NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
NU 160 / NUR 253
Psychiatric Medications & Nursing Interventions Review | 2026–2027
110 Multiple-Choice Questions • Answers • Detailed Rationales
Scope Original mental-health nursing learning resource. NU 160 and NUR 253 are user-supplied course labels; course
equivalence or school affiliation is not asserted. The 2026–2027 label indicates the study edition, not an official exam date.
How to study Attempt each item without looking at the green answer. Review the highlighted rationale and red distractor
explanations; revisit missed safety concepts. Questions are single-best-answer unless otherwise stated.
Safety note Medication orders, observation levels, restraints, emergency responses, and legal rules must follow the prescriber,
local policy, clinical circumstances, and jurisdiction. This resource does not substitute for patient care guidance.
High-yield review map
• Antidepressants
• Antipsychotics
• Mood stabilizers
• Anxiolytics
• Substance use treatment
• Monitoring and urgent adverse effects
Essential current safety updates
Clozapine (2025 update). The FDA removed clozapine REMS effective June 13, 2025. Severe neutropenia risk persists; monitor
ANC as recommended in current prescribing information. Do not teach that federal REMS enrollment is still required.
Major red flags. Serotonin syndrome, NMS, serious rashes, lithium toxicity, severe constipation with clozapine, and sedative-
induced respiratory compromise require urgent assessment.
Original educational practice • Not a school-issued or official examination | Page 1
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Practice Questions with Rationales
Question 1. A patient starting atomoxetine asks about onset and monitoring. Which answer is most accurate?
A. Monitoring is never needed.
B. Benefit can build over weeks; monitor mood and cardiovascular status.
C. It always works within minutes.
D. Atomoxetine is the standard antidote for opioid overdose.
Correct answer: B. Benefit can build over weeks; monitor mood and cardiovascular status.
Detailed rationale: Atomoxetine is a nonstimulant ADHD medication requiring follow-up for efficacy and adverse effects.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
D. Adding or relying on these substances does not address the problem and may introduce new safety risks.
Question 2. A patient wants buspirone to stop an acute panic attack immediately. Which explanation is accurate?
A. Buspirone permanently cures anxiety after one dose.
B. Buspirone acts as rapidly as IV sedatives.
C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
D. Buspirone must be taken only when panic peaks.
Correct answer: C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
Detailed rationale: Buspirone generally requires consistent dosing over time and does not promptly abort a panic attack.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. Adding or relying on these substances does not address the problem and may introduce new safety risks.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 3. A client starts sertraline for major depressive disorder. Which teaching point best sets expectations?
A. Improvement may take several weeks, and the medication should be taken consistently.
B. Use another person’s antidepressant if symptoms persist.
C. Stop after the first dose if mood does not improve.
D. Double the next dose after missing one.
Correct answer: A. Improvement may take several weeks, and the medication should be taken consistently.
Detailed rationale: SSRIs require ongoing adherence; full antidepressant effects often develop over weeks.
Why the other options are incorrect:
B. This alternative is not the relevant response to the described ssris issue. SSRIs require ongoing adherence; full
antidepressant effects often develop over weeks.
C. This alternative is not the relevant response to the described ssris issue. SSRIs require ongoing adherence; full
antidepressant effects often develop over weeks.
D. Dose increases or self-directed medicine changes can cause harm; assess and coordinate with the prescribing team.
Question 4. Clinical debrief: a trainee reviews this situation: A patient taking divalproex reports severe abdominal pain and
vomiting. The trainee favors this interpretation: ‘Expected temporary tooth sensitivity.’ Which alternative should the
supervising nurse emphasize instead?
A. A normal sign of improved mood.
B. Benign sunlight sensitivity only.
C. Expected temporary tooth sensitivity.
D. Pancreatitis requiring prompt evaluation.
Correct answer: D. Pancreatitis requiring prompt evaluation.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Detailed rationale: Valproate can rarely cause serious pancreatitis; acute severe abdominal pain is a warning sign.
Why the other options are incorrect:
A. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
B. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
C. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
Question 5. Clinical debrief: a trainee reviews this situation: A patient taking benztropine complains of dry mouth and
constipation. The trainee favors this interpretation: ‘They prove acute kidney infection.’ Which alternative should the
supervising nurse emphasize instead?
A. They prove acute kidney infection.
B. They mean the drug has no physiologic effects.
C. These can be anticholinergic effects that need monitoring and supportive care.
D. They are mandatory signs of neuroleptic malignant syndrome.
Correct answer: C. These can be anticholinergic effects that need monitoring and supportive care.
