A nurse is caring for a client who is taking a tricyclic antidepressant. For which of the following findings should the nurse monitor as an adverse effect of tricyclic antidepressants?
Orthostatic hypotension
Diarrhea
Hyperactivity
increased urinary output
The Correct Answer is A
A. Orthostatic hypotension: Orthostatic hypotension, a sudden drop in blood pressure upon standing up, is a common adverse effect of tricyclic antidepressants. TCAs can block the alpha-1 adrenergic receptors, leading to decreased vascular tone and subsequent orthostatic hypotension.
B. Diarrhea: Diarrhea is not typically associated with tricyclic antidepressants. In fact, constipation is a more common gastrointestinal adverse effect of TCAs due to their anticholinergic properties, which can slow down bowel motility.
C. Hyperactivity: Hyperactivity is not a common adverse effect of tricyclic antidepressants. Instead, TCAs may cause sedation or drowsiness due to their antihistamine properties.
D. Increased urinary output: Tricyclic antidepressants can cause urinary retention rather than increased urinary output. Anticholinergic effects of TCAs can lead to urinary hesitancy, difficulty initiating urination, or retention, particularly in individuals with benign prostatic hyperplasia.
A. Orthostatic hypotension: Orthostatic hypotension, a sudden drop in blood pressure upon standing up, is a common adverse effect of tricyclic antidepressants. TCAs can block the alpha-1 adrenergic receptors, leading to decreased vascular tone and subsequent orthostatic hypotension.
B. Diarrhea: Diarrhea is not typically associated with tricyclic antidepressants. In fact, constipation is a more common gastrointestinal adverse effect of TCAs due to their anticholinergic properties, which can slow down bowel motility.
C. Hyperactivity: Hyperactivity is not a common adverse effect of tricyclic antidepressants. Instead, TCAs may cause sedation or drowsiness due to their antihistamine properties.
D. Increased urinary output: Tricyclic antidepressants can cause urinary retention rather than increased urinary output. Anticholinergic effects of TCAs can lead to urinary hesitancy, difficulty initiating urination, or retention, particularly in individuals with benign prostatic hyperplasia.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A client who is experiencing withdrawal from oxycodone: While withdrawal from opioids like oxycodone can cause various symptoms, including agitation, anxiety, and muscle aches, it's not typically associated with an increased risk of seizures.
B. A client who is experiencing withdrawal from diazepam: Withdrawal from benzodiazepines like diazepam can indeed increase the risk of seizures. Abrupt cessation of benzodiazepines after prolonged use can lead to withdrawal symptoms, including seizures. Therefore, seizure precautions would be appropriate for this client.
C. A client who has a low lithium level: Low lithium levels can potentially lead to lithium toxicity, which can cause various symptoms, but seizures are not commonly associated with low lithium levels. However, in severe cases of lithium toxicity, seizures can occur.
D. A client who has a low imipramine level: Imipramine is a tricyclic antidepressant (TCA). Low levels of TCAs are not typically associated with an increased risk of seizures. However, high levels of TCAs can be toxic and may lead to seizures.
Correct Answer is B
Explanation
A. Give the client a cup of hot black tea before bed: Consuming caffeinated beverages such as black tea before bed can interfere with sleep and exacerbate sleep disturbances. This instruction is not appropriate for addressing sleep issues in Alzheimer's disease.
B. Wake the client at the same time each morning: Maintaining a consistent wake-up time can help regulate the client's sleep-wake cycle and promote better sleep hygiene. Consistency in waking time is an important aspect of managing sleep disturbances in Alzheimer's disease.
C. Take the client for a walk 2 hours before bedtime each night: Engaging in physical activity during the day, including taking a walk, can promote better sleep patterns. However, engaging in vigorous physical activity close to bedtime may have the opposite effect and disrupt sleep.
D. Allow the client to take a 90-min nap immediately after lunch: While brief daytime naps may be beneficial for some individuals with Alzheimer's disease, allowing a 90-minute nap immediately after lunch may interfere with the client's ability to consolidate nighttime sleep and worsen sleep disturbances.
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