NSG 552 Psychopharmacology Exam 1 Complete Test
Bank: 300 Questions with Correct Answers, NGN Case
Scenarios & Detailed Rationales 2026/2027 | Practice
Study Guide | Guaranteed Pass
1. A patient with major depressive disorder is started on sertraline. Which
side effect should the PMHNP warn the patient about that often improves
within 1–2 weeks?
A) Sexual dysfunction
B) Nausea and headache
C) Weight gain
D) Dry mouth
Answer: B
Rationale: GI upset and headache are common early side effects that often
diminish; sexual dysfunction may persist.
2. A patient on fluoxetine reports feeling “shaky, sweaty, and confused” after
taking tramadol. What is the priority action?
A) Administer naloxone
B) Discontinue the serotonergic drugs and seek emergency care
C) Reduce the fluoxetine dose
D) Give diphenhydramine
Answer: B
,Rationale: This is serotonin syndrome; stop offending agents and provide
supportive care.
3. Which antidepressant is least likely to cause sexual dysfunction?
A) Paroxetine
B) Sertraline
C) Bupropion
D) Venlafaxine
Answer: C
Rationale: Bupropion (NDRI) has minimal sexual side effects; it may also aid
smoking cessation.
4. A patient on phenelzine (MAOI) eats aged cheese and develops severe
headache and hypertension. What is the cause?
A) Serotonin syndrome
B) Tyramine-induced hypertensive crisis
C) Anticholinergic toxicity
D) Neuroleptic malignant syndrome
Answer: B
Rationale: MAOIs prevent tyramine breakdown; tyramine-rich foods cause
catecholamine release and severe hypertension.
2
,5. A patient starting clozapine must have which baseline laboratory test?
A) Liver function tests
B) Absolute neutrophil count (ANC)
C) Serum creatinine
D) Thyroid stimulating hormone
Answer: B
Rationale: Clozapine can cause agranulocytosis; ANC must be monitored weekly
for 6 months.
6. A patient on haloperidol develops a stiff neck, fever, and altered mental
status. Which condition is most likely?
A) Serotonin syndrome
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Tardive dyskinesia
Answer: B
Rationale: NMS is a life-threatening reaction to antipsychotics; stop the drug and
provide supportive care.
7. Which atypical antipsychotic is most associated with weight gain and
metabolic syndrome?
A) Ziprasidone
B) Aripiprazole
3
, C) Olanzapine
D) Lurasidone
Answer: C
Rationale: Olanzapine has the highest metabolic risk among atypicals; monitor
weight, glucose, and lipids.
8. A patient on lithium reports coarse tremor, vomiting, and confusion. What
is the priority nursing action?
A) Administer the next lithium dose
B) Hold lithium and notify the provider immediately
C) Encourage fluid restriction
D) Give a PRN benzodiazepine
Answer: B
Rationale: These are signs of lithium toxicity (level >1.5 mEq/L); hold and seek
emergency care.
9. Which medication is first-line for acute mania in bipolar disorder?
A) Fluoxetine
B) Lithium
C) Bupropion
D) Sertraline
Answer: B
Rationale: Lithium is a first-line mood stabilizer for acute mania and maintenance.
4
Bank: 300 Questions with Correct Answers, NGN Case
Scenarios & Detailed Rationales 2026/2027 | Practice
Study Guide | Guaranteed Pass
1. A patient with major depressive disorder is started on sertraline. Which
side effect should the PMHNP warn the patient about that often improves
within 1–2 weeks?
A) Sexual dysfunction
B) Nausea and headache
C) Weight gain
D) Dry mouth
Answer: B
Rationale: GI upset and headache are common early side effects that often
diminish; sexual dysfunction may persist.
2. A patient on fluoxetine reports feeling “shaky, sweaty, and confused” after
taking tramadol. What is the priority action?
A) Administer naloxone
B) Discontinue the serotonergic drugs and seek emergency care
C) Reduce the fluoxetine dose
D) Give diphenhydramine
Answer: B
,Rationale: This is serotonin syndrome; stop offending agents and provide
supportive care.
3. Which antidepressant is least likely to cause sexual dysfunction?
A) Paroxetine
B) Sertraline
C) Bupropion
D) Venlafaxine
Answer: C
Rationale: Bupropion (NDRI) has minimal sexual side effects; it may also aid
smoking cessation.
4. A patient on phenelzine (MAOI) eats aged cheese and develops severe
headache and hypertension. What is the cause?
A) Serotonin syndrome
B) Tyramine-induced hypertensive crisis
C) Anticholinergic toxicity
D) Neuroleptic malignant syndrome
Answer: B
Rationale: MAOIs prevent tyramine breakdown; tyramine-rich foods cause
catecholamine release and severe hypertension.
2
,5. A patient starting clozapine must have which baseline laboratory test?
A) Liver function tests
B) Absolute neutrophil count (ANC)
C) Serum creatinine
D) Thyroid stimulating hormone
Answer: B
Rationale: Clozapine can cause agranulocytosis; ANC must be monitored weekly
for 6 months.
6. A patient on haloperidol develops a stiff neck, fever, and altered mental
status. Which condition is most likely?
A) Serotonin syndrome
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Tardive dyskinesia
Answer: B
Rationale: NMS is a life-threatening reaction to antipsychotics; stop the drug and
provide supportive care.
7. Which atypical antipsychotic is most associated with weight gain and
metabolic syndrome?
A) Ziprasidone
B) Aripiprazole
3
, C) Olanzapine
D) Lurasidone
Answer: C
Rationale: Olanzapine has the highest metabolic risk among atypicals; monitor
weight, glucose, and lipids.
8. A patient on lithium reports coarse tremor, vomiting, and confusion. What
is the priority nursing action?
A) Administer the next lithium dose
B) Hold lithium and notify the provider immediately
C) Encourage fluid restriction
D) Give a PRN benzodiazepine
Answer: B
Rationale: These are signs of lithium toxicity (level >1.5 mEq/L); hold and seek
emergency care.
9. Which medication is first-line for acute mania in bipolar disorder?
A) Fluoxetine
B) Lithium
C) Bupropion
D) Sertraline
Answer: B
Rationale: Lithium is a first-line mood stabilizer for acute mania and maintenance.
4
