# Psych Final - Cumulative Set

A secondary amine tricyclic antidepressant is prescribed for a patient. The medication will significantly increase the availability of which neurotransmitter?
a. GABA
b. Glutamate
c. Serotonin
d. Norepinephrine
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Terms in this set (1045)
Nortriptyline was prescribed for a 68-year-old patient diagnosed with depression and insomnia. What assessment question should the nurse ask to determine the effectiveness of nortriptyline?
a. "Are you having regular bowel movements?"
b. "Are you no longer experiencing insomnia?"
c. "Have you been successful with weight loss?"
d. "Would you say you are concentrating better?"
A 75-year-old patient with a long history of depression begins amitriptyline 100 mg/day. The patient also takes a diuretic daily for hypertension. What is the highest priority nursing diagnosis this patient is at risk for?
a. Falls related to dizziness and orthostatic hypotension.
b. Ineffective thermoregulation related to anhidrosis.
c. Infection related to suppressed white blood cell count.
d. Constipation related to slowed gastrointestinal peristalsis.
A depressed patient preparing for discharge is prescribed desipramine and will have follow-up outpatient visits. The patient reports, "Why did they gave me only a 1-week supply of my medicine?" Select the nurse's best reply.
a. "Federal law limits the amount you may be given at any one time."
b. "It will save you money if the drug doesn't work well for your symptoms."
c. "This is a way of ensuring that you will come in for your follow-up appointment."
d. "Prescribing a small amount of drug addresses our concerns for your continuing safety."
D

Desipramine is an activating antidepressant, and it might provide a patient who has suicidal ideation with the energy to make an attempt. Because the therapeutic dose and lethal dose are not widely separated, tricyclic antidepressants (TCA) overdose is an often-used suicide plan. Because desipramine appears to be the most toxic TCA, prescribing only a 7-day supply limits the possibility of using the drug in a suicide attempt. The other options are either less relevant or incorrect.
A patient diagnosed with depression is prescribed the tricyclic antidepressant (TCA) bupropion. What is the benefit of this medication for nonhospitalized patients?
a. It has antianxiety properties as well as antidepressant effects.
b. It lowers the seizure threshold to a lesser extent than TCAs.
c. There is reduced potential for lethal overdose.
d. It stimulates appetite and weight gain.
C

Bupropion has no lethal-overdose potential, making it well suited for use in outpatient treatment of depression. Bupropion has a narrow therapeutic index but is far less lethal than TCAs or monoamine oxidase inhibitors (MAOIs). However, it might cause agitation, anxiety, seizures, anorexia, and weight loss.
B

SSRIs often produce sexual dysfunction, such as decreased libido. Patients readily tell nurses about anticholinergic, gastrointestinal, and other side effects, but are not as forthcoming in reporting sexual problems. The nurse might need to ask directly to elicit this information. Patients are more willing to discuss the other options.
A patient tells the nurse, "I've stopped taking sertraline because the drug made me impotent. Which statement by the nurse will provide the best patient support?
c. "Let's talk with your doctor. Changing your medication might be a possibility."
d. "Our priority is to treat your depression. Impotence can be addressed in a few weeks."
A tricyclic antidepressant (TCA) is prescribed for a patient newly diagnosed with depression. What information should be included in patient teaching?
a. "Take this medication on an empty stomach."
b. "Do not eat aged cheese while using this medication."
c. "You might experience sweating, tremors, and excessive urination."
d. "It might be 2 weeks or more before you notice the effects of this medicine."
D

Antidepressant effects might take several weeks to be noticeable. Avoidance of tyramine (as is present in aged cheeses) is necessary for monoamine oxidase inhibitors (MAOIs) therapy but not for TCAs. It is not necessary to take TCAs on an empty stomach. Sweating, tremors, and urination problems are not commonly experienced with TCA therapy.
Why do patients taking tricyclic antidepressants (TCAs) exhibit more side effects than patients taking selective serotonin reuptake inhibitors (SSRIs)?
a. TCAs inhibit reuptake of norepinephrine and serotonin.
b. TCAs selectively inhibit dopamine reuptake.
c. TCAs selectively block serotonin uptake.
d. TCAs block enzymatic breakdown.