TEST BANK INTRODUCTORY CLINICAL PHARMACOLOGY
12TH EDITION By Susan M Ford
Chapter 21, Antidepressant Drugs
1. The nurse is assessing a client for depression. Which symptom would the nurse
prioritize?
A) Drowsiness
B) Extreme sadness
C) Severe headache
D) Dilated pupils
Answer: B
Rationale: The nurse should monitor the client for extreme sadness because this
is a symptom of depression. Drowsiness is an adverse effect of most
antidepressants. Severe headache and dilated pupils are symptoms of
hypertensive crisis which can occur when MAOIs are combined with tyramine,
tryptophan, and meperidine.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 1
Cognitive Level: Apply
Client Needs: Psychosocial Integrity
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 251, Introduction
2. A client with depression has been prescribed amitriptyline. Which drug action
should the nurse integrate into the teaching session for the client?
A) Decreased reuptake of norepinephrine
B) Increased serotonin in the nervous system
C) Increased endogenous norepinephrine
D) Increased endogenous epinephrine
Answer: A
Rationale: The nurse should identify decreased reuptake of norepinephrine as the
effect of the tricyclic antidepressant on the client's body. Increased serotonin in
the nervous system, increased endogenous norepinephrine, and increased
endogenous epinephrine are effects of monoamine oxidase inhibitors.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 255, Tricyclic Antidepressants
,3. A nurse is caring for an older adult client who has been prescribed amoxapine for
depression accompanied by anxiety. After administration of the drug, the nurse
observes muscle rigidity and sweating. Which action should the nurse prioritize?
A) Suggest the client engage in exercise.
B) Get the client to drink a glass of cold water.
C) Encourage the client to breathe deeply.
D) Stop the drug and contact the health care provider.
Answer: D
Rationale: The nurse should identify these as symptoms of neuroleptic malignant
syndrome and discontinue the drug administration and contact the health care
provider. Exercising, drinking cold water, and encouraging deep breaths will not
help the client with these symptoms.
Question Format
Chapter: 21
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 255, Tricyclic Antidepressants
4. A nurse is preparing to teach a client and caregiver about the antidepressant
therapy which will be continued at home. Which precaution should the nurse
suggest if the client experiences dizziness when getting out of bed?
A) Strictly avoid movements if dizziness occurs.
B) Rise slowly when getting out of bed.
C) Have breakfast before getting out of bed.
D) Have a glass of water to overcome dizziness.
Answer: B
Rationale: The nurse should instruct the client to rise slowly when getting out of
bed. Strictly avoiding movements will restrict the client's mobility, which is
unadvisable. Having breakfast or a glass of water before getting out of bed will not
help the client to overcome dizziness because the dizziness is not due to lack of
nourishment.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 6
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Teaching/Learning
Reference: p. 261, Educating the Client and Family
5. A nurse is caring for a client with suicidal tendencies. Which action would be most
important for the nurse to do after administering the drug orally?
A) Inspect the oral cavity to ensure that the drug is swallowed.
B) Monitor body temperature for changes.
, C) Monitor blood pressure for unusual changes.
D) Inspect pulse rate for unusual changes.
Answer: A
Rationale: The immediate nursing intervention is to inspect the oral cavity to
ensure that the client swallowed the drug. Assessment for changes in body
temperature, blood pressure, and pulse rate should be completed once the nurse
ensures that the client has swallowed the drug.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 6
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 260, Suicide Attempt Risk
6. A nurse is caring for a client who has been prescribed a monoamine oxidase
inhibitor (MAOI). Which food should the nurse instruct the client to avoid?
A) Milk
B) Butter
C) Rice
D) Yogurt
Answer: D
Rationale: The nurse should ask the client to avoid yogurt because yogurt
contains tyramine, which interacts with MAOIs and causes hypertensive crisis.
Milk, butter, and rice do not contain tyramine and hence can be consumed when
the client is undergoing treatment with MAOIs.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 6
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Teaching/Learning
Reference: p. 257, Box 21.3 Foods containing Tyramine
7. A client is prescribed a monoamine oxidase inhibitor (MAOI) for depression.
During the initial interview with the client, the nurse discovers that the client is
also receiving an adrenergic agent. The nurse would be alert for which potential
reaction?
