NR 507 EDAPT WEEK 5 DEPRESSION EXAM PRACTICE | COMPREHENSIVE STUDY
GUIDE | ADVANCED TESTBANK WITH PRACTICE QUESTIONS & ANSWERS |
LATEST UPDATE 2026/2027
TABLE OF CONTENTS
i. Major Depressive Disorder and Diagnostic Reasoning
ii. Antidepressant Pharmacology and Mechanisms of Action
iii. Selective Serotonin Reuptake Inhibitors (SSRIs)
iv. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
v. Atypical and Other Antidepressants
vi. Adverse Effects, Drug Interactions, and Safety
vii. Serotonin Syndrome and Antidepressant Toxicity
viii. Treatment Selection, Monitoring, and Clinical Decision-Making
INTRODUCTION
This comprehensive NR 507 Edapt Week 5 Depression practice examination focuses
on advanced pharmacologic management of depressive disorders. Questions
emphasize antidepressant mechanisms, therapeutic selection, adverse-effect
recognition, clinically significant drug interactions, serotonin toxicity, treatment
monitoring, discontinuation considerations, and individualized patient-centered
decision-making. The examination is designed for graduate-level nursing
pharmacology study and requires application rather than simple memorization.
Students should be prepared to interpret clinical presentations, distinguish
expected therapeutic effects from potentially dangerous reactions, evaluate
medication profiles, and select the most appropriate intervention based on
pharmacologic principles. Questions incorporate realistic clinical scenarios, safety
considerations, contraindications, and comparative pharmacotherapy concepts
relevant to advanced nursing practice.
QUESTION 1
A patient with major depressive disorder begins an SSRI. Two weeks later, the
patient reports improved sleep and appetite but continues to experience depressed
mood and anhedonia. The patient asks whether the medication has failed. Which
response by the nurse is most appropriate?
,A. “The medication should be discontinued because therapeutic effects should
occur within several days.”
B. “The medication is ineffective unless all depressive symptoms resolve within 2
weeks.”
C. “Some symptoms may improve before mood, and the full antidepressant
response can require several weeks.”
D. “Increasing the dose immediately will ensure that the antidepressant response
occurs faster.”
🔴 Correct Answer: C. “Some symptoms may improve before mood, and the full
antidepressant response can require several weeks.”
🔵 Explanation: Antidepressant therapeutic effects generally develop gradually.
Changes in sleep, appetite, anxiety, or energy may precede improvement in depressed
mood and anhedonia. Premature discontinuation or rapid dose escalation can be
inappropriate and may increase adverse effects.
QUESTION 2
A patient taking sertraline develops agitation, diaphoresis, diarrhea, hyperreflexia,
and inducible clonus several hours after starting another serotonergic medication.
Which complication should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Hypertensive crisis
🔴 Correct Answer: B. Serotonin syndrome
🔵 Explanation: Serotonin syndrome results from excessive serotonergic activity and
classically presents with mental-status changes, autonomic instability, gastrointestinal
symptoms, hyperreflexia, clonus, and neuromuscular hyperactivity. Rapid recognition
and discontinuation of serotonergic agents are essential.
QUESTION 3
A patient taking an SSRI asks why the medication must generally be continued even
after depressive symptoms begin improving. Which explanation is most accurate?
,A. Continued therapy helps consolidate remission and reduces the risk of relapse.
B. Antidepressants permanently correct serotonin deficiency only after prolonged
use.
C. Stopping therapy after symptom improvement inevitably causes dependence.
D. Continued treatment prevents all future depressive episodes.
🔴 Correct Answer: A. Continued therapy helps consolidate remission and
reduces the risk of relapse.
🔵 Explanation: Antidepressant therapy is commonly continued after symptomatic
improvement to maintain remission and reduce relapse risk. Duration should be
individualized according to illness severity, recurrence history, response, and clinical
risk factors.
QUESTION 4
A patient with depression is prescribed bupropion. Which patient characteristic
would make this medication particularly inappropriate?
A. History of sexual dysfunction with an SSRI
B. Desire to avoid significant weight gain
C. Current bulimia nervosa
D. Prominent fatigue and low energy
🔴 Correct Answer: C. Current bulimia nervosa
🔵 Explanation: Bupropion is contraindicated in patients with bulimia nervosa or
anorexia nervosa because of an increased risk of seizures. Its relatively favorable
sexual and weight-related adverse-effect profile can otherwise make it useful in
selected patients.
