A patient has been taking paroxetine (Paxil) 20 mg per day for 2 weeks and reports headaches, nervousness, and poor appetite.
Which action should the nurse take?
Reassure the patient that these side effects will decrease over time.
Tell the patient to stop taking the drug and contact the provider.
Counsel the patient to take the medication with food.
Suggest that the patient discuss a lower dose with the provider.
The Correct Answer is A
Choice A rationale
This choice is correct. The side effects of paroxetine, including headaches, nervousness, and poor appetite, are common during the initial weeks of treatment and often decrease over time as the patient’s body adjusts to the medication. Reassuring the patient helps them continue the treatment without undue anxiety about these side effects, which are typically transient and manageable.
Choice B rationale
This choice is incorrect. Abruptly stopping paroxetine without consulting a healthcare provider is not recommended because it can lead to withdrawal symptoms and a possible relapse of depression or anxiety. The patient should only discontinue the medication under the guidance of a healthcare provider, who may suggest a gradual tapering off process to minimize withdrawal symptoms.
Choice C rationale
This choice is partially correct. Taking paroxetine with food can help mitigate some gastrointestinal side effects, such as nausea. However, it does not directly address headaches, nervousness, or poor appetite. Although taking the medication with food is a useful tip, it is not the most comprehensive advice for this particular situation.
Choice D rationale
This choice is incorrect. While adjusting the dose may be an option, it is premature to suggest this after only two weeks of treatment. The patient’s body may still be adjusting to the medication, and many side effects diminish with time. The decision to change the dosage should be made by the healthcare provider based on a thorough evaluation of the patient’s response to the treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Cholinergic agonists primarily stimulate the parasympathetic nervous system rather than the central nervous system, affecting activities like digestion, salivation, and decreased heart rate.
Choice B rationale
Parasympathetic nervous system is the correct answer. Cholinergic agonists mimic acetylcholine and stimulate parasympathetic responses, promoting rest-and-digest functions such as reducing heart rate and enhancing glandular secretions.
Choice C rationale
The sympathetic nervous system is not stimulated by cholinergic agonists. Instead, this system is activated by adrenergic agonists, which prepare the body for fight-or-flight responses, increasing heart rate and blood pressure.
Choice D rationale
Voluntary nervous system control is not the primary target of cholinergic agonists. This system governs skeletal muscle movement and is influenced by neuromuscular junctions rather than the autonomic responses modulated by cholinergic drugs. .
Correct Answer is B
Explanation
Choice A rationale
Peripheral edema is more commonly associated with right-sided heart failure rather than left-sided. This is because right-sided heart failure leads to systemic venous congestion, causing fluid to accumulate in the peripheral tissues, particularly in the legs and ankles.
Choice B rationale
Pulmonary edema is a major concern in left-sided heart failure due to the inability of the left ventricle to effectively pump blood out to the systemic circulation. This results in blood backing up into the pulmonary veins, leading to fluid accumulation in the lungs.
Choice C rationale
Liver edema, or hepatomegaly, is more typically seen in right-sided heart failure, where the failure of the right ventricle causes blood to back up into the systemic circulation, affecting the liver and other organs.
Choice D rationale
Abdominal edema, or ascites, is also more associated with right-sided heart failure. This condition occurs due to increased pressure in the veins and capillaries, leading to fluid leakage into the abdominal cavity.
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