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. The orientation stage focuses on establishing trust, building rapport, clarifying roles, and setting boundaries. Developing trust and rapport is essential before deeper therapeutic work can occur.
B. Self-responsibility and autonomy are outcomes seen later in the working/termination phases as the patient gains insight and coping skills.
C. A greater sense of independence is expected as the therapeutic relationship progresses, not in the orientation stage.
D. Transference (patient projecting feelings onto the nurse) may occur at any phase and is addressed in the working phase, not resolved in orientation.
Correct Answer is B
Explanation
A. Suicide precautions should never be discontinued at this time; in fact, suicide risk is highest when energy improves before mood fully stabilizes.
B. Increased energy after starting antidepressants raises suicide risk, as the patient may now have the ability to act on suicidal thoughts. Continuous supervision is the priority for safety.
C. Discharge planning is premature at this stage; safety comes first.
D. Art and music therapy may be beneficial long-term but do not address the immediate suicide risk.
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