Detailed rationale: Benztropine blocks muscarinic effects, causing dry mouth, constipation, and sometimes urinary
retention.
Why the other options are incorrect:
A. This alternative is not the relevant response to the described anticholinergics issue. Benztropine blocks muscarinic
effects, causing dry mouth, constipation, and sometimes urinary retention.
B. This alternative is not the relevant response to the described anticholinergics issue. Benztropine blocks muscarinic
effects, causing dry mouth, constipation, and sometimes urinary retention.
D. This alternative is not the relevant response to the described anticholinergics issue. Benztropine blocks muscarinic
effects, causing dry mouth, constipation, and sometimes urinary retention.
Question 6. A client with a history of bipolar I disorder is prescribed antidepressant monotherapy. Which risk should the
nurse flag?
A. Immediate cure of mania.
B. Irreversible hearing loss in all patients.
C. A predictable increase in hemoglobin.
D. A treatment-emergent manic or hypomanic episode.
Correct answer: D. A treatment-emergent manic or hypomanic episode.
Detailed rationale: Antidepressants can precipitate mood switching in susceptible people; review treatment plans with the
prescriber.
Why the other options are incorrect:
A. This alternative is not the relevant response to the described ssris issue. Antidepressants can precipitate mood
switching in susceptible people; review treatment plans with the prescriber.
B. This alternative is not the relevant response to the described ssris issue. Antidepressants can precipitate mood
switching in susceptible people; review treatment plans with the prescriber.
C. This alternative is not the relevant response to the described ssris issue. Antidepressants can precipitate mood
switching in susceptible people; review treatment plans with the prescriber.
Question 7. A patient starts venlafaxine for depression. Which additional parameter deserves routine monitoring?
A. Blood pressure, especially at higher doses.
B. Finger length.
C. Pupil color.
D. Daily height measurement.
Correct answer: A. Blood pressure, especially at higher doses.
Detailed rationale: SNRIs such as venlafaxine can increase blood pressure in some patients.
Why the other options are incorrect:
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
B. This alternative is not the relevant response to the described snris issue. SNRIs such as venlafaxine can increase
blood pressure in some patients.
C. This alternative is not the relevant response to the described snris issue. SNRIs such as venlafaxine can increase
blood pressure in some patients.
D. This alternative is not the relevant response to the described snris issue. SNRIs such as venlafaxine can increase
blood pressure in some patients.
Question 8. A client receives diazepam while also using opioid pain medicine. Which risk is highest?
A. Additive sedation and potentially fatal respiratory depression.
B. Improved alertness.
C. Faster drug elimination without monitoring.
D. Guaranteed protection from overdose.
Correct answer: A. Additive sedation and potentially fatal respiratory depression.
Detailed rationale: Opioids and benzodiazepines together can dangerously depress breathing.
Why the other options are incorrect:
B. This alternative is not the relevant response to the described benzodiazepines issue. Opioids and benzodiazepines
together can dangerously depress breathing.
C. This alternative is not the relevant response to the described benzodiazepines issue. Opioids and benzodiazepines
together can dangerously depress breathing.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 9. A client asks about zolpidem and night-time behaviors not remembered the next day. What is the correct
safety message?
A. Complex sleep behaviors require immediate medication review and avoidance of further doses until evaluated.
B. Sleep-driving is a harmless intended effect.
C. Take extra medication after unexplained activities.
D. Combine the medicine with alcohol to sleep more deeply.
Correct answer: A. Complex sleep behaviors require immediate medication review and avoidance of further doses until
evaluated.
Detailed rationale: Z-drugs carry serious warnings for complex sleep behaviors and impairment.
Why the other options are incorrect:
B. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
C. This alternative is not the relevant response to the described sleep issue. Z-drugs carry serious warnings for complex
sleep behaviors and impairment.
D. Adding or relying on these substances does not address the problem and may introduce new safety risks.
Question 10. A young adult begins an antidepressant and describes new suicidal thoughts. What is the safest nursing
response?
A. Assess intent, plan, access to means, and immediate safety; escalate care.
B. Tell the client the thoughts are harmless.
C. Wait two weeks for the medication to work.
D. Ask the family to ignore the statements.
Correct answer: A. Assess intent, plan, access to means, and immediate safety; escalate care.
Detailed rationale: New or worsening suicidal thoughts require direct risk assessment and safety action, especially during
early treatment.
