A 16-year-old pregnant adolescent has been treated for depression with cognitive behavioral therapy and fish oil, which contains omega- 3 fatty acids. The patient continues to have symptoms of depression. After further evaluation, the nurse practitioner should consider adding:
St. John's wort.
a serotonin and norepinephrine reuptake inhibitor (SNRI).
a selective serotonin reuptake inhibitor (SSRI)
a tricyclic antidepressant (TCA).
The Correct Answer is C
Rationale:
A. St. John’s wort is not recommended during pregnancy due to limited safety data and potential drug interactions.
B. SNRIs may be considered in adults but have less safety data in pregnancy compared with SSRIs.
C. Selective serotonin reuptake inhibitors (SSRIs) are first-line pharmacologic therapy for depression during pregnancy when nonpharmacologic measures are insufficient. SSRIs like sertraline or fluoxetine have the most safety data for use in pregnant adolescents.
D. Tricyclic antidepressants (TCAs) are generally reserved for cases unresponsive to SSRIs due to more adverse effects and risk of cardiotoxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Inability to retract a previously retractable prepuce (paraphimosis or recurrent phimosis) after treatment may indicate an underlying structural problem and warrants referral to a urologist.
B. Difficulty maintaining hygiene is common in uncircumcised adolescents and can often be managed with education on proper cleaning techniques.
C. Desire for circumcision alone is not an urgent indication for urology referral; it can be elective.
D. Nocturnal erections are a normal physiological process in adolescent males and do not necessitate referral.
Correct Answer is D
Explanation
Rationale:
A. Formal neuropsychological testing is more appropriate for older children who can follow complex instructions; it is not suitable for a 2-year-old.
B. IQ tests require certain language and cognitive skills that a 2-year-old may not yet possess, limiting their utility at this age.
C. Radiographic evaluation can identify structural abnormalities but does not assess functional cognitive abilities.
D. Assessment of developmental milestones is the most practical and effective method for detecting cognitive impairment in a 2-year-old. Tracking language, motor, social, and problem-solving skills provides a reliable indication of cognitive development relative to age norms.
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