200+ NCLEX-STYLE QUESTIONS & ANSWERS
WITH RATIONALES
, ATI PHARMACOLOGY MENTAL HEALTH FINAL EXAM 2026 COMPREHENSIVE PRACTICE QUESTIONS &
ANSWERS WITH RATIONALES
QUESTION 1
A nurse is providing teaching to a client who has a new prescription for sertraline. Which of the
following statements by the client indicates an understanding of the teaching?
A) "I should stop taking this medication if I feel better in a few weeks."
B) "I can take this medication with St. John's wort for better results."
C) "I may notice an improvement in my symptoms in 1 to 3 weeks."
D) "I should take this medication on an empty stomach."
Answer: C) "I may notice an improvement in my symptoms in 1 to 3 weeks."
Rationale: Sertraline, a selective serotonin reuptake inhibitor (SSRI), typically requires 1 to 3 weeks of
consistent use before therapeutic effects are observed, with full effects often taking 6 to 8 weeks.
Clients should be educated about this delayed onset to prevent premature discontinuation. Sertraline
should not be discontinued abruptly, as this can cause withdrawal symptoms. St. John's wort is
contraindicated with SSRIs due to the risk of serotonin syndrome. Sertraline can be taken with or
without food, but taking it with food may help reduce gastrointestinal upset .
QUESTION 2
A client taking lithium carbonate for bipolar disorder reports new-onset coarse hand tremors,
confusion, and nausea. What is the nurse's priority action?
A) Administer the next scheduled dose as prescribed
B) Tell the client this is a normal side effect that will resolve
C) Hold the medication and notify the healthcare provider
D) Encourage the client to increase their fluid intake
,Answer: C) Hold the medication and notify the healthcare provider
Rationale: Coarse tremors, confusion, and nausea are signs of advanced lithium toxicity. Lithium has a
narrow therapeutic range (0.8-1.4 mEq/L for acute mania; 0.6-1.2 mEq/L for maintenance), and toxicity
can occur with small increases in serum levels. Early signs of toxicity include fine tremors, nausea, and
diarrhea, while advanced signs include coarse tremors, confusion, ataxia, and seizures. The medication
should be held immediately, and the provider should be notified for further evaluation and
management .
QUESTION 3
A nurse is monitoring a client who is taking clozapine. Which laboratory finding requires immediate
intervention?
A) WBC count of 2,500/mm³
B) Hemoglobin of 13.5 g/dL
C) Platelet count of 250,000/mm³
D) Serum potassium of 4.0 mEq/L
Answer: A) WBC count of 2,500/mm³
Rationale: Clozapine carries a black box warning for agranulocytosis, a potentially fatal condition
characterized by a severe decrease in white blood cell count. A WBC count of 2,500/mm³ is significantly
below the normal range (4,500-11,000/mm³) and requires immediate intervention. The medication
should be held, and the provider should be notified. Clozapine requires regular WBC monitoring
according to the FDA-mandated REMS program. Baseline WBC must be within normal limits before
initiation, and monitoring continues weekly for the first 6 months, then biweekly for months 6-12, and
monthly thereafter .
QUESTION 4
A client prescribed lamotrigine for bipolar disorder reports developing a new skin rash. Which action
should the nurse take?
, A) Instruct the client to apply hydrocortisone cream to the rash
B) Reassure the client that this is a common, harmless side effect
C) Advise the client to stop taking the medication and notify the provider immediately
D) Recommend taking diphenhydramine for the rash
Answer: C) Advise the client to stop taking the medication and notify the provider immediately
Rationale: Lamotrigine carries a black box warning for Stevens-Johnson syndrome (SJS), a severe and
potentially life-threatening skin reaction. The rash associated with SJS typically appears within 2-8 weeks
of starting the medication. Any new rash in a client taking lamotrigine should be evaluated immediately,
and the medication should be discontinued until the rash can be assessed. SJS is more common in
children and when lamotrigine is started at too high a dose or when co-administered with valproic acid .
QUESTION 5
A nurse is providing education to the family of a client with schizophrenia who is being discharged on
risperidone. Which of the following adverse effects should the nurse include in the teaching?
A) Weight loss and decreased appetite
B) Decreased blood glucose levels
C) Weight gain and increased blood glucose
D) Hypotension and bradycardia
Answer: C) Weight gain and increased blood glucose
Rationale: Atypical antipsychotics like risperidone are associated with metabolic syndrome, which
includes weight gain, hyperglycemia, dyslipidemia, and an increased risk of type 2 diabetes. Clients
taking risperidone should be monitored regularly for weight gain, blood glucose levels, and lipid profiles.
The nurse should educate the client and family about dietary modifications, regular exercise, and the
importance of laboratory monitoring to identify these metabolic changes early .
