A client with major depressive disorder has been taking fluoxetine, an SSRI, for 5 weeks. During the first outpatient visit, the client smiles and states, “I feel like a great weight is off my chest.” How should the nurse interpret this behavior change?
The client’s behavioral change is expected after the time period of medication.
The client may have worked out details of their suicide plan.
The medication dosage should be decreased and a mood stabilizer added.
The medication has potentiated serotonin syndrome.
The Correct Answer is A
The correct answer is a. The client’s behavioral change is expected after the time period of medication.
Choice A Reason:
This choice is correct because fluoxetine, a selective serotonin reuptake inhibitor (SSRI), typically takes about 4 to 6 weeks to start showing its full effects. The client’s statement, “I feel like a great weight is off my chest,” indicates a positive response to the medication, which aligns with the expected timeline for SSRIs to improve mood and alleviate symptoms of depression. This behavioral change suggests that the medication is working as intended, helping to lift the depressive symptoms.
Choice B Reason:
This choice is incorrect and concerning. While it is true that some individuals may experience a temporary increase in energy before their mood improves, which could potentially increase the risk of suicide, the client’s positive statement does not necessarily indicate suicidal planning. It is important for healthcare providers to continuously monitor for any signs of suicidal ideation, but in this context, the client’s statement more likely reflects an improvement in their depressive symptoms.
Choice C Reason:
This choice is incorrect because there is no indication that the medication dosage should be decreased or that a mood stabilizer should be added. Fluoxetine is generally well-tolerated, and the client’s positive response suggests that the current dosage is effective. Mood stabilizers are typically used in the treatment of bipolar disorder, not major depressive disorder, unless there is a specific indication for their use.
Choice D Reason:
This choice is incorrect and indicates a misunderstanding of serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonin activity in the brain, often due to drug interactions or overdose. Symptoms include agitation, confusion, rapid heart rate, and high blood pressure4. The client’s statement of feeling relieved does not align with the symptoms of serotonin syndrome, which are generally severe and require immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
This statement indicates that the client understands the nature of recovery from alcohol abuse. Recovery is indeed a lifelong process that involves continuous effort and commitment. Recognizing that recovery comes in steps shows that the client is aware of the ongoing nature of the process and the need for sustained effort and support. This understanding is crucial for successful long-term recovery.
Choice B Reason:
This statement is incorrect because it reflects a misunderstanding of the recovery process. Detoxification is just the first step in recovery, and it involves removing alcohol from the body. However, recovery involves much more than just detoxification. It includes ongoing therapy, support groups, lifestyle changes, and coping strategies to maintain sobriety and prevent relapse. Therefore, thinking that recovery is complete after detoxification is a misconception.
Choice C Reason:
This statement is also incorrect because it suggests that the goal of recovery is merely to decrease drinking. The goal of recovery from alcohol abuse is to achieve and maintain sobriety, not just to reduce alcohol consumption. Effective recovery involves abstaining from alcohol, addressing the underlying issues that led to alcohol abuse, and developing healthy coping mechanisms and support systems.
Choice D Reason:
While Al-Anon can indeed assist in the recovery process, this statement alone does not indicate that the client has fully understood the nature of recovery. Al-Anon is a support group for friends and family members of people with alcohol use disorder, and it can provide valuable support and resources. However, recognizing the lifelong and step-by-step nature of recovery is a more comprehensive indication of learning.
Correct Answer is B
Explanation
The correct answer is b.
Choice A Reason:
Expect hyperactivity as a common adverse effect. This statement is incorrect. Atomoxetine is a non-stimulant medication used to treat ADHD and does not typically cause hyperactivity. Instead, it helps improve attention and reduce hyperactivity and impulsiveness. Common side effects of atomoxetine include nausea, vomiting, upset stomach, constipation, dry mouth, loss of appetite, mood changes, feeling tired, dizziness, urination problems, or impotence.
Choice B Reason:
Give the dose in the morning to help prevent insomnia. This statement is correct. Atomoxetine should be taken in the morning to help prevent insomnia, as taking it later in the day can interfere with sleep. The medication can be taken with or without food, and if a second dose is prescribed, it is typically taken in the late afternoon or early evening.
Choice C Reason:
Avoid crowds due to the increased risk for infection. This statement is incorrect. Atomoxetine does not increase the risk of infection, and there is no need to avoid crowds while taking this medication3. Common side effects do not include an increased risk of infection.
Choice D Reason:
Limit caloric intake to prevent excessive weight gain. This statement is incorrect. Atomoxetine is more likely to cause weight loss rather than weight gain. It can decrease appetite, which may lead to weight loss in some patients. Therefore, limiting caloric intake is not necessary while taking atomoxetine.
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