A depressed patient who is taking a tricyclic antidepressant tells the nurse, “I don’t think I can keep taking these pills. They make me very dizzy, especially when I stand up.” The best nursing response is:

Correct Answer: B

Rationale: The correct answer is B. The nurse should educate the patient on orthostatic hypotension, a common side effect of tricyclic antidepressants that causes dizziness upon standing. By advising the patient to increase fluid intake and change positions slowly, the nurse is promoting safety and providing a practical solution to manage the side effect. This response addresses the patient's concern effectively and empowers them to take control of their symptoms. Choice A is incorrect because dismissing the patient's symptoms as something to get used to does not address the potential risks of orthostatic hypotension. Choice C is incorrect as it minimizes the patient's discomfort and may invalidate their concerns. Choice D is incorrect as it dismisses the patient's symptoms by attributing them solely to negative thinking, rather than acknowledging the physiological effects of the medication.

Correct Answer: D

Rationale: Rationale: 1. Paroxetine is categorized as an SSRI (Selective Serotonin Reuptake Inhibitor), not a tricyclic antidepressant like Tofranil. 2. SSRIs, such as Paxil, work by increasing serotonin levels in the brain to alleviate depression. 3. Selective norepinephrine reuptake inhibitors (Choice A) target norepinephrine, not serotonin. 4. Tricyclic antidepressants (Choice B) like Tofranil work differently from SSRIs. 5. MAO inhibitors (Choice C) are another class of antidepressants that inhibit monoamine oxidase, not serotonin reuptake.

Correct Answer: D

Rationale: The correct answer is D: Hypothalamus. The hypothalamus is responsible for regulating pituitary hormones through the release of various hormones that control the pituitary gland. It also plays a crucial role in regulating the body's temperature through thermoregulation. The thalamus (A) is involved in relaying sensory information, the cerebellum (B) is primarily responsible for motor coordination, and the limbic system (C) is associated with emotions and memory. Therefore, the hypothalamus is the only choice that directly relates to regulating pituitary hormones and body temperature.

Correct Answer: C

Rationale: The correct answer is C because acetaminophen is primarily metabolized in the liver. Patients with a history of liver disease may have impaired liver function, leading to decreased metabolism of acetaminophen and potential toxicity. Fever and headache are common indications for acetaminophen use and do not necessarily contraindicate its use. Peptic ulcer disease is not a contraindication for acetaminophen as it does not directly affect the gastrointestinal system.

Correct Answer: D

Rationale: The correct answer is D: Captopril is not a prodrug and does not need to be metabolized by the liver before becoming active. Rationale: 1. In severe liver disease, the liver's ability to metabolize drugs can be compromised. 2. Captopril is not a prodrug, meaning it does not require liver metabolism to become active. 3. This characteristic of captopril is advantageous in liver disease as it avoids potential issues related to impaired liver metabolism. Summary: A: Captopril can cause first-dose hypotensive effects, so it is not the advantage for a patient with severe liver disease. B: Captopril can affect electrolyte levels, so it is not the advantage for a patient with severe liver disease. C: Captopril being a prodrug and requiring liver metabolism would be a disadvantage for a patient with severe liver disease.