Which of the following drugs most likely caused the patient's syndrome?

Correct Answer: C

Rationale: The patient most likely exhibited akathisia, which is a common adverse effect of antipsychotic medications like haloperidol. Akathisia is characterized by restlessness, an inability to sit still, and a feeling of wanting to jump out of one's skin. This aligns with the patient's symptoms of increased agitation and confusion, as well as the fact that she had recently started therapy with uphenazine, an antipsychotic medication. The other choices are less likely to cause the specific symptoms described.

Correct Answer: C

Rationale: In this scenario, the most likely drug prescribed for the 43-year-old man with major depressive disorder is Venlafaxine (Option C). Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly used to treat major depressive disorder due to its effectiveness in addressing both serotonin and norepinephrine imbalances associated with depression. Option A, Amitriptyline, is a tricyclic antidepressant that is not typically the first choice for treating major depressive disorder in current practice due to its side effect profile and the availability of newer, better-tolerated options like SSRIs and SNRIs. Option B, Citalopram, is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression. While it is effective for many individuals with major depressive disorder, in this case, the man's likely presentation of norepinephrine-related symptoms would make an SNRI like Venlafaxine a more suitable choice. Option D, Lorazepam, is a benzodiazepine primarily used for anxiety and not a first-line treatment for major depressive disorder. It may be prescribed for comorbid anxiety symptoms but would not be the primary choice for treating major depressive disorder. Educationally, understanding the rationale behind selecting specific medications for different mental health conditions is crucial for nursing practice. It is essential to consider individual patient factors, symptom presentation, pharmacological mechanisms of action, and potential side effects when making prescribing decisions to ensure optimal patient outcomes.

Correct Answer: C

Rationale: In this case, the correct answer is C) Inhibition of serotonin transporter. This mechanism of action is associated with selective serotonin reuptake inhibitors (SSRIs), which are commonly used to treat obsessive-compulsive disorder (OCD), including intrusive thoughts. By inhibiting the reuptake of serotonin, these drugs increase the availability of serotonin in the synaptic cleft, which helps regulate mood and reduce obsessive thoughts. Option A) Inhibition of monoamine oxidase A is incorrect because MAOIs are not typically used as first-line treatment for OCD and can have dangerous interactions with certain foods and medications. Option B) Blockade of serotonergic receptors is incorrect because blocking serotonin receptors would not address the underlying issue of low serotonin levels contributing to OCD symptoms. Option D) Blockade of beta receptors is incorrect because beta blockers are not typically used in the treatment of OCD and intrusive thoughts. Educationally, understanding the mechanism of action of different psychiatric medications is crucial for nurses and other healthcare professionals to make appropriate clinical decisions and provide effective care for patients with mental health disorders. In this scenario, knowing how SSRIs work can help guide treatment choices for patients with OCD symptoms.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) M cholinergic receptors. Imipramine is a tricyclic antidepressant that exerts its pharmacological effects by inhibiting the reuptake of norepinephrine and serotonin. However, it also has anticholinergic properties, leading to adverse effects commonly associated with muscarinic receptor blockade. Beta-1 adrenergic receptors (option A) are not primarily involved in the adverse effects of imipramine. While imipramine can cause tachycardia, it is more related to its anticholinergic effects rather than beta-1 adrenergic stimulation. 5-HT serotonergic receptors (option B) are targeted by selective serotonin reuptake inhibitors (SSRIs) rather than tricyclic antidepressants like imipramine. Imipramine's adverse effects are not primarily mediated through 5-HT receptors. Alpha-1 adrenergic receptors (option D) are not the main mediators of imipramine's adverse effects. While imipramine can cause orthostatic hypotension due to alpha-1 adrenergic blockade, it is not the key mechanism for most adverse effects seen with this drug. Educationally, understanding the pharmacological actions of drugs like imipramine is crucial for nurses and healthcare professionals to anticipate and manage potential adverse effects in patients. Recognizing the role of different receptors in drug actions helps in safe medication administration and patient care.

Correct Answer: C

Rationale: The correct answer is C) Serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonin levels in the body, often due to the use of multiple serotonergic medications. In this case, the signs and symptoms exhibited by the 37-year-old man are indicative of serotonin syndrome, such as altered mental status, hyperthermia, tremors, and muscle rigidity. Option A) Selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome is characterized by flu-like symptoms, dizziness, and mood disturbances when stopping SSRIs abruptly, which do not align with the symptoms described in the case. Option B) Mirtazapine overdose would present with symptoms such as sedation, tachycardia, and confusion, which are different from those seen in serotonin syndrome. Option D) Brain glioblastoma would typically manifest with symptoms related to increased intracranial pressure, neurological deficits, and seizures, which are not consistent with the presentation of serotonin syndrome. In an educational context, understanding the distinguishing features of different drug reactions and medical conditions is crucial for healthcare professionals to make accurate assessments and provide appropriate interventions. Recognizing the signs and symptoms of serotonin syndrome is essential for nursing practice, especially when caring for patients on multiple serotonergic medications to prevent adverse outcomes.