Deck 23: Antidepressants and Mood Stabilizers

Question 1

A patient who has been diagnosed with social anxiety disorder will begin taking venlafaxine (Effexor).The nurse who performs a medication and dietary history will be concerned about ingestion of which substance or drug?

A) Coffee
B) Grapefruit juice
C) Oral hypoglycemic drug
D) St. John's wort

Answer 1

St. John's wort

Question 2

A patient who has a history of migraine headaches is diagnosed with bipolar disorder.The nurse might expect the provider to order which medication for this patient?

A) Carbamazepine (Tegretol)
B) Divalproex (Valproate)
C) Lamotrigine (Lamictal)
D) Lithium citrate (Eskalith)

Answer 2

Divalproex (Valproate)

Question 3

The nurse is preparing to administer paroxetine HCl (Paxil)to a 70-year-old patient.The nurse understands that this patient may require

A) a decreased dose.
B) an increased dose.
C) every other day dosing.
D) more frequent dosing.

Answer 3

a decreased dose.

Question 4

The nurse is preparing to administer a dose of lithium (Lithobid)to a patient who has been taking the drug as maintenance therapy to treat bipolar disorder.The nurse assesses the patient and notes tremors and confusion.The patient's latest serum lithium level was 2 mEq/L.Which action will the nurse take?

A) Administer the dose.
B) Hold the dose and notify the provider.
C) Request an order for a higher dose.
D) Request an order for a lower dose.

Question 5

A patient who is taking amitriptyline (Elavil)reports constipation and dry mouth.The nurse will give the patient which instruction?

A) Increase fluid intake.
B) Notify the provider.
C) Request another antidepressant.
D) Stop taking the medication immediately.

Question 6

A patient has been taking paroxetine (Paxil)20 mg per day for 2 weeks and reports headaches,nervousness,and poor appetite.Which action will the nurse take?

A) Counsel the patient to take the medication with food.
B) Reassure the patient that these side effects will decrease over time.
C) Suggest that the patient discuss a lower dose with the provider.
D) Tell the patient to stop taking the drug and contact the provider.

Question 7

A patient who has been diagnosed with a major depression disorder has been ordered to take doxepin (Sinequan).The nurse will contact the provider if the patient's medical history reveals a history of which condition?

A) Asthma
B) Glaucoma
C) Hypertension
D) Hypoglycemia

Question 8

The nurse is teaching a patient about foods to avoid when taking isocarboxazid (Marplan).Which foods will the nurse instruct the patient to avoid?

A) Bananas
B) Bread
C) Eggs
D) Red wine
E) Sausage
F) Yogurt

Question 9

A patient who has recently begun taking lithium (Lithobid)calls the clinic to report nausea,vomiting,anorexia,and drowsiness.What will the nurse do next?

A) Contact the provider to obtain an order for a serum lithium level.
B) Reassure the patient that these symptoms are common and transient.
C) Tell the patient that the lithium dose is probably too low.
D) Tell the patient to stop taking the medication immediately.

Question 10

A patient has been taking sertraline (Zoloft)20 mg/mL oral concentrate,1 mL daily for several weeks and reports being unable to sleep well.What will the nurse do next?

A) Ask the patient what time of day the medication is taken.
B) Counsel the patient to take the medication at bedtime.
C) Recommend asking the provider about weekly dosing.
D) Suggest that the patient request a lower dose.

Question 11

A patient who has had a loss of interest in most activities,weight loss,and insomnia is diagnosed with a major depressive disorder and will begin taking fluoxetine (Prozac)daily.The patient asks about the weekly dosing that a family member follows.What will the nurse tell the patient about a weekly dosing regimen?

A) It can be used after daily maintenance dosing proves effective and safe.
B) It is used after a trial of tricyclic antidepressant medication fails.
C) It is not effective for this type of depression and its symptoms.
D) It will cause more adverse effects than daily dosing regimens.

Question 12

A patient who takes a monoamine oxidase (MAO)inhibitor asks the nurse about taking over-the-counter medications to treat cold symptoms.Which medication will the nurse counsel the patient to avoid while taking an MAO inhibitor?

A) Diphenhydramine
B) Guaifenesin
C) Pseudoephedrine
D) Saline nasal spray

Question 13

A patient who has been taking a monoamine oxidase (MAO)inhibitor for several months will begin taking amoxapine (Asendin)instead of the MAO inhibitor.The nurse will counsel the patient to begin taking the amoxapine

A) along with the MAO inhibitor for several months.
B) at least 14 days after discontinuing the MAO inhibitor.
C) the day after the last dose of the MAO inhibitor.
D) while withdrawing the MAO inhibitor over several weeks.

Question 14

The nurse assesses a patient who is taking lithium (Lithobid)and notes a large output of clear,dilute urine.The nurse suspects which cause for this finding?

A) Cardiovascular complications
B) Expected lithium side effects
C) Increased mania
D) Lithium toxicity

Question 15

The nurse is teaching a patient who will begin taking doxepin (Sinequan)to treat depression.Which statement by the patient indicates a need for further teaching?

A) "I should expect results within 2 to 4 weeks."
B) "I should increase fluids and fiber while taking this medication."
C) "I should take care when rising from a sitting to standing position."
D) "I will take the medication in the morning before breakfast."

Question 16

A nurse performs a medication history on a newly admitted patient.The patient reports taking amitriptyline (Elavil)75 mg at bedtime for 6 weeks to treat depression.The patient reports having continued fatigue,lack of energy,and depressed mood.The nurse will contact the provider to discuss which intervention?

A) Beginning to taper the amitriptyline
B) Changing to a morning dose schedule
C) Giving the amitriptyline twice daily
D) Increasing the dose of amitriptyline

Question 17

A male patient has been taking venlafaxine (Effexor)37.5 mg daily for 2 weeks and reports ejaculation dysfunction and urinary retention.What action will the nurse take?

A) Contact the provider to discuss decreasing the dose.
B) Reassure the patient that these are common side effects.
C) Report potential serious adverse effects to the provider.
D) Withhold the dose until the provider is notified.

Question 18

A patient who has a major depressive disorder has been taking fluoxetine (Prozac)20 mg daily for 3 months and reports improved mood,less fatigue,and an increased ability to concentrate.The patient's side effects have diminished.What will the nurse counsel this patient to discuss with the provider?

A) Changing to once-weekly dosing
B) Decreasing the dose to 10 mg daily
C) Discontinuing the medication
D) Increasing the dose to 30 mg daily

Question 19

The nurse provides teaching for a patient who will begin taking lithium (Lithobid).Which statement by the patient indicates understanding of the teaching?

A) "I may drink tea or cola but not coffee."
B) "I may stop taking the drug when mania symptoms subside."
C) "I should consume a sodium-restricted diet."
D) "I should drink 2 to 3 liters of fluid each day."

Question 20

A patient who has been diagnosed with depression asks why the provider has not ordered a monoamine oxidase (MAO)inhibitor to treat the disorder.The nurse will explain to the patient that MAO inhibitors

A) are more expensive than other antidepressants.
B) are no longer approved for treating depression.
C) can cause profound hypotension.
D) require strict dietary restrictions.