Comprehensive Psychiatric Medications NCLEX
Mastery Exam – 150 Questions with Detailed
Answers &
2025/2026
1. A patient is prescribed fluoxetine for depression. Which
statement indicates the patient understands the teaching?
a. "I may notice improvement in my mood after a few weeks."
b. "I should stop taking it once I feel better."
c. "I should take it only when I feel depressed."
d. "I can double the dose if I miss one."
Rationale: SSRIs like fluoxetine take 2–4 weeks for therapeutic
effect. Stopping abruptly or adjusting dose without guidance is
unsafe.
2. A patient taking lithium reports diarrhea, vomiting, and coarse
tremors. What is the priority nursing action?
a. Encourage hydration
b. Hold the dose and notify the provider
c. Assess for signs of lithium toxicity
d. Offer antiemetic medication
Rationale: These are signs of lithium toxicity. The nurse should
immediately assess and notify the provider, as toxicity can be
life-threatening.
3. Which lab test should be monitored for a patient on clozapine?
a. Liver function tests
b. Absolute neutrophil count (ANC)
c. Serum potassium
, d. Thyroid function tests
Rationale: Clozapine carries a risk of agranulocytosis. ANC must
be monitored regularly.
4. A patient on sertraline develops sexual dysfunction. What is an
appropriate nursing response?
a. Discontinue the medication immediately
b. Notify the provider; dosage adjustment or switch may be
needed
c. Reassure the patient it will resolve spontaneously in a day
d. Suggest taking an extra dose
Rationale: Sexual side effects are common with SSRIs; the
provider may adjust therapy rather than discontinuing abruptly.
5. A patient taking a monoamine oxidase inhibitor (MAOI) should
avoid which food?
a. Apples
b. Carrots
c. Aged cheese
d. Rice
Rationale: MAOIs can cause hypertensive crisis when foods high
in tyramine, like aged cheese, are ingested.
6. A patient taking valproic acid reports nausea and abdominal pain.
What should the nurse do first?
a. Give with food
b. Hold the medication
c. Assess for signs of hepatotoxicity
d. Administer antiemetic
Rationale: Valproic acid can cause liver toxicity. Nausea and
abdominal pain may indicate hepatotoxicity.
,7. Which adverse effect is most common with first-generation
antipsychotics?
a. Weight loss
b. Hypotension
c. Extrapyramidal symptoms (EPS)
d. Hypertension
Rationale: EPS, including tremor, rigidity, and akathisia, are
common with typical antipsychotics.
8. A patient is prescribed buspirone for anxiety. Which statement
indicates understanding?
a. "It may take several weeks before I notice an effect."
b. "I can use it as needed for panic attacks."
c. "I should avoid all foods with tyramine."
d. "I may double the dose if I feel anxious."
Rationale: Buspirone requires consistent dosing and several
weeks to achieve full anxiolytic effect. It is not used for
immediate relief.
9. Which medication is used to manage alcohol withdrawal
symptoms?
a. Naltrexone
b. Lorazepam
c. Disulfiram
d. Acamprosate
Rationale: Benzodiazepines like lorazepam are first-line for
managing acute alcohol withdrawal.
10. A patient on risperidone develops a temperature of 103°F,
muscle rigidity, and altered mental status. What is the priority
action?
a. Give antipyretics
, b. Monitor vital signs
c. Notify provider for possible neuroleptic malignant syndrome
(NMS)
d. Encourage hydration
Rationale: NMS is a life-threatening reaction to antipsychotics.
Immediate intervention is required.
11. A patient taking bupropion should be monitored for which
adverse effect?
a. Weight gain
b. Hypotension
c. Seizures
d. Agranulocytosis
Rationale: Bupropion lowers the seizure threshold, especially in
patients with seizure disorders.
12. Which statement about SSRIs is correct?
a. They cause severe sedation
b. They require strict dietary restrictions
c. They are first-line treatment for depression and anxiety
d. They are only used short-term
Rationale: SSRIs are commonly prescribed as first-line therapy
due to safety and efficacy.
13. A patient taking MAOIs develops a severe headache and
palpitations. What is the nurse’s first action?
a. Give acetaminophen
b. Assess blood pressure for hypertensive crisis
c. Administer antihypertensive immediately
d. Call family
Rationale: These are signs of hypertensive crisis, a medical
emergency in patients on MAOIs.
