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    RN Comprehensive Predictor Proctored Exam (National U CA San Diego)

    A nurse is providing teaching to a client who has a depressive disorder and a new prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?

    Explanation & Rationale

    Rationale: A. "I know it will be a couple of weeks before the medication helps me feel better.": Tricyclic antidepressants like amitriptyline require 1–3 weeks to begin showing therapeutic effects. Understanding the delayed onset helps the client maintain adherence and avoid premature discontinuation due to perceived lack of efficacy. B. "I can continue to take St. John's wort while taking this medication.": Combining amitriptyline with St. John’s wort can increase the risk of serotonin syndrome. Clients should avoid herbal supplements that may interact with antidepressants. C. "I expect this medication to raise my blood pressure.": Amitriptyline more commonly causes orthostatic hypotension rather than hypertension. Clients should be aware of potential dizziness and fall risk associated with blood pressure drops. D. "I should take this medication on an empty stomach": Incomplete statement, but typically, amitriptyline is taken at bedtime to minimize daytime sedation and anticholinergic side effects. Timing should be clarified to optimize safety and adherence.

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