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 ["B"]
Explanation
Choice A Reason: Family history
Family history is not a modifiable risk factor. It refers to the genetic predisposition to certain health conditions based on the medical history of one’s family. While it is important to be aware of family history to understand potential risks, it cannot be changed or modified through lifestyle adjustments.
Choice B Reason: Weight
Weight is a modifiable risk factor. Maintaining a healthy weight through diet and exercise can significantly reduce the risk of various health conditions, including heart disease, diabetes, and hypertension. Weight management is crucial for overall health and can be controlled through lifestyle changes.
Choice C Reason: Sedentary lifestyle
A sedentary lifestyle is a modifiable risk factor. Increasing physical activity and reducing sedentary behavior can improve cardiovascular health, enhance mental well-being, and reduce the risk of chronic diseases. Encouraging regular exercise and active living is essential for health improvement.
Choice D Reason: Alcohol consumption
Alcohol consumption is a modifiable risk factor. Limiting or avoiding alcohol can reduce the risk of liver disease, certain cancers, and other health issues. Moderation in alcohol intake is important for maintaining good health and preventing related complications.
Correct Answer is D
Explanation
The correct answer is d. Restrict your child’s intake of caffeine while she is taking this medication.
Choice A Reason:
This statement is incorrect. Methylphenidate does not typically increase saliva production. In fact, it is more commonly associated with dry mouth as a side effect. Therefore, informing parents that the medication might increase saliva production would be misleading and not based on the known side effects of the drug.
Choice B Reason:
This statement is incorrect. Methylphenidate should generally be administered in the morning or early afternoon to avoid insomnia, as it is a stimulant and can interfere with sleep if taken too late in the day. Administering the medication at bedtime would likely cause sleep disturbances, which is counterproductive for managing ADHD symptoms.
Choice C Reason:
This statement is incorrect. Methylphenidate is more commonly associated with weight loss rather than weight gain. The medication can suppress appetite, leading to reduced food intake and potential weight loss. Therefore, it is important to monitor the child’s weight and nutritional intake while on the medication, but weight gain is not a typical concern.
Choice D Reason:
This statement is correct. Caffeine is a stimulant and can exacerbate the side effects of methylphenidate, such as increased heart rate, jitteriness, and anxiety. Therefore, it is advisable to restrict the child’s intake of caffeine while taking this medication to avoid these potential interactions and side effects. This includes limiting consumption of caffeinated beverages like coffee, tea, and certain sodas.
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