Deck 28: Antidepressants and Mood Stabilizers

Question 1

A client is ordered fluoxetine (Prozac) for mild depression. The nurse would monitor for which side effect(s)?

A) Dry mouth and eyes
B) Extrapyramidal syndrome
C) Leukopenia (decrease in WBCs)
D) Nervousness, restlessness, and insomnia

Answer 1

Nervousness, restlessness, and insomnia

Question 2

The client is due to be started on Prozac. What changes in the client's bodily functioning should the nurse anticipate?

A) Daytime drowsiness
B) Increased sodium level
C) ECG changes
D) Thyroid dysfunction

Answer 2

ECG changes

Question 3

Serum lithium level is important to monitor because it has a narrow therapeutic range. What is the reference (therapeutic) range?

A) 0.5 to 1 mEq/L
B) 0.5 to 1.5 mEq/L
C) 1.5 to 3 mEq/L
D) 2 to 2.5 mEq/L

Answer 3

0.5 to 1.5 mEq/L

Question 4

Which beverage will the nurse instruct a client taking lithium (Eskalith) for treatment of bipolar disorder to avoid?

A) Cola
B) Grape juice
C) Milk
D) Orange juice

Question 5

A client is taking fluoxetine (Prozac) for mild depressive disorder. The nurse is providing teaching and counseling. The client complains of lack of sexual desire and diminished sexual arousal. The nurse's response is based on the fact that:

A) this is a known side effect and may require intervention.
B) this side effect will go away in 1 to 2 weeks.
C) this is a side effect of depression, not of medication.
D) clients may stop the medication on days they want to have sex.

Question 6

The client has been treated with antidepressants for mild depression for 3 years. The client says her medication is no longer working, and she states that she has heard that MAO inhibitors are effective medications in treating depression. The nurse would respond based on the knowledge that:

A) there are few side effects with this medication.
B) this medication requires significant dietary restrictions.
C) this medication is relatively ineffective for depression.
D) this medication causes hypertensive crisis.

Question 7

The client is a 10 year old who is being considered for lithium therapy. What should the nurse recognize as a priority in this decision?

A) The normal adult dosage should be halved for this client.
B) Lithium is contraindicated for a client this age.
C) The standard dosage of lithium can be administered.
D) The pediatric dosage must be clarified with the pharmacist.

Question 8

Which intervention is highest priority for the care plan of a client on lithium therapy?

A) Drink 1 to 2 L of water per day.
B) Limit caffeinated beverages.
C) Eat three meals daily.
D) Suck on ice chips for dry mouth.

Question 9

A client is taking an antidepressant. What would indicate a side effect of anticholinergic origin?

A) Diarrhea
B) Increased salivation and drooling
C) Urinary retention
D) Bradycardia

Question 10

A client is ordered a tricyclic antidepressant. In monitoring this client, the nurse would assess for:

A) orthostatic hypotension.
B) secondary hypertension.
C) gastrointestinal upset.
D) bradycardia.

Question 11

A client is receiving lithium (Eskalith). Which serum electrolyte level is of greatest concern to the nurse?

A) Calcium level of 4.5 mEq/L
B) Potassium level of 3 mEq/L
C) Sodium level of 130 mEq/L
D) Potassium level of 5.7 mEq/L

Question 12

A client is on maintenance lithium therapy for bipolar disorder. The client enters the emergency department complaining of tremors. The client appears to be giddy and confused. A serum lithium level is drawn and is found to be 2 mEq/L. The nurse would anticipate:

A) holding the next dose of lithium.
B) administering the next dose of lithium at the next scheduled time.
C) administering the next dose of lithium STAT.
D) administering a dose of lithium double the normal dose.

Question 13

The client is being treated with lithium regularly. The best time for blood to be drawn from the client to check her lithium level is _____ hours after the previous dose.

A) 4 to 8
B) 6 to 10
C) 8 to 12
D) 10 to 14

Question 14

The client is on medication for hypertension as well as a monamine oxidase inhibitor. The highest priority instruction that the nurse should give to the client regarding supplements or herbal preparations is to avoid:

A) food with brewer's yeast.
B) food containing garlic.
C) ginger supplements.
D) feverfew supplements.

Question 15

A nurse is scheduling a client's medications. The client is ordered to receive a daily dose of fluoxetine (Prozac). Because of the major side effects of this medication, the nurse correctly scheduled this medication at:

A)0800.
B)1200.
C)1700.
D) 2200.

Question 16

The client has been started on Elavil. He tells the nurse that he does not take any other medication except for St. John's wort, which he has found to be mildly therapeutic. What should be the nurse's highest priority response to this information?

A) The combination of Elavil and St. John's wort can be particularly therapeutic.
B) Use of St. John's wort can cause the dosage of Elavil to require increase.
C) Use of St. John's wort can cause the Elavil to be completely ineffective.
D) The combination of St. John's wort and Elavil can produce serotonin syndrome.

Question 17

A client begins taking paroxetine (Paxil) for obsessive-compulsive disorder. Which client statement would indicate that the medication is effective?

A) "I have so much energy now, I don't need sleep."
B) "I stayed up all last night cleaning my house."
C) "I am learning to set priorities for what has to be done."
D) "I do not go out much because of the germs."

Question 18

A nurse is scheduling a client's medications. The client is ordered to receive a daily dose of amitriptyline (Elavil). Because of the major side effects of this medication, the nurse correctly schedules this medication at:

A) 8:00 AM.
B) 12:00 PM.
C) 5:00 PM.
D) 10:00 PM.

Question 19

A nurse works in an assisted living setting. The nurse is administering a selective serotonin reuptake inhibitor to an 84-year-old client. The nurse is aware that the daily dose of this medication for the older adult client would be _____ the adult dose.

A) the same as
B) higher than
C) about half
D) about one-fourth