Nokea
A patient with depression has been taking paroxetine (Paxil) for the last 3 months and has noticed improvement of symptoms. Which of the following side effects would the nurse expect the patient to report?
- A. A headache after eating wine and cheese
- B. A decrease in sexual pleasure during intimacy
- C. An intense need to move about
- D. Persistent runny nose
Correct Answer: B
Rationale: Sexual dysfunction is a common side effect of SSRIs like paroxetine due to enhanced serotonin transmission. Headaches from tyramine interactions are associated with MAOIs, not SSRIs. An intense need to move about is an extrapyramidal side effect of antipsychotics, and runny nose is not typical.
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The nurse is assessing a patient suffering a head injury as a result of an altercation with two other individuals. The patient has difficulty accurately reporting the events of the altercation and appears very emotional during the assessment. The nurse suspects which part of the brain received the greatest amount of injury?
- A. Cerebrum
- B. Cerebellum
- C. Medulla
- D. Amygdala
Correct Answer: A
Rationale: The frontal lobes of the cerebrum control the organization of thought, body movement, memories, emotions, and moral behavior. The cerebellum is the center for coordination of movements and postural adjustments. The medulla contains vital centers for respiration and cardiovascular functions. The amygdala is involved in emotional arousal and memory.
When the client asks the nurse how long it will take before the SSRI antidepressant medication will be effective, which of the following replies is most accurate and therapeutic?
- A. This is a good medication! It will be effective within 20 minutes of the first dose.
- B. You will have gradual improvement in symptoms over the next few weeks, but the changes may be so subtle that you may not notice them for a while. It is important for you to keep taking the medication.
- C. It will probably take months for the medication to work. In the meantime, you should work on improving your attitude.
- D. If you believe it will work, then it will. You have to have faith!
Correct Answer: B
Rationale: SSRIs typically take 2-3 weeks to show effectiveness, with gradual symptom improvement that may be subtle initially, requiring continued adherence.
A client on the unit suddenly cries out in fear. The nurse notices that the client's head is twisted to one side, his back is arched, and his eyes have rolled back in their sockets. The client has recently begun drug therapy with haloperidol (Haldol).
- A. Get a stat order for a serum drug level.
- B. Hold the client's medication until the symptoms subside.
- C. Place an urgent call to the client's physician.
- D. Give a PRN dose of benztropine (Cogentin).
Correct Answer: D
Rationale: The client is experiencing an acute dystonic reaction, common with high-potency antipsychotics like haloperidol. Immediate treatment with an anticholinergic like benztropine provides rapid relief.
When teaching a client about restrictions for tranylcypromine (Parnate), the nurse will tell the client to avoid which of the following foods?
- A. Broad beans
- B. Citrus fruit
- C. Egg products
- D. Fried foods
Correct Answer: A
Rationale: Broad beans (fava beans) contain tyramine, which must be avoided when taking MAOIs like tranylcypromine to prevent hypertensive crisis.
A patient with bipolar disorder takes lithium 300 mg three times daily. The nurse evaluates that the dose is appropriate when the patient reports
- A. Feeling sleepy and less energetic.
- B. Weight gain of 7 pounds in the last month.
- C. Minimum mood swings.
- D. Increased feelings of self-worth.
Correct Answer: C
Rationale: Mood-stabilizing drugs like lithium aim to minimize mood swings in bipolar disorder. Weight gain and lethargy may occur but are not indicators of appropriate dosing, and inflated self-worth is a symptom that should diminish with treatment.