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KAPLAN PSYCHIATRIC MEDICATIONS ASSESSMENT
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
PSYCHIATRIC
Prepare for the Kaplan Psychiatric Medications Assessment with a focused study
resource covering essential concepts in psychopharmacology and medication
management. It supports review of psychiatric medication classes, therapeutic
effects, adverse reactions, safety considerations, patient education, and nursing
responsibilities. Use the material to reinforce pharmacology knowledge, strengthen
clinical judgment, and identify areas that may require additional study. This resource
is best suited for nursing students and NCLEX candidates preparing for psychiatric
medication assessments.
MULTIPLE CHOICE.
SECTION 1: ANTIDEPRESSANTS — SSRIs (Questions 1-15)
1. A client is prescribed fluoxetine (Prozac) for major depressive disorder.
The nurse should educate the client that therapeutic effects may take:
a) 1-3 days
b) 1-2 weeks
c) 2-4 weeks
d) 6-8 weeks
Answer: c) 2-4 weeks
Rationale: SSRIs such as fluoxetine typically take 2-4 weeks to achieve
therapeutic effects. Clients should be instructed to continue taking the
medication as prescribed and not to stop abruptly, even if they do not feel
immediate improvement. Full therapeutic benefit may take up to 8 weeks.
2. A client is prescribed sertraline (Zoloft) for depression. The nurse
should monitor for which common side effect?
a) Sedation and weight gain
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b) Insomnia and gastrointestinal upset
c) Hypertension and tachycardia
d) Hypoglycemia and weight loss
Answer: b) Insomnia and gastrointestinal upset
Rationale: Sertraline commonly causes insomnia, nausea, diarrhea, and
gastrointestinal upset. It is typically more activating than other SSRIs. Weight
gain is more common with paroxetine, and hypertension is not a typical SSRI
side effect.
3. A client prescribed an SSRI reports sexual dysfunction. The nurse
understands that this side effect is caused by:
a) Increased dopamine levels
b) Increased serotonin levels
c) Decreased norepinephrine levels
d) Decreased acetylcholine levels
Answer: b) Increased serotonin levels
Rationale: SSRIs increase serotonin levels, which can lead to sexual
dysfunction (decreased libido, anorgasmia, erectile dysfunction). This is a
common and often distressing side effect that may lead to non-adherence.
The nurse should discuss this with the client and provider.
4. A client is prescribed paroxetine (Paxil). The nurse should be especially
cautious when discontinuing this medication because:
a) It has a short half-life and causes significant withdrawal symptoms
b) It has a long half-life and accumulates in the body
c) It is a controlled substance with high abuse potential
d) It causes permanent damage to serotonin receptors
Answer: a) It has a short half-life and causes significant withdrawal
symptoms
Rationale: Paroxetine has a short half-life compared to other SSRIs and is
associated with more significant discontinuation syndrome (withdrawal
symptoms) including dizziness, nausea, headache, and "brain zaps." It should
be tapered slowly under medical supervision.
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5. A client is prescribed fluvoxamine (Luvox). The nurse understands that
this medication is primarily used for:
a) Major depressive disorder
b) Generalized anxiety disorder
c) Obsessive-compulsive disorder
d) Panic disorder
Answer: c) Obsessive-compulsive disorder
Rationale: Fluvoxamine is an SSRI that is FDA-approved for obsessive-
compulsive disorder (OCD). While SSRIs are used for other conditions,
fluvoxamine is most commonly associated with OCD treatment.
6. A client prescribed citalopram (Celexa) should be monitored for which
serious adverse effect?
a) Hepatotoxicity
b) QT prolongation
c) Nephrotoxicity
d) Cardiotoxicity
Answer: b) QT prolongation
Rationale: Citalopram is associated with QT prolongation, particularly at
higher doses (>40 mg/day). The FDA has recommended a maximum dose of
40 mg/day and 20 mg/day for clients over 60 or those with hepatic impairment.
ECG monitoring may be indicated.
