A nurse is completing medication reconciliation on a client.

Exhibits

For each potential provider's prescription, click to specify if the potential prescription is anticipated, or contraindicated for the client.

A. Midazolam. Midazolam is a benzodiazepine primarily used for sedation, anesthesia, and anxiety management. It is not an antidepressant and does not treat major depressive disorder (MDD).
B. Fluoxetine. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), which is the first-line treatment for major depressive disorder. SSRIs are preferred due to their effectiveness, safety profile, and lower risk of overdose compared to older antidepressants like tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors (MAOIs).
C. Cyclobenzaprine. Cyclobenzaprine is a muscle relaxant used to treat muscle spasms. It is not indicated for depression and does not affect serotonin levels in a way that would benefit clients with MDD.
D. Valproic acid. Valproic acid is a mood stabilizer and anticonvulsant primarily used for bipolar disorder and epilepsy. While mood stabilizers can help in mood disorders, they are not first-line treatments for unipolar depression.

A. Dissociation. Dissociation is a defense mechanism that causes a client to disconnect from thoughts, memories, feelings, or sense of identity in response to trauma. Clients with PTSD may experience memory gaps (dissociative amnesia) as a way to protect themselves from the emotional distress of the traumatic event.
B. Rationalization. Rationalization involves justifying unacceptable behaviors or feelings with logical explanations to avoid true emotions. If the client were rationalizing, they might say, "The assault wasn’t that bad because I fought back." This does not explain memory loss related to PTSD.
C. Undoing. Undoing is a defense mechanism where a person tries to reverse or "undo" a negative action or thought by performing an opposite behavior. For example, an individual who was aggressive toward someone might later be overly kind to compensate. This does not relate to memory loss.
D. Reaction formation. Reaction formation occurs when a person expresses the opposite of their true feelings to cope with distress. For example, if the client felt fear from the attack but acted overly confident or dismissive about it, this would be reaction formation. However, it does not explain inability to recall details of the trauma.