A 29-year-old male patient is being treated with an antidepressant drug, and his mood is improving. However, he complains of feeling 'jittery' and agitated at times, and if he takes his medication in the afternoon he finds it difficult to get to sleep at night. He seems to have lost weight during the 6 months that he has been taking the drug. He has been warned not to take other drugs without consultation because severe reactions have occurred with opioid analgesics including meperidine. This patient is probably taking

Correct Answer: C

Rationale: Paroxetine, an SSRI, treats depression by inhibiting serotonin reuptake, often improving mood. Its side effects include agitation and insomnia (especially if taken late), due to serotonin's stimulating effects, and weight loss can occur initially, unlike TCAs which cause gain. A critical clue is the warning against opioids like meperidine: SSRIs can cause serotonin syndrome when combined with MAOIs or other serotonergic drugs, though meperidine's risk is notable in polypharmacy. Alprazolam, a benzodiazepine, sedates rather than agitates. Chlorpromazine, an antipsychotic, causes sedation and weight gain. Amitriptyline, a TCA, is sedating and linked to weight gain, not loss. Trazodone promotes sleep. Paroxetine's profile—activation, insomnia, weight loss, and drug interaction risks—matches the patient's experience.

Correct Answer: A

Rationale: Interferon Alfa-2b, used for hepatitis or cancer, commonly causes flu-like symptoms—dizziness , fatigue , and anorexia —due to its immune-modulating effects. Dizziness reflects CNS impact, often early in therapy, while fatigue and appetite loss stem from systemic inflammation. An itchy rash might suggest hypersensitivity but is less frequent than these systemic effects. The nurse identifies dizziness as a common adverse effect (correct answers: 1, 3, 4), distinguishing it from severe reactions requiring intervention. This aligns with interferon's side effect profile, where patients often report such symptoms within days of starting, necessitating education on management (e.g., rest, hydration). Choice A is a key identifier among expected effects, ensuring appropriate monitoring.

Correct Answer: C

Rationale: Lisinopril, an ACE inhibitor, manages hypertension but requires adherence even if symptoms improve, as stopping abruptly risks rebound hypertension, indicating a teaching gap. Reporting a dry cough is correct due to bradykinin buildup, a common side effect needing evaluation. Rising slowly prevents orthostatic hypotension, a known effect. Avoiding potassium-rich salt substitutes prevents hyperkalemia, as lisinopril inhibits aldosterone. The statement ‘I can stop this medication if I feel better' reflects misunderstanding of chronic disease management, where consistent therapy maintains control, not just symptom relief. Further teaching must emphasize this, aligning with lisinopril's role in long-term vascular protection, making C the statement needing correction.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.