A patient diagnosed with major depressive disorder began taking citalopram (Celexa) 4 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to:

Explain the time lag before antidepressants relieve symptoms.

Discuss with the health care provider the need to increase the dose.

Critically assess the patient for symptoms of improvement.

Reassure the patient that the medication will be effective soon.

Answer and Explanation

The Correct Answer is A

Choice A reason: Citalopram, an SSRI, increases serotonin levels, requiring 4-6 weeks to upregulate serotonin receptors and modulate prefrontal-amygdala circuits for mood improvement. Explaining this delay addresses patient expectations, reducing frustration and enhancing adherence by clarifying the neurochemical timeline of antidepressant action.

Choice B reason: Increasing the dose after 4 days is premature, as SSRIs like citalopram require weeks to alter serotonin signaling and neural plasticity. Premature dose escalation risks side effects like serotonin syndrome without addressing the expected therapeutic lag, making it an inappropriate intervention.

Choice C reason: Assessing for improvement after 4 days is unlikely to yield significant findings, as citalopram’s serotonin modulation takes weeks to impact mood via prefrontal cortex changes. This approach may reinforce the patient’s frustration without addressing the neurochemical basis of the delayed response.

Choice D reason: Reassuring effectiveness without explaining the delay is misleading. Citalopram’s action on serotonin pathways requires time for receptor upregulation and neural circuit adaptation. This vague reassurance does not educate the patient on the neurochemical timeline, potentially reducing trust and adherence.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is ["400"]

Explanation

Step 1: Convert the infusion time from minutes to hours.
15 minutes ÷ 60 minutes/hour = 0.25 hours
Result at step 1 = 0.25 hours

Step 2: Calculate the infusion rate in mL/hr.
100 mL ÷ 0.25 hours = 400 mL/hr
Result at step 2 = 400 mL/hr

Step 3: Round to the nearest whole number.
400 mL/hr is already a whole number.
Result at step 3 = 400 mL/hr

A. Notify the provider for a restraint order and assessment. B. Advise the cafeteria staff of plastic utensils that can be used as weapons. C. Ask staff members how the patient was able to acquire the utensil. D. Notify the house supervisor for further direction.

Correct Answer is A

Explanation

Choice A reason: Notifying the provider ensures legal and medical oversight for restraints, addressing self-harm risk driven by serotonin deficits and amygdala hyperactivity. This prioritizes patient safety and evaluates underlying psychiatric causes, ensuring appropriate intervention to stabilize neural dysregulation.

Choice B reason: Advising cafeteria staff is a preventive measure but not the priority during acute self-harm. Serotonin-driven impulsivity requires immediate medical assessment, and addressing utensil access is secondary to stabilizing the patient’s acute neurochemical crisis.

Choice C reason: Investigating utensil acquisition is important for future prevention but not urgent. The patient’s self-harm, driven by serotonin deficits and amygdala hyperactivity, requires immediate medical intervention to ensure safety and address acute psychiatric needs first.

Choice D reason: Notifying the house supervisor is administrative, not clinical, and delays direct intervention. Self-harm reflects serotonin dysregulation and amygdala-driven impulsivity, requiring immediate provider assessment for restraints and psychiatric evaluation, making this less urgent.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A patient diagnosed with major depressive disorder began taking citalopram (Celexa) 4 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer lactated Ringer's 100 mL IV over 15 minutes. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round to the nearest whole number.)

Correct Answer is ["400"]

Explanation

During lunch, a patient cuts herself with a plastic eating utensil. The patient refuses redirection and continues to attempt to cut herself. The patient is safely secured in a restraint chair. What is the next priority action for the nurse?

Correct Answer is A

Explanation

Which finding indicates the successful completion of an individual’s grieving process?

A patient states, "I feel detached from myself and weird all the time. It is as though I am looking at life through a cloudy window. Everything seems unreal. It really messes up things at work and school." This scenario is most suggestive of which health problem?

The nurse preparing to teach a patient diagnosed with post-traumatic stress disorder (PTSD) about recommended psychotherapy and psychopharmacology will discuss:

A depressed older adult client is being treated with a tricyclic antidepressant (TCA). Which side effects are important to assess for?

A nurse is conducting a visit to a client who is receiving palliative care at home for dying. The client’s husband tells the nurse, "I know she needs to be with God. That is the best place for her now." The client is experiencing which stage of Kubler-Ross’ stages of grieving?

A nurse is preparing to administer methylprednisolone 10 mg IV bolus. The amount available from the pharmacy is 40 mg/mL. How many mL should the nurse administer? (Round to the nearest tenth.)

When assessing a patient's plan for suicide, what aspect has priority?

A nurse is preparing to administer dextrose 5% in water (D5W) 1,000 mL IV to infuse over 10 hours. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round to the nearest whole number.)