WITH RATIONALES
, ATI PHARMACOLOGY MENTAL HEALTH FINAL EXAM 2026 COMPREHENSIVE PRACTICE QUESTIONS &
ANSWERS WITH RATIONALES
QUESTION 1
A nurse is providing teaching to a client who has a new prescription for sertraline. Which of the
following statements by the client indicates an understanding of the teaching?
A) "I should stop taking this medication if I feel better in a few weeks."
B) "I can take this medication with St. John's wort for better results."
C) "I may notice an improvement in my symptoms in 1 to 3 weeks."
D) "I should take this medication on an empty stomach."
Answer: C) "I may notice an improvement in my symptoms in 1 to 3 weeks."
Rationale: Sertraline, a selective serotonin reuptake inhibitor (SSRI), typically requires 1 to 3 weeks of
consistent use before therapeutic effects are observed, with full effects often taking 6 to 8 weeks.
Clients should be educated about this delayed onset to prevent premature discontinuation. Sertraline
should not be discontinued abruptly, as this can cause withdrawal symptoms. St. John's wort is
contraindicated with SSRIs due to the risk of serotonin syndrome. Sertraline can be taken with or
without food, but taking it with food may help reduce gastrointestinal upset .
QUESTION 2
A client taking lithium carbonate for bipolar disorder reports new-onset coarse hand tremors,
confusion, and nausea. What is the nurse's priority action?
A) Administer the next scheduled dose as prescribed
B) Tell the client this is a normal side effect that will resolve
C) Hold the medication and notify the healthcare provider
D) Encourage the client to increase their fluid intake
,Answer: C) Hold the medication and notify the healthcare provider
Rationale: Coarse tremors, confusion, and nausea are signs of advanced lithium toxicity. Lithium has a
narrow therapeutic range (0.8-1.4 mEq/L for acute mania; 0.6-1.2 mEq/L for maintenance), and toxicity
can occur with small increases in serum levels. Early signs of toxicity include fine tremors, nausea, and
diarrhea, while advanced signs include coarse tremors, confusion, ataxia, and seizures. The medication
should be held immediately, and the provider should be notified for further evaluation and
management .
QUESTION 3
A nurse is monitoring a client who is taking clozapine. Which laboratory finding requires immediate
intervention?
A) WBC count of 2,500/mm³
B) Hemoglobin of 13.5 g/dL
C) Platelet count of 250,000/mm³
D) Serum potassium of 4.0 mEq/L
Answer: A) WBC count of 2,500/mm³
Rationale: Clozapine carries a black box warning for agranulocytosis, a potentially fatal condition
characterized by a severe decrease in white blood cell count. A WBC count of 2,500/mm³ is significantly
below the normal range (4,500-11,000/mm³) and requires immediate intervention. The medication
should be held, and the provider should be notified. Clozapine requires regular WBC monitoring
according to the FDA-mandated REMS program. Baseline WBC must be within normal limits before
initiation, and monitoring continues weekly for the first 6 months, then biweekly for months 6-12, and
monthly thereafter .
QUESTION 4
A client prescribed lamotrigine for bipolar disorder reports developing a new skin rash. Which action
should the nurse take?
, A) Instruct the client to apply hydrocortisone cream to the rash
B) Reassure the client that this is a common, harmless side effect
C) Advise the client to stop taking the medication and notify the provider immediately
D) Recommend taking diphenhydramine for the rash
Answer: C) Advise the client to stop taking the medication and notify the provider immediately
Rationale: Lamotrigine carries a black box warning for Stevens-Johnson syndrome (SJS), a severe and
potentially life-threatening skin reaction. The rash associated with SJS typically appears within 2-8 weeks
of starting the medication. Any new rash in a client taking lamotrigine should be evaluated immediately,
and the medication should be discontinued until the rash can be assessed. SJS is more common in
children and when lamotrigine is started at too high a dose or when co-administered with valproic acid .
QUESTION 5
A nurse is providing education to the family of a client with schizophrenia who is being discharged on
risperidone. Which of the following adverse effects should the nurse include in the teaching?
A) Weight loss and decreased appetite
B) Decreased blood glucose levels
C) Weight gain and increased blood glucose
D) Hypotension and bradycardia
Answer: C) Weight gain and increased blood glucose
Rationale: Atypical antipsychotics like risperidone are associated with metabolic syndrome, which
includes weight gain, hyperglycemia, dyslipidemia, and an increased risk of type 2 diabetes. Clients
taking risperidone should be monitored regularly for weight gain, blood glucose levels, and lipid profiles.
The nurse should educate the client and family about dietary modifications, regular exercise, and the
importance of laboratory monitoring to identify these metabolic changes early .
