Chapter 15: Antidepressant Drugs
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. A secondary amine tricyclic antidepressant is prescribed for a patient. The medication will
significantly increase the availability of which neurotransmitter?
a. GABA
b. Glutamate
c. Serotonin
d. Norepinephrine
ANS: D
Secondary amines increase the availability and enhance the action of norepinephrine. They do
have a similar effect on any of the other options.
DIF: Cognitive level: Understanding TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
2. Nortriptyline was prescribed for a 68-year-old patient diagnosed with depression and
insomnia. What assessment question should the nurse ask to determine the effectiveness of
nortriptyline?
a. ―Are you having regular bowel movements?‖
b. ―Are you no longer experiencing insomnia?‖
c. ―Have you been successful with weight loss?‖
d. ―Would you say you are concentrating better?‖
ANS: B
, Nortriptyline is a secondary amine with a good side effect profile. It is somewhat sedating, which
is helpful to patients with insomnia. The other options are not considered outcomes for this
medication.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
3. A 75-year-old patient with a long history of depression begins amitriptyline 100 mg/day. The
patient also takes a diuretic daily for hypertension. What is the highest priority nursing diagnosis
this patient is at risk for?
a. Falls related to dizziness and orthostatic hypotension.
b. Ineffective thermoregulation related to anhidrosis.
c. Infection related to suppressed white blood cell count.
d. Constipation related to slowed gastrointestinal peristalsis.
ANS: A
Amitriptyline is a tricyclic antidepressants (TCA) that has a high risk of producing orthostatic
hypotension. The patient is placed at even greater risk because of older age and diuretic therapy,
which reduces fluid volume. The other options are either unassociated or are remote
possibilities.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
4. A depressed patient preparing for discharge is prescribed desipramine and will have follow-up
outpatient visits. The patient reports, ―Why did they gave me only a 1-week supply of my
medicine?‖ Select the nurse‘s best reply.
a. ―Federal law limits the amount you may be given at any one time.‖
b. ―It will save you money if the drug doesn‘t work well for your symptoms.‖
c. ―This is a way of ensuring that you will come in for your follow-up appointment.‖
d. ―Prescribing a small amount of drug addresses our concerns for your continuing
safety.‖
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. A secondary amine tricyclic antidepressant is prescribed for a patient. The medication will
significantly increase the availability of which neurotransmitter?
a. GABA
b. Glutamate
c. Serotonin
d. Norepinephrine
ANS: D
Secondary amines increase the availability and enhance the action of norepinephrine. They do
have a similar effect on any of the other options.
DIF: Cognitive level: Understanding TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
2. Nortriptyline was prescribed for a 68-year-old patient diagnosed with depression and
insomnia. What assessment question should the nurse ask to determine the effectiveness of
nortriptyline?
a. ―Are you having regular bowel movements?‖
b. ―Are you no longer experiencing insomnia?‖
c. ―Have you been successful with weight loss?‖
d. ―Would you say you are concentrating better?‖
ANS: B
, Nortriptyline is a secondary amine with a good side effect profile. It is somewhat sedating, which
is helpful to patients with insomnia. The other options are not considered outcomes for this
medication.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
3. A 75-year-old patient with a long history of depression begins amitriptyline 100 mg/day. The
patient also takes a diuretic daily for hypertension. What is the highest priority nursing diagnosis
this patient is at risk for?
a. Falls related to dizziness and orthostatic hypotension.
b. Ineffective thermoregulation related to anhidrosis.
c. Infection related to suppressed white blood cell count.
d. Constipation related to slowed gastrointestinal peristalsis.
ANS: A
Amitriptyline is a tricyclic antidepressants (TCA) that has a high risk of producing orthostatic
hypotension. The patient is placed at even greater risk because of older age and diuretic therapy,
which reduces fluid volume. The other options are either unassociated or are remote
possibilities.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
4. A depressed patient preparing for discharge is prescribed desipramine and will have follow-up
outpatient visits. The patient reports, ―Why did they gave me only a 1-week supply of my
medicine?‖ Select the nurse‘s best reply.
a. ―Federal law limits the amount you may be given at any one time.‖
b. ―It will save you money if the drug doesn‘t work well for your symptoms.‖
c. ―This is a way of ensuring that you will come in for your follow-up appointment.‖
d. ―Prescribing a small amount of drug addresses our concerns for your continuing
safety.‖