Why the other options are incorrect:
B. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
D. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Original educational practice • Not a school-issued or official examination | Page 4
NU 160 / NUR 253
Psychiatric Medications & Nursing Interventions Review | 2026–2027
110 Multiple-Choice Questions • Answers • Detailed Rationales
Scope Original mental-health nursing learning resource. NU 160 and NUR 253 are user-supplied course labels; course
equivalence or school affiliation is not asserted. The 2026–2027 label indicates the study edition, not an official exam date.
How to study Attempt each item without looking at the green answer. Review the highlighted rationale and red distractor
explanations; revisit missed safety concepts. Questions are single-best-answer unless otherwise stated.
Safety note Medication orders, observation levels, restraints, emergency responses, and legal rules must follow the prescriber,
local policy, clinical circumstances, and jurisdiction. This resource does not substitute for patient care guidance.
High-yield review map
• Antidepressants
• Antipsychotics
• Mood stabilizers
• Anxiolytics
• Substance use treatment
• Monitoring and urgent adverse effects
Essential current safety updates
Clozapine (2025 update). The FDA removed clozapine REMS effective June 13, 2025. Severe neutropenia risk persists; monitor
ANC as recommended in current prescribing information. Do not teach that federal REMS enrollment is still required.
Major red flags. Serotonin syndrome, NMS, serious rashes, lithium toxicity, severe constipation with clozapine, and sedative-
induced respiratory compromise require urgent assessment.
Original educational practice • Not a school-issued or official examination | Page 1
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Practice Questions with Rationales
Question 1. A patient starting atomoxetine asks about onset and monitoring. Which answer is most accurate?
A. Monitoring is never needed.
B. Benefit can build over weeks; monitor mood and cardiovascular status.
C. It always works within minutes.
D. Atomoxetine is the standard antidote for opioid overdose.
Correct answer: B. Benefit can build over weeks; monitor mood and cardiovascular status.
Detailed rationale: Atomoxetine is a nonstimulant ADHD medication requiring follow-up for efficacy and adverse effects.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
D. Adding or relying on these substances does not address the problem and may introduce new safety risks.
Question 2. A patient wants buspirone to stop an acute panic attack immediately. Which explanation is accurate?
A. Buspirone permanently cures anxiety after one dose.
B. Buspirone acts as rapidly as IV sedatives.
C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
D. Buspirone must be taken only when panic peaks.
Correct answer: C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
Detailed rationale: Buspirone generally requires consistent dosing over time and does not promptly abort a panic attack.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. Adding or relying on these substances does not address the problem and may introduce new safety risks.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 3. A client starts sertraline for major depressive disorder. Which teaching point best sets expectations?
A. Improvement may take several weeks, and the medication should be taken consistently.
B. Use another person’s antidepressant if symptoms persist.
C. Stop after the first dose if mood does not improve.
D. Double the next dose after missing one.
Correct answer: A. Improvement may take several weeks, and the medication should be taken consistently.
Detailed rationale: SSRIs require ongoing adherence; full antidepressant effects often develop over weeks.
Why the other options are incorrect:
B. This alternative is not the relevant response to the described ssris issue. SSRIs require ongoing adherence; full
antidepressant effects often develop over weeks.
C. This alternative is not the relevant response to the described ssris issue. SSRIs require ongoing adherence; full
antidepressant effects often develop over weeks.
D. Dose increases or self-directed medicine changes can cause harm; assess and coordinate with the prescribing team.
Question 4. Clinical debrief: a trainee reviews this situation: A patient taking divalproex reports severe abdominal pain and
vomiting. The trainee favors this interpretation: ‘Expected temporary tooth sensitivity.’ Which alternative should the
supervising nurse emphasize instead?
A. A normal sign of improved mood.
B. Benign sunlight sensitivity only.
C. Expected temporary tooth sensitivity.
D. Pancreatitis requiring prompt evaluation.
Correct answer: D. Pancreatitis requiring prompt evaluation.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Detailed rationale: Valproate can rarely cause serious pancreatitis; acute severe abdominal pain is a warning sign.
Why the other options are incorrect:
A. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
B. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
C. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
Question 5. Clinical debrief: a trainee reviews this situation: A patient taking benztropine complains of dry mouth and
constipation. The trainee favors this interpretation: ‘They prove acute kidney infection.’ Which alternative should the
supervising nurse emphasize instead?
A. They prove acute kidney infection.
B. They mean the drug has no physiologic effects.
C. These can be anticholinergic effects that need monitoring and supportive care.
D. They are mandatory signs of neuroleptic malignant syndrome.
Correct answer: C. These can be anticholinergic effects that need monitoring and supportive care.
