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)

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Assessing lung sounds and extremities is not a priority in this context unless there are signs of fluid overload or other complications; it does not address the psychosocial aspect of anorexia recovery.

B. Positive reinforcement encourages the patient’s healthy behaviors and progress, helping to build motivation and self-esteem during the challenging refeeding process. Recognizing the patient’s achievement supports therapeutic engagement and adherence to treatment goals.

C. Immediately establishing a higher weight gain goal may increase anxiety or pressure on the patient, potentially undermining adherence and progress. Goals should remain realistic and individualized.

D. Suggesting aerobic exercise is inappropriate at this stage of refeeding, as excessive activity can interfere with weight restoration and may reinforce disordered behaviors.

A. "Give the dose in the morning to help prevent insomnia." B. "Limit caloric intake to prevent excessive weight gain." C. "Expect hyperactivity as a common adverse effect." D. "Avoid crowds due to the increased risk for infection."

Correct Answer is A

Explanation

A. Atomoxetine, a selective norepinephrine reuptake inhibitor (SNRI), can cause insomnia if taken late in the day; morning dosing reduces this risk.

B. Unlike some antipsychotics, atomoxetine is more commonly associated with appetite suppression and weight loss, not weight gain.

C. Atomoxetine is not a stimulant; it usually reduces hyperactivity and impulsivity.

D. Atomoxetine does not suppress the immune system; infection risk is not a concern.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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