MENTAL HEALTH EXAM 3 |
COMPREHENSIVE PSYCHIATRIC
NURSING STUDY GUIDE 2026 | GRADED
A+ | GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,A major depressive episode lasts how long? At least 2 weeks, during which the person experiences a depressed mood or
loss of pleasure in nearly all activities
-twice as common in women
-1.5 to 3 times greater incidence in first-degree relatives
-Decreases with age in women; increases with age in men; highest in single,
divorced people
-50% to 60% will suffer recurrence
-Approximately 20% will develop a chronic form of depression
-Symptoms range from mild to severe
Major depressive 7 symptoms 1. changes in eating habits, resulting in unplanned weight gain or loss
2. hypersomnia (excessive sleepiness) or insomnia
3. impaired concentration, decision making, or problem solving abilities
4. inability to cope with daily life
5. feelings of worthlessness, hopelessness, guilt, or despair
6. thoughts of death/suicide
7. pessimistic thinking with no hope of improvement
Selective serotonin reuptake inhibitors (SSRI) Newest category; has the fewest side effects making them safer for older adults
-more compliant to treatment regimen
-insomnia decreases in 3-4 days
-appetite returns to normal in 5-7 days
-energy returns in 4-7 days
-mood, concentration, & interest in life improve in 7-10 days
,5 SSRI antidepressants names & nursing considerations 1. fluoxetine (prozac)
-HA, nervousness, anxiety, sedation, tremor, sexual dysfunction, anorexia,
constipation, nausea, diarrhea, weight loss
-administer in AM if nervous; PM if drowsy
-monitor for hyponatremia
-encourage fluids
-report sexual difficulties
2. sertraline (zoloft)
-dizziness, sedation, HA, insomnia, tremor, sexual dysfunction, diarrhea, dry
mouth/throat, NV, sweating
-admin in PM if drowsy
-sugar free beverages & hard candy; drink adequate fluids
-monitor for hyponatremia
-report sexual difficulties
3. paroxetine (paxil)
-dizziness, sedation, HA, insomnia, weakness, fatigue, constipation, dry
mouth/throat, NVD, sweating
-admin with food
-admin in PM if drowsy
-encourage sugar free hard candy or beverages
-adequate fluids
4. Citalopram (celexa)
-drowsiness, sedation, insomnia, nausea, vomiting, weight gain, constipation,
diarrhea
-monitor for hyponatremia
-admin with food at 6 PM or later
-promote nutrition & exercise
5. escitalopram (lexapro)
-drowsiness, dizziness, weight gain, sexual dysfunction, restlessness, dry mouth,
HA, nausea, diarrhea
-check orthostatic BP
-assist to rise slowly
-sugar free beverages & hard candy
-admin with food
, Cyclic antidepressants Oldest antidepressants
-takes 6 weeks to reach full effect
-lag period of 1-4 weeks before steady plasma levels are reached & symptoms
begin to decrease
-cost less bc they have been around longer
-contraindicated in severe impairment of liver function & in myocardial infarction
-cannot be given with MAOIs
-bc of anticholinergic side effects, must be used in caution in clients with
glaucoma, BPH, urinary retention/obstruction, DM, CV disease, resp. disease, or
renal impairment
-overdosage occurs over several days & results in confusion, agitation,
hallucinations, hyperpyrexia, & increased reflexes
-seizures, coma, & CV toxicity can occur with ensuing tachycardia, decreased
output, decreased contractility, & AV block
-used less often in geriatric population
2 Cyclic antidepressants names & nursing considerations 1. amitriptyline (elavil)
-dizziness, orthostatic hypotension, tachycardia, sedation, HA, tremor, blurred
vision, constipation, dry mouth/throat, weight gain, urinary hesitancy, sweating
-assist client to rise slowly
-administer at bedtime
-encourage sugar free beverages & hard candy
-ensure adequate fluids & balanced nutrition
-encourage exercise
-monitor cardiac function
2. imipramine (tofranil)
-dizziness, orthostatic hypotension, weakness, fatigue, blurred vision,
constipation, dry mouth/throat, weight gain
-assist client to rise slowly
-ensure adequate fluids & balanced nutrition
-sugar free beverages & hard candy
-encourage exercise
Atypical antidepressants Used when the client has an inadequate response to or side effects from SSRIs
