Deck 15: Antidepressant Drugs

Question 1

A patient prescribed fluoxetine is being changed to tranylcypromine. The nurse provides education on this change that will include a time lapse between the last dose of fluoxetine and the first dose of tranylcypromine of at least how long?

A) 7 days.
B) 14 days.
C) 3 weeks.
D) 6 weeks.

Answer 1

6 weeks.

Question 2

What is the nurse's priority assessment for a patient taking an antidepressant medication?

A) Presence of suicidal ideations
B) Presence of antiadrenergic side effects
C) Presence of anticholinergic side effects
D) Presence of symptoms of sexual dysfunction

Answer 2

Presence of suicidal ideations

Question 3

A patient tells the nurse, "I've stopped taking sertraline because the drug made me impotent. Which statement by the nurse will provide the best patient support?

A) "Your doctor still wants you to continue taking your medication."
B) "Have you talked with your therapist regarding your feelings about sex?"
C) "Let's talk with your doctor. Changing your medication might be a possibility."
D) "Our priority is to treat your depression. Impotence can be addressed in a few weeks."

Answer 3

"Let's talk with your doctor. Changing your medication might be a possibility."

Question 4

A patient diagnosed with depression is prescribed the tricyclic antidepressant (TCA) bupropion. What is the benefit of this medication for nonhospitalized patients?

A) It has antianxiety properties as well as antidepressant effects.
B) It lowers the seizure threshold to a lesser extent than TCAs.
C) There is reduced potential for lethal overdose.
D) It stimulates appetite and weight gain.

Question 5

What is the nurse's highest priority when caring for a patient after a tricyclic antidepressant (TCA) overdose?

A) Frequently monitor blood pressure and heart rate/rhythm.
B) Monitor for skin rashes, particularly on the torso.
C) Measure and record intake and output every 12 hours.
D) Institute cooling blankets for hyperthermia.

Question 6

Evaluation of a patient's response after 1 week of tricyclic antidepressant (TCA) therapy would be expected to focus on what assessment question? (Select all that apply.)

A) "Have you noticed a change in your sleep patterns?"
B) "Has your appetite improved?"
C) "Are you still having suicidal ideations?"
D) "Are you feeling less depressed?"
E) "Would you say you are less anxious now?"

Question 7

Which assessment finding warrants the nurse's priority attention when caring for a patient prescribed a selective serotonin reuptake inhibitor (SSRI)? (Select all that apply.)

A) Hyperthermia
B) Frontal headache
C) Confusion
D) Photophobia
E) Agitation

Question 8

When teaching about the monoamine oxidase inhibitor (MAOI) tranylcypromine, the nurse should consider it a priority to provide what information?

A) A list of tyramine-rich foods
B) A warning to avoid direct sunlight
C) Instructions to manage fever with acetaminophen
D) Directions to report dry mouth and blurred vision

Question 9

A secondary amine tricyclic antidepressant is prescribed for a patient. The medication will significantly increase the availability of which neurotransmitter?

A) GABA
B) Glutamate
C) Serotonin
D) Norepinephrine

Question 10

What are the priority history assessments for a patient beginning amitriptyline therapy? (Select all that apply.)

A) Agranulocytosis
B) Seizures
C) Sexual dysfunction
D) Orthostatic hypotension
E) Blurred vision

Question 11

A tricyclic antidepressant (TCA) is prescribed for a patient newly diagnosed with depression. What information should be included in patient teaching?

A) "Take this medication on an empty stomach."
B) "Do not eat aged cheese while using this medication."
C) "You might experience sweating, tremors, and excessive urination."
D) "It might be 2 weeks or more before you notice the effects of this medicine."

Question 12

A 75-year-old patient with a long history of depression begins amitriptyline 100 mg/day. The patient also takes a diuretic daily for hypertension. What is the highest priority nursing diagnosis this patient is at risk for?

A) Falls related to dizziness and orthostatic hypotension.
B) Ineffective thermoregulation related to anhidrosis.
C) Infection related to suppressed white blood cell count.
D) Constipation related to slowed gastrointestinal peristalsis.

Question 13

A patient prescribed phenelzine reports a sudden headache and palpitations. What is the nurse's initial intervention when observing the patient demonstrating dilated pupils and diaphoresis?

A) Assess for cogwheel rigidity.
B) Notify the health care provider.
C) Assess the patient's blood pressure.
D) Withhold the morning dose of phenelzine.

Question 14

A nurse teaches a patient taking a monoamine oxidase inhibitor (MAOI) about important dietary guidelines. Which nutritional choices by the patient indicate that the teaching was effective? (Select all that apply.)

A) Sausage
B) Avocados
C) Pork chops
D) Strawberries
E) Chocolate chip cookies

Question 15

A pregnant patient took selective serotonin reuptake inhibitors (SSRIs) during the third trimester of pregnancy. The newborn will be carefully assessed for which neonatal complication?

A) Temperature dysregulation
B) Serotonin syndrome
C) Seizure disorder
D) Diabetes

Question 16

A depressed patient preparing for discharge is prescribed desipramine and will have follow-up outpatient visits. The patient reports, "Why did they gave me only a 1-week supply of my medicine?" Select the nurse's best reply.

A) "Federal law limits the amount you may be given at any one time."
B) "It will save you money if the drug doesn't work well for your symptoms."
C) "This is a way of ensuring that you will come in for your follow-up appointment."
D) "Prescribing a small amount of drug addresses our concerns for your continuing safety."

Question 17

Why do patients taking tricyclic antidepressants (TCAs) exhibit more side effects than patients taking selective serotonin reuptake inhibitors (SSRIs)?

A) TCAs inhibit reuptake of norepinephrine and serotonin.
B) TCAs selectively inhibit dopamine reuptake.
C) TCAs selectively block serotonin uptake.
D) TCAs block enzymatic breakdown.

Question 18

A patient diagnosed with depression has taken a selective serotonin reuptake inhibitor (SSRI) for 1 month. The nurse should use direct questions to evaluate which potential side effect?

A) Aggressive impulses
B) Sexual dysfunction
C) Paranoid delusions
D) Weight gain

Question 19

Nortriptyline was prescribed for a 68-year-old patient diagnosed with depression and insomnia. What assessment question should the nurse ask to determine the effectiveness of nortriptyline?

A) "Are you having regular bowel movements?"
B) "Are you no longer experiencing insomnia?"
C) "Have you been successful with weight loss?"
D) "Would you say you are concentrating better?"