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Test 5: Special medical issues in maternal mental health

  1. Which statement about HIV and mental illness is correct?
    • HIV-positive women are usually mentally ill
    • Pregnant HIV-positive mothers will have babies that are mentally ill
    • Mental illness is more common among HIV-positive women
    • ARV treatment usually makes mothers mentally ill
  2. What difficulties may HIV-positive mothers face after the birth of their baby?
    • Difficulties deciding how best to feed their infant
    • Difficulties in getting their partners to feed the infant
    • Difficulties in changing nappies due to loss of muscle tone
    • Difficulties in breastfeeding due to inverted nipples
  3. How can mental illness affect HIV?
    • It does not as they are separate illnesses
    • Poorer adherence to HIV management, e.g. PMTCT or ART
    • Mental wellbeing means you won’t get HIV
    • Mental illness automatically lowers the CD4 count
  4. What is substance misuse?
    • Occasional use of alcohol in a social setting
    • Use of illegal drugs on one occasion
    • Harmful use of alcohol or drugs for non-medical purposes
    • Use of any drugs for medical purposes
  5. How does substance misuse affect mental health?
    • Drugs to treat mental illness make one an addict
    • Both substance misuse and mental disease are untreatable
    • All mentally ill people need illegal substances to cope with reality
    • Mentally ill people may use alcohol or drugs in an attempt to make themselves feel better
  6. What signs of substance misuse can be confused with signs of depression?
    • Being sociable and wanting to party
    • Being thirsty and wanting to drink
    • Agitation or mood swings
    • Being responsible and taking care of one’s appearance
  7. What is the best approach to finding out if a mother is misusing substances?
    • Ask if she has used alcohol or drugs in the past
    • Be direct and ask her if she is drunk
    • Check her bag for alcohol or drugs
    • Tell her that you think she is an alcoholic and ask if this is true
  8. Which of the following statements about suicide is true?
    • Suicidal people always want to die
    • Suicide usually happens without warning
    • Suicide is an important cause of maternal mortality
    • Improvement following a suicidal crisis means that the crisis is over
  9. How common is postnatal suicide in South Africa?
    • It is the most common cause of postnatal death
    • The risk of suicide after delivery is high
    • It is only common in women who have attempted suicide before pregnancy
    • It is uncommon
  10. Which of the following is a sign that a woman may be at risk of suicide?
    • She is a person who ‘acts out’ rather than ‘talking out’ her problems
    • She is a person who enjoys others’ company but now says they are boring to her
    • She has done lots of shopping for the baby, planning for the birth
    • She has complained of putting on too much weight and is feeling uncomfortable with the pregnancy
  11. What can a health or social worker say to help a suicidal pregnant woman?
    • Think about your baby!
    • This is just your hormones, you will feel better soon
    • Do you really think that this is going to solve all the problems?
    • It sounds like you have more emotional pain than you can cope with and need help in deciding how to cope
  12. What help may a health or social worker need when she has dealt with a suicidal mother?
    • A stiff drink
    • Debriefing and support
    • Nothing special, this is what you are trained to do
    • A thank-you letter from the suicidal woman
  13. How often does postnatal psychosis occur?
    • With all women who were depressed before they gave birth
    • With all women who are bipolar when pregnant
    • 1 in 100 births
    • 1 in 1000 births
  14. Which of the following symptoms could indicate postnatal psychosis?
    • Feeling tired following a difficult delivery
    • Feeling joyful after the birth of a healthy baby
    • Feeling paranoid once the baby is breastfeeding normally
    • Feeling fearful and suspicious prior to birth when told of other women’s stories of delivery
  15. Which of the following is a treatment for postnatal psychosis?
    • Vitamin B12 injection
    • Antipsychotic medication
    • Hysterectomy
    • No treatment is available
  16. Which of the following statements about postnatal psychosis is true?
    • Women can improve quickly with the right treatment
    • Women will only improve very slowly and they need a lot of time, sometimes years to recover
    • Women who have had postnatal psychosis will never be mentally healthy
    • Women who have had postnatal psychosis will always be out of touch with reality in subsequent pregnancies
  17. How does losing a baby affect a woman’s mental health?
    • It does not because it is a physical problem only
    • She may be in shock and unable to believe what has happened
    • Her mental illness may have caused the loss
    • Blood loss from a miscarriage affects the functioning of the brain, causing mental illness
  18. How can a health worker help a woman who has just had a miscarriage?
    • Clean up quickly so that she can be left alone to grieve
    • Explain that it must have been caused by something that she ate or drank
    • Explain that as many as a third of pregnancies can miscarry, it is not her fault
    • Tell her that the fetus was probably deformed and it is better that it did not survive
  19. How can a health worker help a woman who has had a stillbirth?
    • Carry the baby out of the room quickly so that the parents don’t see it
    • Ignore the parents if they are angry as it is not your fault
    • There is nothing you can do to help, what has happened is the way the world works
    • Treat the infant gently at birth, wrap it in blankets and show respect
  20. Do health or social workers need support after helping parents cope with pregnancy loss?
    • Loss is part of life, so they must just deal with it
    • Health or social workers may need to talk to someone for debriefing
    • Loss is upsetting so they should take sick leave to grieve alone
    • They are trained professionals so they should manage the stress