Question 1

Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI),a thyroid hormone,and a multivitamin?

Accepted Answer

Morphine is the safest choice among the options for a patient on an MAOI, as meperidine can cause severe reactions with MAOIs, and ibuprofen and acetaminophen are not narcotics.

Question 2

A patient taking vilazodone has been vomiting persistently for 12 hours.The priority nursing diagnosis for this patient is:

Accepted Answer

Persistent vomiting for 12 hours can lead to fluid volume deficit, which is a potentially life-threatening condition. The priority nursing diagnosis is to address this deficit and prevent further complications. Nausea and imbalanced nutrition are important concerns, but they do not take precedence over addressing the fluid volume deficit. Altered peripheral tissue perfusion is not directly related to vomiting and is therefore not the priority nursing diagnosis in this situation.

Question 3

Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?

Accepted Answer

Assessing the patient for thoughts of suicide is the most important nursing action when providing care to a patient diagnosed with a mood disorder. Patients with mood disorders, such as depression, have an increased risk for suicide, so it is critical for the nurse to assess this risk and take appropriate actions to ensure the patient's safety. Providing supplemental feedings, assisting with activities of daily living, and offering opportunities for interaction with other patients are important aspects of care, but they are not as crucial as assessing for suicidal ideation.

Question 4

Which nursing assessment(s)is/are important before the initiation of antidepressant therapy? (Select all that apply.)

Accepted Answer

The answer of Which nursing assessment(s)is/are important before the initiation...

Question 5

Which area(s)should be addressed by the nurse when obtaining a history of a patient admitted with depression? (Select all that apply.)

Accepted Answer

These areas are important to assess in a patient with depression because they can provide insight into the patient's current symptoms, potential triggers, and risk factors.

Question 6

What is the major advantage of selective serotonin reuptake inhibitors (SSRIs)over other types of antidepressant therapy?

Accepted Answer

The major advantage of SSRIs over other types of antidepressant therapy is that they do not cause anticholinergic and cardiovascular adverse effects, which are commonly seen with other classes of antidepressants such as tricyclic antidepressants (TCAs). This makes SSRIs a safer choice, especially for older adults and patients with cardiovascular or other medical conditions. However, it should be noted that SSRIs may still have other side effects and may not be the best choice for all patients.

Question 7

What is the action of MAOIs on neurotransmitters?

Accepted Answer

MAOIs (monoamine oxidase inhibitors) work by blocking the enzyme monoamine oxidase which is responsible for the destruction of neurotransmitters such as serotonin, dopamine, and norepinephrine. By blocking their destruction, MAOIs increase the levels of these neurotransmitters in the brain, which can improve mood and alleviate symptoms of depression.

Question 8

What will the nurse include in a teaching plan for a patient with depression being treated with amitriptyline (Elavil)? (Select all that apply.)

Accepted Answer

Amitriptyline (Elavil) is a tricyclic antidepressant that can cause anticholinergic side effects such as dry mouth, hence sucking on sugar-free candy or chewing gum can help. It may also cause orthostatic hypotension, so patients should be advised to rise slowly to prevent dizziness. Alcohol and barbiturates can interact with amitriptyline, increasing sedation and other side effects, so they should be avoided. Discontinuing the medication without consulting a healthcare provider is not advised due to potential withdrawal symptoms and the risk of worsening depression. Antidepressants typically take several weeks to show a significant improvement in mood, so an immediate elevation in mood is not expected.

Question 9

The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin)for smoking cessation.Which statement by the patient would indicate the need for further teaching?

Accepted Answer

Bupropion should not be taken more often or in larger doses than prescribed. Patients should not self-adjust their dosage. If they feel the urge to smoke, they should report it to their healthcare provider for further guidance. A is accurate because the initial dose of bupropion is low and gradually increases over the course of several days. B is accurate because bupropion should be taken whole and not crushed, chewed or cut. D is incorrect because bupropion should be tapered to avoid withdrawal symptoms.

Question 10

What occurs with mania associated with bipolar disorder?

Accepted Answer

Mania associated with bipolar disorder is characterized by distinct episodes of elation, euphoria, grandiosity, hyperactivity, and decreased need for sleep.

