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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is ["5"]

Explanation

Step 1: Determine the concentration of Heparin in units per mL. 25,000 units ÷ 250 mL = 100 units per mL Result: 100

Step 2: Determine the rate in mL per hour needed to deliver 500 units per hour. 500 units ÷ 100 units per mL = 5 mL per hour Result: 5 mL per hour

The nurse should set the infusion pump to deliver at a rate of 5 mL per hour.

A. I am so relieved that my family can be with me when I die. B. I will have pain medicine available when I need it. C. In a few months, I will be strong enough to travel to my cabin and go fishing. D. I will be able to be in my own bed and home until I die.

Correct Answer is C

Explanation

Choice A Reason: I am so relieved that my family can be with me when I die

This statement reflects an accurate understanding of hospice care. Hospice care often allows patients to be surrounded by their loved ones during their final days. It emphasizes comfort and support, ensuring that the patient is not alone.

Choice B Reason: I will have pain medicine available when I need it

This statement is also correct. One of the primary goals of hospice care is to manage pain and other symptoms to ensure the patient’s comfort. Pain management is a critical component of hospice care, and medications are readily available to address the patient’s needs.

Choice C Reason: In a few months, I will be strong enough to travel to my cabin and go fishing

This statement indicates a need for further education. Hospice care is typically provided to patients who have a life expectancy of six months or less and who are no longer seeking curative treatment. The focus is on comfort and quality of life rather than recovery or improvement in physical strength. The expectation of becoming strong enough to travel and engage in activities like fishing is unrealistic in the context of hospice care.

Choice D Reason: I will be able to be in my own bed and home until I die

This statement is accurate. Hospice care often allows patients to remain in their own homes, surrounded by familiar surroundings and loved ones. The goal is to provide a comfortable and supportive environment for the patient during their final days.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is to receive a continuous Heparin infusion at s00 units per hour. Pharmacy supplies Heparin in a concentration of 25,000 units per 250mL of NSS. Calculate the rate at which the nurse should set the infusion pump.

Correct Answer is ["5"]

Explanation

The nurse is caring for a client who has been placed on hospice care. Which statement by the client indicates a need for further education?

Correct Answer is C

Explanation

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