The risk of experiencing serotonin syndrome is increased when SSRIs are given with monoamine oxidase inhibitors such as phenelzine (Nardil). Serotonin syndrome is best characterized in which of the following?
Tea-colored urine and constipation
A productive cough and vomiting
Muscle rigidity and high fever
Hypotension and urinary retention
The Correct Answer is C
Choice A reason:
Tea-colored urine and constipation are not characteristic symptoms of serotonin syndrome. These symptoms may indicate other medical conditions but are not related to the excessive accumulation of serotonin in the body.
Choice B reason:
A productive cough and vomiting are not typical symptoms of serotonin syndrome. While vomiting can occur in severe cases, a productive cough is unrelated to serotonin syndrome and more indicative of respiratory conditions.
Choice C reason:
Muscle rigidity and high fever are hallmark symptoms of serotonin syndrome. This condition results from an excess of serotonin in the central nervous system and can lead to severe autonomic instability, hyperthermia, and neuromuscular abnormalities. Immediate medical intervention is required to manage these symptoms and prevent complications.
Choice D reason:
Hypotension and urinary retention are not primary symptoms of serotonin syndrome. While autonomic dysfunction can occur, the key features of serotonin syndrome include neuromuscular hyperactivity, autonomic instability, and altered mental status.
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Correct Answer is C
Explanation
Choice A reason:
Being afraid of medical providers is not a determining factor for the suitability of rTMS. While patient comfort and willingness to undergo treatment are important, the primary considerations for rTMS eligibility are medical and safety-related.
Choice B reason:
His family’s agreement to take him to the hospital each week is supportive but not a primary criterion for rTMS eligibility. The focus should be on the patient’s medical suitability and safety for the procedure.
Choice C reason:
Signing an informed consent and having no presence of metal in the area of the magnetic stimulation, such as cochlear implants or medication pumps, are critical factors for rTMS eligibility. Metal implants in the head or neck can interfere with the magnetic fields used in rTMS, posing safety risks. Informed consent ensures that the patient understands the procedure, risks, and benefits.
Choice D reason:
Being angry about the death of his father is an emotional response and does not impact the medical suitability for rTMS. The decision to use rTMS should be based on medical criteria and safety considerations.
Correct Answer is ["B","C","D"]
Explanation
Choice A reason:
Canceling Netflix by Internet service is not relevant to Mr. Jones’ discharge planning. While managing finances and subscriptions may be part of overall life management, it does not address the immediate safety and mental health needs of Mr. Jones.
Choice B reason:
Releasing information signed for family to secure Mr. Jones’ loaded gun or having the police secure the gun if needed prior to discharge is crucial for ensuring his safety. Removing access to firearms reduces the risk of self-harm and is an important step in discharge planning for someone with suicidal ideation.
Choice C reason:
Obtaining a psychiatric provider follow-up appointment as soon as possible and evaluating for PHP (Partial Hospitalization Program) or residential treatment with the treatment team is essential. Continuity of care and appropriate follow-up are critical for managing Mr. Jones’ depression and preventing relapse.
Choice D reason:
Assisting in developing a safety plan prior to discharge that is written with phone numbers and interventions is vital. A safety plan provides Mr. Jones with clear steps to take if he feels at risk of harming himself, including contact information for crisis services and supportive individuals.