A depressed client states that her daughter uses amphetamines, then asks the nurse, “What will happen when my daughter can’t get them and goes into withdrawal from them?” Which response by the nurse would be helpful information for the client?

“Your daughter will become very tired and may experience depression.”

“It’s hard to say because she may not have any problems except mild nausea.”

“Sometimes it can cause people to become agitated and act aggressively toward others.”

“There’s a high risk of seizures and other neurological problems.”

Answer and Explanation

The Correct Answer is A

Amphetamine withdrawal occurs when chronic use of stimulant drugs like amphetamine or methamphetamine is abruptly discontinued. The body, having adapted to elevated dopamine and norepinephrine levels, experiences a neurochemical crash. This leads to symptoms such as fatigue, hypersomnia, depression, and anhedonia. The withdrawal process is largely psychological, with physical symptoms being mild. While cravings and mood instability are common, seizures and severe neurological complications are rare unless there is co-occurring substance use or underlying pathology.

Rationale for correct answer

1. Fatigue and depression are hallmark symptoms of amphetamine withdrawal. The sudden drop in stimulant-induced neurotransmitter activity leads to lethargy, hypersomnia, and low mood. These symptoms reflect the body’s attempt to recalibrate after prolonged stimulation and are expected in most cases of withdrawal.

Rationale for incorrect answers

2. Mild nausea is not a defining feature of amphetamine withdrawal. This response minimizes the psychological impact and may mislead the client into underestimating the seriousness of mood-related symptoms like depression and anhedonia.

3. While agitation can occur, it is not the most common or defining symptom. Aggression is more typical during intoxication or in cases of polysubstance withdrawal. This response may unnecessarily alarm the client and misrepresent the usual withdrawal profile.

4. Seizures are not a high-risk feature of amphetamine withdrawal. Unlike alcohol or benzodiazepines, stimulants do not typically cause withdrawal seizures unless there is concurrent use of other substances or predisposing neurological conditions.

Take Home Points

Amphetamine withdrawal commonly causes fatigue, hypersomnia, and depressed mood due to neurotransmitter depletion.
Severe neurological symptoms like seizures are rare unless other substances are involved.
Agitation may occur but is less common than emotional and energy-related symptoms.
Accurate education helps families anticipate and support withdrawal safely and effectively.

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Correct Answer is ["A","B","C"]

Explanation

Electroconvulsive therapy (ECT) is a procedure that induces a controlled seizure to treat severe psychiatric conditions. Prior to ECT, specific medications are administered to reduce cardiac complications, facilitate anesthesia, and prevent muscle injury. These agents are chosen to optimize safety and seizure quality without interfering with the therapeutic mechanism.

Rationale for correct answers

1. Glycopyrrolate is an anticholinergic used pre-ECT to reduce salivary secretions and prevent bradycardia during the procedure. Its peripheral action minimizes central side effects, making it ideal for ECT preparation.

2. Thiopental sodium is a barbiturate anesthetic that induces rapid unconsciousness before ECT. It has a short duration of action and minimal impact on seizure threshold, making it suitable for brief procedures.

3. Succinylcholine is a neuromuscular blocker administered to prevent musculoskeletal injury during the seizure. It produces short-term paralysis, reducing the risk of fractures or dislocations during convulsions.

Rationale for incorrect answers

4. Lorazepam is a benzodiazepine that raises the seizure threshold and may blunt the therapeutic seizure. Its sedative properties interfere with ECT efficacy, making it contraindicated before the procedure.

5. Divalproex sodium is an anticonvulsant that suppresses seizure activity. Administering it before ECT would counteract the intended seizure induction, reducing treatment effectiveness.

Take Home Points

Pre-ECT medications include anticholinergics, anesthetics, and muscle relaxants to optimize safety and seizure quality.
Benzodiazepines and anticonvulsants are avoided as they interfere with seizure induction.
Glycopyrrolate prevents bradycardia and excessive secretions during ECT.
Succinylcholine minimizes physical injury by inducing short-term paralysis during the seizure.

A. The client will express feeling rested on awakening. B. The client will rate pain level at or below a 4/10. C. The client will sleep 6 to 8 hours at night by day 5. D. The client will maintain a steady sleep pattern while hospitalized.

Correct Answer is C

Explanation

Sleep disturbance in depression is a core symptom, often presenting as insomnia or hypersomnia. In clients with major depressive disorder, sleep disruption is frequently exacerbated by somatic pain, which interferes with sleep initiation and maintenance. The goal of nursing care is to restore restorative sleep patterns through behavioral, pharmacologic, and environmental interventions. Sleep quality directly influences mood regulation, cognitive function, and pain perception. Short-term goals must be measurable, time-bound, and focused on functional improvement.

Rationale for correct answer

3. A goal of sleeping 6 to 8 hours by day 5 is measurable and time-specific, aligning with short-term outcome criteria. It reflects a realistic target for sleep restoration in clients with depression and pain, allowing evaluation of nursing interventions and adjustment of care plans.

Rationale for incorrect answers

1. Rested is a subjective term and lacks measurable criteria. While feeling rested is desirable, it cannot be objectively evaluated or tracked over time, making it unsuitable for short-term outcome documentation.

2. Pain rating addresses the physical symptom but not the sleep pattern directly. Although pain management is essential, this outcome does not reflect improvement in sleep behavior, which is the focus of the nursing diagnosis.

4. Steady sleep pattern is vague and lacks a defined timeframe or quantifiable metric. Without specifying duration or quality, it cannot be reliably assessed or used to guide care.

Take Home Points

Sleep goals in depression should be specific, measurable, and time-bound to evaluate progress.
Pain management supports sleep but must be linked to sleep outcomes for relevance.
Subjective feelings like “rested” are not reliable indicators for nursing outcomes.
Vague terms like “steady” lack the precision needed for short-term goal setting.

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A depressed client states that her daughter uses amphetamines, then asks the nurse, “What will happen when my daughter can’t get them and goes into withdrawal from them?” Which response by the nurse would be helpful information for the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following medications may be administered before electroconvulsive therapy? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

A client admitted with major depressive disorder has a nursing diagnosis of ineffective sleep pattern related to aches and pains. Which is an appropriate short-term outcome for this client?

Correct Answer is C

Explanation

Which statement describes a major difference between a client diagnosed with major depressive disorder and a client diagnosed with dysthymic disorder?

A client diagnosed with major depressive disorder has an outcome that states, “The client will verbalize a measure of hope about the future by day 3.” Which client statement indicates this outcome was successful?

Which client is at highest risk for the diagnosis of major depressive disorder?

A depressed client states that her daughter uses amphetamines, then asks the nurse, “What will happen when my daughter can’t get them and goes into withdrawal from them?” Which response by the nurse would be helpful information for the client?

Which of the following medications may be administered before electroconvulsive therapy? Select all that apply.

A client is admitted to an in-patient psychiatric unit with a diagnosis of major depressive disorder. Which of the following data would the nurse expect to assess? Select all that apply.

Which intervention takes priority when working with newly admitted clients experiencing suicidal ideations?

A client diagnosed with major depressive disorder is being considered for electroconvulsive therapy (ECT). Which client teaching should the nurse prioritize?