Nokea
A nurse determines the need to administer a prescribed antidepressant in the morning because of the increased likelihood of insomnia. Which drug would this most likely be?
- A. Amitriptyline
- B. Bupropion
- C. Citalopram
- D. Paroxetine
- E. Sertraline
Correct Answer: C,D,E
Rationale: SSRIs like citalopram, paroxetine, and sertraline are more likely to cause insomnia, making morning administration preferable.
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After teaching a client who is prescribed lithium about the drug, the nurse determines that the teaching was successful when the client states which of limited how much I drink
- A. I need to limit how much I drink
- B. Salt is something that I need to avoid
- C. I should take the drug with food
- D. I need to call the doctor if I have a painful erection
Correct Answer: C
Rationale: Taking lithium with food reduces gastrointestinal irritation, and the client's statement reflects understanding of this instruction.
A nurse is caring for a client who has been prescribed a monoamine oxidase inhibitor (MAOI). Which of the following should the nurse instruct the client to avoid?
- A. Milk
- B. Butter
- C. Rice
- D. Yogurt
Correct Answer: D
Rationale: Yogurt contains tyramine, which can interact with MAOIs to cause hypertensive crisis; milk, butter, and rice are safe.
A nurse understands that duloxetine may be used to treat which of the following?
- A. Obsessive-compulsive disorder
- B. Depression
- C. Fibromyalgia
- D. Diabetic neuropathy
- E. Stress incontinence
Correct Answer: B,C,D,E
Rationale: Duloxetine, an SNRI, is indicated for depression, fibromyalgia, diabetic neuropathy, and stress incontinence due to its effects on serotonin and norepinephrine.
A client receiving clomipramine is given a prescription for zolpidem for sleep. The primary health care provider was unaware the client was taking clomipramine. Which of the following reactions might the nurse observe in this client?
- A. Respiratory depression
- B. CNS depression
- C. Hypertensive crisis
- D. Easy bruising
- E. Hyperglycemia
Correct Answer: A,B
Rationale: Combining clomipramine with zolpidem increases the risk of respiratory and CNS depression due to additive sedative effects.
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.