Nokea
Clozapine, an atypical antipsychotic, is prescribed for a patient. The nurse will monitor for which adverse effect during this drug therapy?
- A. Edema
- B. Photosensitivity
- C. Hypotension
- D. Severe neutropenia
Correct Answer: D
Rationale: Atypical antipsychotics may cause severe neutropenia. The other effects are adverse effects of conventional antipsychotics.
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A patient who has been taking a selective serotonin reuptake inhibitor (SSRI) states that he -felt awful when he started taking an over-the-counter St. John's wort herbal product at home. The nurse suspects that he is experiencing serotonin syndrome. Which of these are symptoms of serotonin syndrome?
- A. Agitation
- B. Drowsiness
- C. Tremors
- D. Bradycardia
- E. Sweating
Correct Answer: A,C,E
Rationale: Common symptoms of serotonin syndrome include delirium, agitation, tachycardia, sweating, hyperreflexia, shivering, coarse tremors, and others.
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 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.
The nurse is reviewing medications used for depression. Which of these statements is a reason that selective serotonin reuptake inhibitors (SSRIs) are more widely prescribed today than tricyclic antidepressants?
- A. SSRIs have fewer sexual side effects.
- B. Unlike tricyclic antidepressants, SSRIs do not have drug-food interactions.
- C. Tricyclic antidepressants cause serious cardiac dysrhythmias if an overdose occurs.
- D. SSRIs cause a therapeutic response faster than tricyclic antidepressants.
Correct Answer: C
Rationale: Death from overdose of tricyclic antidepressants usually results from either seizures or dysrhythmias. SSRIs are associated with significantly fewer and less severe systemic adverse effects, especially anticholinergic and cardiovascular adverse effects. The other options are incorrect.
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.