A 39-year-old woman with difficult-to-treat depression has tried all the antidepressant classes except MAOIs. She is currently taking an SSRI that will require a 5-week washout period before switching to an MAOI. Which of the following SSRIs is she currently taking?
Escitalopram (Lexapro)
Sertraline (Zoloft)
Fluoxetine (Prozac)
Paroxetine (Paxil)
The Correct Answer is C
Choice A reason: Escitalopram has a relatively short half-life and typically requires a 2-week washout period before initiating an MAOI to avoid serotonin syndrome.
Choice B reason: Sertraline also has a shorter half-life and does not require a 5-week washout. A 2-week period is generally sufficient.
Choice C reason: Fluoxetine has the longest half-life among SSRIs, with active metabolites that persist in the body for weeks. Due to this extended duration, a 5-week washout period is recommended before starting an MAOI to prevent serotonin toxicity.
Choice D reason: Paroxetine has a short half-life and would not necessitate a 5-week washout. A 2-week interval is typically adequate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Taking detailed notes may help with documentation but does not directly foster a therapeutic alliance. It does not address the interpersonal dynamics or belief differences between the clinician and client.
Choice B reason: Asking preset questions may help structure the interview but can feel impersonal or rigid. It does not ensure respect for the client’s worldview or promote emotional safety.
Choice C reason: Nonjudgment is essential in therapeutic relationships, especially when personal beliefs differ. It allows the clinician to accept the client’s values and experiences without imposing their own. This fosters trust, openness, and psychological safety.
Choice D reason: While explaining that personal views won’t interfere may seem reassuring, it can come across as defensive or dismissive. Actions demonstrating nonjudgment and respect are more effective than verbal assurances alone.
Correct Answer is D
Explanation
Choice A reason: Melatonin is a hormone that regulates the sleep-wake cycle and induces drowsiness. While it affects consciousness and is technically psychoactive, it is not classified as an herbal supplement but rather a hormone. Its psychoactivity is mild and primarily limited to sleep regulation.
Choice B reason: Tryptophan is an amino acid precursor to serotonin, which influences mood and sleep. It has psychoactive properties due to its role in serotonin synthesis, but it is not typically categorized as a standalone psychoactive herbal supplement.
Choice C reason: SAM-e (S-Adenosyl-L-methionine) is a compound involved in neurotransmitter synthesis and is used for mood disorders. It alters mental states and is considered psychoactive, but it is a synthesized supplement rather than a traditional herbal product.
Choice D reason: Valerian is a well-known herbal supplement with sedative properties. It acts on GABA receptors in the brain, promoting relaxation and drowsiness. Among the choices, it is the most classically recognized psychoactive herbal product due to its direct central nervous system effects.
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