NCLEX-RN practice › Psychosocial Integrity
NCLEX mental health question: postpartum psychosis
Psychosocial Integrity · Multiple choice · Clinical judgment step: Take action
Client record
Partner's report
Has not slept for 3 nights. Talks about the baby being "switched" and says a voice tells them the baby must be "set free".
The baby is at home with the grandmother.
Assessment
Pacing, rapid speech, laughing inappropriately. Denies wanting to hurt anyone, then says "I have to do what the voice says".
A client 10 days postpartum is brought to the clinic by their partner. Based on the client record, what is the nurse's priority?
- A. Arrange immediate psychiatric evaluation and ensure the client is not left alone with the infant
- B. Schedule a follow-up visit in 1 week to screen for postpartum depression
- C. Teach the partner about sleep hygiene for new parents
- D. Reassure the client that baby blues are common and resolve in 2 weeks
Show the answer and rationales
Answer: A
Postpartum psychosis (delusions, hallucinations, disorganisation) usually starts in the first 2 weeks after birth and is an emergency. Keep the client and infant safe and arrange urgent psychiatric care.
- A. Correct. Correct. Hallucinations commanding harm to the infant indicate postpartum psychosis, a psychiatric emergency with a risk of infanticide and suicide. Safety for the client and infant comes first.
- B. Incorrect. Delaying care in postpartum psychosis is dangerous.
- C. Incorrect. Sleep teaching does not address an emergency involving command hallucinations.
- D. Incorrect. Baby blues do not cause hallucinations or delusions.
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