In addition to antianxiety agents, which classification of drugs is commonly prescribed to treat anxiety and anxiety disorders?

Correct Answer: C

Rationale: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are frequently used in the treatment of anxiety disorders. These medications help alleviate symptoms by affecting neurotransmitters in the brain associated with mood regulation and anxiety.

Correct Answer: B

Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.

Correct Answer: D

Rationale: The correct answer is D, Substance use disorder. Ramelteon is preferred for patients with substance use disorder because it lacks abuse potential. This makes it a safer choice for individuals with a history of substance misuse. Choosing a medication with a lower risk of abuse in this population is crucial to prevent potential misuse or dependence issues.

Correct Answer: A

Rationale: Choice A is the correct answer because it shows that the patient understands the dual benefits of bupropion (Wellbutrin) in treating depression and aiding in smoking cessation. Bupropion is commonly prescribed for these reasons as it has a lower risk of weight gain compared to other antidepressants. Choices B, C, and D are not the most appropriate because they do not specifically reflect the benefits or key information related to bupropion therapy.

Correct Answer: B

Rationale: Antipsychotics (Choice B) are the correct answer because they are strongly associated with the risk of extrapyramidal symptoms (EPS) and other movement disorders due to their dopamine receptor blockade in the nigrostriatal pathway. These disorders include acute dystonia, akathisia, parkinsonism, and tardive dyskinesia, which can develop even at therapeutic doses. First-generation (typical) antipsychotics like haloperidol have a higher risk, but second-generation (atypical) antipsychotics such as risperidone and aripiprazole can also cause these effects. Nurses must monitor for early signs, such as muscle stiffness, restlessness, or involuntary movements, as tardive dyskinesia can become irreversible. SSRIs (Choice A) primarily affect serotonin reuptake and are not typically linked to movement disorders. While they can cause side effects like agitation or tremors, these are not classified as extrapyramidal symptoms. Rare cases of SSRI-induced akathisia exist, but it is not a hallmark concern like with antipsychotics, making this choice incorrect. Benzodiazepines (Choice C) act on GABA receptors and are used for anxiety, insomnia, or muscle relaxation. They do not cause EPS or tardive dyskinesia. Instead, they may lead to sedation, dizziness, or dependence, but movement disorders are outside their usual adverse effect profile, ruling them out as the correct answer. Tricyclic antidepressants (Choice D) primarily inhibit norepinephrine and serotonin reuptake and have anticholinergic effects. While they can cause side effects like dry mouth, constipation, or orthostatic hypotension, they are not associated with EPS or tardive dyskinesia. Their mechanism does not involve dopamine blockade, so movement disorders are not a clinical concern, making this choice incorrect. The key distinction lies in the pharmacological action: antipsychotics directly interfere with dopamine pathways critical for motor control, while the other drug groups lack this mechanism. Nursing assessments for movement abnormalities are thus essential for antipsychotics but not for SSRIs, benzodiazepines, or tricyclics.