A patient who has been taking an antidepressant for 2 months shares with the nurse, “Since my depression is over, I’ve stopped the Prozac and I won’t need to see you any longer.” Which response by a nurse would be most therapeutic?

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Question 1 of 5

A patient who has been taking an antidepressant for 2 months shares with the nurse, “Since my depression is over, I’ve stopped the Prozac and I won’t need to see you any longer.” Which response by a nurse would be most therapeutic?

Correct Answer: A

Rationale: Most patients who respond initially to antidepressant therapy require at least 1 year of therapy and may take medication on a lifetime basis. This is similar to patients who take antihypertensives or insulin. The patient’s statement alerts the nurse to set clear therapy goals that extend beyond medication assessment. Prozac takes 2 to 4 weeks to reach a steady state and is maintained in the body for several weeks after it is discontinued, but the nurse’s suggestion of tapering off the medication is a wise intervention for this patient, who seems impulsive about medication adherence. A patient with a knowledge deficit and nonadherence potential requires communication that recalls prior teaching and that builds on the knowledge he or she already has. Reminding the patient of the time it takes to become depressed provides anticipatory guidance about the possibility of needing medication on a lifetime basis. Sarcastic humor is usually a poor response that demeans the patient and may reflect the nurse’s impatience and a judgmental attitude toward the patient, and a laissez-faire response does not reflect a caring attitude. Withdrawal usually is not a problem for medications with a long half-life.

Question 2 of 5

A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be 'in his system' when he goes to school the next morning. What is the nurse’s appropriate evaluation of the mother’s actions?

Correct Answer: D

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

Question 3 of 5

While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient?

Correct Answer: B

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

Question 4 of 5

When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?

Correct Answer: A

Rationale: There is an increased risk for digitalis toxicity in the presence of hypokalemia, which may develop with hydrochlorothiazide therapy. Potassium supplements are often prescribed with hydrochlorothiazide therapy to prevent hypokalemia. The other options do not have interactions with hydrochlorothiazide.

Question 5 of 5

Pharmacokinetics is:

Correct Answer: B

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

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