The patient has been receiving amitriptyline (Elavil) for 2 ...

[Haya94]

The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?
 
  1. It is working, but it can take several weeks to have an effect.
  2. You might still feel depressed, but you are looking much better.
  3. This may not be the best medicine for you; I'll call your doctor.
  4. It is working, but it can take several months to have an effect.

Question 2

The mother of a 7-year-old child says to the nurse, My child is distractible in school, cannot complete assignments on time, and interrupts other children while they are speaking. What do you think? What is the best response by the nurse?
 
  1. This sounds like your child is depressed; depression looks different in children and is very serious.
  2. This sounds like bipolar disorder; you might want to have your child tested by a child psychiatrist.
  3. This could be attention-deficit hyperactivity disorder (ADHD); you might want to have your child tested.
  4. This sounds like typical 7-year-old behaviors to me; if they do not resolve, have your child tested.

[ricroger]

Answer to Question 1

Correct Answer: 1
Rationale: The therapeutic effects of tricyclic antidepressants may take 2 to 6 weeks to occur. It is inappropriate for the nurse to call the physician; tricyclic antidepressants need time to work. Telling a depressed patient he looks better negates the patient's feelings and is inappropriate. The time frame for efficacy is several weeks, not several months.

Answer to Question 2

Correct Answer: 3
Rationale: Symptoms of attention-deficit hyperactivity disorder (ADHD) include difficulty in paying attention and focusing on tasks, hyperactivity, distractibility, impulsivity, and talking excessively. Being distractible, unable to complete assignments, and interrupting other children are not typical 7-year-old behaviors. Depression does look different in children, but these symptoms are clearly symptoms of attention-deficit hyperactivity disorder (ADHD). Being distractible, unable to complete assignments, and interrupting other children are symptoms of attention-deficit hyperactivity disorder (ADHD), not bipolar disorder.

[Haya94]

Thank you!

[ricroger]

Always glad to help...