Nokea
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.
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Before beginning a patient's therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class?
- A. Aspirin
- B. Warfarin
- C. Diuretics
- D. Nonsteroidal anti-inflammatory drugs
Correct Answer: B
Rationale: Use of selective serotonin reuptake inhibitor (SSRI) antidepressants with warfarin results in an increased anticoagulant effect. SSRI antidepressants do not interact with the other drugs or drug classes listed.
A patient has been taking lithium for 1 year, and the most recent lithium level is 0.5 mEq/L. What concern will the nurse have, if any?
- A. The level is too low, indicating a subtherapeutic dose.
- B. The level is within the therapeutic range.
- C. The level is too high, indicating a toxic dose.
- D. No concerns, as lithium levels do not need monitoring.
Correct Answer: A
Rationale: Therapeutic lithium levels are typically between 0.6 and 1.2 mEq/L for maintenance therapy. A level of 0.5 mEq/L is subtherapeutic, which may reduce the effectiveness of the treatment. Monitoring lithium levels is critical due to its narrow therapeutic index.
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.
The nurse reads in the patient's medication history that the patient is taking buspirone. The nurse interprets that the patient may have which disorder?
- A. Anxiety disorder
- B. Depression
- C. Schizophrenia
- D. Bipolar disorder
Correct Answer: A
Rationale: Buspirone is indicated for the treatment of anxiety disorders, not depression, schizophrenia, or bipolar disorder.
A patient has been taking haloperidol for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects?
- A. Increased paranoia
- B. Drowsiness and dizziness
- C. Involuntary motor symptoms
- D. Dry mouth and constipation
Correct Answer: C
Rationale: Extrapyramidal symptoms are manifested by involuntary motor symptoms, and the incidence of such symptoms is high during haloperidol therapy. The other options are incorrect.