QUESTION 5
A patient taking paroxetine reports decreased libido and difficulty achieving orgasm
but otherwise has substantial improvement in depressive symptoms. Which
pharmacologic explanation best accounts for this adverse effect?
A. Increased cholinergic transmission
B. Serotonergic effects involving sexual-function pathways
C. Excessive dopamine stimulation
D. Reduced peripheral norepinephrine metabolism
, 🔴 Correct Answer: B. Serotonergic effects involving sexual-function pathways
🔵 Explanation: SSRIs can cause decreased libido, delayed orgasm, and other sexual
dysfunction through serotonergic effects on neural pathways involved in sexual
function. Management may involve dose adjustment, switching agents, or selecting an
antidepressant with a lower risk of sexual adverse effects.
QUESTION 6
A patient taking venlafaxine has a substantial reduction in depressive symptoms but
develops persistent elevated blood pressure. Which nursing action is most
appropriate?
A. Assume the blood pressure elevation is unrelated to venlafaxine.
B. Monitor blood pressure and notify the prescriber regarding persistent
hypertension.
C. Abruptly discontinue venlafaxine without further assessment.
D. Administer an SSRI concurrently to counteract the blood-pressure effect.
🔴 Correct Answer: B. Monitor blood pressure and notify the prescriber
regarding persistent hypertension.
🔵 Explanation: Venlafaxine can increase blood pressure, particularly at higher doses.
Persistent clinically significant hypertension warrants assessment and communication
with the prescriber. Abrupt discontinuation is undesirable because discontinuation
symptoms can occur.
QUESTION 7
A patient taking an antidepressant reports that depressive symptoms have
improved but states, “I suddenly have enough energy to act on thoughts of suicide
that I had before treatment.” What is the nurse's priority response?
A. Reassure the patient that suicidal thoughts are expected during treatment.
B. Recommend waiting several weeks for the medication to stabilize.
C. Perform an immediate suicide-risk assessment and initiate appropriate safety
interventions.
D. Explain that antidepressants eliminate suicide risk once energy improves.
🔴 Correct Answer: C. Perform an immediate suicide-risk assessment and initiate
appropriate safety interventions.
GUIDE | ADVANCED TESTBANK WITH PRACTICE QUESTIONS & ANSWERS |
LATEST UPDATE 2026/2027
TABLE OF CONTENTS
i. Major Depressive Disorder and Diagnostic Reasoning
ii. Antidepressant Pharmacology and Mechanisms of Action
iii. Selective Serotonin Reuptake Inhibitors (SSRIs)
iv. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
v. Atypical and Other Antidepressants
vi. Adverse Effects, Drug Interactions, and Safety
vii. Serotonin Syndrome and Antidepressant Toxicity
viii. Treatment Selection, Monitoring, and Clinical Decision-Making
INTRODUCTION
This comprehensive NR 507 Edapt Week 5 Depression practice examination focuses
on advanced pharmacologic management of depressive disorders. Questions
emphasize antidepressant mechanisms, therapeutic selection, adverse-effect
recognition, clinically significant drug interactions, serotonin toxicity, treatment
monitoring, discontinuation considerations, and individualized patient-centered
decision-making. The examination is designed for graduate-level nursing
pharmacology study and requires application rather than simple memorization.
Students should be prepared to interpret clinical presentations, distinguish
expected therapeutic effects from potentially dangerous reactions, evaluate
medication profiles, and select the most appropriate intervention based on
pharmacologic principles. Questions incorporate realistic clinical scenarios, safety
considerations, contraindications, and comparative pharmacotherapy concepts
relevant to advanced nursing practice.
QUESTION 1
A patient with major depressive disorder begins an SSRI. Two weeks later, the
patient reports improved sleep and appetite but continues to experience depressed
mood and anhedonia. The patient asks whether the medication has failed. Which
response by the nurse is most appropriate?
,A. “The medication should be discontinued because therapeutic effects should
occur within several days.”
B. “The medication is ineffective unless all depressive symptoms resolve within 2
weeks.”
C. “Some symptoms may improve before mood, and the full antidepressant
response can require several weeks.”
D. “Increasing the dose immediately will ensure that the antidepressant response
occurs faster.”
🔴 Correct Answer: C. “Some symptoms may improve before mood, and the full
antidepressant response can require several weeks.”