A) Hypertensive episodes
B) Severe convulsions
C) Hyperpyretic episodes
D) Cardiac arrhythmias
Answer: D
12TH EDITION By Susan M Ford
Chapter 21, Antidepressant Drugs
1. The nurse is assessing a client for depression. Which symptom would the nurse
prioritize?
A) Drowsiness
B) Extreme sadness
C) Severe headache
D) Dilated pupils
Answer: B
Rationale: The nurse should monitor the client for extreme sadness because this
is a symptom of depression. Drowsiness is an adverse effect of most
antidepressants. Severe headache and dilated pupils are symptoms of
hypertensive crisis which can occur when MAOIs are combined with tyramine,
tryptophan, and meperidine.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 1
Cognitive Level: Apply
Client Needs: Psychosocial Integrity
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 251, Introduction
2. A client with depression has been prescribed amitriptyline. Which drug action
should the nurse integrate into the teaching session for the client?
A) Decreased reuptake of norepinephrine
B) Increased serotonin in the nervous system
C) Increased endogenous norepinephrine
D) Increased endogenous epinephrine
Answer: A
Rationale: The nurse should identify decreased reuptake of norepinephrine as the
effect of the tricyclic antidepressant on the client's body. Increased serotonin in
the nervous system, increased endogenous norepinephrine, and increased
endogenous epinephrine are effects of monoamine oxidase inhibitors.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 255, Tricyclic Antidepressants
,3. A nurse is caring for an older adult client who has been prescribed amoxapine for
depression accompanied by anxiety. After administration of the drug, the nurse
observes muscle rigidity and sweating. Which action should the nurse prioritize?
A) Suggest the client engage in exercise.
B) Get the client to drink a glass of cold water.
C) Encourage the client to breathe deeply.
D) Stop the drug and contact the health care provider.
Answer: D
Rationale: The nurse should identify these as symptoms of neuroleptic malignant
syndrome and discontinue the drug administration and contact the health care
provider. Exercising, drinking cold water, and encouraging deep breaths will not
help the client with these symptoms.
Question Format
Chapter: 21
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 255, Tricyclic Antidepressants
4. A nurse is preparing to teach a client and caregiver about the antidepressant
therapy which will be continued at home. Which precaution should the nurse
suggest if the client experiences dizziness when getting out of bed?
A) Strictly avoid movements if dizziness occurs.
B) Rise slowly when getting out of bed.
C) Have breakfast before getting out of bed.
D) Have a glass of water to overcome dizziness.
Answer: B
Rationale: The nurse should instruct the client to rise slowly when getting out of
bed. Strictly avoiding movements will restrict the client's mobility, which is
unadvisable. Having breakfast or a glass of water before getting out of bed will not
help the client to overcome dizziness because the dizziness is not due to lack of
nourishment.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 6
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Teaching/Learning
Reference: p. 261, Educating the Client and Family
5. A nurse is caring for a client with suicidal tendencies. Which action would be most
important for the nurse to do after administering the drug orally?
A) Inspect the oral cavity to ensure that the drug is swallowed.
B) Monitor body temperature for changes.
, C) Monitor blood pressure for unusual changes.
D) Inspect pulse rate for unusual changes.
Answer: A
Rationale: The immediate nursing intervention is to inspect the oral cavity to
ensure that the client swallowed the drug. Assessment for changes in body
temperature, blood pressure, and pulse rate should be completed once the nurse
ensures that the client has swallowed the drug.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 6
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 260, Suicide Attempt Risk
6. A nurse is caring for a client who has been prescribed a monoamine oxidase
inhibitor (MAOI). Which food should the nurse instruct the client to avoid?
A) Milk
B) Butter
C) Rice
D) Yogurt
Answer: D
Rationale: The nurse should ask the client to avoid yogurt because yogurt
contains tyramine, which interacts with MAOIs and causes hypertensive crisis.
Milk, butter, and rice do not contain tyramine and hence can be consumed when
the client is undergoing treatment with MAOIs.
Question Format: Multiple Choice
Chapter: 21
Learning Objective: 6
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Teaching/Learning
Reference: p. 257, Box 21.3 Foods containing Tyramine
7. A client is prescribed a monoamine oxidase inhibitor (MAOI) for depression.
During the initial interview with the client, the nurse discovers that the client is
also receiving an adrenergic agent. The nurse would be alert for which potential
reaction?
A) Hypertensive episodes
B) Severe convulsions
C) Hyperpyretic episodes
D) Cardiac arrhythmias
Answer: D
