Nokea
A patient with depression asks the nurse about possible herbal supplements. Which of the following would the nurse identify as being commonly used?
- A. Valerian
- B. St. John?s wort
- C. Kava
- D. Melatonin
Correct Answer: B
Rationale: St. John?s wort is commonly used for mild to moderate depression due to its serotonergic effects. Valerian and melatonin are used for sleep, and kava for anxiety, not primarily for depression.
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After teaching a patient who is receiving phenelzine, the nurse determines that the teaching was successful when the patient states the need to avoid which of the following?
- A. Fresh cottage cheese
- B. Cooked sliced ham
- C. Tap beers
- D. Soy milk
Correct Answer: C
Rationale: Phenelzine, an MAOI, requires avoiding tyramine-rich foods and drinks like tap beers, which can cause a hypertensive crisis. Fresh cottage cheese, cooked ham, and soy milk are generally safe, as they have low tyramine content.
A nurse is performing an admission assessment. The patient complains that it has been taking larger and larger amounts of medication to get the desired effect. Based on this information, the nurse interprets this as suggesting which of the following?
- A. Desensitization
- B. Tolerance
- C. Therapeutic index
- D. Toxicity
Correct Answer: B
Rationale: Tolerance occurs when a patient requires increasing doses of a medication to achieve the same effect, as described. Desensitization is a broader term, therapeutic index measures safety margins, and toxicity indicates harmful effects, not increased dose requirements.
The nurse is caring for a 70-year-old psychiatric patient who has been prescribed a number of medications. When teaching the patient about the medications, which explanation would be most appropriate?
- A. Your stomach empties more quickly as you age; therefore, you may feel the effect of your medications almost immediately.
- B. Your entire GI system speeds up, so your medications are digested much more quickly. Therefore, it is important that you not drive after you take your medications.
- C. Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic.
- D. Because of age-related circulation changes, your body will be able to deliver therapeutic doses of your medication to select body sites more quickly.
Correct Answer: C
Rationale: Aging reduces liver function, decreasing metabolism of medications, which can lead to higher drug levels and potential toxicity in older adults. Stomach emptying slows with age, the GI system does not speed up, and circulation changes do not enhance drug delivery as described.
A nurse is preparing a continuing education presentation for a group of psychiatric-mental health nurses about various psychopharmacologic agents. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply.
- A. Fluoxetine
- B. Duloxetine
- C. Sertraline
- D. Venlafaxine
- E. Bupropion
- F. Amoxapine
Correct Answer: A,C
Rationale: SSRIs include fluoxetine (A) and sertraline (C), which selectively inhibit serotonin reuptake. Duloxetine and venlafaxine are SNRIs, bupropion is an NDRI, and amoxapine is a tricyclic antidepressant, not SSRIs.
A patient is prescribed medication for a psychiatric disorder. After 3 days, the patient tells the nurse that he or she has been constipated. Which instruction would the nurse give the patient?
- A. You need to eat more high-protein foods such as meat and peanut butter.
- B. You need to eat more fruits and vegetables and drink more water.
- C. Ask your psychiatrist to prescribe a stool softener for you.
- D. This side effect should disappear within a week or so.
Correct Answer: B
Rationale: Constipation, a common side effect of psychiatric medications, can be managed by increasing dietary fiber (fruits and vegetables) and hydration (water). High-protein foods may worsen constipation, a stool softener may be premature without dietary changes, and waiting for resolution dismisses the patient?s discomfort.