C HAPTER 16: D RUGS U SED FOR D EPRESSIVE
AND B IPOLAR D ISORDERS
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which action applies to MAOIs on neurotransmitters?
a. Blocking their reuptake
b. Increasing their production
c. Blocking their destru ction
d. Increasing their reuptake
ANS: C
MAOIs act by blocking the metabolic destruction of epinephrine,
norepinephrine, dopamine, and serotonin neurotransmitters by the enz yme
monoamine oxidase in the presynaptic neurons of the brain. They prevent the
degradation of these central nervous system (CNS) neurotransmitters so that
their concentration is increased. MAOIs do not block or increase the reuptake
of neurotransmitters. MAOIs do not increase production of neurotransmitters.
DIF: Cognitive Level: Comprehension REF: p. 245 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment
,2. A patient who is taking an MAOI to treat depression admits to eating
pickled herring and cheese and drinking red wine. Which assessment
finding alerts the nurse to a potential complication?
a. Constipation
b. Hypotension
c. Neck stiffness
d. Urinary retention
ANS: C
Hypertensive crisis is a major potential complication. Common prodromal
s ymptoms of hypertensi ve crisis include severe occipital headache, stiff neck,
sweating, nausea, vomiting, and sharpl y elevated blood pressure.
Constipation, hypotension, and urinary retention are not indicative of a major
potential complication when patients consume foods high in t yramine.
DIF: Cognitive Level: Application REF: p. 245 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment |
Safet y
3. Which assessment would the nurse expect to observe in a patient who has
been prescribed trazodone for treatment anxiet y?
a. Excessive thirst
b. Hand tremor
c. Drowsiness
d. Diarrhea
ANS: C
Drowsiness is a common adverse effect, and people who work with
machinery, drive a car, administer medicines, or perform other d uties in
which they must remain mentall y alert should not take trazodone while
, working. Excessive thirst, hand tremors, and diarrhea are not adverse effects
associated with trazodone.
DIF: Cognitive Level: Comprehension REF: p. 255 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment
4. The nurse is caring for a patient who is taking a newl y prescribed drug,
nefazodone, for treatment of depression. Which physical assessment
finding is most important for the nurse to report to the healthcare provider
immediatel y?
a. Bradycardia
b. Dizziness
c. Drowsiness
d. Urinary retention
ANS: A
Bradycardia with a drop in 15 beats/min is to be reported to the healthcare
provider immediately; withholding the dose is warranted until approved.
Dizziness, drowsiness, and urinary retention are common adverse effects that
would not need to be reported to the healthcare provider.
DIF: Cognitive Level: Comprehension REF: p. 255 OBJ: 4
NAT: NCLEX Client Needs C ategory: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment
5. Which statement by the patient would indicate the need for further teaching
after being educated on bupropion (Wellbutrin) prescribed for smoking
cessation?
a. “M y dose will increase after 3 days. ”
b. “I should swallow this medication whole. ”
AND B IPOLAR D ISORDERS
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which action applies to MAOIs on neurotransmitters?
a. Blocking their reuptake
b. Increasing their production
c. Blocking their destru ction
d. Increasing their reuptake
ANS: C
MAOIs act by blocking the metabolic destruction of epinephrine,
norepinephrine, dopamine, and serotonin neurotransmitters by the enz yme
monoamine oxidase in the presynaptic neurons of the brain. They prevent the
degradation of these central nervous system (CNS) neurotransmitters so that
their concentration is increased. MAOIs do not block or increase the reuptake
of neurotransmitters. MAOIs do not increase production of neurotransmitters.
DIF: Cognitive Level: Comprehension REF: p. 245 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment
,2. A patient who is taking an MAOI to treat depression admits to eating
pickled herring and cheese and drinking red wine. Which assessment
finding alerts the nurse to a potential complication?
a. Constipation
b. Hypotension
c. Neck stiffness
d. Urinary retention
ANS: C
Hypertensive crisis is a major potential complication. Common prodromal
s ymptoms of hypertensi ve crisis include severe occipital headache, stiff neck,
sweating, nausea, vomiting, and sharpl y elevated blood pressure.
Constipation, hypotension, and urinary retention are not indicative of a major
potential complication when patients consume foods high in t yramine.
DIF: Cognitive Level: Application REF: p. 245 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment |
Safet y
3. Which assessment would the nurse expect to observe in a patient who has
been prescribed trazodone for treatment anxiet y?
a. Excessive thirst
b. Hand tremor
c. Drowsiness
d. Diarrhea
ANS: C
Drowsiness is a common adverse effect, and people who work with
machinery, drive a car, administer medicines, or perform other d uties in
which they must remain mentall y alert should not take trazodone while
, working. Excessive thirst, hand tremors, and diarrhea are not adverse effects
associated with trazodone.
DIF: Cognitive Level: Comprehension REF: p. 255 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment
4. The nurse is caring for a patient who is taking a newl y prescribed drug,
nefazodone, for treatment of depression. Which physical assessment
finding is most important for the nurse to report to the healthcare provider
immediatel y?
a. Bradycardia
b. Dizziness
c. Drowsiness
d. Urinary retention
ANS: A
Bradycardia with a drop in 15 beats/min is to be reported to the healthcare
provider immediately; withholding the dose is warranted until approved.
Dizziness, drowsiness, and urinary retention are common adverse effects that
would not need to be reported to the healthcare provider.
DIF: Cognitive Level: Comprehension REF: p. 255 OBJ: 4
NAT: NCLEX Client Needs C ategory: Physiological Integrit y
TOP: Nursing Process Step: Assessment CON: Clinical Judgment
5. Which statement by the patient would indicate the need for further teaching
after being educated on bupropion (Wellbutrin) prescribed for smoking
cessation?
a. “M y dose will increase after 3 days. ”
b. “I should swallow this medication whole. ”
