Chapter 15: Antidepressant Drugs

Chapter 15: Antidepressant Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. 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

 

 

ANS:  D

Secondary amines increase the availability and enhance the action of norepinephrine.

 

DIF:    Cognitive level: Understanding        REF:   pp. 156, 163-164

TOP:   Nursing process: Planning               MSC:  NCLEX: Physiologic Integrity

 

2. Nortriptyline (Aventyl) was prescribed for a 68-year-old patient diagnosed with depression and insomnia. Benefits specific to use of nortriptyline would include:

a.	regular bowel movements.
b.	improved sleep pattern.
c.	weight loss.
d.	anhedonia.

 

 

ANS:  B

Nortriptyline is a secondary amine with a good side effect profile. It has a minimal tendency to cause orthostatic hypotension, meaning the risk of falls is low. It is somewhat sedating, which is helpful to patients with insomnia. The other options are either undesirable or nonspecific outcomes.

 

DIF:    Cognitive level: Analyzing              REF:   p. 164

TOP:   Nursing process: Outcome Planning

MSC:  NCLEX: Physiologic Integrity

 

3. Priority assessments for a patient beginning amitriptyline (Elavil) include:

a.	nausea, diarrhea, and irritability.
b.	seizures, agranulocytosis, and insomnia.
c.	headache, sexual dysfunction, and weight loss.
d.	history of falls, arrhythmias, and blurred vision.

 

 

ANS:  D

Tricyclic antidepressants (TCAs) produce anticholinergic (blurred vision) and antiadrenergic (orthostatic hypotension leading to falls and arrhythmias) side effects. Gastrointestinal symptoms, sexual dysfunction, and weight variations are related to selective serotonin reuptake inhibitor (SSRI) therapy. Seizures are seen with bupropion therapy. Agranulocytosis is not considered a major problem with any of the groups of antidepressants.

 

DIF:    Cognitive level: Analyzing              REF:   pp. 164

TOP:   Nursing process: Assessment           MSC:  NCLEX: Physiologic Integrity

 

4. A 75-year-old patient with a long history of depression begins amitriptyline (Elavil) 100 mg/day. The patient also takes a diuretic daily for hypertension. The highest priority nursing diagnosis is 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 peristalsis.

 

 

ANS:  A

Amitriptyline is a TCA that has a high risk of producing orthostatic hypotension. The patient is placed at even greater risk because of older age and diuretic therapy, which reduces fluid volume. The other options are either unassociated or are remote possibilities.

 

DIF:    Cognitive level: Analyzing              REF:   p. 166             TOP:   Nursing process: Planning

MSC:  NCLEX: Physiologic Integrity