Ten days after attempting suicide using an antidepressant medication, a 23-year-old woman receives a prescription for venlafaxine. She becomes tachycardic, diaphoretic, and develops myoclonic jerks. Which of the following medications did she take to attempt suicide?
Bupropion (Wellbutrin)
Phenelzine (Nardil)
Lorazepam (Ativan)
Hydroxyzine (Vistaril)
The Correct Answer is B
Choice A reason: Bupropion is a norepinephrine-dopamine reuptake inhibitor and does not significantly increase serotonin levels. While it can cause seizures in overdose, it is not typically associated with serotonin syndrome.
Choice B reason: Phenelzine is a monoamine oxidase inhibitor (MAOI) that prevents the breakdown of serotonin. When combined with venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), it can lead to dangerously elevated serotonin levels and trigger serotonin syndrome. The symptoms described—tachycardia, diaphoresis, and myoclonic jerks—are classic signs.
Choice C reason: Lorazepam is a benzodiazepine and acts on GABA receptors. It does not affect serotonin levels and is not implicated in serotonin syndrome.
Choice D reason: Hydroxyzine is an antihistamine with anxiolytic properties. It does not influence serotonin metabolism and is not associated with serotonin syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: The sensorimotor stage occurs from birth to approximately 2 years of age and involves learning through sensory experiences and motor actions. All adults have passed this stage.
Choice B reason: The preoperational stage spans ages 2 to 7 and is characterized by symbolic thinking and egocentrism. Adults universally progress beyond this stage.
Choice C reason: The concrete operational stage (ages 7–11) involves logical thinking about concrete events. Most adults reach and surpass this stage.
Choice D reason: The formal operational stage begins around age 11 and involves abstract reasoning, hypothetical thinking, and deductive logic. Piaget acknowledged that not all adults develop this level of cognitive functioning, especially if their environment does not demand it.
Correct Answer is B
Explanation
Choice A reason: Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that can be used for depression and pain. However, it has moderate CYP2D6 inhibition, which may interfere with tamoxifen metabolism and reduce its efficacy.
Choice B reason: Venlafaxine is an SNRI with minimal CYP2D6 inhibition. It is effective for depression and also helps alleviate hot flashes, making it the most appropriate choice for this patient.
Choice C reason: Bupropion is a norepinephrine-dopamine reuptake inhibitor and a strong CYP2D6 inhibitor. It can significantly reduce the conversion of tamoxifen to its active metabolite, endoxifen, thereby compromising its therapeutic effect.
Choice D reason: Fluoxetine is a potent CYP2D6 inhibitor and should be avoided in patients taking tamoxifen due to the risk of reducing its efficacy in preventing breast cancer recurrence.
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