NSG 552 Psychopharmacology Practice Exam
Questions and Answers with Rationales Latest
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Question 1
A patient is beginning treatment with an SSRI for major depressive disorder.
Which neurotransmitter system is primarily affected by SSRIs?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Answer: B. Serotonin
Rationale: Selective serotonin reuptake inhibitors (SSRIs) primarily inhibit the
serotonin transporter, increasing serotonin availability in the synaptic cleft. SSRIs
include fluoxetine, sertraline, escitalopram, citalopram, and paroxetine.
Question 2
A patient taking sertraline reports mild nausea during the first week of treatment.
What is the most appropriate response by the nurse?
A. "Stop the medication immediately."
B. "This may occur early in treatment and often improves with continued therapy."
C. "This indicates serotonin syndrome."
D. "Take twice the prescribed dose."
Answer: B. "This may occur early in treatment and often improves with
continued therapy."
Rationale: Gastrointestinal symptoms such as nausea are common early adverse
effects of SSRIs and frequently diminish as the patient adjusts. The medication
should not be abruptly discontinued without clinical guidance.
,Question 3
Which finding in a patient taking an SSRI requires the most immediate
intervention?
A. Mild headache
B. Dry mouth
C. Hyperreflexia, agitation, fever, and clonus
D. Mild nausea
Answer: C. Hyperreflexia, agitation, fever, and clonus
Rationale: These findings are characteristic of serotonin syndrome, a potentially
life-threatening condition associated with excessive serotonergic activity. Severe
cases can progress to seizures, hyperthermia, rhabdomyolysis, and organ failure.
Question 4
A patient prescribed phenelzine asks which food should be avoided. Which
response is correct?
A. Fresh apples
B. Aged cheese
C. White rice
D. Lettuce
Answer: B. Aged cheese
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Patients taking
MAOIs must avoid foods high in tyramine, including aged cheeses, cured meats,
fermented foods, and certain other foods. Excess tyramine can precipitate a
hypertensive crisis.
Question 5
,A patient taking an MAOI develops severe headache, palpitations, neck stiffness,
and markedly elevated blood pressure after eating a large amount of aged cheese.
What complication should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Hypertensive crisis
C. Serotonin withdrawal
D. Anticholinergic toxicity
Answer: B. Hypertensive crisis
Rationale: Tyramine-containing foods can cause excessive catecholamine release
in patients taking MAOIs, potentially producing severe hypertension, headache,
palpitations, and cardiovascular complications.
Question 6
Which antidepressant is generally associated with the greatest concern for sexual
adverse effects?
A. SSRIs
B. Bupropion
C. Mirtazapine
D. Trazodone
Answer: A. SSRIs
Rationale: Sexual dysfunction—including decreased libido, delayed orgasm, and
erectile dysfunction—is a common adverse effect of SSRIs. Bupropion generally
has a lower incidence of sexual dysfunction.
Question 7
A patient with depression and significant nicotine dependence is prescribed
bupropion. Which additional benefit does the nurse recognize?
, A. It can assist with smoking cessation.
B. It is primarily a mood stabilizer.
C. It directly blocks dopamine receptors.
D. It is used primarily to treat acute mania.
Answer: A. It can assist with smoking cessation.
Rationale: Bupropion is an antidepressant that also has an indication for smoking
cessation. It affects norepinephrine and dopamine neurotransmission and does not
primarily function through serotonin reuptake inhibition.
Question 8
Which patient would require particular caution before receiving bupropion?
A. Patient with seasonal allergies
B. Patient with a seizure disorder
C. Patient with mild hypertension
D. Patient with insomnia
Answer: B. Patient with a seizure disorder
Rationale: Bupropion lowers the seizure threshold and is contraindicated or
requires significant caution in patients with seizure disorders and certain eating
disorders, particularly bulimia nervosa and anorexia nervosa.
Question 9
A patient taking lithium for bipolar disorder develops coarse tremor, severe
diarrhea, vomiting, confusion, and unsteady gait. What should the nurse do first?
A. Administer the next dose with food.
B. Encourage the patient to exercise.
C. Hold lithium and notify the prescriber immediately.
D. Give an additional dose of lithium.
Answer: C. Hold lithium and notify the prescriber immediately.
