200+ NCLEX-STYLE QUESTIONS & ANSWERS
WITH RATIONALES
,ATI PHARMACOLOGY MENTAL HEALTH FINAL EXAM 2026 PRACTICE QUESTIONS,
ANSWERS & RATIONALES
1. A nurse is teaching a client who is beginning treatment with sertraline. Which
statement should the nurse include?
A. “You should expect immediate improvement after the first dose.”
B. “It may take several weeks before you experience the full therapeutic effect.”
C. “Stop taking the medication when your mood improves.”
D. “Take this medication only when you feel depressed.”
Answer: B
Rationale: SSRIs such as sertraline often require several weeks to achieve their
full therapeutic effect. Clients should not discontinue the medication abruptly or
use it only as needed.
2. A client taking fluoxetine develops agitation, diaphoresis, tremors, and
hyperreflexia. The nurse should suspect which condition?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Tardive dyskinesia
D. Anticholinergic toxicity
Answer: B
Rationale: Serotonin syndrome can cause agitation, diaphoresis, tremors,
hyperreflexia, diarrhea, and hyperthermia. It requires prompt medical evaluation.
3. Which adverse effect is commonly associated with tricyclic antidepressants?
A. Increased salivation
B. Orthostatic hypotension
C. Diarrhea
D. Bradycardia
,Answer: B
Rationale: Tricyclic antidepressants can produce anticholinergic effects and
orthostatic hypotension. Clients should change positions slowly to reduce the risk
of falls.
4. A nurse is caring for a client who is taking amitriptyline. Which finding requires
immediate intervention?
A. Dry mouth
B. Mild constipation
C. Suicidal ideation
D. Blurred vision
Answer: C
Rationale: Any emergence or worsening of suicidal thoughts requires immediate
assessment and intervention. Some antidepressants may initially increase energy
before mood improves.
5. A client is prescribed phenelzine. Which food should the nurse instruct the
client to avoid?
A. Fresh apples
B. Aged cheese
C. Steamed rice
D. Grilled chicken
Answer: B
Rationale: MAOIs can interact with tyramine-rich foods such as aged cheeses,
cured meats, and some fermented products, potentially causing hypertensive
crisis.
6. Which finding is most consistent with a hypertensive crisis in a client taking an
MAOI?
, A. Severe headache and hypertension
B. Hypothermia and bradycardia
C. Constipation and dry mouth
D. Drowsiness and hypotension
Answer: A
Rationale: A hypertensive crisis may include severe headache, markedly elevated
blood pressure, palpitations, diaphoresis, and nausea.
7. A client taking lithium reports vomiting, coarse tremors, and difficulty walking.
What is the nurse’s priority action?
A. Encourage increased physical activity
B. Withhold the medication and notify the provider
C. Give the next dose with food
D. Reassure the client that the effects are expected
Answer: B
Rationale: These findings can indicate lithium toxicity. The medication should be
withheld, and the provider should be notified.
8. Which instruction should the nurse include for a client taking lithium?
A. “Restrict your fluid intake.”
B. “Maintain a consistent intake of sodium and fluids.”
C. “Avoid all dietary sodium.”
D. “Double your dose if you miss one.”
Answer: B
Rationale: Consistent sodium and fluid intake helps maintain stable lithium levels.
Changes in hydration or sodium balance can increase the risk of toxicity.
9. A nurse is monitoring a client receiving clozapine. Which laboratory value is
especially important?
WITH RATIONALES
,ATI PHARMACOLOGY MENTAL HEALTH FINAL EXAM 2026 PRACTICE QUESTIONS,
ANSWERS & RATIONALES
1. A nurse is teaching a client who is beginning treatment with sertraline. Which
statement should the nurse include?
A. “You should expect immediate improvement after the first dose.”
B. “It may take several weeks before you experience the full therapeutic effect.”
C. “Stop taking the medication when your mood improves.”
D. “Take this medication only when you feel depressed.”
Answer: B
Rationale: SSRIs such as sertraline often require several weeks to achieve their
full therapeutic effect. Clients should not discontinue the medication abruptly or
use it only as needed.
2. A client taking fluoxetine develops agitation, diaphoresis, tremors, and
hyperreflexia. The nurse should suspect which condition?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Tardive dyskinesia
D. Anticholinergic toxicity
Answer: B
Rationale: Serotonin syndrome can cause agitation, diaphoresis, tremors,
hyperreflexia, diarrhea, and hyperthermia. It requires prompt medical evaluation.
3. Which adverse effect is commonly associated with tricyclic antidepressants?
A. Increased salivation
B. Orthostatic hypotension
C. Diarrhea
D. Bradycardia
,Answer: B
Rationale: Tricyclic antidepressants can produce anticholinergic effects and
orthostatic hypotension. Clients should change positions slowly to reduce the risk
of falls.
4. A nurse is caring for a client who is taking amitriptyline. Which finding requires
immediate intervention?
A. Dry mouth
B. Mild constipation
C. Suicidal ideation
D. Blurred vision
Answer: C
Rationale: Any emergence or worsening of suicidal thoughts requires immediate
assessment and intervention. Some antidepressants may initially increase energy
before mood improves.
5. A client is prescribed phenelzine. Which food should the nurse instruct the
client to avoid?
A. Fresh apples
B. Aged cheese
C. Steamed rice
D. Grilled chicken
Answer: B
Rationale: MAOIs can interact with tyramine-rich foods such as aged cheeses,
cured meats, and some fermented products, potentially causing hypertensive
crisis.
6. Which finding is most consistent with a hypertensive crisis in a client taking an
MAOI?
, A. Severe headache and hypertension
B. Hypothermia and bradycardia
C. Constipation and dry mouth
D. Drowsiness and hypotension
Answer: A
Rationale: A hypertensive crisis may include severe headache, markedly elevated
blood pressure, palpitations, diaphoresis, and nausea.
7. A client taking lithium reports vomiting, coarse tremors, and difficulty walking.
What is the nurse’s priority action?
A. Encourage increased physical activity
B. Withhold the medication and notify the provider
C. Give the next dose with food
D. Reassure the client that the effects are expected
Answer: B
Rationale: These findings can indicate lithium toxicity. The medication should be
withheld, and the provider should be notified.
8. Which instruction should the nurse include for a client taking lithium?
A. “Restrict your fluid intake.”
B. “Maintain a consistent intake of sodium and fluids.”
C. “Avoid all dietary sodium.”
D. “Double your dose if you miss one.”
Answer: B
Rationale: Consistent sodium and fluid intake helps maintain stable lithium levels.
Changes in hydration or sodium balance can increase the risk of toxicity.
9. A nurse is monitoring a client receiving clozapine. Which laboratory value is
especially important?
