A nurse is caring for patients receiving clozapine, lithium, fluoxetine, and venlafaxine. Which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

Clozapine

Lithium

Fluoxetine

Venlafaxine

Answer and Explanation

The Correct Answer is B

Choice A reason: Clozapine, an antipsychotic, primarily causes agranulocytosis and metabolic issues, not fluid or electrolyte imbalances. Its effects on the central nervous system and bone marrow do not directly disrupt electrolyte homeostasis, making this choice incorrect for this concern.

Choice B reason: Lithium, a mood stabilizer, affects renal function, impairing sodium and water reabsorption, leading to potential hyponatremia or dehydration. This requires close monitoring of electrolytes, as imbalances can cause toxicity, making this the correct choice for heightened alertness.

Choice C reason: Fluoxetine, an SSRI, primarily affects serotonin levels, with minimal impact on fluid or electrolyte balance. Side effects like nausea do not significantly disrupt electrolytes, making this choice incorrect compared to lithium’s known renal effects.

Choice D reason: Venlafaxine, an SNRI, influences serotonin and norepinephrine but does not significantly affect fluid or electrolyte balance. Its side effects, like hypertension, are unrelated to electrolyte homeostasis, making this choice incorrect for this specific concern.

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Correct Answer is A

Explanation

Choice A reason: MAOIs inhibit monoamine oxidase, increasing catecholamine levels. Consuming tyramine-rich foods or certain drugs can cause excessive norepinephrine release, leading to a hypertensive crisis with severe blood pressure elevation. This life-threatening condition requires strict dietary and drug restrictions, making this the correct nursing consideration.

Choice B reason: Hypoglycemia is unrelated to MAOIs, which primarily affect neurotransmitter metabolism, not glucose regulation. MAOIs do not interact with insulin or glucose pathways, and dietary restrictions focus on tyramine, not sugars. This condition is not a risk associated with MAOI use, making this choice incorrect.

Choice C reason: Hypotensive shock is not a primary risk of MAOIs. While orthostatic hypotension can occur, the more critical concern is hypertensive crisis due to tyramine interactions. Hypotensive shock is unrelated to MAOI pharmacology or dietary restrictions, making this an incorrect choice for nursing instructions.

Choice D reason: Cardiac dysrhythmias are not a primary risk of MAOI-related food or drug interactions. While cardiovascular effects like hypertension can occur, the specific risk is hypertensive crisis, not arrhythmias. This choice does not accurately reflect the primary concern of MAOI use, making it incorrect.

A. Arrange for social services to address the patient’s housing needs B. Contact the landlord to discuss the eviction situation further C. Determine whether the adverse medication reaction was genuine D. Delay discharge until the patient’s mental status improves

Correct Answer is A

Explanation

Choice A reason: Arranging social services addresses the patient’s eviction, a social determinant of health impacting mental stability. This holistic approach supports recovery by ensuring housing stability, aligning with psychiatric nursing’s focus on comprehensive care, making this the correct choice.

Choice B reason: Contacting the landlord directly exceeds the nurse’s role and may violate privacy. It does not address the patient’s immediate housing needs or mental health, making it less appropriate than coordinating with social services for professional support.

Choice C reason: Questioning the medication reaction’s validity is inappropriate without evidence and distracts from addressing the eviction. It undermines trust and does not support discharge planning, making this choice irrelevant to the patient’s current needs.

Choice D reason: Delaying discharge without clinical justification risks unnecessary hospitalization. The eviction requires social support, not prolonged admission, as mental status improvement is not specified as a concern, making this choice incorrect.

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A nurse is caring for patients receiving clozapine, lithium, fluoxetine, and venlafaxine. Which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse instructs a patient taking a monoamine oxidase inhibitor (MAOI) drug to avoid certain foods and drugs because of the risk of which condition?

Correct Answer is A

Explanation

A patient was hospitalized for 24 hours after a reaction to a psychotropic medication. While planning discharge, the nurse learned the patient received a notice of eviction immediately prior to admission. Select the nurse’s most appropriate action.

Correct Answer is A

Explanation

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