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 ["A","B","D","E"]
Explanation
A. Providing frequent meals and snacks is generally beneficial, it’s essential to focus on nutritious options.
C. Manic episodes can lead to impulsive behavior, increased activity, and risk-taking. Close monitoring ensures early detection of any safety concerns, such as self-harm or aggression.
D. Manic clients are often hypersensitive to stimuli, and a calm, low-stimulation environment can help reduce agitation and prevent exacerbation of symptoms.
E. While adequate rest is essential, discouraging daytime naps may help regulate the client’s sleep patterns and prevent excessive energy levels associated with mania.
B. Regular weight monitoring is essential for assessing overall health, but it may not be a priority specifically related to mania.
Correct Answer is D
Explanation
D. It acknowledges the client’s comfort while emphasizing the nurse’s professional role. It sets clear boundaries and reinforces that the nurse’s primary purpose is to provide care and support within the therapeutic context.
A. This response acknowledges the client’s feelings but does not set clear boundaries. It may
inadvertently encourage the client to view the nurse as a friend rather than a professional caregiver.
B. While this response establishes boundaries, it may come across as abrupt or cold. It lacks empathy and understanding.
C. This response reflects empathy and encourages further exploration of the client’s feelings. However, it does not address the professional boundaries explicitly.
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