Drowsiness, dizziness, and postural hypotension usually subside after the first few weeks of therapy with tricyclic antidepressants. Postural hypotension can be managed by teaching the patient to stay well hydrated and rise slowly. Knowing this information may convince the patient to continue the medication. Activity is an important aspect of the patient’s treatment plan and should not be limited to activities that can be done in a sitting position. Withholding the drug, forcing oral fluids, and notifying the health care provider are unnecessary actions. Independent nursing action is called for. Updating a mental status examination is unnecessary.
an ax
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 14-35, 60 (Table 14-6), 73 (Box 14-5) TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity 9. A patient diagnosed with major depressive disorder is receiving imipramine 200 mg qhs.
nd
_x
Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug? a. Dry mouth b. Blurred vision c. Nasal congestion d. Urinary retention ANS: D
_a
All the side effects mentioned are the result of the anticholinergic effects of the drug. Only urinary retention and severe constipation warrant immediate medical attention. Dry mouth, blurred vision, and nasal congestion may be less troublesome as therapy continues.
an
ks
PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 14-34, 60 (Table 14-6) | Page 14-73 (Box 14-5) TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 10. A patient diagnosed with major depressive disorder tells the nurse, “Bad things that happen
:t
es
tb
are always my fault.” Which response by the nurse will best assist the patient to reframe this overgeneralization? a. “I really doubt that one person can be blamed for all the bad things that happen.” b. “Let’s look at one bad thing that happened to see if another explanation exists.” c. “You are being extremely hard on yourself. Try to have a positive focus.” d. “Are you saying that you don’t have any good things happen?” ANS: B
eB
ay
By questioning a faulty assumption, the nurse can help the patient look at the premise more objectively and reframe it as a more accurate representation of fact. The incorrect responses cast doubt but do not require the patient to evaluate the statement. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 14-27, 57 (Table 14-4) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
11. A nurse worked with a patient diagnosed with major depressive disorder, severe withdrawal,
and psychomotor retardation. After 3 weeks, the patient did not improve. The nurse is most at risk for feelings of a. guilt and despair. b. over-involvement.
eBay: testbanks_and_xanax
