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Which of the following antidepressant drugs is a preferred drug for clients at high risk of suicide?
- A. Tranylcypromine (Parnate)
- B. Sertraline (Zoloft)
- C. Imipramine (Tofranil)
- D. Phenelzine (Nardil)
Correct Answer: B
Rationale: SSRIs like sertraline are preferred for clients at high risk of suicide because they carry no risk of lethal overdose, unlike MAOIs (Parnate, Nardil) or tricyclic antidepressants (Tofranil).
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When the client experiences facial flushing, a throbbing headache, nausea and vomiting after consuming alcohol while taking Disulfiram (Antabuse), the nurse is aware that this is due to which of the following?
- A. A mild side effect of the medication.
- B. The intended therapeutic result.
- C. An idiosyncratic reaction
- D. A severe allergy to the medication.
Correct Answer: B
Rationale: Disulfiram causes an adverse reaction when mixed with alcohol, producing symptoms like flushing, headache, nausea, and vomiting as the intended therapeutic effect to deter alcohol consumption.
One week after beginning therapy with thiothixene (Navane), the client demonstrates muscle rigidity, a temperature of 39.5?°C, and altered mental status. The nurse should notify the physician because these symptoms are indicative of
- A. Acute dystonia
- B. Extrapyramidal side effects
- C. Neuroleptic malignant syndrome
- D. Tardive dyskinesia
Correct Answer: C
Rationale: These symptoms "muscle rigidity, high fever, and altered mental status "are classic signs of neuroleptic malignant syndrome, a potentially fatal reaction requiring immediate medical attention.
A patient is seen for frequent exacerbation of schizophrenia due to nonadherence to medication regimen. The nurse should assess for which of the following common contributors to nonadherence?
- A. The patient is symptom-free and therefore does not need to adhere to the medication regimen.
- B. The patient cannot clearly see the instructions written on the prescription bottle.
- C. The patient dislikes the weight gain associated with antipsychotic therapy.
- D. The patient sells the antipsychotics to addicts in the neighborhood.
Correct Answer: C
Rationale: Weight gain is a common side effect of antipsychotics and a frequent reason for nonadherence, as patients may struggle with body image and health concerns.
The nurse knows that the client understands the rationale for dietary restrictions when taking MAOI when the client makes which of the following statements?
- A. I am now allergic to foods that are high in the amino acid tyramine such as aged cheese, organ meats, wine, and chocolate.
- B. Certain foods will cause me to have sexual dysfunction when I take this medication.
- C. Foods that are high in tyramine will reduce the medication's effectiveness.
- D. I should avoid foods that are high in the amino acid tyramine such as aged cheese, meats, and chocolate because this drug causes the level of tyramine to go up to dangerous levels.
Correct Answer: D
Rationale: MAOIs inhibit the enzyme that breaks down tyramine, leading to increased serum tyramine levels, which can cause severe hypertension and other symptoms. The correct statement reflects understanding of the need to avoid tyramine-rich foods to prevent dangerous reactions.
Which of the following is the primary consideration with clients taking antidepressants?
- A. Decreased mobility
- B. Emotional changes
- C. Suicide
- D. Increased sleep
Correct Answer: C
Rationale: Suicide is always a primary consideration when treating clients with depression due to the risk of worsening symptoms or medication-related effects.