COMPREHENSIVE PSYCHIATRIC
NURSING STUDY GUIDE 2026 | GRADED
A+ | GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,A major depressive episode lasts how long? At least 2 weeks, during which the person experiences a depressed mood or
loss of pleasure in nearly all activities
-twice as common in women
-1.5 to 3 times greater incidence in first-degree relatives
-Decreases with age in women; increases with age in men; highest in single,
divorced people
-50% to 60% will suffer recurrence
-Approximately 20% will develop a chronic form of depression
-Symptoms range from mild to severe
Major depressive 7 symptoms 1. changes in eating habits, resulting in unplanned weight gain or loss
2. hypersomnia (excessive sleepiness) or insomnia
3. impaired concentration, decision making, or problem solving abilities
4. inability to cope with daily life
5. feelings of worthlessness, hopelessness, guilt, or despair
6. thoughts of death/suicide
7. pessimistic thinking with no hope of improvement
Selective serotonin reuptake inhibitors (SSRI) Newest category; has the fewest side effects making them safer for older adults
-more compliant to treatment regimen
-insomnia decreases in 3-4 days
-appetite returns to normal in 5-7 days
-energy returns in 4-7 days
-mood, concentration, & interest in life improve in 7-10 days
,5 SSRI antidepressants names & nursing considerations 1. fluoxetine (prozac)
-HA, nervousness, anxiety, sedation, tremor, sexual dysfunction, anorexia,
constipation, nausea, diarrhea, weight loss
-administer in AM if nervous; PM if drowsy
-monitor for hyponatremia
-encourage fluids
-report sexual difficulties
2. sertraline (zoloft)
-dizziness, sedation, HA, insomnia, tremor, sexual dysfunction, diarrhea, dry
mouth/throat, NV, sweating
-admin in PM if drowsy
-sugar free beverages & hard candy; drink adequate fluids
-monitor for hyponatremia
-report sexual difficulties
3. paroxetine (paxil)
-dizziness, sedation, HA, insomnia, weakness, fatigue, constipation, dry
mouth/throat, NVD, sweating
-admin with food
-admin in PM if drowsy
-encourage sugar free hard candy or beverages
-adequate fluids
4. Citalopram (celexa)
-drowsiness, sedation, insomnia, nausea, vomiting, weight gain, constipation,
diarrhea
-monitor for hyponatremia
-admin with food at 6 PM or later
-promote nutrition & exercise
5. escitalopram (lexapro)
-drowsiness, dizziness, weight gain, sexual dysfunction, restlessness, dry mouth,
HA, nausea, diarrhea
-check orthostatic BP
-assist to rise slowly
-sugar free beverages & hard candy
-admin with food
, Cyclic antidepressants Oldest antidepressants
-takes 6 weeks to reach full effect
-lag period of 1-4 weeks before steady plasma levels are reached & symptoms
begin to decrease
-cost less bc they have been around longer
-contraindicated in severe impairment of liver function & in myocardial infarction
-cannot be given with MAOIs
-bc of anticholinergic side effects, must be used in caution in clients with
glaucoma, BPH, urinary retention/obstruction, DM, CV disease, resp. disease, or
renal impairment
-overdosage occurs over several days & results in confusion, agitation,
hallucinations, hyperpyrexia, & increased reflexes
-seizures, coma, & CV toxicity can occur with ensuing tachycardia, decreased
output, decreased contractility, & AV block
-used less often in geriatric population
2 Cyclic antidepressants names & nursing considerations 1. amitriptyline (elavil)
-dizziness, orthostatic hypotension, tachycardia, sedation, HA, tremor, blurred
vision, constipation, dry mouth/throat, weight gain, urinary hesitancy, sweating
-assist client to rise slowly
-administer at bedtime
-encourage sugar free beverages & hard candy
-ensure adequate fluids & balanced nutrition
-encourage exercise
-monitor cardiac function
2. imipramine (tofranil)
-dizziness, orthostatic hypotension, weakness, fatigue, blurred vision,
constipation, dry mouth/throat, weight gain
-assist client to rise slowly
-ensure adequate fluids & balanced nutrition
-sugar free beverages & hard candy
-encourage exercise
Atypical antidepressants Used when the client has an inadequate response to or side effects from SSRIs