Mastery Exam – 150 Questions with Detailed
Answers &
2025/2026
1. A patient is prescribed fluoxetine for depression. Which
statement indicates the patient understands the teaching?
a. "I may notice improvement in my mood after a few weeks."
b. "I should stop taking it once I feel better."
c. "I should take it only when I feel depressed."
d. "I can double the dose if I miss one."
Rationale: SSRIs like fluoxetine take 2–4 weeks for therapeutic
effect. Stopping abruptly or adjusting dose without guidance is
unsafe.
2. A patient taking lithium reports diarrhea, vomiting, and coarse
tremors. What is the priority nursing action?
a. Encourage hydration
b. Hold the dose and notify the provider
c. Assess for signs of lithium toxicity
d. Offer antiemetic medication
Rationale: These are signs of lithium toxicity. The nurse should
immediately assess and notify the provider, as toxicity can be
life-threatening.
3. Which lab test should be monitored for a patient on clozapine?
a. Liver function tests
b. Absolute neutrophil count (ANC)
c. Serum potassium
, d. Thyroid function tests
Rationale: Clozapine carries a risk of agranulocytosis. ANC must
be monitored regularly.
4. A patient on sertraline develops sexual dysfunction. What is an
appropriate nursing response?
a. Discontinue the medication immediately
b. Notify the provider; dosage adjustment or switch may be
needed
c. Reassure the patient it will resolve spontaneously in a day
d. Suggest taking an extra dose
Rationale: Sexual side effects are common with SSRIs; the
provider may adjust therapy rather than discontinuing abruptly.
5. A patient taking a monoamine oxidase inhibitor (MAOI) should
avoid which food?
a. Apples
b. Carrots
c. Aged cheese
d. Rice
Rationale: MAOIs can cause hypertensive crisis when foods high
in tyramine, like aged cheese, are ingested.
6. A patient taking valproic acid reports nausea and abdominal pain.
What should the nurse do first?
a. Give with food
b. Hold the medication
c. Assess for signs of hepatotoxicity
d. Administer antiemetic
Rationale: Valproic acid can cause liver toxicity. Nausea and
abdominal pain may indicate hepatotoxicity.
,7. Which adverse effect is most common with first-generation
antipsychotics?
a. Weight loss
b. Hypotension
c. Extrapyramidal symptoms (EPS)
d. Hypertension
Rationale: EPS, including tremor, rigidity, and akathisia, are
common with typical antipsychotics.
8. A patient is prescribed buspirone for anxiety. Which statement
indicates understanding?
a. "It may take several weeks before I notice an effect."
b. "I can use it as needed for panic attacks."
c. "I should avoid all foods with tyramine."
d. "I may double the dose if I feel anxious."
Rationale: Buspirone requires consistent dosing and several
weeks to achieve full anxiolytic effect. It is not used for
immediate relief.
9. Which medication is used to manage alcohol withdrawal
symptoms?
a. Naltrexone
b. Lorazepam
c. Disulfiram
d. Acamprosate
Rationale: Benzodiazepines like lorazepam are first-line for
managing acute alcohol withdrawal.
10. A patient on risperidone develops a temperature of 103°F,
muscle rigidity, and altered mental status. What is the priority
action?
a. Give antipyretics
, b. Monitor vital signs
c. Notify provider for possible neuroleptic malignant syndrome
(NMS)
d. Encourage hydration
Rationale: NMS is a life-threatening reaction to antipsychotics.
Immediate intervention is required.
11. A patient taking bupropion should be monitored for which
adverse effect?
a. Weight gain
b. Hypotension
c. Seizures
d. Agranulocytosis
Rationale: Bupropion lowers the seizure threshold, especially in
patients with seizure disorders.
12. Which statement about SSRIs is correct?
a. They cause severe sedation
b. They require strict dietary restrictions
c. They are first-line treatment for depression and anxiety
d. They are only used short-term
Rationale: SSRIs are commonly prescribed as first-line therapy
due to safety and efficacy.
13. A patient taking MAOIs develops a severe headache and
palpitations. What is the nurse’s first action?
a. Give acetaminophen
b. Assess blood pressure for hypertensive crisis
c. Administer antihypertensive immediately
d. Call family
Rationale: These are signs of hypertensive crisis, a medical
emergency in patients on MAOIs.
