Question 1

A TCA is prescribed for a patient newly diagnosed with depression. What information should be included in patient teaching?

Accepted Answer

A)   "Take this medication on an empty stomach."
B)   "Do not eat aged cheese while using this medication."
C)   "You might experience sweating, tremors, and excessive urination."
D)   "It might be 2 weeks or more before you notice the effects of this medicine." D

Question 2

A patient diagnosed with depression who has reported vague suicidal ideation will stay at home, have close family supervision, and make weekly visits to the health care provider. Bupropion (Wellbutrin) is prescribed. What is the benefit of bupropion in this scenario?

Accepted Answer

A)   It has antianxiety properties as well as antidepressant effects.
B)   It lowers the seizure threshold to a lesser extent than TCAs.
C)   There is reduced potential for lethal overdose.
D)   It stimulates appetite and weight gain. C

Question 3

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

Accepted Answer

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. D

Question 4

A depressed patient prepares for discharge. The patient is prescribed desipramine (Norpramin) and will have outpatient visits. The patient reports, "They gave me only a 1-week supply of my medicine." Select the nurse's best reply.

Accepted Answer

A)   "Federal law limits the amount you may be given at any one time."
B)   "It will save you money if the drug doesn't work well for your symptoms."
C)   "This is a way of ensuring that you will come in for your follow-up appointment."
D)   "Prescribing a small amount of drug addresses our concerns for your continuing safety."

Question 5

What is the nurse's highest priority when caring for a patient after a TCA overdose?

Accepted Answer

A)   Frequently monitor blood pressure and heart rate/rhythm.
B)   Monitor for skin rashes, particularly on the torso.
C)   Measure and record intake and output every 12 hours.
D)   Institute cooling blankets for hyperthermia.

Question 6

The nurse cares for four patients receiving SSRIs. Which assessment finding warrants the nurse's priority attention?

Accepted Answer

A)   Dry mouth and stuffy nose
B)   Malaise and frontal headache
C)   Confusion, agitation, and hyperthermia
D)   Constipation, photophobia, and anhidrosis

Question 7

Evaluation of a patient's response after 1 week of tricyclic antidepressant therapy would be expected to show:

Accepted Answer

A)   no change in objective or subjective symptoms.
B)   increased appetite and weight gain.
C)   decreased suicidal ideation.
D)   improved mood and affect.

Question 8

A secondary amine tricyclic antidepressant is prescribed for a patient. The medication will significantly increase the availability of which neurotransmitter?

Accepted Answer

A)   GABA
B)   Glutamate
C)   Serotonin
D)   Norepinephrine

Question 9

A patient prescribed fluoxetine ( Prozac ) is being changed to tranylcypromine ( Parnate ). The nurse schedules a time lapse between the last dose of fluoxetine and the first dose of tranylcypromine of at least:

Accepted Answer

A)   7 days.
B)   14 days.
C)   3 weeks.
D)   6 weeks.

Question 10

Patients taking TCAs exhibit more side effects than patients taking SSRIs, because TCAs:

Accepted Answer

A)   inhibit reuptake of norepinephrine and serotonin.
B)   selectively inhibit dopamine reuptake.
C)   selectively block serotonin uptake.
D)   block enzymatic breakdown.

Question 11

A patient with depression has taken an SSRI for 1 month. The nurse should use direct questions to evaluate which potential side effect?

Accepted Answer

A)   Aggressive impulses
B)   Sexual dysfunction
C)   Paranoid delusions
D)   Weight gain

Question 12

A nurse teaches a patient taking an MAOI antidepressant about important dietary guidelines. Which nutritional choices by the patient indicate that the teaching was effective? Select all that apply.

Accepted Answer

A)   Sausage
B)   Avocados
C)   Pork chops
D)   Strawberries
E)   Chocolate chip cookies

Question 13

A patient tells the nurse that he stopped taking sertraline (Zoloft) because the drug made him impotent. The nurse can be most helpful by saying:

Accepted Answer

A)   "Your doctor wants you to continue taking your medication."
B)   "Have you talked with your therapist regarding your feelings about sex?"
C)   "Let's talk with your doctor. Changing your medication might be a possibility."
D)   "Our priority is to treat your depression. Impotence can be addressed in a few weeks."

Question 14

A patient for whom phenelzine (Nardil) is prescribed complains of a sudden headache and palpitations. The nurse observes dilated pupils and diaphoresis. The nurse's first action should be:

Accepted Answer

A)   assess for cogwheel rigidity.
B)   notify the health care provider.
C)   assess the patient's blood pressure.
D)   withhold the morning dose of phenelzine.

Question 15

A pregnant patient took SSRI antidepressants during the third trimester of pregnancy. The newborn will be carefully assessed for neonatal:

Accepted Answer

A)   temperature dysregulation.
B)   serotonin syndrome.
C)   seizure disorder.
D)   diabetes.

Question 16

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

Accepted Answer

A)   regular bowel movements.
B)   improved sleep pattern.
C)   weight loss.
D)   anhedonia.

Question 17

When teaching about the MAOI tranylcypromine (Parnate), the nurse should consider it a priority to:

Accepted Answer

A)   provide a list of tyramine-rich foods.
B)   instruct the patient to avoid direct sunlight.
C)   advise the patient to manage fever with acetaminophen.
D)   direct the patient to report dry mouth and blurred vision.

Question 18

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:

Accepted Answer

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.

Question 19

The nurse's priority assessment for a patient taking an antidepressant medication is for the presence of:

Accepted Answer

A)   suicidal ideation.
B)   antiadrenergic side effects.
C)   anticholinergic side effects.
D)   symptoms of sexual dysfunction.

Exam 15: Antidepressant Drugs