Registered Practical Nurse (RPN) Practice Test

In which situation should tricyclic antidepressant therapy be approached with extreme caution?

1. Patients with insomnia

2. Patients exhibiting suicidal ideation

3. Patients with chronic pain

4. Patients with high blood pressure

The correct answer is: Patients exhibiting suicidal ideation

In the context of antidepressant therapy, particularly with tricyclic antidepressants (TCAs), there is a significant concern regarding their use in patients exhibiting suicidal ideation. TCAs can have sedative effects, which might lead to increased risk if a patient has serious thoughts of self-harm. The lethality of TCAs in overdose situations is another critical factor; because these medications can be dangerous in large quantities, this population requires careful monitoring and consideration of alternatives. Since TCAs also have an infrastructure of side effects and withdrawal symptoms, close supervision is essential for patients who might be contemplating suicide. Their potential for misuse or an increase in risk for overdose in such situations renders their use highly cautious in cases of suicidal thoughts. Thus, this context justifies the need for extreme caution when prescribing these medications to individuals facing such serious mental health challenges.