ATI Pharmacology: Psychiatric Medications Exam 8 Study Guide 2026
|Questions |Answers |Rationales
1. A nurse is teaching a client about a new prescription for alprazolam. Which of
the following instructions should the nurse include?
A. Take this medication with a high-fat meal.
B. Stop the medication immediately if you experience dizziness.
C. Expect a full therapeutic effect in 4 to 6 weeks.
D. Avoid driving until the initial effects are known.
Answer: D
Rationale: Alprazolam is a benzodiazepine that causes CNS depression; clients should
avoid activities requiring alertness until they know how the drug affects them. It works
quickly, not in weeks, and must be tapered to avoid withdrawal.
2. A nurse is monitoring a client who has been taking fluoxetine for two weeks.
Which of the following findings should the nurse prioritize?
A. Nausea and vomiting
B. Occasional tremors
C. Hallucinations and hyperreflexia
D. Decreased libido
Answer: C
Rationale: Hallucinations, hyperreflexia, agitation, and fever are signs of Serotonin
Syndrome, a potentially life-threatening emergency. Nausea, tremors, and sexual
dysfunction are common but less urgent side effects.
,3. A nurse is caring for a client with a lithium level of 1.9 mEq/L. Which action is
most appropriate?
A. Withhold the medication and notify the provider.
B. Increase the client’s sodium intake.
C. Administer the next scheduled dose.
D. Request a repeat lab draw for tomorrow morning.
Answer: A
Rationale: A lithium level of 1.9 mEq/L indicates moderate to severe toxicity (therapeutic
range is 0.6-1.2 mEq/L). The nurse should withhold the dose immediately.
4. Which of the following foods should a client taking phenelzine be instructed
to avoid?
A. Cottage cheese
B. Baked potatoes
C. Fresh strawberries
D. Pepperoni pizza
Answer: D
Rationale: Phenelzine is an MAOI. Cured meats like pepperoni contain tyramine, which can
trigger a hypertensive crisis in clients taking MAOIs.
5. A nurse is assessing a client taking haloperidol who has developed a high
fever, muscle rigidity, and autonomic instability. Which condition is likely?
A. Acute dystonia
B. Tardive dyskinesia
C. Pseudoparkinsonism
D. Neuroleptic Malignant Syndrome (NMS)
Answer: D
Rationale: NMS is a medical emergency associated with typical antipsychotics,
characterized by ‘lead pipe’ rigidity, high fever, and unstable vital signs.
, 6. A client is prescribed buspirone for anxiety. What is an advantage of this
medication over benzodiazepines?
A. It has an immediate onset of action.
B. It does not cause physical dependence or abuse.
C. It can be used as a PRN medication.
D. It provides better muscle relaxation.
Answer: B
Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not carry the risk of
dependence, though it takes 2-4 weeks for full effect.
7. A client is starting clozapine for treatment-resistant schizophrenia. Which lab
test is mandatory for this client?
A. Serum potassium
B. Weekly WBC with absolute neutrophil count (ANC)
C. Liver function tests (LFTs) every 3 months
D. Serum creatinine
Answer: B
Rationale: Clozapine carries a risk for agranulocytosis. Weekly monitoring of WBCs and
ANCs is required by the FDA to identify early bone marrow suppression.
8. A nurse is teaching a client about amitriptyline. Which instruction helps
manage anticholinergic effects?
A. Restrict fluid intake to 1 liter per day.
B. Take a hot bath to relax muscles.
C. Wear sunglasses when outdoors.
D. Avoid high-fiber foods.
Answer: C
Rationale: Amitriptyline causes photophobia (dilated pupils); sunglasses help. Other
anticholinergic management includes increasing fluids and fiber for constipation.
|Questions |Answers |Rationales
1. A nurse is teaching a client about a new prescription for alprazolam. Which of
the following instructions should the nurse include?
A. Take this medication with a high-fat meal.
B. Stop the medication immediately if you experience dizziness.
C. Expect a full therapeutic effect in 4 to 6 weeks.
D. Avoid driving until the initial effects are known.
Answer: D
Rationale: Alprazolam is a benzodiazepine that causes CNS depression; clients should
avoid activities requiring alertness until they know how the drug affects them. It works
quickly, not in weeks, and must be tapered to avoid withdrawal.
2. A nurse is monitoring a client who has been taking fluoxetine for two weeks.
Which of the following findings should the nurse prioritize?
A. Nausea and vomiting
B. Occasional tremors
C. Hallucinations and hyperreflexia
D. Decreased libido
Answer: C
Rationale: Hallucinations, hyperreflexia, agitation, and fever are signs of Serotonin
Syndrome, a potentially life-threatening emergency. Nausea, tremors, and sexual
dysfunction are common but less urgent side effects.
,3. A nurse is caring for a client with a lithium level of 1.9 mEq/L. Which action is
most appropriate?
A. Withhold the medication and notify the provider.
B. Increase the client’s sodium intake.
C. Administer the next scheduled dose.
D. Request a repeat lab draw for tomorrow morning.
Answer: A
Rationale: A lithium level of 1.9 mEq/L indicates moderate to severe toxicity (therapeutic
range is 0.6-1.2 mEq/L). The nurse should withhold the dose immediately.
4. Which of the following foods should a client taking phenelzine be instructed
to avoid?
A. Cottage cheese
B. Baked potatoes
C. Fresh strawberries
D. Pepperoni pizza
Answer: D
Rationale: Phenelzine is an MAOI. Cured meats like pepperoni contain tyramine, which can
trigger a hypertensive crisis in clients taking MAOIs.
5. A nurse is assessing a client taking haloperidol who has developed a high
fever, muscle rigidity, and autonomic instability. Which condition is likely?
A. Acute dystonia
B. Tardive dyskinesia
C. Pseudoparkinsonism
D. Neuroleptic Malignant Syndrome (NMS)
Answer: D
Rationale: NMS is a medical emergency associated with typical antipsychotics,
characterized by ‘lead pipe’ rigidity, high fever, and unstable vital signs.
, 6. A client is prescribed buspirone for anxiety. What is an advantage of this
medication over benzodiazepines?
A. It has an immediate onset of action.
B. It does not cause physical dependence or abuse.
C. It can be used as a PRN medication.
D. It provides better muscle relaxation.
Answer: B
Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not carry the risk of
dependence, though it takes 2-4 weeks for full effect.
7. A client is starting clozapine for treatment-resistant schizophrenia. Which lab
test is mandatory for this client?
A. Serum potassium
B. Weekly WBC with absolute neutrophil count (ANC)
C. Liver function tests (LFTs) every 3 months
D. Serum creatinine
Answer: B
Rationale: Clozapine carries a risk for agranulocytosis. Weekly monitoring of WBCs and
ANCs is required by the FDA to identify early bone marrow suppression.
8. A nurse is teaching a client about amitriptyline. Which instruction helps
manage anticholinergic effects?
A. Restrict fluid intake to 1 liter per day.
B. Take a hot bath to relax muscles.
C. Wear sunglasses when outdoors.
D. Avoid high-fiber foods.
Answer: C
Rationale: Amitriptyline causes photophobia (dilated pupils); sunglasses help. Other
anticholinergic management includes increasing fluids and fiber for constipation.
