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A patient has been admitted to the emergency department with a suspected overdose of a tricyclic antidepressant. The nurse will prepare for what immediate concern?
- A. Hypertension
- B. Renal failure
- C. Cardiac dysrhythmias
- D. Gastrointestinal bleeding
Correct Answer: C
Rationale: Tricyclic antidepressant overdoses are notoriously lethal. The primary organ systems affected are the central nervous system and the cardiovascular system, and death usually results from either seizures or dysrhythmias.
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A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine for 6 months. The patient wants to go to a party and asks the nurse, -Will just one beer be a problem? I Which advice from the nurse is correct?
- A. You can drink beer as long as you have a designated driver.
- B. Now that you've been on the drug for 6 months, there will be no further dietary restrictions.
- C. If you begin to experience a throbbing headache, rapid pulse, or nausea, you'll need to stop drinking.
- D. You need to avoid all foods that contain tyramine, including beer, while taking this medication.
Correct Answer: D
Rationale: Foods containing tyramine, such as beer and aged cheeses, should be avoided while a patient is taking an MAOI. Drinking beer while taking an MAOI may precipitate a dangerous hypertensive crisis. The other options are incorrect.
A patient has been taking the selective serotonin reuptake inhibitor (SSRI) sertraline for about 6 months. At a recent visit, she tells the nurse that she has been interested in herbal therapies and wants to start taking St. John's wort. Which response by the nurse is appropriate?
- A. That should be no problem.
- B. Good idea! Hopefully you'll be able to stop taking the Zoloft.
- C. Be sure to stop taking the herb if you notice a change in side effects.
- D. Taking St. John's wort with this medication may cause severe interactions and is not recommended.
Correct Answer: D
Rationale: The herbal product St. John's wort must not be used with SSRIs because of the potential for serotonin syndrome. The other responses by the nurse are inappropriate.
When a patient is receiving a second-generation antipsychotic drug, such as risperidone, the nurse will monitor for which therapeutic effect?
- A. Fewer panic attacks
- B. Decreased paranoia and delusions
- C. Decreased feeling of hopelessness
- D. Improved tardive dyskinesia
Correct Answer: B
Rationale: The therapeutic effects of the antipsychotic drugs include improvement in mood and affect, and alleviation or decrease in psychotic symptoms (decrease in hallucinations, paranoia, delusions, garbled speech). Tardive dyskinesia is a potential adverse effect of these drugs. The other options are incorrect.
The wife of a patient who has been diagnosed with depression calls the office and says, -It's been an entire week since he started that new medicine for his depression, and there's no change! The medicine is not working! What is the nurse's best response?
- A. The medication may not be effective for him. He may need to try another type.
- B. It may take 4 to 6 weeks to notice any therapeutic effects. Let's wait a little longer to see how he does.
- C. It sounds like the dose is not high enough. I'll check about increasing the dosage.
- D. Some patients never recover from depression. He may not respond to this therapy.
Correct Answer: B
Rationale: Patients and family members need to be told that antidepressant drugs commonly require several weeks before full therapeutic effects are noted. The other answers are incorrect.
A patient with the diagnosis of schizophrenia is hospitalized and is taking a phenothiazine drug. Which statement by this patient indicates that he is experiencing a common adverse effect of phenothiazines?
- A. I can't sleep at night
- B. I feel hungry all the time.
- C. Look at how red my hands are.
- D. My mouth has been so dry lately.
Correct Answer: D
Rationale: Phenothiazines produce anticholinergic-like adverse effects of dry mouth, urinary hesitancy, and constipation.