A nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago with a planned dosage increase 1 week ago. The client reports having an improved appetite, but still feels very depressed and is still having trouble sleeping. Which of the following actions should the nurse take?
Speak to the provider about adding an MAOI to the current medication regimen.
Explain that antidepressants often take several weeks to be fully effective.
Tell the client that the provider will need to change citalopram to a different medication.
Recommend a sleep study be done on the client
The Correct Answer is B
This action might be premature. MAOIs (Monoamine Oxidase Inhibitors) are a class of antidepressants with specific dietary and medication interactions. They are typically considered when other classes of antidepressants have not been effective. It's important to exhaust other options before considering a switch to MAOIs.
B. Explain that antidepressants often take several weeks to be fully effective:
Explanation: Correct Answer. This is an appropriate response. Antidepressants, including citalopram, can take several weeks to show their full therapeutic effects. It's common for some symptoms to improve before others. Educating the client about the delayed onset of action is important to manage their expectations.
C. Tell the client that the provider will need to change citalopram to a different medication:
Explanation: It might be too early to consider changing the medication after just two weeks, especially since the client reports an improved appetite. Changes in dosage or medication should ideally be discussed with the provider after an adequate trial period.
D. Recommend a sleep study be done on the client:
Explanation: While sleep problems can be associated with depression, it might not be the most appropriate next step based solely on the information provided. It's more important to address the ongoing depressive symptoms before focusing solely on sleep.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
To calculate the number of capsules that the nurse should administer per dose, the nurse should first divide the total daily dose of tetracycline by the number of doses per day. This gives the dose per administration:
2 grams / 4 doses = 0.5 grams per dose
Next, the nurse should convert the dose from grams to milligrams, since the available capsules are in milligrams. There are 1000 milligrams in one gram, so the nurse should multiply the dose by 1000:
0.5 grams x 1000 mg/g = 500 mg per dose
Finally, the nurse should divide the dose in milligrams by the strength of each capsule, which is 250 mg. This gives the number of capsules that the nurse should administer per dose:
500 mg / 250 mg/capsule = 2 capsules per dose
Therefore, the nurse should administer 2 capsules of tetracycline every 6 hours to the client.
Correct Answer is D
Explanation
A. Providing an activity schedule that changes from day to day might be overwhelming and confusing for a client with Alzheimer's disease, as routine and predictability are often more beneficial.
B. Constantly rotating caregivers can lead to increased confusion for the client, as familiarity and consistency are important in their care.
C. Limiting time for the client to perform activities can add unnecessary stress and may not be conducive to a comfortable and supportive environment for someone with Alzheimer's disease.
D. Talk the client through tasks one step at a time.
For a client with Alzheimer's disease, providing clear and simple instructions is crucial. Breaking tasks down into manageable steps helps the client follow and complete activities more effectively. This approach reduces confusion and frustration and promotes the client's ability to engage in activities of daily living.
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