The client presents to the emergency department with a headache in the back of the head, diaphoresis, and neck stiffness. The client's blood pressure measures 180/124 mm Hg and heart rate is 168 beats/min. The spouse says the client is currently prescribed "something for depression" and denies any history of cardiac disease. The nurse should suspect the use of what medication?
A monoamine oxidase inhibitor (MAOI)
A selective serotonin reuptake inhibitor (SSRI)
A tricyclic antidepressant (TCA)
An atypical antipsychotic
None
None
The Correct Answer is A
A. MAOIs are a class of antidepressants that work by inhibiting the activity of monoamine oxidase, an enzyme that breaks down neurotransmitters such as serotonin, dopamine, and norepinephrine. MAOIs can interact with certain foods and other medications, potentially leading to a hypertensive crisis characterized by severe hypertension, headache, diaphoresis, and other symptoms.
B. SSRIs are commonly prescribed antidepressants that work by increasing the levels of serotonin in the brain. Serotonin syndrome can present with symptoms such as headache, diaphoresis, tachycardia, and hyperthermia, but it typically doesn't cause severe hypertension.
C. TCAs are another class of antidepressants that work by inhibiting the reuptake of serotonin and norepinephrine. TCAs can cause anticholinergic effects such as dry mouth, blurred vision, constipation, and urinary retention. However, TCAs are less commonly associated with severe hypertension compared to MAOIs.
D. Atypical antipsychotics are used to treat various psychiatric disorders, including schizophrenia and bipolar disorder. While they are not typically associated with causing severe hypertension directly, they can have cardiovascular side effects such as tachycardia and orthostatic hypotension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Remaining with the client provides support and reassurance during a period of agitation and restlessness. The presence of the nurse can help the client feel safe and supported, and it allows the nurse to assess the client's condition closely and intervene as needed.
A. While administering a PRN (as needed) sleeping medication may be considered in some situations, it is not the first-line intervention when a client is experiencing agitation and restlessness.
B. Encouraging the client to return to bed may be appropriate if they are willing and able to do so. However, if the client is agitated and pacing the floor, they may not feel comfortable or able to go back to bed.
C. Exploring alternatives to pacing the floor involves assessing the client's needs and preferences and identifying activities or strategies that may help alleviate agitation and promote relaxation. However, proper observation of the client behavior should be prioritized.
Correct Answer is ["B"]
Explanation
A. Disordered thinking, also known as formal thought disorder, involves disturbances in the thought process, such as loosening of associations, thought blocking, or tangentiality. These disturbances result in fragmented or illogical thinking patterns.
B. Flat affect refers to a reduction or absence of emotional expression. Individuals with flat affect may appear emotionally dull or unresponsive, showing little variation in facial expressions or vocal tone.
D. Apathy refers to a lack of motivation, interest, or enthusiasm in engaging with one's environment or pursuing goals. Individuals with schizophrenia may experience extreme apathy, which can contribute to social withdrawal and functional impairment.
E. Lack of initiative, also known as avolition, refers to a reduction or absence of goal-directed behavior or motivation to engage in purposeful activities. Individuals with schizophrenia may have difficulty initiating and sustaining activities of daily living or pursuing personal interests.
F. Social withdrawal involves the avoidance or reduction of social interactions and activities. It may result from factors such as social anxiety, apathy, or disinterest in socializing due to psychotic symptoms or negative symptoms of schizophrenia.
C. Trouble concentrating is not typically considered a primary symptom of schizophrenia. While difficulties with concentration or attention may occur, they are more often associated with cognitive impairments rather than positive or negative symptoms.
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