Focus on Nursing Pharmacology, 6th Edition by Amy M. Karch
Focus on Nursing Pharmacology, 6th Edition by Amy M. Karch
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Chapter 21- Antidepressant Agents
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | The mental health nursing instructor is talking with the class about depression. What deficiency does the instructor explain will result in depression? | |
| A) | Epinephrine, norepinephrine, and acetylcholine | |
| B) | Norepinephrine, dopamine, and serotonin | |
| C) | Acetylcholine, gamma-aminobutyric acid, and serotonin | |
| D) | Gamma-aminobutyric acid, dopamine, and epinephrine | |
| Ans: | B | |
| Feedback: | ||
| A current hypothesis regarding the cause of depression is a deficiency of norepinephrine, dopamine, or serotonin, which are all biogenic amines, in key areas of the brain. Acetylcholine is a neurotransmitter that communicates between nerves and muscles. Epinephrine is a catecholamine that serves as a neurotransmitter that is released in the sympathetic branch of the autonomic nervous system and can be hormones when released from cells in the adrenal medulla. Gamma-aminobutyric acid is a neurotransmitter that inhibits nerve activity and prevents over excitability or stimulation. | ||
| 2. | What is the physiological action of tricyclic antidepressants (TCAs)? | |
| A) | Inhibiting monoamine oxidase inhibitors that break down norepinephrine | |
| B) | Inhibiting nerve activity, which prevents over excitability or stimulation | |
| C) | Blocking the reuptake of serotonin, which increases the levels of norepinephrine | |
| D) | Inhibiting reuptake of norepinephrine and serotonin | |
| Ans: | D | |
| Feedback: | ||
| TCAs inhibit presynaptic reuptake of norepinephrine and serotonin, which cause an accumulation of the neurotransmitters that is thought to create the antidepressant effect. Monoamine oxidase inhibitors irreversibly inhibit monoamine oxidase that breaks down norepinephrine and serotonin. Selective serotonin reuptake inhibitors block the reuptake of serotonin; gamma-aminobutyric acid inhibits nerve activity. | ||
| 3. | A nurse is working with a 9-year-old child who exhibits signs and symptoms of obsessive-compulsive disorder (OCD). What drug will the nurse anticipate may be prescribed for the child? | |
| A) | Phenelzine (Nardil) | |
| B) | Amitriptyline (Elavil) | |
| C) | Fluvoxamine (Prozac) | |
| D) | Isocarboxazid (Marplan) | |
| Ans: | C | |
| Feedback: | ||
| Fluvoxamine is a selective serotonin reuptake inhibitor that has established pediatric dosage guidelines for the treatment of obsessive-compulsive disorder. Isocarboxazid and phenelzine are monoamine oxidase inhibitors and should be avoided in pediatric use because of the potential drug–food interactions and other serious adverse effects. Amitriptyline is also a tricyclic antidepressant not recommended for pediatric use. | ||
| 4. | A patient explains to a nurse that he had been taking amitriptyline (Elavil) for depression and that his physician changed his medication to clomipramine (Anafranil). The patient is confused and does not understand why his medication was changed. The nurse’s best response to the patient would be what? | |
| A) | “These drugs are similar but some patients respond better to one drug than another.” | |
| B) | “Did you take the amitriptyline like you should have?” | |
| C) | “Maybe the old medicine wasn’t working anymore.” | |
| D) | “Clomipramine is newer and will be much better for you.” | |
| Ans: | A | |
| Feedback: | ||
| Because all tricyclic antidepressants (TCAs) are similarly effective, the choice of which TCA depends on individual response to the drug and tolerance of adverse effects. A patient who does not respond to one TCA may respond to another drug from this class. In addition, the nurse might inform the physician of the patient’s question so the physician can explain his or her rationale for changing medications. By asking the patient if he took the medication as prescribed, the nurse is insinuating that he may not have and could damage the trusting nurse–patient relationship. The nurse has no basis for commenting that the medication might not be working or that another drug would work better. | ||
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