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 A

Explanation

A. Heroin is an opioid, which causes central nervous system depression, leading to drowsiness, miosis (pinpoint pupils), and slurred speech.

B. These are more typical of stimulant use such as cocaine or methamphetamine, not heroin.

C. These are withdrawal symptoms of opioids, not effects immediately following injection.

D. These are associated with stimulant intoxication or withdrawal, not opioid intoxication.

A. Nystagmus B. Dilated pupils C. Depression D. Hypersomnia

Correct Answer is B

Explanation

A. This is more commonly associated with phencyclidine (PCP) or alcohol intoxication, not cocaine.

B. Cocaine is a powerful stimulant that activates the sympathetic nervous system. This results in mydriasis (dilated pupils), increased heart rate, elevated blood pressure, hypervigilance, and euphoria.

C. Depression is more likely during cocaine withdrawal, not intoxication.

D. Like depression, hypersomnia is a withdrawal symptom. Intoxication typically causes insomnia and restlessness.

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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

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