A client is prescribed sertraline, a selective serotonin reuptake inhibitor, for the treatment of depression. The nurse understands that the therapeutic effect of this medication is achieved through which pharmacologic action?

increasing the release of dopamine and norepinephrine in the brains

Blocking the reuptake of serotonin and increasing availability in the brain.

Blocking acetylcholine receptors to reduce anxiety and elevate mood.

Decreasing serotonin production in the brain to prevent overstimulation

Answer and Explanation

The Correct Answer is B

A. Increasing the release of dopamine and norepinephrine in the brain: Sertraline primarily affects serotonin, not dopamine or norepinephrine. Increasing dopamine or norepinephrine release is the mechanism of action for other antidepressants, such as certain SNRIs or bupropion.

B. Blocking the reuptake of serotonin and increasing availability in the brain: Sertraline inhibits the reabsorption of serotonin into presynaptic neurons, increasing its concentration in the synaptic cleft. This enhances serotonergic neurotransmission, which contributes to improved mood and reduction of depressive symptoms over time.

C. Blocking acetylcholine receptors to reduce anxiety and elevate mood: Anticholinergic effects are not the mechanism by which sertraline works. Blocking acetylcholine receptors may cause side effects like dry mouth or constipation but does not produce the antidepressant effect.

D. Decreasing serotonin production in the brain to prevent overstimulation: Sertraline does not decrease serotonin production. Reducing serotonin levels would worsen depressive symptoms rather than treat them. Its therapeutic action relies on increasing serotonin availability.

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Correct Answer is D

Explanation

A. Polyethylene glycol, an osmotic laxative:Polyethylene glycol is used to treat constipation by drawing water into the intestines. It does not prevent chemotherapy-induced nausea or vomiting and is not effective for this purpose.

B. Omeprazole, a proton pump inhibitor:Omeprazole decreases gastric acid production and is used for gastroesophageal reflux or ulcers. It does not prevent chemotherapy-induced nausea or vomiting and is not indicated for prophylaxis.

C. Loperamide, an opioid:Loperamide is an antidiarrheal that slows intestinal motility. It does not prevent nausea or vomiting related to chemotherapy and is not used for this purpose.

D. Ondansetron, a selective 5-HT3 receptor antagonist given 30 minutes before chemotherapy:Ondansetron blocks serotonin receptors in the chemoreceptor trigger zone and gastrointestinal tract, preventing nausea and vomiting. Administering it 30 minutes before chemotherapy provides effective prophylaxis, in patients with severe chemotherapy-induced nausea and vomiting.

A. Hepatic B. Renal C. Gastrointestinal D. Neurological

Correct Answer is B

Explanation

A. Hepatic:Hepatic (liver) damage from NSAIDs usually presents with jaundice, fatigue, or elevated liver enzymes. Dark yellow urine could suggest bilirubinuria, but in the context of edema and decreased urine output, liver involvement is less likely the primary concern.

B. Renal:NSAIDs can reduce renal perfusion and cause nephrotoxicity, leading to fluid retention (bilateral foot swelling), oliguria (decreased urine output), and dark yellow urine due to concentrated urine. These findings indicate renal system damage and possible NSAID-induced nephropathy.

C. Gastrointestinal:NSAID toxicity commonly causes GI irritation, ulcers, or bleeding, often presenting with abdominal pain, nausea, or melena. The patient’s current symptoms do not reflect primary GI involvement.

D. Neurological:Neurological toxicity from NSAIDs is uncommon. Symptoms such as confusion, dizziness, or headache would indicate CNS involvement, which is not seen in this case.

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A client is prescribed sertraline, a selective serotonin reuptake inhibitor, for the treatment of depression. The nurse understands that the therapeutic effect of this medication is achieved through which pharmacologic action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer medication to a client about to begin chemotherapy and has a history of severe nausea and vomiting as a result. Which medication should the nurse anticipate administering prophylactically to best prevent nausea and vomiting related to chemotherapy?

Correct Answer is D

Explanation

A client who reports the use of ibuprofen for chronic back pain is being assessed for possible NSAID toxicity. The nurse identifies symptoms including bilateral foot swelling, dark yellow urine, and a decrease in urinary frequency. Which system is likely being damaged?

Correct Answer is B

Explanation

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