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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Correct Answer is A

Explanation

A. Walking with the client at a gradually slower pace can provide support and reassurance while helping to regulate the client's activity level. This approach acknowledges the client's distress and offers physical companionship during a challenging time.

B. Instructing the client to sit down and stop pacing may be perceived as confrontational or dismissive of the client's distress. For individuals with generalized anxiety disorder, pacing often serves as a coping mechanism to manage feelings of agitation or restlessness.

C. While ensuring the client's safety is important, forcibly removing them from the corridor may exacerbate feelings of distress or agitation. It is essential to respect the client's autonomy and use interventions that promote de-escalation and emotional support.

D. While allowing the client to pace alone may initially seem like a non-intrusive approach, it may not address the client's underlying emotional distress or provide therapeutic support.

A. Monitor food intake and eliminate potential sources of tyramine. B. Assess for weight loss and difficulty sleeping. C. Monitor the client for migraines. D. Implement suicide precautions.

Correct Answer is D

Explanation

D. Children and adolescents with depression, especially when initiating or adjusting antidepressant medications like SSRIs, are at an increased risk of suicidal ideation and behavior. Therefore, it is crucial to prioritize the safety of the client by implementing suicide precautions, which may include close observation, removing potential means of self-harm, and involving the client in structured activities under supervision.

A. Monitoring food intake and eliminating potential sources of tyramine are considerations for clients taking monoamine oxidase inhibitors (MAOIs), another class of antidepressant medications, due to the risk of hypertensive crisis.

B. Weight loss and difficulty sleeping are potential side effects of SSRIs that may occur, particularly during the initial phases of treatment. However, suicide precautions are a priority

C. While SSRIs may cause headaches or migraines as potential side effects, monitoring for migraines specifically would not typically be a priority

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received a telephone call that was upsetting. and now the client is pacing up and down the corridors of the unit. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

An 11-year-old client has been hospitalized on the adolescent psychiatry unit with severe depression. For the past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the priority nursing action?

Correct Answer is D

Explanation

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

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 caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse's discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

A nurse is providing care to children on a general pediatric unit. Which of the following children should the nurse identify as a potential victim of abuse?

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?

Which are common reasons why abused persons remain with an abusive partner? Select all that apply.

A nurse is caring for a client with paranoid personality disorder who is extremely suspicious of the nursing staff and other clients. Which of the following nursing approaches is appropriate when establishing a therapeutic relationship with this client?