Nokea
Administering an MAOI with food containing tyramine may develop a potentially fatal condition known as which of the following?
- A. Psychosis
- B. Serotonin syndrome
- C. Hypertensive crisis
- D. Hallucinations
Correct Answer: C
Rationale: When a MAOI is combined with foods containing tyramine, another monoamine, clients are likely to develop a potentially fatal hypertensive crisis, with symptoms such as elevated blood pressure and palpitations.
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The nurse is employed in a pediatric mental health clinic. Which statement made by the client is an indication of a clinical effect of selective serotonin reuptake inhibitors (SSRI)?
- A. I have gained 25 lb in the last year.
- B. I feel that I am so sleepy all of the time.
- C. No one cares about me. I just want to die.
- D. I have a difficult time concentrating.
Correct Answer: C
Rationale: In the pediatric client, clinical evidence has stated an ominous link between SSRI use and an increased risk of suicidal thoughts and behavior. Some side effects of medication use include nausea, weight loss, insomnia, nervousness, tremor, and headache.
The nurse is caring for a client on long-standing lithium therapy for a bipolar disorder. Which component of drug therapy administration would require follow-up?
- A. A lab result showing serum lithium level of 1 mEq
- B. Client states, 'I use salt on my potato salad.'
- C. Client states, 'I take my medication each morning.'
- D. Client states, 'I only take lithium after breastfeeding.'
Correct Answer: D
Rationale: Follow-up would be required if a client reported breastfeeding and taking lithium. Lithium administered to infants through breast milk can cause toxicity; thus, breastfeeding mothers should avoid use. None of the other options require further intervention.
What is an example of sub-acute symptoms that may be observed in the older adult who may be depressed?
- A. Weight gain
- B. Lack of energy
- C. Memory loss
- D. Increased sleep
Correct Answer: B
Rationale: The examples of sub-acute symptoms that may be observed in the older adult who may be depressed are loss of appetite, trouble sleeping, lack of energy, and weight loss.
The nurse is caring for a middle-aged client prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect of medication therapy leads to the most common cause of noncompliance?
- A. Hypertension
- B. Dizziness
- C. Hallucinations
- D. Sexual dysfunction
Correct Answer: D
Rationale: When taking a selective serotonin reuptake inhibitor, the nurse must instruct on the most common side effect, which is sexual dysfunction. Unfortunately, sexual dysfunction (reduced desire for sex, erectile and ejaculatory dysfunction, and the inability to orgasm) is a frequent and undesirable side effect that leads to noncompliance in medication regimen. The other side effects are not associated with use of SSRIs.
Which nursing consideration is most important when administering medications to a suicidal client?
- A. Do not leave any syringe unattended.
- B. Watch the client place all pills in the mouth.
- C. View the inside of the mouth to make sure that all medications are swallowed.
- D. Remove all medications and medication administration equipment from client area.
Correct Answer: C
Rationale: It is most important for the nurse to view the inside of the mouth when administering medications. This is done by inspecting the client's mouth and under the tongue because clients may 'cheek' medications to stockpile and use the medications. Not leaving syringes unattended, watching the client place the pills in their mouth, and removing all medications and equipment are all appropriate nursing actions, but the most important is not allowing the opportunity for the client to overdose on medications.