# A 28-year-old client newly diagnosed with major depressive disorder is starting sertraline 50 mg PO daily. Which client teaching is most important?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375252&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A 28-year-old client newly diagnosed with major depressive disorder is starting sertraline 50 mg PO daily. Which client teaching is most important?

## Option

1. Stop the medication after 1 week if you feel better.
2. Take it only when you feel sad.
3. Take it consistently each day; full antidepressant effect takes 4 to 6 weeks; report worsening mood, suicidal thoughts, or new agitation especially in the first weeks (FDA boxed warning under 25 years); avoid combining with St John wort, triptans, MAOIs, tramadol, dextromethorphan; do not stop abruptly because of discontinuation syndrome; report sexual dysfunction and GI side effects. **✔ Correct answer**
4. You should feel better within 24 hours; if not, double the dose.

**Correct answer: 3**

## Explanation

Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) and a first-line treatment for major depressive disorder, anxiety disorders, OCD, PTSD, panic, and PMDD. Key teaching: (1) it must be taken consistently, with full antidepressant effect taking 4 to 6 weeks; partial improvement may begin in 1 to 2 weeks; (2) FDA boxed warning for increased suicidal ideation in patients under age 25 — monitor mood and report new or worsening depression, suicidal thoughts, agitation, panic, hostility, akathisia, or impulsivity especially in the first weeks and after dose changes; have a safety plan; (3) serotonin syndrome with combinations such as triptans, MAOIs, tramadol, meperidine, dextromethorphan, ondansetron, linezolid, methylene blue, St John wort, recreational MDMA, other SSRIs/SNRIs/TCAs; recognize hyperreflexia, clonus, agitation, autonomic instability; (4) common side effects — nausea, headache, insomnia or somnolence, sexual dysfunction (decreased libido, anorgasmia), GI upset, weight changes; (5) discontinuation syndrome with abrupt stop especially short-half-life agents (paroxetine) — flu-like, dizziness, brain zaps, anxiety, insomnia; taper gradually; (6) avoid alcohol; (7) hyponatremia (SIADH) and bleeding risk especially with NSAIDs/anticoagulants; (8) report pregnancy because of risk-benefit reassessment. Doubling, PRN use, and stopping early are unsafe.

## In-depth explanation

Consistent daily use, 4-6 weeks for full effect, mood and suicidality monitoring, taper rather than abrupt stop, avoid serotonergic combos.

## Related questions

- [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en)
- [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=en)
- [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en)
- [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en)
- [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en)
- [A 76-year-old female with chronic heart failure and atrial fibrillation receives digoxin 0…](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en)
- [A 70-year-old client on long-term digoxin therapy reports new yellow-green halos around li…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=en)
- [A 58-year-old client with type 2 diabetes mellitus and migraine prophylaxis is taking prop…](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=375252&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=375252&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=375252&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=375252&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=375252&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._