Nokea
When describing the action of antidepressants, the nursing instructor would include the belief that they exert their effect by causing slow adaptive changes to which of the following receptor systems?
- A. Beta-adrenergic
- B. Baroreceptors
- C. Norepinephrine
- D. Serotonin
- E. Nicotinic
Correct Answer: C,D
Rationale: Antidepressants, particularly those affecting monoamine systems, induce adaptive changes in norepinephrine and serotonin receptor systems, enhancing neurotransmission over time.
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A client is receiving lithium therapy at a health care facility. The client informs the nurse that he is taking antacids for heartburn. The nurse would be alert for which of the following due to the interaction of the two drugs?
- A. Decreased effectiveness of lithium
- B. Increased risk of lithium toxicity
- C. Increased risk for bipolar disorder
- D. Increased psychotic symptoms
Correct Answer: A
Rationale: Antacids can reduce lithium absorption, leading to decreased effectiveness of the drug.
The nurse suspects that a client is experiencing major depression based on assessment of which of the following?
- A. Feelings of hopelessness
- B. Minimal changes in weight
- C. Focused concentration
- D. Loss of energy
- E. Excessive guilt
Correct Answer: A,D,E
Rationale: Major depression is characterized by hopelessness, loss of energy, and excessive guilt, which are core diagnostic symptoms.
A nurse determines the need to administer a prescribed antidepressant in the morning because of the increased likelihood of insomnia. Which drug would this most likely be?
- A. Amitriptyline
- B. Bupropion
- C. Citalopram
- D. Paroxetine
- E. Sertraline
Correct Answer: C,D,E
Rationale: SSRIs like citalopram, paroxetine, and sertraline are more likely to cause insomnia, making morning administration preferable.
A nurse is caring for an older adult client who has been prescribed amoxapine for depression accompanied by anxiety. After administration of the drug, the nurse observes muscle rigidity and sweating. The nurse identifies these as the symptoms of neuroleptic malignant syndrome. Which of the following would the nurse do next?
- A. Suggest the client engage in exercise
- B. Get the client to drink a glass of cold water
- C. Encourage the client to breathe deeply
- D. Stop the drug and contact the physician
Correct Answer: D
Rationale: Neuroleptic malignant syndrome is a medical emergency; stopping the drug and contacting the physician is the appropriate action.
After teaching a group of nursing students about the action of antidepressants, the instructor determines that the teaching was successful when the students identify which of the following classes as exerting their effects by inhibiting reuptake of norepinephrine and serotonin?
- A. Amitriptyline
- B. Bupropion
- C. Clomipramine
- D. Duloxetine
- E. Venlafaxine
Correct Answer: A,C
Rationale: Tricyclic antidepressants like amitriptyline and clomipramine inhibit the reuptake of norepinephrine and serotonin, increasing their availability in the synaptic cleft.