ANS PHARM 201 Exam -Questions with Correct
Solutions
1) Which medication class includes amitriptyline?
a. Tricyclics
b. Monoamine oxidase inhibitors (MAOIs)
c. Selective serotonin reuptake inhibitors (SSRIs)
d. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
a. Tricyclics
Rationale: Amitriptyline is one of several tricyclic antidepressants used to treat anxiety disorders.
It is not an MAOI, SSRI, or SNRI.
2) Nortriptyline is prescribed for a depressed client. Which time period identifies when the
nurse would expect a therapeutic response?
a. 1to3days
b. 12 to 24 hours
c. 30 minutes to 2 hours
d. 2to3weeks
d. 2to3weeks
Rationale: As with other tricyclics, optimal therapeutic effects take 2 to 3 weeks to occur. One to
3 days, 12 to 24 hours, and 30 minutes to 2 hours are all too soon to expect a response to
nortriptyline.
4) A 65-year-old client is receiving amitriptyline. Which recommendation will the nurse
make to the client concerning this medication?
,a. 'Obtain a complete cholesterol and lipid profile.'
b. 'Have an eye examination to check for glaucoma.'
c. 'Check your temperature daily for nighttime increases.'
d. 'Watch for excessive sweating and possible weight loss.'
b. 'Have an eye examination to check for glaucoma.'
Rationale: In addition to baseline laboratory tests, an older adult should have an eye examination
with glaucoma testing when taking amitriptyline. It causes dilation of the pupil (mydriasis),
which interferes with drainage of aqueous humor through the canal of Schlemm. Interfering with
the outflow of aqueous humor will increase intraocular pressure and may cause a progressive
loss of vision in clients with glaucoma. Amitriptyline does not affect cholesterol production or
temperature regulation. It does not cause excessive sweating or weight loss, but it can increase
appetite especially for sweets, resulting in weight gain.
5) A depressed client has been prescribed a tricyclic antidepressant. Which time period
indicates how long it usually takes before the client notices a significant change in the
depression?
a. 4 to 6 days
b. 2to4weeks
c. 5to6weeks
d. 12 to 16 hours
b. 2to4weeks
Rationale: It takes 2 to 4 weeks for the tricyclic antidepressant to reach a therapeutic blood level.
Time spans of 4 to 6 days and 12 to 16 hours are both too short for a therapeutic blood level of
, the medication to be achieved. Improvement in depression should be demonstrated sooner than 5
to 6 weeks.
6)Which statement accurately describes nortriptyline? Select all that apply. One, some, or
all responses may be correct.
a. Overdosage is often lethal.
b. Constipation and urinary retention may occur.
c. It is a selective serotonin reuptake inhibitor (SSRI).
d. Weight gain is a common side effect.
e. It increases effectiveness of monoamine oxidase inhibitors (MAOIs).
a. Overdosage is often lethal.
b. Constipation and urinary retention may occur.
d. Weight gain is a common side effect.
Rationale: Nortriptyline is notoriously lethal; between 70% and 80% of people who die from
overdose do so before reaching the hospital. Nortriptyline can cause constipation and urinary
retention because it causes blockage of cholinergic receptors, and it tends to increase appetite
and cause weight gain. Nortriptyline is not an SSRI; it is a tricyclic antidepressant and affects the
balance of neurotransmitters in the brain. The interaction between nortriptyline and MAOIs is
severe and possibly fatal.
7) The nurse is teaching a nursing student about tricyclic antidepressant medications.
Which statement made by the student indicates the need for further teaching? Select all
that apply. One, some, or all responses may be correct.
a. Nortriptyline is contraindicated in older adult clients.
b. Desipramine is preferred for use in older adult clients.
Solutions
1) Which medication class includes amitriptyline?
a. Tricyclics
b. Monoamine oxidase inhibitors (MAOIs)
c. Selective serotonin reuptake inhibitors (SSRIs)
d. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
a. Tricyclics
Rationale: Amitriptyline is one of several tricyclic antidepressants used to treat anxiety disorders.
It is not an MAOI, SSRI, or SNRI.
2) Nortriptyline is prescribed for a depressed client. Which time period identifies when the
nurse would expect a therapeutic response?
a. 1to3days
b. 12 to 24 hours
c. 30 minutes to 2 hours
d. 2to3weeks
d. 2to3weeks
Rationale: As with other tricyclics, optimal therapeutic effects take 2 to 3 weeks to occur. One to
3 days, 12 to 24 hours, and 30 minutes to 2 hours are all too soon to expect a response to
nortriptyline.
4) A 65-year-old client is receiving amitriptyline. Which recommendation will the nurse
make to the client concerning this medication?
,a. 'Obtain a complete cholesterol and lipid profile.'
b. 'Have an eye examination to check for glaucoma.'
c. 'Check your temperature daily for nighttime increases.'
d. 'Watch for excessive sweating and possible weight loss.'
b. 'Have an eye examination to check for glaucoma.'
Rationale: In addition to baseline laboratory tests, an older adult should have an eye examination
with glaucoma testing when taking amitriptyline. It causes dilation of the pupil (mydriasis),
which interferes with drainage of aqueous humor through the canal of Schlemm. Interfering with
the outflow of aqueous humor will increase intraocular pressure and may cause a progressive
loss of vision in clients with glaucoma. Amitriptyline does not affect cholesterol production or
temperature regulation. It does not cause excessive sweating or weight loss, but it can increase
appetite especially for sweets, resulting in weight gain.
5) A depressed client has been prescribed a tricyclic antidepressant. Which time period
indicates how long it usually takes before the client notices a significant change in the
depression?
a. 4 to 6 days
b. 2to4weeks
c. 5to6weeks
d. 12 to 16 hours
b. 2to4weeks
Rationale: It takes 2 to 4 weeks for the tricyclic antidepressant to reach a therapeutic blood level.
Time spans of 4 to 6 days and 12 to 16 hours are both too short for a therapeutic blood level of
, the medication to be achieved. Improvement in depression should be demonstrated sooner than 5
to 6 weeks.
6)Which statement accurately describes nortriptyline? Select all that apply. One, some, or
all responses may be correct.
a. Overdosage is often lethal.
b. Constipation and urinary retention may occur.
c. It is a selective serotonin reuptake inhibitor (SSRI).
d. Weight gain is a common side effect.
e. It increases effectiveness of monoamine oxidase inhibitors (MAOIs).
a. Overdosage is often lethal.
b. Constipation and urinary retention may occur.
d. Weight gain is a common side effect.
Rationale: Nortriptyline is notoriously lethal; between 70% and 80% of people who die from
overdose do so before reaching the hospital. Nortriptyline can cause constipation and urinary
retention because it causes blockage of cholinergic receptors, and it tends to increase appetite
and cause weight gain. Nortriptyline is not an SSRI; it is a tricyclic antidepressant and affects the
balance of neurotransmitters in the brain. The interaction between nortriptyline and MAOIs is
severe and possibly fatal.
7) The nurse is teaching a nursing student about tricyclic antidepressant medications.
Which statement made by the student indicates the need for further teaching? Select all
that apply. One, some, or all responses may be correct.
a. Nortriptyline is contraindicated in older adult clients.
b. Desipramine is preferred for use in older adult clients.
