(Select all that apply): A client with MDD is prescribed an atypical antidepressant. Which statements are true about atypical antidepressants? (Select three).

Choice B rationale:

Bupropion, an atypical antidepressant, indeed blocks the reuptake of both dopamine and norepinephrine. Unlike many other antidepressants, which primarily target serotonin, bupropion's mechanism of action involves increasing the levels of dopamine and norepinephrine in the brain.

Choice C rationale:

Mirtazapine, another atypical antidepressant, blocks serotonin and histamine receptors. By blocking histamine receptors, mirtazapine often leads to drowsiness, which can be a side effect of this medication.

Choice E rationale:

Atypical antidepressants are associated with common side effects such as dry mouth and blurred vision. These side effects are often due to their impact on various neurotransmitter systems, including histamine and acetylcholine. Choices A and D are incorrect because they misrepresent the mechanisms of atypical antidepressants.

Choice A rationale:

Choice A (They have the same mechanisms of action as SSRIs) is incorrect. Atypical antidepressants have different mechanisms of action compared to SSRIs. While SSRIs primarily target serotonin reuptake inhibition, atypical antidepressants like bupropion and mirtazapine have unique mechanisms involving other neurotransmitters.

Choice D rationale:

Choice D (Trazodone blocks the reuptake of serotonin only) is incorrect. Trazodone is an atypical antidepressant with a complex mechanism of action. It is an antagonist at certain serotonin receptors and inhibits serotonin reuptake, but it also has antagonistic effects on histamine receptors, which contribute to its sedative properties.

Choice A rationale:

This response is not appropriate as it may come across as confrontational and dismissive of the client's current state. The client's difficulty in concentrating is a symptom of their manic episode, and using such phrasing might increase their agitation and escalate the situation.

Choice B rationale:

"I'm here to listen. Let's try to stick to one topic at a time." This response acknowledges the client's difficulty while providing support and a gentle redirection to stay focused on one topic. It maintains a therapeutic and non-confrontational approach, promoting effective communication with the client.

Choice C rationale:

While it's important to ensure fair participation in group conversations, this response may not address the immediate need of the client in a manic episode. It could potentially trigger further irritability or resistance from the client.

Choice D rationale:

This response may be interpreted as the nurse not making an effort to understand the client's thoughts, which could exacerbate the client's frustration and hinder therapeutic communication. It lacks empathy and a collaborative approach.