NR 293 Pharmacology: CNS Drugs (Antidepressants, Antipsychotics,
Sedatives) Practice Pack 2026/2027 Chamberlain College
1. A patient is starting fluoxetine for depression. Which statement by the
patient indicates a correct understanding of the medication’s timeframe?
A. I will feel much better within 24 to 48 hours of the first dose.
B. I should see the full therapeutic effect in about 1 to 4 weeks.
C. If I don’t feel better in 3 days, I should stop taking the pill.
D. I need to take this for only two weeks to cure my depression.
Answer: B
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine typically require
1 to 4 weeks to reach full therapeutic effect. Patients should be taught not to expect
immediate results.
2. Which food item should a patient taking phenelzine (an MAOI) avoid to
prevent a hypertensive crisis?
A. Aged cheddar cheese
B. Grilled chicken breast
C. Fresh apples
D. Boiled white rice
Answer: A
Rationale: MAOIs interact with tyramine-rich foods, such as aged cheeses, cured meats,
and red wine, which can lead to a life-threatening hypertensive crisis.
,3. A patient on amitriptyline reports blurred vision, dry mouth, and
constipation. These are examples of which type of side effects?
A. Extrapyramidal symptoms
B. Adverse cardiac events
C. Serotonin syndrome
D. Anticholinergic effects
Answer: D
Rationale: Tricyclic antidepressants (TCAs) like amitriptyline frequently cause
anticholinergic side effects, including dry mouth, blurred vision, urinary retention, and
constipation.
4. A nurse is assessing a patient taking haloperidol who is experiencing muscle
rigidity, high fever, and tachycardia. What complication does the nurse suspect?
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome (NMS)
C. Akathisia
D. Dystonia
Answer: B
Rationale: NMS is a rare but fatal complication of antipsychotics characterized by ‘lead-
pipe’ muscle rigidity, high fever, autonomic instability (tachycardia), and altered mental
status.
5. Which laboratory test is a priority for a patient prescribed clozapine?
A. Serum potassium
B. Platelet count
C. Blood urea nitrogen (BUN)
D. White blood cell (WBC) count
Answer: D
, Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC). Regular
monitoring of WBC and Absolute Neutrophil Count (ANC) is mandatory.
6. What is the therapeutic serum range for lithium in a patient with acute
mania?
A. 0.1 to 0.5 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.5 mEq/L
D. 3.0 to 4.5 mEq/L
Answer: B
Rationale: The therapeutic range for lithium is narrow, typically 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L indicate toxicity.
7. A patient taking sertraline and St. John’s Wort presents with confusion,
agitation, and tremors. What is the likely cause?
A. Serotonin syndrome
B. Anticholinergic toxicity
C. Lithium toxicity
D. Hypertensive crisis
Answer: A
Rationale: Serotonin syndrome occurs when multiple drugs that increase serotonin (like
SSRIs and herbal St. John’s Wort) are taken together, leading to hyperreflexia, agitation, and
autonomic dysfunction.
8. Which medication is the specific antidote for benzodiazepine overdose?
A. Naloxone
B. Acetylcysteine
C. Protamine sulfate
D. Flumazenil
Answer: D
Sedatives) Practice Pack 2026/2027 Chamberlain College
1. A patient is starting fluoxetine for depression. Which statement by the
patient indicates a correct understanding of the medication’s timeframe?
A. I will feel much better within 24 to 48 hours of the first dose.
B. I should see the full therapeutic effect in about 1 to 4 weeks.
C. If I don’t feel better in 3 days, I should stop taking the pill.
D. I need to take this for only two weeks to cure my depression.
Answer: B
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine typically require
1 to 4 weeks to reach full therapeutic effect. Patients should be taught not to expect
immediate results.
2. Which food item should a patient taking phenelzine (an MAOI) avoid to
prevent a hypertensive crisis?
A. Aged cheddar cheese
B. Grilled chicken breast
C. Fresh apples
D. Boiled white rice
Answer: A
Rationale: MAOIs interact with tyramine-rich foods, such as aged cheeses, cured meats,
and red wine, which can lead to a life-threatening hypertensive crisis.
,3. A patient on amitriptyline reports blurred vision, dry mouth, and
constipation. These are examples of which type of side effects?
A. Extrapyramidal symptoms
B. Adverse cardiac events
C. Serotonin syndrome
D. Anticholinergic effects
Answer: D
Rationale: Tricyclic antidepressants (TCAs) like amitriptyline frequently cause
anticholinergic side effects, including dry mouth, blurred vision, urinary retention, and
constipation.
4. A nurse is assessing a patient taking haloperidol who is experiencing muscle
rigidity, high fever, and tachycardia. What complication does the nurse suspect?
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome (NMS)
C. Akathisia
D. Dystonia
Answer: B
Rationale: NMS is a rare but fatal complication of antipsychotics characterized by ‘lead-
pipe’ muscle rigidity, high fever, autonomic instability (tachycardia), and altered mental
status.
5. Which laboratory test is a priority for a patient prescribed clozapine?
A. Serum potassium
B. Platelet count
C. Blood urea nitrogen (BUN)
D. White blood cell (WBC) count
Answer: D
, Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC). Regular
monitoring of WBC and Absolute Neutrophil Count (ANC) is mandatory.
6. What is the therapeutic serum range for lithium in a patient with acute
mania?
A. 0.1 to 0.5 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.5 mEq/L
D. 3.0 to 4.5 mEq/L
Answer: B
Rationale: The therapeutic range for lithium is narrow, typically 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L indicate toxicity.
7. A patient taking sertraline and St. John’s Wort presents with confusion,
agitation, and tremors. What is the likely cause?
A. Serotonin syndrome
B. Anticholinergic toxicity
C. Lithium toxicity
D. Hypertensive crisis
Answer: A
Rationale: Serotonin syndrome occurs when multiple drugs that increase serotonin (like
SSRIs and herbal St. John’s Wort) are taken together, leading to hyperreflexia, agitation, and
autonomic dysfunction.
8. Which medication is the specific antidote for benzodiazepine overdose?
A. Naloxone
B. Acetylcysteine
C. Protamine sulfate
D. Flumazenil
Answer: D
