A 51-year-old woman presents to the PMHNP with complaints of depressed mood, fatigue, and anhedonia. She is in menopause and reports vasomotor symptoms. Which of the following medications effectively treats both depressive and vasomotor symptoms?
Bupropion (Wellbutrin)
Escitalopram (Lexapro)
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
The Correct Answer is C
Choice A reason: Bupropion primarily acts as a norepinephrine-dopamine reuptake inhibitor and is effective in treating depressive symptoms. However, it has little to no efficacy in managing vasomotor symptoms associated with menopause, such as hot flashes or night sweats, and therefore would not address both conditions simultaneously.
Choice B reason: Escitalopram, a selective serotonin reuptake inhibitor, is effective in treating depression and anxiety but has limited effectiveness in alleviating vasomotor symptoms. While SSRIs can sometimes help with hot flashes, their efficacy is not as pronounced as that of certain SNRIs like desvenlafaxine.
Choice C reason: Desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor, has demonstrated efficacy in treating both depressive symptoms and vasomotor symptoms such as hot flashes in menopausal women. Its dual action on serotonin and norepinephrine pathways contributes to both mood stabilization and modulation of thermoregulatory symptoms, making it the optimal choice for patients presenting with both conditions.
Choice D reason: Duloxetine is also an SNRI effective for depression and anxiety. While it can have some effect on vasomotor symptoms, its evidence base for treating menopausal hot flashes is less robust compared to desvenlafaxine. Therefore, it is not the first-line option when targeting both depression and vasomotor symptoms simultaneously.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A living will is a legal document that specifies a person's wishes regarding medical treatment in situations where they are unable to communicate their decisions. However, it is not uniformly recognized or enforceable in all 50 states, as the exact requirements and legal weight of a living will can vary by state.
Choice B reason: A durable power of attorney (DPOA) for healthcare is recognized in all 50 states. It allows a designated agent to make healthcare decisions on behalf of the individual if they are incapacitated, providing a consistent and legally enforceable method of decision-making across the country.
Choice C reason: A living will does not typically address financial matters. It is specifically focused on healthcare decisions, such as the use of life-sustaining treatment, resuscitation, and palliative care preferences. Financial matters are addressed separately, often through a general durable power of attorney or estate planning documents.
Choice D reason: A living will is distinct from a healthcare proxy. While both relate to healthcare decisions, a healthcare proxy (or medical power of attorney) designates an agent to make decisions on the individual's behalf, whereas a living will documents specific treatment preferences directly.
Correct Answer is B
Explanation
Choice A reason: The right hemisphere primarily governs spatial awareness, attention, and nonverbal processing. Difficulty with language and motor planning is less likely to result from right-sided lesions.
Choice B reason: The left hemisphere typically controls language and fine motor planning, especially in right-handed individuals. Difficulty with word-finding (aphasia) and daily activities (apraxia) suggests involvement of the left hemisphere, consistent with this patient’s deficits.
Choice C reason: The brainstem controls basic vital functions, cranial nerves, and motor/sensory pathways but is not the primary center for language or fine motor planning.
Choice D reason: The cerebellum coordinates movement, balance, and motor learning. Cerebellar lesions typically produce ataxia, dysmetria, and tremor, but not language deficits or apraxia.
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