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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Physiologic doses of glucocorticoids, like hydrocortisone, mimic normal cortisol production (20-30 mg/day) in adrenal insufficiency, restoring hypothalamic-pituitary-adrenal axis feedback. This maintains metabolism, stress response, and immune function without excess. This statement is accurate, as these doses replace deficient cortisol to stabilize endocrine function.
Choice B reason: Physiologic doses have minimal impact on fluid and electrolyte balance compared to pharmacologic doses, which cause sodium retention via mineralocorticoid effects. In adrenal insufficiency, physiologic doses normalize cortisol without significant fluid shifts. This statement is inaccurate, as electrolyte effects are secondary and less pronounced.
Choice C reason: Physiologic doses replace cortisol in adrenal insufficiency, not treat inflammation. Pharmacologic (higher) doses suppress inflammation in diseases like rheumatoid arthritis by inhibiting cytokine production. This statement is inaccurate, as physiologic doses are insufficient for anti-inflammatory effects required in such conditions.
Choice D reason: Glucocorticoids increase, not lower, blood glucose by promoting gluconeogenesis and insulin resistance. Physiologic doses maintain normal glucose metabolism in adrenal insufficiency but do not replace insulin’s role. This statement is inaccurate, as glucocorticoids oppose insulin’s glucose-lowering effects, even at physiologic levels.
Correct Answer is A
Explanation
Choice A reason: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, not primarily an inflammatory disease. While low-grade inflammation may be present in some cases, IBS is characterized by altered gut motility and visceral hypersensitivity without significant inflammatory markers, unlike inflammatory bowel diseases like Crohn’s or ulcerative colitis. This statement is inaccurate.
Choice B reason: Stress is a well-documented trigger for IBS symptoms. The brain-gut axis, involving the hypothalamic-pituitary-adrenal axis, modulates gut motility and sensitivity. Psychological stress can exacerbate visceral pain, diarrhea, or constipation by altering neurotransmitter release and gut microbiome interactions, making this statement accurate for IBS pathophysiology.
Choice C reason: IBS treatment focuses on symptom relief, as there is no cure. Strategies include dietary modifications (e.g., low FODMAP diet), antispasmodics, laxatives, or antidiarrheals to manage pain, bloating, and bowel irregularities. This statement is accurate, reflecting the symptomatic approach to improving quality of life in IBS patients.
Choice D reason: IBS symptoms commonly include constipation, diarrhea, or alternating patterns, along with abdominal pain and bloating. These result from dysregulated gut motility and visceral hypersensitivity, affecting the enteric nervous system. This statement is accurate, as variable bowel habits are a hallmark of IBS diagnostic criteria.
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