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When a patient with major depressive disorder is started on fluoxetine, what is the most important side effect for the nurse to monitor?
- A. Weight gain
- B. Suicidal ideation
- C. Hypertension
- D. Hyperglycemia
Correct Answer: B
Rationale: When initiating fluoxetine therapy in a patient with major depressive disorder, monitoring for suicidal ideation is crucial due to the increased risk of suicidal thoughts or behaviors that can occur, especially in the initial phase of treatment. This close monitoring is essential to ensure patient safety and intervene promptly if such symptoms arise. Weight gain, hypertension, and hyperglycemia are potential side effects of some medications used to treat depression, but suicidal ideation is the most critical and immediate side effect to monitor for when starting fluoxetine.
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When assessing a patient with schizophrenia who exhibits disorganized speech and behavior, these symptoms are classified as:
- A. Positive symptoms
- B. Negative symptoms
- C. Cognitive symptoms
- D. Mood symptoms
Correct Answer: A
Rationale: Positive symptoms in schizophrenia refer to excesses or distortions in normal behavior and include symptoms like hallucinations, delusions, and disorganized speech and behavior. Disorganized speech and behavior are considered positive symptoms because they represent an excess or distortion of normal functions. Negative symptoms involve deficits in normal behavior, cognitive symptoms affect thinking processes, and mood symptoms relate to emotional experiences. Therefore, in this scenario, the disorganized speech and behavior exhibited by the patient are classified as positive symptoms.
In a patient with schizophrenia, which of the following symptoms would indicate a poor prognosis?
- A. Auditory hallucinations
- B. Paranoia
- C. Flat affect
- D. Delusions of grandeur
Correct Answer: C
Rationale: A flat affect, characterized by a lack of emotional expression, is often linked to a poorer prognosis in schizophrenia. It can hinder social interactions and affect the individual's ability to engage in therapy or express emotions, thereby impacting the overall treatment outcomes. Auditory hallucinations (Choice A) and delusions of grandeur (Choice D) are common symptoms in schizophrenia but may not always indicate a poor prognosis. Paranoia (Choice B) can also vary in its impact on prognosis depending on the individual and the severity of the symptom.
A patient with major depressive disorder is prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse should educate the patient about which potential side effect?
- A. Hypertension
- B. Diarrhea
- C. Sexual dysfunction
- D. Weight gain
Correct Answer: C
Rationale: Corrected Rationale: Selective serotonin reuptake inhibitors (SSRIs) are commonly associated with sexual dysfunction as a side effect. This adverse effect includes decreased libido, delayed orgasm, and erectile dysfunction. Educating patients about this potential side effect is crucial to manage expectations and consider appropriate interventions. Choices A, B, and D are incorrect as SSRIs are not typically associated with hypertension, diarrhea, or weight gain as common side effects.
A patient with major depressive disorder is started on venlafaxine. Which class of antidepressant does this medication belong to?
- A. Selective serotonin reuptake inhibitors (SSRIs)
- B. Tricyclic antidepressants (TCAs)
- C. Monoamine oxidase inhibitors (MAOIs)
- D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Correct Answer: D
Rationale: Venlafaxine is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs work by increasing the levels of both serotonin and norepinephrine in the brain, which helps alleviate symptoms of depression. This mechanism of action distinguishes SNRIs from other classes of antidepressants like SSRIs, TCAs, and MAOIs, making venlafaxine an effective choice for patients with major depressive disorder. Therefore, the correct answer is D. Choice A, SSRIs, primarily target serotonin reuptake only. Choice B, TCAs, work by inhibiting the reuptake of norepinephrine and serotonin, but they are not as selective as SNRIs. Choice C, MAOIs, inhibit the enzyme monoamine oxidase, leading to increased levels of various neurotransmitters, including serotonin and norepinephrine, but they are typically used as second- or third-line agents due to dietary restrictions and potential side effects.
Which therapeutic approach is most effective for managing obsessive-compulsive disorder (OCD)?
- A. Cognitive-behavioral therapy
- B. Psychoanalysis
- C. Medication management
- D. Group therapy
Correct Answer: A
Rationale: Cognitive-behavioral therapy (CBT), especially exposure and response prevention, is considered the most effective therapeutic approach for managing obsessive-compulsive disorder (OCD). CBT helps individuals identify and modify their distorted beliefs and behaviors related to OCD, while exposure and response prevention specifically target the core symptoms of OCD by gradually exposing the individual to feared stimuli and preventing compulsive responses. While medication management can be used as an adjunct to therapy, CBT has shown to have long-lasting benefits in reducing OCD symptoms and improving the overall quality of life. Psychoanalysis focuses more on exploring unconscious conflicts and childhood experiences, which may not be as effective for OCD. Group therapy can be beneficial as a supplemental treatment but is not typically as effective as individual CBT tailored to the specific needs of the individual with OCD.