After a client has been prescribed fluoxetine (Prozac) for a diagnosis of anxiety disorder, which of the following information should the nurse be sure to include in the client teaching?
The client should not stop this medication abruptly to avoid discontinuation syndrome
The client may experience frequent constipation and should increase their intake of dietary fiber
This medication takes 4-6 months to be effective, the client should be told to be patient
This medication can cause addiction, so the client should not take more than prescribed
The Correct Answer is A
Choice A reason: Abruptly stopping fluoxetine, an SSRI, disrupts serotonin levels, causing discontinuation syndrome with symptoms like dizziness and irritability due to rapid neurotransmitter imbalance in the brain. Gradual tapering stabilizes serotonin, preventing withdrawal, making this critical teaching for safe medication management in anxiety treatment.
Choice B reason: Constipation is not a common side effect of fluoxetine, which primarily causes nausea or diarrhea via serotonin modulation. Anticholinergic drugs, not SSRIs, typically cause constipation. This teaching is inaccurate, as fluoxetine’s side effect profile does not emphasize gastrointestinal slowing, making it incorrect.
Choice C reason: Fluoxetine takes 4-8 weeks, not months, to reach efficacy by increasing serotonin in the prefrontal cortex and amygdala. Overstating the timeline discourages adherence, as patients expect faster relief from anxiety symptoms, making this teaching point scientifically inaccurate and misleading.
Choice D reason: Fluoxetine is not addictive, as it lacks the reinforcing GABA effects of benzodiazepines. It modulates serotonin for anxiety without dependence risk. This teaching is incorrect, as it misrepresents fluoxetine’s pharmacological profile, potentially causing unnecessary fear about its safe use in treatment.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Suppressing anger ignores countertransference, which can impair therapeutic neutrality. Anger may stem from patient behaviors linked to dopamine-driven paranoia, but suppression risks unconscious bias affecting care. Addressing feelings through supervision maintains professionalism, making this response less effective for managing emotions.
Choice B reason: Discussing anger with a manager addresses countertransference, a reaction to patient behaviors like suspicion from dopamine dysregulation. This allows reflection, reducing bias and maintaining therapeutic neutrality. It supports professional care by processing emotions, aligning with evidence-based psychiatric nursing practices for managing countertransference.
Choice C reason: Expressing anger directly risks damaging the therapeutic alliance. Suspicion, tied to mesolimbic dopamine excess, may escalate with confrontation, increasing patient anxiety. This approach disregards professional boundaries and neurobiological sensitivities, making it inappropriate for maintaining effective psychiatric care.
Choice D reason: Reassigning the patient avoids addressing countertransference, neglecting professional growth. Suspicion, linked to neurobiological paranoia, requires consistent care. Reassignment disrupts continuity, potentially worsening patient trust and outcomes, making this an ineffective response compared to processing feelings through supervision.
Correct Answer is A
Explanation
Choice A reason: Venlafaxine inhibits serotonin and norepinephrine reuptake, enhancing synaptic levels of these neurotransmitters in the prefrontal cortex and amygdala, improving mood and anxiety. This mechanism aligns with SNRIs, making it the correct choice for treating conditions like depression or anxiety with dual neurotransmitter modulation.
Choice B reason: Propranolol is a beta-blocker, reducing sympathetic activity by blocking norepinephrine at beta receptors, not reuptake. It treats physical anxiety symptoms, not mood via serotonin-norepinephrine pathways. This makes it incorrect for an SNRI, as it lacks reuptake inhibition properties.
Choice C reason: Amitriptyline, a tricyclic antidepressant, inhibits serotonin and norepinephrine reuptake but also affects other receptors, causing significant side effects. It is not classified as an SNRI due to its broader mechanism, making it an incorrect choice compared to venlafaxine’s specific SNRI action.
Choice D reason: Fluoxetine is an SSRI, selectively inhibiting serotonin reuptake, not norepinephrine. It enhances serotonin in mood-regulating areas like the hippocampus but lacks norepinephrine modulation, making it incorrect for an SNRI, which requires dual reuptake inhibition for broader neurotransmitter effects.
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