A patient has recently started antidepressant therapy. Which of the following is the highest priority nursing intervention during the initial weeks of treatment?

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

The highest priority is monitoring for suicidal ideation, which aligns with the FDA's 'black box warning' for antidepressants.
Antidepressants can increase a patient's energy levels before their mood improves. This creates a 'window of risk' where a patient might have the physical capacity to act on suicidal thoughts.
This risk is highest in the first 1-4 weeks of treatment and is particularly pronounced in children, adolescents, and young adults.
The period before therapeutic effects are seen is when the patient is at the highest risk for self-harm and suicide.

Option A: A high-protein diet is not a universal priority for all antidepressants. It does not address the immediate safety risk.
Option C: Restricting fluids is not indicated and can lead to dehydration and other complications. It is contrary to general good nursing care.
Option D: This is dangerous advice. Abruptly stopping antidepressants can lead to discontinuation syndrome (withdrawal) and a relapse of depressive symptoms.

Visual 1: Infographic: A timeline showing the 'Window of Risk' for suicide during initial antidepressant therapy. The graphic would illustrate energy levels rising faster than mood improves in the first 1-4 weeks.
Visual 2: Chart: A summary of the FDA Black Box Warning for antidepressants, highlighting the increased risk of suicidality in children, adolescents, and young adults.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Priority nursing interventions during initial antidepressant therapy in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Nurses are on the front line of patient safety and must perform diligent suicide risk assessments. This involves asking direct questions about suicidal thoughts, plans, and intent at every patient encounter, especially during the initial phase of treatment.
Patient and family education is a critical nursing responsibility. Explaining the delayed therapeutic effect and the immediate risk of increased suicidal ideation helps ensure adherence and empowers families to recognize and report warning signs.
What if the patient is an adolescent? The risk of suicide is significantly higher in this population when starting antidepressants. This requires more frequent monitoring, closer collaboration with mental health specialists, and open communication with both the patient and their guardians.

How to Approach the Question

First, identify that this is a 'priority' question. This means all options may be plausible nursing actions, but you must choose the most important one.
Next, focus on the keywords: 'antidepressant therapy' and 'initial weeks'. This specific timeframe is the key to the question.
Recall the most critical safety concern associated with starting antidepressants. The 'black box warning' for increased suicidal ideation should come to mind.
Evaluate each option based on the principle of patient safety. Monitoring for suicide risk is a direct, life-saving safety intervention.
Compare this priority to the other options. Diet, fluid status (in this context), and medication adherence are important but are secondary to the immediate risk of self-harm.

Concept Tested & Keywords

Concept Tested: Priority nursing interventions during initial antidepressant therapy
Stem keywords: antidepressant therapy, initial weeks, highest priority, nursing intervention
Lead-in keywords: highest priority
Clinical cues: Patient recently started antidepressant therapy

QXgqJCPNpmYB71IZTWJIla

Practise the full AIIMS M.Sc. Nsg Entrance exam-2026

Attempt every question from this paper in a timed mock, then review the full solution for each one.