A client who was placed on a medication for depression 7 days ago is concerned that he is not experiencing any change in his symptoms. What is the best response by the nurse?
This is normal because it typically takes 3-6 weeks for medications for depression to reach full therapeutic effect
Your symptoms should have improved by now. You need to schedule a follow-up appointment with your provider
Clients who do not have symptom relief in 5-7 days usually need to be placed on a different medication
It is normal for clients to have incomplete symptom relief, but any symptoms that remain after 7 days will be permanent
The Correct Answer is A
Choice A reason: Antidepressants, like SSRIs or tricyclics, require 3-6 weeks to achieve full therapeutic effect due to gradual neuroplastic changes, including upregulation of serotonin or norepinephrine receptors. Initial synaptic monoamine increases take time to translate into mood improvement, making this statement accurate and reassuring for the patient.
Choice B reason: Expecting symptom improvement within 7 days is unrealistic, as antidepressants require weeks to alter brain chemistry effectively. Suggesting immediate follow-up implies treatment failure prematurely, which is inaccurate. Monitoring is needed, but this statement misrepresents the typical timeline for antidepressant efficacy.
Choice C reason: Lack of symptom relief in 5-7 days does not necessitate switching medications, as antidepressants typically take 3-6 weeks for effect. Early non-response does not indicate failure, as synaptic and receptor adaptations are gradual. This statement is inaccurate and may lead to unnecessary medication changes.
Choice D reason: Incomplete symptom relief at 7 days is normal, but stating remaining symptoms are permanent is inaccurate. Antidepressants often achieve partial or full response by 6-8 weeks, and adjustments can optimize outcomes. This statement is misleading, as it falsely suggests persistent symptoms are unchangeable.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Methotrexate, a DMARD, inhibits folate metabolism, suppressing immune activity in rheumatoid arthritis. A common side effect is nausea, resulting from gastrointestinal mucosal irritation due to folate antagonism. This affects rapidly dividing cells in the gut, making nausea a recognized complication requiring monitoring or antiemetic support.
Choice B reason: Joint swelling is a symptom of active rheumatoid arthritis, not a complication of methotrexate. Methotrexate reduces joint inflammation by inhibiting immune responses. Persistent swelling suggests inadequate disease control, not a drug side effect, making this finding unrelated to methotrexate complications.
Choice C reason: Generalized aching and stiffness are symptoms of rheumatoid arthritis itself, not methotrexate complications. Methotrexate aims to alleviate these by reducing synovial inflammation. If these persist, it indicates disease activity, not a drug side effect, making this finding incorrect for a methotrexate complication.
Choice D reason: Rheumatoid nodules are a feature of rheumatoid arthritis, not a side effect of methotrexate. These subcutaneous nodules result from chronic inflammation, not drug toxicity. Methotrexate may reduce nodule formation by controlling disease activity, making this finding unrelated to medication complications.
Correct Answer is B
Explanation
Choice A reason: Achieving euthyroid state before hyperthyroidism procedures, like thyroidectomy, aims to normalize thyroid hormone levels, not prevent hypothyroidism. Post-procedure hypothyroidism is a separate concern managed with hormone replacement. This statement is inaccurate, as the primary goal is to stabilize metabolism, not prevent low thyroid function.
Choice B reason: Medications like methimazole or propylthiouracil are used pre-procedure to achieve euthyroid state, reducing thyroid hormone levels to prevent thyroid storm—a life-threatening hypermetabolic crisis triggered by surgery or stress. This statement is accurate, as stabilizing thyroid function minimizes perioperative complications like tachycardia or hyperthermia.
Choice C reason: Euthyroid state does not directly enhance the efficacy of anti-thyroid medications but rather prepares the patient for surgery by reducing hyperthyroid symptoms. Medications are effective independently, and this statement is inaccurate, as the rationale focuses on patient safety, not drug potentiation.
Choice D reason: While euthyroid state reduces metabolic stress, it does not primarily minimize bleeding risk. Bleeding is managed through surgical techniques and coagulation status, not thyroid hormone levels. This statement is inaccurate, as bleeding risk is not the primary concern addressed by achieving euthyroid state pre-procedure.
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