HESI RN PHARMACOLOGY EXAM 2024 verified The client diagnosed with a major depressive disorder who is taking fluoxetine reports feeling confused restless and having an elevated temperature Which intervention should the clinic psychiatric nurse implement 1 Determine if the client has flu like symptoms 2 Instruct the client to stop taking the fluoxetine 3 Recommend the client take the medication at night 4 Explain that these are expected side effects ESEs 2 Serotonin syndrome is a serious complication of SSRIs Fluoxetine Prozac produces mental changes confusion anxiety and restlessness hypertension tremors sweating hyperpyrexia elevated temperature and ataxia Conservative treatment includes stopping the SSRI and supportive treatment If untreated expected side effects can lead to death The client diagnosed with a major depressive disorder asks the nurse Why did my psychiatrist prescribe a selective serotonin reuptake inhibitor SSRI medication rather than one of the other types of antidepressants Which statement by the nurse is most appropriate 1 Probably it is the medication that your insurance will pay for 2 You should ask your psychiatrist why the SSRI was ordered 3 SSRIs have fewer side effects than the other classifications 4 The SSRI medications work faster than the other medications 3 SSRIs have the same efficacy as monoamine oxidase inhibitors MAOs and tricyclics but SSRIs are safer because they do not have the sympathomimetic effects tachycardia and hypertension and anticholinergic effects dry mouth blurred vision urinary retention and constipation of the MAOs and tricyclics The client diagnosed with pneumonia is admitted to the medical unit The nurse notes the client is taking an antidepressant medication Which data best indicates that the antidepressant therapy is effective 1 The client reports a 2 on a 1 10 scale with 10 being very depressed 2 The client reports not feeling very depressed today 3 The client gets out of bed and completes activities of daily living ADLs 4 The client eats 90 of all meals that are served during the shift 1 Depression is subjective and the nurse does not know this client therefore asking the client to rate the depression on a scale of 1 10 best indicates the effectiveness of the medication Any subjective data can be put on a scale to make it objective The client diagnosed with depression is prescribed phenelzine Which statement by the client indicates to the nurse the medication teaching is effective 1 I am taking the herb ginseng to help my attention span 2 I drink extra fluids especially coffee and iced tea 3 I am eating three well balanced meals a day 4 At a family cookout I had chicken instead of a hot dog 4 Taking phenelzine Nardil a monoamine oxidase MAO inhibitor requires adherence to strict dietary restrictions concerning tyramine containing foods such as processed meat hot dogs bologna and salami yeast products beer and red wines Eating these foods can cause a life threatening hypertensive crisis The client diagnosed with a major depressive disorder is suicidal The client was prescribed imipramine 3 weeks ago Which priority intervention should the nurse implement 1 Determine if the client has a plan to commit suicide 2 Assess if the client is sleeping better at night 3 Ask the family if the client still wants to kill himself or herself 4 Observe the client for signs of wanting to commit suicide 1 The nurse should ask if the client has a plan to commit suicide As the client begins to recover from both psychological and physical depression the client s energy level increases making the client more prone to commit suicide during this time It takes 2 to 6 weeks for therapeutic effects of tricyclic antidepressant imipramine Tofranil to be effective The client diagnosed with a major depressive disorder has been taking amitriptyline for more than 1 year and tells the psychiatric clinic nurse the client wants to quit taking the antidepressant Which intervention is most important for the nurse to discuss with the client 1 Ask questions to determine if the client is still depressed 2 Ask the client why he or she wants to stop taking the medication 3 Tell the client to notify the HCP before stopping medication 4 Explain the importance of tapering off the medication 4 The client must first know the importance of needing to taper off the medication because rebound dysphoria irritability or sleepiness may occur if amitriptyline Elavil a tricyclic antidepressant is discontinued abruptly Then the client should see the HCP to determine what action should be taken because the client doesn t want to take the medication The client diagnosed with a major depressive disorder is prescribed duloxetine The client tells the nurse I am going to take my medication at night instead of in the morning Which statement is the nurse s best response 1 You really should take the medication in the morning for the best results 2 It is all right to take the medication at night It may help you sleep 3 The medication should be taken with food so you should not take it at night 4 Have you discussed taking the medication at night with your psychiatrist 2 Antidepressants may cause central nervous system CNS depression which causes drowsiness therefore taking the duloxetine Cymbalta an atypical antidepressant at night may help the client sleep at night and relieve daytime sedation This is the nurse s best response The client admitted to the psychiatric unit for a diagnosis of major depressive disorder and attempted suicide is prescribed an antidepressant medication Which interventions should the psychiatric nurse implement Select all that apply 1 Assess the client s apical pulse and blood pressure 2 Check the client s serum antidepressant level 3 Monitor the client s liver function status 4 Provide for and ensure the client s safety 5 Evaluate the effectiveness of the medication 1 Antidepressant medications may cause orthostatic hypotension and the nurse should question administering the medication if the blood pressure is less than 90 60 3 Many antidepressants may cause hepatotoxicity therefore the nurse should monitor the client s liver function tests 4 The nurse should ensure the client s safety Many antidepressants may cause orthostatic hypotension and increase the risk for dizziness falls and injuries The client diagnosed with major depression who attempted suicide is being discharged from the psychiatric facility after a 2 week stay Which discharge intervention is most