Question 11

Which statement(s)is/are true regarding the pharmacologic actions of certain antidepressant drugs? (Select all that apply.)

Accepted Answer

B) SSRIs (Selective Serotonin Reuptake Inhibitors) work by inhibiting the reuptake of serotonin into the presynaptic cell, increasing the amount of serotonin available at the synaptic cleft to bind to the postsynaptic receptor.D) Monocyclic antidepressants like bupropion (Wellbutrin) do have a mechanism of action that is not fully understood, but they are thought to influence neurotransmitter levels by inhibiting the reuptake of norepinephrine and dopamine to a certain extent.E) SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) function by inhibiting the reuptake of both serotonin and norepinephrine, increasing their levels in the synaptic cleft and prolonging their action on the postsynaptic neuron.

Question 12

The nurse is caring for a patient who is taking a newly prescribed drug,nefazodone,for treatment of depression.Which physical assessment finding is most important for the nurse to report to the healthcare provider immediately?

Accepted Answer

Bradycardia can be a serious side effect of nefazodone, indicating potential cardiac issues that need immediate attention.

Question 13

Lithium (Eskalith)is the drug of choice for which of the following disorders?

Accepted Answer

Lithium is the drug of choice for bipolar disorders. It helps stabilize moods and prevent both manic and depressive episodes. It is not typically used for psychotic episodes, OCDs, or depressive disorders.

Question 14

On what is the choice of tricyclic antidepressants based?

Accepted Answer

The answer of On what is the choice of tricyclic...

Question 15

A patient is admitted to a long-term psychiatric setting.The MAOI medication previously prescribed is discontinued by the physician.New orders are obtained to initiate imipramine therapy.The nurse will provide the first dose of imipramine to the patient _____ the MAOI drug.

Accepted Answer

Imipramine should not be started for at least 14 days after discontinuing an MAOI medication in order to avoid the risk of serotonin syndrome, a potentially life-threatening condition that can occur when multiple drugs that affect serotonin levels are taken together. Therefore, the first dose of imipramine should be provided to the patient in 14 days following the last dose of the MAOI medication.

Question 16

Which psychological manifestation of depression will improve in response to antidepressant therapy?

Accepted Answer

The answer of Which psychological manifestation of depression will improve...

Question 17

Which food(s)containing significant amounts of tyramine will be contraindicated when a patient is on MAOI therapy? (Select all that apply.)

Accepted Answer

Beer, aged cheeses, and bananas contain significant amounts of tyramine, which can cause hypertensive crises in patients on MAOI therapy.

Question 18

A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine.Which assessment finding alerts the nurse to a potential complication?

Accepted Answer

Neck stiffness is a potential symptom of a hypertensive crisis, a dangerous complication that can occur when an MAOI is taken with foods or drinks that contain tyramine, such as pickled herring, cheese, and red wine. The other options are not typically associated with this interaction.

Question 19

The nurse is teaching a patient about medication treatment for depression.The patient asks how long it will take before sleep and appetite will begin to improve.Which response by the nurse is most accurate?

Accepted Answer

Improvements in sleep and appetite can often be some of the first benefits seen from antidepressant therapy, typically starting to improve within the first 1-2 weeks, with 1 week being a common early milestone for noticing some changes.

Question 20

Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?

Accepted Answer

Trazodone is a sedative antidepressant, and drowsiness is a common side effect. Excessive thirst (A) and hand tremors (B) are not typically associated with trazodone use. Diarrhea (D) is a possible but less common side effect.

Quiz 16: Drugs Used for Depressive and Bipolar Disorders

Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI) ,a thyroid hormone,and a multivitamin?

A patient taking vilazodone has been vomiting persistently for 12 hours.The priority nursing diagnosis for this patient is:

Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?

Which nursing assessment(s) is/are important before the initiation of antidepressant therapy? (Select all that apply.)

Which area(s) should be addressed by the nurse when obtaining a history of a patient admitted with depression? (Select all that apply.)

What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy?

What is the action of MAOIs on neurotransmitters?

What will the nurse include in a teaching plan for a patient with depression being treated with amitriptyline (Elavil) ? (Select all that apply.)

The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation.Which statement by the patient would indicate the need for further teaching?