A 29-year-old man has been diagnosed by the PMHNP with depression, and they have mutually agreed on a trial of an SSRI. The client asks the PMHNP, "Should I stop taking my St. John's Wort?" What is the most appropriate response?
"If you've been taking St. John's Wort and it's not working, an SSRI might not be the best choice. Let's look at other options."
"No, the two actually complement each other well."
"Yes, the interaction between the prescription and St. John's Wort could be life-threatening."
"Maybe you didn't give the St. John's Wort long enough to start working. Give it some more time before you start the SSRI."
The Correct Answer is C
Choice A reason: This response incorrectly implies that lack of efficacy from St. John's Wort precludes SSRI use. The concern is not efficacy overlap but the risk of serotonin syndrome due to additive serotonergic effects.
Choice B reason: This is incorrect and dangerous. St. John's Wort and SSRIs both increase serotonin levels, and their combination can lead to serotonin syndrome. They do not complement each other and should not be used together.
Choice C reason: This is the correct response. St. John's Wort has serotonergic properties and can interact with SSRIs, increasing the risk of serotonin syndrome. The combination is contraindicated due to the potential for life-threatening adverse effects.
Choice D reason: This response delays appropriate treatment and overlooks the safety concern. Continuing St. John's Wort while initiating an SSRI is unsafe and not recommended.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Countertransference refers to the clinician’s emotional reactions to the client, often based on the clinician’s own unconscious processes. It does not apply to the client’s behavior in this scenario.
Choice B reason: Transference occurs when a client unconsciously redirects feelings and expectations from a significant person in their past onto the therapist. Calling the PMHNP by her sister’s name and expressing emotional familiarity are classic signs of transference.
Choice C reason: Projection involves attributing one’s own unacceptable thoughts or feelings to another person. It is not evident in this scenario, where the client is associating the therapist with a lost loved one.
Choice D reason: Repression is a defense mechanism where distressing thoughts are pushed out of conscious awareness. The client is actively expressing feelings and memories, not repressing them.
Correct Answer is A
Explanation
Choice A reason: Dopamine plays a central role in the pathophysiology of extrapyramidal symptoms. EPS occurs due to dopamine receptor blockade in the nigrostriatal pathway, particularly with antipsychotic medications. Reducing dopamine activity in this pathway leads to motor disturbances similar to Parkinsonism. Therefore, managing EPS often involves balancing dopamine levels or using medications that counteract dopamine blockade.
Choice B reason: Serotonin is involved in mood regulation and other central nervous system functions, but it is not directly implicated in the development of EPS. While some antipsychotics affect serotonin receptors, EPS symptoms are primarily linked to dopamine dysregulation.
Choice C reason: Norepinephrine is associated with arousal, attention, and stress responses. It does not play a significant role in the extrapyramidal system, and altering its levels would not directly alleviate EPS.
Choice D reason: Glutamate is the primary excitatory neurotransmitter and is involved in learning and memory. Although it interacts with dopamine systems, it is not the primary neurotransmitter responsible for EPS, and decreasing glutamate would not be a targeted approach for treating these symptoms.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.