7. A client is prescribed escitalopram (Lexapro). Which statement by the
client indicates understanding of the medication?
a) "I can stop the medication once I start feeling better."
b) "I should take the medication at the same time each day."
c) "I can take this medication with St. John's wort for better effect."
d) "I will feel better immediately after starting this medication."
Answer: b) "I should take the medication at the same time each day."
Rationale: SSRIs should be taken at the same time each day to maintain
consistent blood levels. Clients should not stop abruptly, should avoid St.
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John's wort (risk of serotonin syndrome), and should understand that
therapeutic effects take 2-4 weeks.
8. Serotonin syndrome is a life-threatening adverse effect of SSRIs. Which
of the following is a sign of serotonin syndrome?
a) Bradycardia and hypotension
b) Sedation and respiratory depression
c) Agitation, hyperthermia, and muscle rigidity
d) Pinpoint pupils and constipation
Answer: c) Agitation, hyperthermia, and muscle rigidity
Rationale: Serotonin syndrome is characterized by agitation, confusion,
hyperthermia, diaphoresis, muscle rigidity, and clonus. It can occur when
SSRIs are combined with other serotonergic agents (MAOIs, SNRIs, triptans,
St. John's wort). It requires immediate medical intervention.
9. A client is prescribed an SSRI and reports bruising and easy bleeding.
The nurse should:
a) Reassure the client that this is a normal side effect
b) Notify the provider immediately
c) Increase the client's fluid intake
d) Discontinue the medication
Answer: b) Notify the provider immediately
Rationale: SSRIs can affect platelet function and increase bleeding risk,
especially when combined with NSAIDs, aspirin, or anticoagulants. Bruising
and easy bleeding should be reported to the provider for further evaluation.
10. Which SSRI is most likely to cause sedation?
a) Fluoxetine (Prozac)
b) Sertraline (Zoloft)
c) Paroxetine (Paxil)
d) Escitalopram (Lexapro)
Answer: c) Paroxetine (Paxil)
KAPLAN PSYCHIATRIC MEDICATIONS ASSESSMENT
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
PSYCHIATRIC
Prepare for the Kaplan Psychiatric Medications Assessment with a focused study
resource covering essential concepts in psychopharmacology and medication
management. It supports review of psychiatric medication classes, therapeutic
effects, adverse reactions, safety considerations, patient education, and nursing
responsibilities. Use the material to reinforce pharmacology knowledge, strengthen
clinical judgment, and identify areas that may require additional study. This resource
is best suited for nursing students and NCLEX candidates preparing for psychiatric
medication assessments.
MULTIPLE CHOICE.
SECTION 1: ANTIDEPRESSANTS — SSRIs (Questions 1-15)
1. A client is prescribed fluoxetine (Prozac) for major depressive disorder.
The nurse should educate the client that therapeutic effects may take:
a) 1-3 days
b) 1-2 weeks
c) 2-4 weeks
d) 6-8 weeks
Answer: c) 2-4 weeks
Rationale: SSRIs such as fluoxetine typically take 2-4 weeks to achieve
therapeutic effects. Clients should be instructed to continue taking the
medication as prescribed and not to stop abruptly, even if they do not feel
immediate improvement. Full therapeutic benefit may take up to 8 weeks.
2. A client is prescribed sertraline (Zoloft) for depression. The nurse
should monitor for which common side effect?
a) Sedation and weight gain
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b) Insomnia and gastrointestinal upset
c) Hypertension and tachycardia
d) Hypoglycemia and weight loss
Answer: b) Insomnia and gastrointestinal upset
Rationale: Sertraline commonly causes insomnia, nausea, diarrhea, and
gastrointestinal upset. It is typically more activating than other SSRIs. Weight
gain is more common with paroxetine, and hypertension is not a typical SSRI
side effect.
