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

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is D

Explanation

D. This statement indicates symptoms of anxiety, which alprazolam is commonly prescribed to alleviate. Alprazolam is a benzodiazepine medication with anxiolytic properties, meaning it helps reduce feelings of anxiety and promote relaxation.

A. This statement suggests the presence of delusional thinking, which is a common symptom of schizophrenia. Alprazolam is not typically indicated for the treatment of delusions associated with schizophrenia.

B. While fatigue may be distressing for the client, it is not an indication for the use of alprazolam. Alprazolam is specifically prescribed for the management of anxiety symptoms.

C. This statement suggests the presence of hallucinations, which are another common symptom of schizophrenia. Alprazolam is not indicated for the treatment of hallucinations associated with schizophrenia.

A. "Why do you feel you are worthless?" B. "You've been feeling that your life has no meaning." C. "It's not unusual for depressed people to feel that way." D. "You have a great deal to live for."

Correct Answer is C

Explanation

C. Acknowledging the client’s feelings while normalizing them can help reduce the sense of isolation and

provide validation. It’s essential to maintain empathy and avoid dismissing the client’s emotions.

A. While this response acknowledges the client’s feelings, it may come across as confrontational or probing. It’s essential to approach the conversation with empathy and avoid putting the client on the defensive.

B. This response reflects understanding and empathy. However, it does not directly address the client’s

statement about worthlessness.

D. It’s essential to avoid making assumptions about what the client values or finds meaningful. Focusing on empathy and understanding is more effective.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has schizophrenia and generalized anxiety disorder. The client has a prescription for alprazolam 0.25 mg PO every 8 hr PRN anxiety. For which of the following client statements should the nurse consider administering alprazolam?

Correct Answer is D

Explanation

A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse. "I should have died because I am totally worthless." Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A nurse in a clinic is caring for a client who is 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling "down" and sad, having no energy, and wanting to cry. Which of the following is a priority action by the nurse?

A nurse is discussing postpartum depression with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of this condition?

A nurse is caring for a client who has obsessive-compulsive disorder (OCD). Which of the following characteristics are expected findings of OCD? (Select all that apply.)

A nurse is creating a plan of care for a client who is experiencing mania. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

A nurse is planning care for a client who is in the manic phase of bipolar disorder. Which of the following interventions should the nurse include in the client's plan of care?

A nurse is caring for a client with delirium who is experiencing illusions. What environmental conditions should the nurse arrange for this client?

A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse?