A nurse is caring for a client who has been prescribed fluoxetine for major depressive disorder. Which finding should the nurse recognize as a priority to report to the provider?

The client reports dry mouth and mild insomnia

The client reports new-onset agitation and thoughts of self-harm

The client reports improved energy and appetite

The client reports nausea and headache during the first week

Answer and Explanation

The Correct Answer is B

A. The client reports dry mouth and mild insomnia: These are common, mild side effects of selective serotonin reuptake inhibitors (SSRIs) like fluoxetine. They are generally self-limiting and manageable with supportive care or lifestyle modifications.

B. The client reports new-onset agitation and thoughts of self-harm: New or worsening suicidal ideation, particularly during the first few weeks of SSRI therapy, is a critical safety concern. Increased energy from improved depressive symptoms can sometimes enable clients to act on existing suicidal thoughts. Immediate reporting to the provider is essential for risk assessment and intervention.

C. The client reports improved energy and appetite: These findings indicate therapeutic improvement and response to treatment. They do not represent an adverse event and would not require urgent intervention.

D. The client reports nausea and headache during the first week: Mild gastrointestinal or neurological side effects are common early in SSRI therapy. These symptoms typically resolve within days to weeks and are monitored but do not necessitate immediate reporting unless they worsen significantly.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. “You may become addicted to the medication and need it to feel normal.": Addiction involves compulsive drug-seeking behavior and psychological dependence, which is distinct from physiological tolerance. Tolerance refers specifically to reduced pharmacologic effect over time, not the development of a psychological need for the drug.

B. "You will not experience withdrawal symptoms if you stop taking the medication suddenly.": Withdrawal symptoms occur when the body has adapted to long-term opioid exposure and the drug is abruptly discontinued. This reflects physical dependence, not tolerance. Educating about withdrawal is important, but it is separate from explaining tolerance.

C. "You may need higher doses of the medication over time to achieve the same level of pain relief.": Tolerance occurs when repeated exposure to a drug reduces its pharmacologic effect, requiring progressively higher doses to achieve the original therapeutic outcome. This is a normal physiological adaptation to prolonged opioid therapy.

D. "You will no longer get any therapeutic effects from this drug.": Tolerance does not typically eliminate all therapeutic effects; it reduces responsiveness, meaning higher doses may be needed to maintain efficacy. Complete loss of effect is not a defining feature of drug tolerance.

Correct Answer is ["56.8"]

Explanation

Calculation:

Identify the client’s weight in pounds

Weight: 125 lbs

Convert pounds to kilograms

1 kg = 2.2 lbs

Weight in kg = 125 ÷ 2.2

= 56.818 kg

Round to one decimal place

= 56.8 kg

View Question and Answer

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A nurse is caring for a client who has been prescribed fluoxetine for major depressive disorder. Which finding should the nurse recognize as a priority to report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving opioid therapy for pain management. The nurse is educating the client about the effects of long-term opioid use. Which statement by the nurse best explains the concept of drug tolerance?

Correct Answer is C

Explanation

A nurse is preparing to administer a medication to a client. The prescribed dose is 0.05 mg/kg. The client weighs 125 pounds. How many kilograms does the client weigh?

Correct Answer is ["56.8"]

Explanation

A nurse is caring for a client who has been prescribed fluoxetine for major depressive disorder. Which finding should the nurse recognize as a priority to report to the provider?

A nurse is providing teaching to a client with opioid use disorder who is prescribed naltrexone. Which client statement demonstrates an accurate understanding of how naltrexone works?

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