. Neural tube defects
b. Congenital syphilis
c. Fetal alcohol spectrum disorder (FASD)
d. Down syndrome
Answer: c. Fetal alcohol spectrum disorder (FASD)
Rationale: Alcohol use during pregnancy can lead to FASD, characterized by growth
retardation, facial abnormalities, and neurodevelopmental disorders. Neural tube defects
(a) are linked to folic acid deficiency, congenital syphilis (b) is caused by Treponema
pallidum, and Down syndrome (d) results from a chromosomal abnormality.
Postpartum Depression (PPD) & Anxiety
3. A new mother reports feeling overwhelmed, anxious, and tearful two weeks after giving
birth. Which of the following differentiates postpartum depression from postpartum
blues?
a. Postpartum depression lasts longer and includes feelings of worthlessness or suicidal
thoughts
b. Postpartum blues always require medication
c. Postpartum blues involve hallucinations and delusions
d. Postpartum depression resolves within two weeks without intervention
, Answer: a. Postpartum depression lasts longer and includes feelings of
worthlessness or suicidal thoughts
Rationale: Postpartum blues is a transient condition resolving within two weeks, while
postpartum depression is more severe, lasting longer, and can include suicidal ideation
and feelings of worthlessness. Hallucinations and delusions (c) suggest postpartum
psychosis.
Anxiety Disorders in Women
4. A woman with generalized anxiety disorder (GAD) asks about non-pharmacologic
management strategies. Which intervention should the nurse recommend?
a. Limit sleep to five hours per night
b. Avoid exercise as it increases anxiety
c. Practice deep breathing and mindfulness techniques
d. Increase caffeine intake for alertness
Answer: c. Practice deep breathing and mindfulness techniques
Rationale: Mindfulness, deep breathing, and relaxation techniques are evidence-based
strategies for managing GAD. Limiting sleep (a) and increasing caffeine (d) can worsen
anxiety, while avoiding exercise (b) is incorrect as physical activity reduces anxiety.
Priority & SATA (Select All That Apply) Questions
5. (Prioritization) A nurse is assessing four postpartum patients. Which patient should the
nurse prioritize for immediate intervention?
a. A patient who reports feeling sad but is bonding with her baby
b. A patient experiencing auditory hallucinations telling her to harm her newborn
c. A patient with sleep deprivation and difficulty breastfeeding
d. A patient crying frequently due to stress from motherhood
Answer: b. A patient experiencing auditory hallucinations telling her to harm her
newborn
Rationale: Postpartum psychosis is a medical emergency due to the risk of harm to the
infant or mother. The other patients may need support but are not immediate safety
concerns.
6. (SATA) Which factors increase a woman’s risk of developing postpartum depression?
(Select all that apply.)
a. History of depression or anxiety
b. Strong social support system
, c. Unplanned pregnancy
d. Previous traumatic birth experience
e. Exclusive breastfeeding
Answer: a. History of depression or anxiety, c. Unplanned pregnancy, d. Previous
traumatic birth experience
Rationale: A prior mental health history, stressors like an unplanned pregnancy, and a
traumatic birth experience all increase the risk of PPD. Strong social support (b) is
protective, and breastfeeding (e) is not a risk factor.
Depression and Suicide Risk
7. A 26-year-old woman with major depressive disorder states, "I don't think I can go on
anymore." Which is the most appropriate nursing intervention?
a. Encourage her to write in a journal about her feelings
b. Ask directly if she has thoughts of harming herself
c. Tell her to think about her family and how they would feel
d. Encourage her to engage in physical exercise
Answer: b. Ask directly if she has thoughts of harming herself
Rationale: Suicide risk assessment requires direct questioning. Journaling (a) and
exercise (d) may help with mood but are not immediate interventions. Telling her to
consider her family (c) may dismiss her feelings.
8. A woman with a history of bipolar disorder is seen in the emergency department with
agitation, rapid speech, and grandiosity. What is the priority nursing action?
a. Administer prescribed mood stabilizers
b. Provide a low-stimulation environment
c. Encourage participation in group therapy
d. Confront delusional thinking
Answer: b. Provide a low-stimulation environment
Rationale: Patients in a manic state need a calm, structured environment. Medications (a)
may be necessary but are not the first step. Group therapy (c) is inappropriate during
mania, and confronting delusions (d) can increase agitation.
Anxiety and PTSD
9. A woman with post-traumatic stress disorder (PTSD) is experiencing a flashback. What
is the priority nursing action?