After a client has been prescribed fluoxetine (Prozac) for a diagnosis of anxiety disorder, which of the following information should the nurse be sure to include in the client teaching?

The client should not stop this medication abruptly to avoid discontinuation syndrome

The client may experience frequent constipation and should increase their intake of dietary fiber

This medication takes 4-6 months to be effective, the client should be told to be patient

This medication can cause addiction, so the client should not take more than prescribed

Answer and Explanation

The Correct Answer is A

Choice A reason: Abruptly stopping fluoxetine, an SSRI, disrupts serotonin levels, causing discontinuation syndrome with symptoms like dizziness and irritability due to rapid neurotransmitter imbalance in the brain. Gradual tapering stabilizes serotonin, preventing withdrawal, making this critical teaching for safe medication management in anxiety treatment.

Choice B reason: Constipation is not a common side effect of fluoxetine, which primarily causes nausea or diarrhea via serotonin modulation. Anticholinergic drugs, not SSRIs, typically cause constipation. This teaching is inaccurate, as fluoxetine’s side effect profile does not emphasize gastrointestinal slowing, making it incorrect.

Choice C reason: Fluoxetine takes 4-8 weeks, not months, to reach efficacy by increasing serotonin in the prefrontal cortex and amygdala. Overstating the timeline discourages adherence, as patients expect faster relief from anxiety symptoms, making this teaching point scientifically inaccurate and misleading.

Choice D reason: Fluoxetine is not addictive, as it lacks the reinforcing GABA effects of benzodiazepines. It modulates serotonin for anxiety without dependence risk. This teaching is incorrect, as it misrepresents fluoxetine’s pharmacological profile, potentially causing unnecessary fear about its safe use in treatment.

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Correct Answer is A

Explanation

Choice A reason: Muscarinic receptor blockers inhibit parasympathetic activity, reducing salivary gland secretion via acetylcholine pathways. This causes dry mouth, as muscarinic receptors in salivary glands are blocked, decreasing saliva production. This anticholinergic effect is common in drugs like benztropine, requiring assessment to manage discomfort and prevent oral health issues.

Choice B reason: Orthostatic hypotension is linked to alpha-1 adrenergic blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic pathways, not vascular tone regulated by norepinephrine. While autonomic effects occur, hypotension is not a primary consequence, making this side effect unrelated to muscarinic receptor antagonism.

Choice C reason: Pseudoparkinsonism results from dopamine receptor blockade, common in antipsychotics, not muscarinic blockers. Muscarinic receptors regulate parasympathetic functions like salivation, not motor control. Blocking muscarinic receptors may alleviate parkinsonism by balancing cholinergic-dopaminergic activity, making this an incorrect side effect for assessment.

Choice D reason: Gynecomastia is associated with hormonal imbalances or dopamine blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic systems, not prolactin or estrogen pathways. This side effect is unrelated to muscarinic antagonism, which primarily causes anticholinergic effects like dry mouth, not endocrine changes.

A. Remain silent and add the suggested outcome to the plan B. Formulate a more appropriate outcome without the patient’s input C. Explore with the patient possible consequences of the outcome D. Educate the patient that the outcome is not realistic

Correct Answer is C

Explanation

Choice A reason: Silently adding an inappropriate outcome disregards patient safety and autonomy. Outcomes must align with neurobiological needs, like serotonin modulation for depression. This approach fails to engage the patient in decision-making, risking ineffective treatment and neglecting evidence-based collaborative care principles.

Choice B reason: Formulating outcomes without patient input violates autonomy. Collaborative goal-setting, considering neurobiological factors like dopamine imbalances, ensures patient engagement and effective treatment. Excluding the patient disregards their perspective, reducing adherence and therapeutic alliance, making this approach contrary to evidence-based psychiatric nursing.

Choice C reason: Exploring consequences respects autonomy while guiding patients toward safe outcomes. Discussing implications, like medication non-adherence worsening dopamine-driven symptoms, fosters informed decisions. This collaborative approach aligns with cognitive-behavioral principles and neurobiological treatment needs, ensuring effective, patient-centered care in psychiatric practice.

Choice D reason: Educating that an outcome is unrealistic may dismiss patient autonomy. While addressing neurobiological realities, like serotonin deficits, is important, unilateral education risks disengagement. Collaborative exploration of consequences is more effective, promoting informed choices and adherence, making this option less suitable than discussion.

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After a client has been prescribed fluoxetine (Prozac) for a diagnosis of anxiety disorder, which of the following information should the nurse be sure to include in the client teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

Correct Answer is A

Explanation

A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

Correct Answer is C

Explanation

After assessing the patient and formulating the nursing diagnoses for a plan of care, what is the next action a nurse should take?

A patient reports experiencing performance anxiety in front of an audience. The nurse should be aware that this type of anxiety is often treated with which medication?

Which statement most clearly reflects the stigma of mental illness?

A patient presents with anxiety, increased heart rate, and fear. The nurse suspects the activation of which neurotransmitter?

Which of the following side effects is associated with the blockade of attachment of norepinephrine to alpha-1 receptors?

Which of the following speech patterns is an example of tangential thinking?

A patient with paranoia states, “The state is monitoring us through the listening devices hidden in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?

A client is newly prescribed a medication that will block the effects of histamine for the treatment of a mental health disorder. The client asks, “What side effects should I anticipate with this new medication?” Which response by the nurse is accurate?