Nokea
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.
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The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?
- A. Grapefruit juice
- B. Salami sandwich
- C. Scrambled eggs
- D. Pancakes and maple syrup
Correct Answer: B
Rationale: Cured meats such as salami contain tyramine. Patients who are taking MAOIs need to avoid tyramine-containing foods because of a severe hypertensive reaction that may occur. The other foods listed do not contain tyramine.
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.
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.
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.
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.