200+ QUESTIONS & ANSWERS WITH
RATIONALES
,ATI PHARMACOLOGY — MENTAL HEALTH MIDTERM 2026 COMPREHENSIVE PRACTICE EXAM
1. A nurse is caring for a client who has a prescription for fluoxetine. Which adverse effect
should the nurse monitor for?
A. Severe hypertension
B. Serotonin syndrome
C. Agranulocytosis
D. Tardive dyskinesia
Answer: B. Serotonin syndrome
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI). Excess serotonergic
activity can cause serotonin syndrome, characterized by agitation, confusion, diaphoresis,
hyperreflexia, tremor, and hyperthermia.
2. A nurse is teaching a client who is beginning sertraline therapy. Which statement should
the nurse include?
A. "You should notice maximum improvement within 24 hours."
B. "Stop taking the medication when you feel better."
C. "It can take several weeks to experience the full therapeutic effect."
D. "Take an extra dose if you miss a dose."
Answer: C. "It can take several weeks to experience the full therapeutic effect."
Rationale: Antidepressants generally require several weeks for their full therapeutic effects.
Clients should continue taking the medication as prescribed even if improvement is not
immediate.
,3. A nurse is assessing a client who takes lithium. Which laboratory value is most important
to monitor?
A. Serum sodium
B. Hemoglobin
C. Platelet count
D. Serum amylase
Answer: A. Serum sodium
Rationale: Sodium and fluid balance significantly affect lithium levels. Sodium depletion can
increase lithium retention and increase the risk of toxicity.
4. A client taking lithium reports diarrhea, vomiting, coarse tremors, and confusion. Which
action should the nurse take?
A. Administer the next dose with food.
B. Encourage caffeine intake.
C. Hold the medication and notify the provider.
D. Administer an additional dose.
Answer: C. Hold the medication and notify the provider.
Rationale: Vomiting, diarrhea, coarse tremors, and confusion can indicate lithium toxicity. The
medication should be withheld and the provider notified. A serum lithium level and other
laboratory studies may be required.
5. Which statement by a client taking lithium indicates an understanding of dietary teaching?
A. "I should drastically reduce my salt intake."
B. "I should maintain a consistent intake of dietary sodium."
, C. "I should avoid drinking fluids."
D. "I should increase my caffeine consumption."
Answer: B. "I should maintain a consistent intake of dietary sodium."
Rationale: Sudden changes in sodium intake can alter lithium concentrations. Clients should
maintain a consistent sodium intake and adequate hydration.
6. A nurse is administering haloperidol to a client. Which finding requires immediate
intervention?
A. Mild dry mouth
B. Muscle rigidity and hyperthermia
C. Increased appetite
D. Mild drowsiness
Answer: B. Muscle rigidity and hyperthermia
Rationale: Severe muscle rigidity, hyperthermia, altered mental status, and autonomic
instability can indicate neuroleptic malignant syndrome (NMS), a potentially life-threatening
reaction to antipsychotic medications.
7. A client receiving an antipsychotic medication develops involuntary movements of the
tongue and facial muscles. The nurse should recognize these findings as:
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Answer: C. Tardive dyskinesia
RATIONALES
,ATI PHARMACOLOGY — MENTAL HEALTH MIDTERM 2026 COMPREHENSIVE PRACTICE EXAM
1. A nurse is caring for a client who has a prescription for fluoxetine. Which adverse effect
should the nurse monitor for?
A. Severe hypertension
B. Serotonin syndrome
C. Agranulocytosis
D. Tardive dyskinesia
Answer: B. Serotonin syndrome
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI). Excess serotonergic
activity can cause serotonin syndrome, characterized by agitation, confusion, diaphoresis,
hyperreflexia, tremor, and hyperthermia.
2. A nurse is teaching a client who is beginning sertraline therapy. Which statement should
the nurse include?
A. "You should notice maximum improvement within 24 hours."
B. "Stop taking the medication when you feel better."
C. "It can take several weeks to experience the full therapeutic effect."
D. "Take an extra dose if you miss a dose."
Answer: C. "It can take several weeks to experience the full therapeutic effect."
Rationale: Antidepressants generally require several weeks for their full therapeutic effects.
Clients should continue taking the medication as prescribed even if improvement is not
immediate.
,3. A nurse is assessing a client who takes lithium. Which laboratory value is most important
to monitor?
A. Serum sodium
B. Hemoglobin
C. Platelet count
D. Serum amylase
Answer: A. Serum sodium
Rationale: Sodium and fluid balance significantly affect lithium levels. Sodium depletion can
increase lithium retention and increase the risk of toxicity.
4. A client taking lithium reports diarrhea, vomiting, coarse tremors, and confusion. Which
action should the nurse take?
A. Administer the next dose with food.
B. Encourage caffeine intake.
C. Hold the medication and notify the provider.
D. Administer an additional dose.
Answer: C. Hold the medication and notify the provider.
Rationale: Vomiting, diarrhea, coarse tremors, and confusion can indicate lithium toxicity. The
medication should be withheld and the provider notified. A serum lithium level and other
laboratory studies may be required.
5. Which statement by a client taking lithium indicates an understanding of dietary teaching?
A. "I should drastically reduce my salt intake."
B. "I should maintain a consistent intake of dietary sodium."
, C. "I should avoid drinking fluids."
D. "I should increase my caffeine consumption."
Answer: B. "I should maintain a consistent intake of dietary sodium."
Rationale: Sudden changes in sodium intake can alter lithium concentrations. Clients should
maintain a consistent sodium intake and adequate hydration.
6. A nurse is administering haloperidol to a client. Which finding requires immediate
intervention?
A. Mild dry mouth
B. Muscle rigidity and hyperthermia
C. Increased appetite
D. Mild drowsiness
Answer: B. Muscle rigidity and hyperthermia
Rationale: Severe muscle rigidity, hyperthermia, altered mental status, and autonomic
instability can indicate neuroleptic malignant syndrome (NMS), a potentially life-threatening
reaction to antipsychotic medications.
7. A client receiving an antipsychotic medication develops involuntary movements of the
tongue and facial muscles. The nurse should recognize these findings as:
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Answer: C. Tardive dyskinesia
