Amitriptyline, a tricyclic antidepressant, is prescribed for an adult client who is clinically depressed.
The client is admitted to the hospital due to suicidal ideation five days after starting the medication.
The client informs the practical nurse (PN) that the medication isn’t working as suicidal thoughts persist.
What information should the PN provide?
A review of the medication regimen is required due to the poor drug response.
A dosage increase may be needed, which requires in-hospital evaluation.
Therapy sessions may be needed to enhance the medication’s action on depression.
Antidepressant medication can take 2 to 4 weeks to become effective.
The Correct Answer is D
The correct answer is D. Antidepressant medication can take 2 to 4 weeks to become effective. Choice A rationale While it’s important to review the medication regimen if a patient is not responding to treatment, it’s also crucial to understand that antidepressants like amitriptyline don’t typically show their full effects immediately. It’s common for these medications to take several weeks before their full therapeutic effect becomes apparent. Choice B rationale A dosage increase may be considered if the patient shows no improvement after a sufficient period, typically several weeks. However, since the patient has only been on the medication for five days, it’s too early to consider a dosage increase. Choice C rationale Therapy can indeed be beneficial in treating depression and can enhance the effect of medication. However, the statement that the medication isn’t working after five days is likely due to the fact that antidepressants usually take longer to start showing effects. Choice D rationale This is the correct answer. Antidepressants like amitriptyline often take 2 to 4 weeks to start showing their full effects. It’s important for patients to know this so they don’t get discouraged and stop taking the medication too soon.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Involuntary movements of the lips and tongue are typically associated with antipsychotic medications, not nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac15. Therefore, observing the client for these symptoms would not be a relevant intervention for a client taking ketorolac15.
Choice B rationale
Administering the medication at least 30 minutes before meals is not a specific requirement for ketorolac15. Therefore, this would not be a necessary intervention for a client taking this medication15.
Choice C rationale
Ketorolac, like other NSAIDs, can increase the risk of bleeding15. This can manifest as areas of ecchymosis (bruising) or other signs of bleeding on the skin15. Therefore, assessing the skin daily for these signs would be an important intervention for a client taking ketorolac15.
Choice D rationale
Peak and trough serum levels are typically monitored for medications with a narrow therapeutic index, such as certain antibiotics15. Ketorolac does not typically require
monitoring of serum levels15. Therefore, ensuring peak and trough serum levels are collected would not be a necessary intervention for a client taking this medication15.
Correct Answer is B
Explanation
Choice A rationale
While it is generally recommended to take prednisone with meals to reduce stomach upset, this is not the most important instruction regarding the dosing schedule.
Choice B rationale
Prednisone is a corticosteroid that is often prescribed in a tapering schedule, meaning the dosage is gradually reduced over time. This is to allow the body to adjust and to minimize potential side effects, such as adrenal insufficiency, which can occur if prednisone is stopped suddenly.
Choice C rationale
While monitoring of blood glucose levels is important for patients taking prednisone, especially those with diabetes, as prednisone can increase blood sugar levels, it is not the most important instruction regarding the dosing schedule.
Choice D rationale
Monitoring of oral temperature daily is not typically required for patients taking prednisone.
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