3. A client prescribed an SSRI reports sexual dysfunction. The nurse
understands that this side effect is caused by:
a) Increased dopamine levels
b) Increased serotonin levels
c) Decreased norepinephrine levels
d) Decreased acetylcholine levels
Answer: b) Increased serotonin levels
Rationale: SSRIs increase serotonin levels, which can lead to sexual
dysfunction (decreased libido, anorgasmia, erectile dysfunction). This is a
common and often distressing side effect that may lead to non-adherence.
The nurse should discuss this with the client and provider.
4. A client is prescribed paroxetine (Paxil). The nurse should be especially
cautious when discontinuing this medication because:
a) It has a short half-life and causes significant withdrawal symptoms
b) It has a long half-life and accumulates in the body
c) It is a controlled substance with high abuse potential
d) It causes permanent damage to serotonin receptors
Answer: a) It has a short half-life and causes significant withdrawal
symptoms
Rationale: Paroxetine has a short half-life compared to other SSRIs and is
associated with more significant discontinuation syndrome (withdrawal
symptoms) including dizziness, nausea, headache, and "brain zaps." It should
be tapered slowly under medical supervision.
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5. A client is prescribed fluvoxamine (Luvox). The nurse understands that
this medication is primarily used for:
a) Major depressive disorder
b) Generalized anxiety disorder
c) Obsessive-compulsive disorder
d) Panic disorder
Answer: c) Obsessive-compulsive disorder
Rationale: Fluvoxamine is an SSRI that is FDA-approved for obsessive-
compulsive disorder (OCD). While SSRIs are used for other conditions,
fluvoxamine is most commonly associated with OCD treatment.
6. A client prescribed citalopram (Celexa) should be monitored for which
serious adverse effect?
a) Hepatotoxicity
b) QT prolongation
c) Nephrotoxicity
d) Cardiotoxicity
Answer: b) QT prolongation
Rationale: Citalopram is associated with QT prolongation, particularly at
higher doses (>40 mg/day). The FDA has recommended a maximum dose of
40 mg/day and 20 mg/day for clients over 60 or those with hepatic impairment.
ECG monitoring may be indicated.
7. A client is prescribed escitalopram (Lexapro). Which statement by the
client indicates understanding of the medication?
a) "I can stop the medication once I start feeling better."
b) "I should take the medication at the same time each day."
c) "I can take this medication with St. John's wort for better effect."
d) "I will feel better immediately after starting this medication."
Answer: b) "I should take the medication at the same time each day."
Rationale: SSRIs should be taken at the same time each day to maintain
consistent blood levels. Clients should not stop abruptly, should avoid St.
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John's wort (risk of serotonin syndrome), and should understand that
therapeutic effects take 2-4 weeks.
8. Serotonin syndrome is a life-threatening adverse effect of SSRIs. Which
of the following is a sign of serotonin syndrome?
a) Bradycardia and hypotension
b) Sedation and respiratory depression
c) Agitation, hyperthermia, and muscle rigidity
d) Pinpoint pupils and constipation
Answer: c) Agitation, hyperthermia, and muscle rigidity
Rationale: Serotonin syndrome is characterized by agitation, confusion,
hyperthermia, diaphoresis, muscle rigidity, and clonus. It can occur when
SSRIs are combined with other serotonergic agents (MAOIs, SNRIs, triptans,
St. John's wort). It requires immediate medical intervention.
9. A client is prescribed an SSRI and reports bruising and easy bleeding.
The nurse should:
a) Reassure the client that this is a normal side effect
b) Notify the provider immediately
c) Increase the client's fluid intake
d) Discontinue the medication
Answer: b) Notify the provider immediately
Rationale: SSRIs can affect platelet function and increase bleeding risk,
especially when combined with NSAIDs, aspirin, or anticoagulants. Bruising
and easy bleeding should be reported to the provider for further evaluation.
10. Which SSRI is most likely to cause sedation?
a) Fluoxetine (Prozac)
b) Sertraline (Zoloft)
c) Paroxetine (Paxil)
d) Escitalopram (Lexapro)
Answer: c) Paroxetine (Paxil)
