Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
When prescribing a tricyclic antidepressant, which patient would we be most concerned about dispensing the medication to?
A. A 30-year-old female who has not responded to 2 other antidepressant medications.
This patient has not responded to two other antidepressant medications, indicating a history of treatment resistance. While this is a concern, the choice of medication should be based on various factors beyond treatment history.
B. A patient with a recent suicide attempt.
This is the correct choice. Tricyclic antidepressants (TCAs) have a high potential for overdose and can be lethal in cases of deliberate self-harm. Dispensing TCAs to a patient with a recent suicide attempt could greatly increase the risk of overdose and potential harm.
C. A 50-year-old male with hyperlipidemia.
Hyperlipidemia, or high cholesterol, is not a primary concern when prescribing tricyclic antidepressants. This choice is less relevant to the immediate safety considerations associated with TCAs.
D. A patient with refractory anxiety.
While a patient with refractory anxiety is an important consideration, the most concerning scenario among the choices is dispensing TCAs to a patient with a recent suicide attempt. The question asks for the patient about whom we would be most concerned, and that is the patient with a recent suicide attempt due to the high risk of overdose with TCAs.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Custom Psych Nursing Spring 2023 Proctored Exam 3. Take the full exam now
Similar Questions
A patient comes to the emergency department with complaints of a headache and vomiting. Upon questioning, the patient says she is taking the drug phenelzine. The nurse should continue the assessment by first asking:.
A. What foods have you been eating?.
This is the correct choice. Phenelzine is a monoamine oxidase inhibitor (MAOI), and patients taking MAOIs need to follow a strict dietary regimen to avoid consuming foods high in tyramine. These foods, such as aged cheeses, cured meats, and certain beverages, can lead to hypertensive crisis when ingested by patients on MAOIs. Therefore, assessing the patient's dietary intake is crucial to ensuring their safety.
B. What dose of phenelzine are you taking?.
Inquiring about the dose of phenelzine is important, but assessing dietary intake takes precedence due to the potential for interactions between certain foods and MAOIs.
C. Do you have flu symptoms?.
Asking about flu symptoms is not directly relevant to the patient's use of phenelzine. The primary concern with phenelzine is its interaction with tyramine-rich foods, not flu symptoms.
D. Tell me about your history of headaches.
While the patient's history of headaches is important, assessing dietary intake is more urgent in this situation. The patient's use of phenelzine requires immediate attention due to the risk of dietary interactions, which can have severe consequences.
Which of the following medication orders should the nurse question?
A. A benzodiazepine for an elderly patient with agitation.
B. Quetiapine for a patient with refractory anxiety.
Quetiapine, an atypical antipsychotic, is often used to manage refractory anxiety. While it might not be the first-line option, it can be effective in certain cases. Therefore, this choice does not need to be questioned as it aligns with current treatment guidelines.
C. A low starting dose of an SSRI.
A low starting dose of a selective serotonin reuptake inhibitor (SSRI) is an appropriate approach when initiating treatment for depression or anxiety. It helps minimize the risk of side effects, especially in the early stages of therapy when the patient is adjusting to the medication. Therefore, this choice does not need to be questioned, as it reflects a standard practice.
D. Prazosin for nightmares in patients with PTSD.
Prazosin is an alpha-1 adrenergic antagonist commonly used to treat nightmares associated with post-traumatic stress disorder (PTSD). It helps alleviate symptoms by reducing the effects of norepinephrine. This choice does not need to be questioned as it is a recognized treatment option for this specific condition.
A nurse on an inpatient mental health unit is caring for a client who has major depressive disorder and malnutrition. Which of the following actions should the nurse take to improve the client's nutritional status?
A. Ask the provider to arrange a consultation with the facility chaplain.
This option is not directly related to improving the client's nutritional status. While spiritual support and counseling can be beneficial for overall well-being, it may not address the specific nutritional needs of the client.
B. Enroll the client in a nutritional class on the unit.
While education about nutrition can be helpful, enrolling the client in a nutritional class may not be the most immediate or effective intervention. Clients with major depressive disorder and malnutrition may benefit more from personalized support and encouragement during meals.
C. Weigh the client at the same time every morning.
Regular weight monitoring is important in assessing changes in nutritional status. Weighing the client at the same time every morning can provide consistent and valuable data to track progress or identify any concerns related to malnutrition.
D. Sit with the client during meals and snacks.
This is the most appropriate intervention among the options provided. Sitting with the client during meals and snacks can offer emotional support, encourage the client to eat, and provide an opportunity for the nurse to monitor the client's food intake. It also creates a positive social interaction during meals, which can be particularly beneficial for clients with major depressive disorder who may experience appetite changes or difficulty eating alone.