Questions and Answers with Rationales Latest
Versions Top Rated A+
Question 1
A patient is beginning treatment with an SSRI for major depressive disorder.
Which neurotransmitter system is primarily affected by SSRIs?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Answer: B. Serotonin
Rationale: Selective serotonin reuptake inhibitors (SSRIs) primarily inhibit the
serotonin transporter, increasing serotonin availability in the synaptic cleft. SSRIs
include fluoxetine, sertraline, escitalopram, citalopram, and paroxetine.
Question 2
A patient taking sertraline reports mild nausea during the first week of treatment.
What is the most appropriate response by the nurse?
A. "Stop the medication immediately."
B. "This may occur early in treatment and often improves with continued therapy."
C. "This indicates serotonin syndrome."
D. "Take twice the prescribed dose."
Answer: B. "This may occur early in treatment and often improves with
continued therapy."
Rationale: Gastrointestinal symptoms such as nausea are common early adverse
effects of SSRIs and frequently diminish as the patient adjusts. The medication
should not be abruptly discontinued without clinical guidance.
,Question 3
Which finding in a patient taking an SSRI requires the most immediate
intervention?
A. Mild headache
B. Dry mouth
C. Hyperreflexia, agitation, fever, and clonus
D. Mild nausea
Answer: C. Hyperreflexia, agitation, fever, and clonus
Rationale: These findings are characteristic of serotonin syndrome, a potentially
life-threatening condition associated with excessive serotonergic activity. Severe
cases can progress to seizures, hyperthermia, rhabdomyolysis, and organ failure.
Question 4
A patient prescribed phenelzine asks which food should be avoided. Which
response is correct?
A. Fresh apples
B. Aged cheese
C. White rice
D. Lettuce
Answer: B. Aged cheese
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Patients taking
MAOIs must avoid foods high in tyramine, including aged cheeses, cured meats,
fermented foods, and certain other foods. Excess tyramine can precipitate a
hypertensive crisis.
Question 5
,A patient taking an MAOI develops severe headache, palpitations, neck stiffness,
and markedly elevated blood pressure after eating a large amount of aged cheese.
What complication should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Hypertensive crisis
C. Serotonin withdrawal
D. Anticholinergic toxicity
Answer: B. Hypertensive crisis
Rationale: Tyramine-containing foods can cause excessive catecholamine release
in patients taking MAOIs, potentially producing severe hypertension, headache,
palpitations, and cardiovascular complications.
Question 6
Which antidepressant is generally associated with the greatest concern for sexual
adverse effects?
A. SSRIs
B. Bupropion
C. Mirtazapine
D. Trazodone
Answer: A. SSRIs
Rationale: Sexual dysfunction—including decreased libido, delayed orgasm, and
erectile dysfunction—is a common adverse effect of SSRIs. Bupropion generally
has a lower incidence of sexual dysfunction.
Question 7
A patient with depression and significant nicotine dependence is prescribed
bupropion. Which additional benefit does the nurse recognize?
, A. It can assist with smoking cessation.
B. It is primarily a mood stabilizer.
C. It directly blocks dopamine receptors.
D. It is used primarily to treat acute mania.
Answer: A. It can assist with smoking cessation.
Rationale: Bupropion is an antidepressant that also has an indication for smoking
cessation. It affects norepinephrine and dopamine neurotransmission and does not
primarily function through serotonin reuptake inhibition.
Question 8
Which patient would require particular caution before receiving bupropion?
A. Patient with seasonal allergies
B. Patient with a seizure disorder
C. Patient with mild hypertension
D. Patient with insomnia
Answer: B. Patient with a seizure disorder
Rationale: Bupropion lowers the seizure threshold and is contraindicated or
requires significant caution in patients with seizure disorders and certain eating
disorders, particularly bulimia nervosa and anorexia nervosa.
Question 9
A patient taking lithium for bipolar disorder develops coarse tremor, severe
diarrhea, vomiting, confusion, and unsteady gait. What should the nurse do first?
A. Administer the next dose with food.
B. Encourage the patient to exercise.
C. Hold lithium and notify the prescriber immediately.
D. Give an additional dose of lithium.
Answer: C. Hold lithium and notify the prescriber immediately.