🔵 Explanation: Antidepressant therapeutic effects generally develop gradually.
Changes in sleep, appetite, anxiety, or energy may precede improvement in depressed
mood and anhedonia. Premature discontinuation or rapid dose escalation can be
inappropriate and may increase adverse effects.
QUESTION 2
A patient taking sertraline develops agitation, diaphoresis, diarrhea, hyperreflexia,
and inducible clonus several hours after starting another serotonergic medication.
Which complication should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Hypertensive crisis
🔴 Correct Answer: B. Serotonin syndrome
🔵 Explanation: Serotonin syndrome results from excessive serotonergic activity and
classically presents with mental-status changes, autonomic instability, gastrointestinal
symptoms, hyperreflexia, clonus, and neuromuscular hyperactivity. Rapid recognition
and discontinuation of serotonergic agents are essential.
QUESTION 3
A patient taking an SSRI asks why the medication must generally be continued even
after depressive symptoms begin improving. Which explanation is most accurate?
,A. Continued therapy helps consolidate remission and reduces the risk of relapse.
B. Antidepressants permanently correct serotonin deficiency only after prolonged
use.
C. Stopping therapy after symptom improvement inevitably causes dependence.
D. Continued treatment prevents all future depressive episodes.
🔴 Correct Answer: A. Continued therapy helps consolidate remission and
reduces the risk of relapse.
🔵 Explanation: Antidepressant therapy is commonly continued after symptomatic
improvement to maintain remission and reduce relapse risk. Duration should be
individualized according to illness severity, recurrence history, response, and clinical
risk factors.
QUESTION 4
A patient with depression is prescribed bupropion. Which patient characteristic
would make this medication particularly inappropriate?
A. History of sexual dysfunction with an SSRI
B. Desire to avoid significant weight gain
C. Current bulimia nervosa
D. Prominent fatigue and low energy
🔴 Correct Answer: C. Current bulimia nervosa
🔵 Explanation: Bupropion is contraindicated in patients with bulimia nervosa or
anorexia nervosa because of an increased risk of seizures. Its relatively favorable
sexual and weight-related adverse-effect profile can otherwise make it useful in
selected patients.
QUESTION 5
A patient taking paroxetine reports decreased libido and difficulty achieving orgasm
but otherwise has substantial improvement in depressive symptoms. Which
pharmacologic explanation best accounts for this adverse effect?
A. Increased cholinergic transmission
B. Serotonergic effects involving sexual-function pathways
C. Excessive dopamine stimulation
D. Reduced peripheral norepinephrine metabolism
, 🔴 Correct Answer: B. Serotonergic effects involving sexual-function pathways
🔵 Explanation: SSRIs can cause decreased libido, delayed orgasm, and other sexual
dysfunction through serotonergic effects on neural pathways involved in sexual
function. Management may involve dose adjustment, switching agents, or selecting an
antidepressant with a lower risk of sexual adverse effects.
QUESTION 6
A patient taking venlafaxine has a substantial reduction in depressive symptoms but
develops persistent elevated blood pressure. Which nursing action is most
appropriate?
A. Assume the blood pressure elevation is unrelated to venlafaxine.
B. Monitor blood pressure and notify the prescriber regarding persistent
hypertension.
C. Abruptly discontinue venlafaxine without further assessment.
D. Administer an SSRI concurrently to counteract the blood-pressure effect.
🔴 Correct Answer: B. Monitor blood pressure and notify the prescriber
regarding persistent hypertension.
🔵 Explanation: Venlafaxine can increase blood pressure, particularly at higher doses.
Persistent clinically significant hypertension warrants assessment and communication
with the prescriber. Abrupt discontinuation is undesirable because discontinuation
symptoms can occur.
QUESTION 7
A patient taking an antidepressant reports that depressive symptoms have
improved but states, “I suddenly have enough energy to act on thoughts of suicide
that I had before treatment.” What is the nurse's priority response?
A. Reassure the patient that suicidal thoughts are expected during treatment.
B. Recommend waiting several weeks for the medication to stabilize.
C. Perform an immediate suicide-risk assessment and initiate appropriate safety
interventions.
D. Explain that antidepressants eliminate suicide risk once energy improves.
🔴 Correct Answer: C. Perform an immediate suicide-risk assessment and initiate
appropriate safety interventions.
