An adult outpatient diagnosed with major depressive disorder has a history of several suicide attempts by overdose. Given this patient's history and diagnosis, which antidepressant medication would the nurse expect to be prescribed to this patient?
Tranylcypromine sulfate (Parnate)
Amitriptyline (Elavil)
Desipramine (Norpramin)
Fluoxetine (Prozac)
The Correct Answer is D
A. Tranylcypromine sulfate (Parnate) is a monoamine oxidase inhibitor (MAOI) that carries a high risk of toxicity in overdose and is generally avoided in patients with a history of suicide attempts.
B. Amitriptyline (Elavil) is a tricyclic antidepressant (TCA), which can be lethal in overdose, making it unsafe for patients at high risk for suicide.
C. Desipramine (Norpramin) is also a TCA and poses a similar overdose risk as amitriptyline, so it is not preferred for suicidal patients.
D. Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI), which has a much lower lethality in overdose compared to TCAs or MAOIs, making it the preferred choice for patients with a history of suicidal behavior.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Haloperidol, a typical antipsychotic, commonly causes extrapyramidal side effects (EPS) such as muscle stiffness, rigidity, tremors, and sedation, which can make patients feel “robotic.”
B. Headache, watery eyes, and runny nose are not typical side effects of haloperidol; they are more consistent with allergy or upper respiratory symptoms.
C. Mild fever, sore throat, and skin rash could indicate a serious reaction such as agranulocytosis, which is rare and more common with atypical antipsychotics like clozapine.
D. Sweating, nausea, and diarrhea are not primary side effects of haloperidol; they may occur with other medications or conditions but are not typical EPS.
Correct Answer is B
Explanation
A. The patient’s symptoms are physiological and neurological, not intentional behaviors for attention.
B. Alcohol withdrawal delirium (delirium tremens) typically occurs 48–72 hours after the last drink and includes tremors, agitation, anxiety, diaphoresis, tachycardia, hallucinations, and nightmares—all present in this patient.
C. Although head injury can cause confusion and agitation, the timing of symptoms following alcohol withdrawal aligns more closely with delirium tremens.
D. Acute psychosis can present with hallucinations, but in this case, the onset following alcohol cessation and accompanying autonomic hyperactivity point toward alcohol withdrawal delirium.
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