A client is discontinued from fluoxetine. The nurse correctly ...

[APUS57]

A client is discontinued from fluoxetine. The nurse correctly understands that a return of signs and symptoms of depression as a result of complete elimination of fluoxetine from the body will MOST likely occur:
 
  a. between 1 and 2 days
  b. between 1 and 2 weeks
  c. between 2 and 4 weeks
  d. between 1 and 2 months

Question 2

A psychiatric nurse begins the initial meeting with a new client by requiring the client to sign a written explanation of all the rules the client must follow while under psychiatric care.
 
  By the end of the meeting, the client has stopped talking and displays a closed, guarded affect and nonverbal behavior. This is MOST likely because the nurse failed to first: a. convey that the nurse is kind as well as willing and competent to provide psychiatric nursing care
  b. thoroughly assess the client's knowledge of his or her diagnosis
  c. present a written care plan and have the client sign that the client understands and agrees with the care plan
  d. administer medication to reduce the client's level of anxiety prior to the meeting

[ndhahbi]

Answer to Question 1

D
Fluoxetine will be completely eliminated from the body between 1 and 2 months after administration of the medication has been discontinued. Fluoxetine's (trade name Prozac) long elimination period is seen as a benefit in situations where a client may miss taking the medication for a day or more. However, it makes it especially difficult when it is necessary to switch to another medication such as an MAOI.

Answer to Question 2

A
The client's behavior indicates that trust between the client and nurse has not developed. A critical aspect in beginning any relationship is to identify the roles of both parties. This will facilitate the development of trust and rapport. Beginning with the rules that the client must follow indicates that the nurse is not caring and implies that the relationship is not mutual but one-sided.