Nokea
A client taking phenelzine (Nardil) is at a dinner party and has several glasses of red wine. The client begins to feel nauseated and develops a terrible headache. The client is taken to the nearest emergency department (ED). This client might be experiencing a hypertensive crisis. What other symptoms might the nurse in the ED assess if the client is experiencing a hypertensive crisis?
- A. Constricted pupils
- B. Chills
- C. Chest pain
- D. Tachycardia
- E. Stiff neck
Correct Answer: C,D,E
Rationale: Hypertensive crisis from MAOI-tyramine interactions may present with chest pain, tachycardia, and stiff neck, among other symptoms.
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Antidepressants can often have GI adverse reactions that can result in a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which of the following would be appropriate for the nurse to suggest to minimize these effects?
- A. Increase fiber intake
- B. Decrease fiber intake
- C. Increase fluid intake
- D. Decrease fluid intake
- E. Chew sugarless gum
Correct Answer: A,C,E
Rationale: Increasing fiber and fluid intake helps manage constipation, while sugarless gum alleviates dry mouth, both common antidepressant side effects.
When developing the plan of care for a client who is receiving lithium therapy, which nursing diagnosis would the nurse most likely identify as a priority?
- A. Self-Care Deficit
- B. Disturbed Sleep Pattern
- C. Imbalanced Nutrition: Less Than Body Requirements
- D. Imbalanced Fluid Volume
Correct Answer: D
Rationale: Imbalanced fluid volume is a priority due to lithium's narrow therapeutic index, where fluid status directly impacts toxicity risk.
Before administering an antidepressant to a client, which of the following would the nurse assess?
- A. Vital signs
- B. Presence of suicidal ideation
- C. Complete medical history
- D. Weight
- E. Mental status
Correct Answer: A,B,C,D,E
Rationale: A comprehensive assessment including vital signs, suicidal ideation, medical history, weight, and mental status is critical to ensure safe antidepressant administration.
The nurse is reviewing the medical records of several clients who are receiving lithium. Which of the following would the nurse identify as being at increased risk for the development of lithium toxicity?
- A. Clients receiving furosemide (Lasix)
- B. Clients experiencing diarrhea
- C. Clients with renal insufficiency
- D. Clients with liver cirrhosis
- E. Clients experiencing vomiting
Correct Answer: A,B,C,E
Rationale: Diuretics like furosemide, diarrhea, vomiting, and renal insufficiency increase lithium levels by reducing clearance, heightening toxicity risk.
A nurse would assess the client for an increase in anticholinergic symptoms if the client is prescribed cimetidine with which antidepressant?
- A. Phenelzine
- B. Sertraline
- C. Venlafaxine
- D. Clomipramine
- E. Escitalopram
Correct Answer: B,C,D,E
Rationale: Cimetidine can enhance anticholinergic effects of antidepressants like sertraline, venlafaxine, clomipramine, and escitalopram by inhibiting their metabolism.