Chapter 32: Antidepressants

Chapter 32: Antidepressants

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A patient taking fluoxetine (Prozac) complains of decreased sexual interest. A prescriber orders a “drug holiday.” What teaching by the nurse would best describe a “drug holiday”?

a.	Don’t take the medication on Friday and Saturday.
b.	Cut the tablet in half anytime to reduce the dosage.
c.	Take the drug every other day.
d.	Discontinue the drug for 1 week.

 

 

ANS:   A

Sexual dysfunction may be managed by having the patient take a “drug holiday” which involves discontinuing medication on Fridays and Saturdays.

Cutting the tablet in half any time to reduce the dosage is an inappropriate way to effectively manage drug administration. In addition, it does not describe a “drug holiday.”

The patient should not take the drug every other day, nor should it be discontinued for a week at a time as this will diminish the therapeutic levels of the drug, thereby minimizing the therapeutic effects. In addition, neither option describes a “drug holiday.”

 

DIF:    Cognitive Level: Application             REF:    p. 344

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

 

2. A patient comes to the clinic for a routine blood pressure check. After reviewing the patient’s medications, a nurse recognizes that the patient is taking a monoamine oxidase inhibitor. The nurse provides patient education regarding diet. Which breakfast choice made by the patient would indicate the need for additional teaching?

a.	Orange juice
b.	Carbonated beverages
c.	Fried eggs
d.	Yogurt

 

 

ANS:   D

Yogurt, aged cheeses, chocolate, red wine, and other foods with tyramine are contraindicated in patients taking monoamine oxidase inhibitors, because they can precipitate a hypertensive crisis.

Orange juice, carbonated beverages, and fried eggs are not contraindicated in patients taking monoamine oxidase inhibitors.

 

DIF:    Cognitive Level: Application             REF:    pp. 350-351

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

 

3. A nurse is reviewing a patient’s antidepressant medications. The nurse understands that the monoamine oxidase inhibitor antidepressants are typically used for which patient?

a.	A patient who has just started on antidepressants
b.	A patient who has not responded to selective serotonin reuptake inhibitors and tricyclic antidepressants
c.	A patient who has developed serotonin syndrome
d.	A patient who has difficulty sleeping

 

 

ANS:   B

The monoamine oxidase inhibitors are the second or third choice of antidepressants for most patients, after selective serotonin reuptake inhibitors and tricyclic antidepressants.

Monoamine oxidase inhibitors are not used as first-line agents for the treatment of depression.

Monoamine oxidase inhibitors are not used in patients who have serotonin syndrome or difficulty sleeping.

 

DIF:    Cognitive Level: Application             REF:    p. 349

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A nurse is assessing a patient taking a monoamine oxidase inhibitor who complains of a headache, nausea, and vomiting. The patient’s vital signs are pulse 128/minute, blood pressure 194/106, and, respiration 30/minute. The patient confesses to the nurse that she has been drinking a glass of red wine with dinner each night. The nurse would be correct to suspect the patient is experiencing which of the following health alterations?

a.	Allergic reaction
b.	Reflex tachycardia
c.	Rebound hypertension
d.	Hypertensive crisis

 

 

ANS:   D

Hypertensive crisis is characterized by hypertension, headache, tachycardia, nausea, and vomiting; it can be brought on if the patient eats foods rich in tyramine, such as aged cheese and wine, while taking a monoamine oxidase inhibitor to manage depression.

The patient’s cluster of symptoms is not indicative of an allergic reaction, reflex tachycardia, or rebound hypertension.

 

DIF:    Cognitive Level: Analysis                  REF:    pp. 349-351

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies