A nurse is caring for a client at a clinic.
Complete the following sentence by using the lists of options.
The client is at risk for developing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Rationale for Correct Choices:
• Serotonin syndrome: The client’s symptoms recent SSRI dose increase indicate possible serotonin toxicity. Serotonin syndrome occurs when excessive serotonin accumulates in the body, typically following dose escalation or interaction between serotonergic medications. It is a medical emergency that can progress to seizures or death if not promptly identified and treated.
• Adverse effects of paroxetine: The increase in paroxetine dosage one week prior likely triggered excessive serotonergic activity. Paroxetine, an SSRI, elevates serotonin levels, and dose escalation can precipitate serotonin syndrome.
Rationale for Incorrect Choices:
• Generalized anxiety disorder: Although the client has a history of anxiety, the acute onset of fever, disorientation, and autonomic instability points to a physiological reaction rather than worsening anxiety. Anxiety may cause restlessness but does not produce hyperthermia or confusion.
• Neuroleptic malignant syndrome: This condition is associated with antipsychotic drugs, not SSRIs like paroxetine. While both syndromes can present with fever and altered mental status, the client’s medication profile and timing support serotonin toxicity instead.
• Feelings of hopelessness: Although ongoing hopelessness is part of the client’s depression, it does not explain the acute physical manifestations. Emotional symptoms may persist with depression, but fever and disorientation indicate a pharmacologic rather than psychological cause.
• Anxiety: Anxiety alone cannot account for the client’s fever, disorientation, or abdominal pain. These findings suggest a systemic reaction consistent with serotonin excess, not a purely psychological state.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Smoked salmon: Smoked and cured meats are rich in tyramine, which can trigger a hypertensive crisis when combined with monoamine oxidase inhibitors (MAOIs) such as phenelzine. Clients must avoid aged, fermented, or smoked foods to prevent dangerous elevations in blood pressure related to MAOI therapy.
B. Grapefruit: Grapefruit primarily interacts with medications metabolized by the cytochrome P450 enzyme system, but it does not have a clinically significant interaction with MAOIs like phenelzine. Therefore, grapefruit is not restricted for clients taking this medication.
C. Spinach: Fresh vegetables, including spinach, contain negligible amounts of tyramine and are safe to consume with phenelzine. A diet rich in fresh fruits and vegetables is encouraged to support overall health and medication adherence.
D. Cottage cheese: Unlike aged cheeses, cottage cheese contains minimal tyramine and is considered safe for clients on MAOIs. It provides a good source of protein and calcium without the risk of precipitating hypertensive complications.
Correct Answer is B
Explanation
Rationale:
A. Fibrocystic breast condition: Fibrocystic breast changes are benign and do not contraindicate oral contraceptive use. Oral contraceptives may sometimes improve symptoms, but this condition alone is not a reason to avoid them.
B. Hypertension: Oral contraceptives can elevate blood pressure and increase the risk of cardiovascular complications. Clients with uncontrolled or severe hypertension are at higher risk and should avoid combined estrogen-progestin contraceptives, making this a significant contraindication.
C. Asthma: Asthma is not a contraindication for oral contraceptive use. Hormonal contraceptives generally do not exacerbate asthma, and clients with well-controlled asthma can safely use these medications.
D. Fibromyalgia: Fibromyalgia is a chronic musculoskeletal pain disorder that does not affect cardiovascular or thrombotic risk. It is not a contraindication for oral contraceptives, and use is generally safe in these clients.
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