Detailed rationale: Benztropine blocks muscarinic effects, causing dry mouth, constipation, and sometimes urinary
retention.
Why the other options are incorrect:
A. This alternative is not the relevant response to the described anticholinergics issue. Benztropine blocks muscarinic
effects, causing dry mouth, constipation, and sometimes urinary retention.
B. This alternative is not the relevant response to the described anticholinergics issue. Benztropine blocks muscarinic
effects, causing dry mouth, constipation, and sometimes urinary retention.
D. This alternative is not the relevant response to the described anticholinergics issue. Benztropine blocks muscarinic
effects, causing dry mouth, constipation, and sometimes urinary retention.
Question 6. A client with a history of bipolar I disorder is prescribed antidepressant monotherapy. Which risk should the
nurse flag?
A. Immediate cure of mania.
B. Irreversible hearing loss in all patients.
C. A predictable increase in hemoglobin.
D. A treatment-emergent manic or hypomanic episode.
Correct answer: D. A treatment-emergent manic or hypomanic episode.
Detailed rationale: Antidepressants can precipitate mood switching in susceptible people; review treatment plans with the
prescriber.
Why the other options are incorrect:
A. This alternative is not the relevant response to the described ssris issue. Antidepressants can precipitate mood
switching in susceptible people; review treatment plans with the prescriber.
B. This alternative is not the relevant response to the described ssris issue. Antidepressants can precipitate mood
switching in susceptible people; review treatment plans with the prescriber.
C. This alternative is not the relevant response to the described ssris issue. Antidepressants can precipitate mood
switching in susceptible people; review treatment plans with the prescriber.
Question 7. A patient starts venlafaxine for depression. Which additional parameter deserves routine monitoring?
A. Blood pressure, especially at higher doses.
B. Finger length.
C. Pupil color.
D. Daily height measurement.
Correct answer: A. Blood pressure, especially at higher doses.
Detailed rationale: SNRIs such as venlafaxine can increase blood pressure in some patients.
Why the other options are incorrect:
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
B. This alternative is not the relevant response to the described snris issue. SNRIs such as venlafaxine can increase
blood pressure in some patients.
C. This alternative is not the relevant response to the described snris issue. SNRIs such as venlafaxine can increase
blood pressure in some patients.
D. This alternative is not the relevant response to the described snris issue. SNRIs such as venlafaxine can increase
blood pressure in some patients.
Question 8. A client receives diazepam while also using opioid pain medicine. Which risk is highest?
A. Additive sedation and potentially fatal respiratory depression.
B. Improved alertness.
C. Faster drug elimination without monitoring.
D. Guaranteed protection from overdose.
Correct answer: A. Additive sedation and potentially fatal respiratory depression.
Detailed rationale: Opioids and benzodiazepines together can dangerously depress breathing.
Why the other options are incorrect:
B. This alternative is not the relevant response to the described benzodiazepines issue. Opioids and benzodiazepines
together can dangerously depress breathing.
C. This alternative is not the relevant response to the described benzodiazepines issue. Opioids and benzodiazepines
together can dangerously depress breathing.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 9. A client asks about zolpidem and night-time behaviors not remembered the next day. What is the correct
safety message?
A. Complex sleep behaviors require immediate medication review and avoidance of further doses until evaluated.
B. Sleep-driving is a harmless intended effect.
C. Take extra medication after unexplained activities.
D. Combine the medicine with alcohol to sleep more deeply.
Correct answer: A. Complex sleep behaviors require immediate medication review and avoidance of further doses until
evaluated.
Detailed rationale: Z-drugs carry serious warnings for complex sleep behaviors and impairment.
Why the other options are incorrect:
B. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
C. This alternative is not the relevant response to the described sleep issue. Z-drugs carry serious warnings for complex
sleep behaviors and impairment.
D. Adding or relying on these substances does not address the problem and may introduce new safety risks.
Question 10. A young adult begins an antidepressant and describes new suicidal thoughts. What is the safest nursing
response?
A. Assess intent, plan, access to means, and immediate safety; escalate care.
B. Tell the client the thoughts are harmless.
C. Wait two weeks for the medication to work.
D. Ask the family to ignore the statements.
Correct answer: A. Assess intent, plan, access to means, and immediate safety; escalate care.
Detailed rationale: New or worsening suicidal thoughts require direct risk assessment and safety action, especially during
early treatment.
Why the other options are incorrect:
B. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
D. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Original educational practice • Not a school-issued or official examination | Page 4
