HESI Mental Health RN Psychopharmacology and Medication
Management Exam – Complete Questions and Answers with
Rationales 2026/2027
Antidepressants
1. A client taking sertraline reports nausea during the first week of
treatment. Which response by the nurse is best?
A. “Stop taking the medication immediately.”
B. “Nausea can occur initially and may improve with continued
treatment.”
C. “Take twice the prescribed dose.”
D. “This indicates serotonin syndrome.”
Answer: B
Rationale: Mild gastrointestinal effects are common early with SSRIs
and often improve as the body adjusts.
2. Which finding in a client taking an SSRI requires the most immediate
intervention?
A. Dry mouth
B. Mild headache
C. Hyperreflexia, agitation, and fever
D. Decreased appetite
Answer: C
Rationale: These findings may indicate serotonin syndrome, a
potentially life-threatening reaction.
3. A client taking fluoxetine says, “I feel more energetic, but my
depression hasn't improved yet.” What is the priority nursing
consideration?
A. Increased energy can precede improvement in mood
B. Fluoxetine should always be stopped after one week
C. The client has developed psychosis
,D. The medication is ineffective
Answer: A
Rationale: Increased activation may occur before mood improves,
potentially increasing suicide risk in vulnerable clients.
4. Which medication is an SSRI?
A. Venlafaxine
B. Sertraline
C. Bupropion
D. Mirtazapine
Answer: B
Rationale: Sertraline is a selective serotonin reuptake inhibitor.
5. Which adverse effect is particularly associated with SSRIs?
A. Severe hypoglycemia
B. Sexual dysfunction
C. Permanent hearing loss
D. Gingival hyperplasia
Answer: B
Rationale: Decreased libido, delayed orgasm, and other sexual adverse
effects are common with SSRIs.
6. A client taking paroxetine asks why the medication should not be
stopped abruptly. What is the best response?
A. “Abrupt discontinuation can cause withdrawal-like symptoms.”
B. “Stopping suddenly causes permanent addiction.”
C. “The medication remains in your body for months.”
D. “Abrupt discontinuation causes immediate psychosis in everyone.”
Answer: A
Rationale: SSRI discontinuation can produce dizziness, irritability,
sensory disturbances, anxiety, and flu-like symptoms.
,7. Which antidepressant is also commonly used for smoking cessation?
A. Bupropion
B. Fluoxetine
C. Sertraline
D. Paroxetine
Answer: A
Rationale: Bupropion has antidepressant and smoking-cessation
indications.
8. Which client should generally avoid bupropion unless specifically
determined appropriate by the prescriber?
A. Client with seasonal depression
B. Client with a seizure disorder
C. Client with mild insomnia
D. Client with low appetite
Answer: B
Rationale: Bupropion can lower the seizure threshold.
9. Which instruction is appropriate for a client taking an MAOI?
A. Consume unlimited aged cheese
B. Avoid foods high in tyramine
C. Take pseudoephedrine freely
D. Stop all fluid intake
Answer: B
Rationale: Tyramine-rich foods can precipitate severe hypertension in
clients taking MAOIs.
10. A client taking phenelzine develops a severe headache and
palpitations after eating aged cheese. What complication should the
nurse suspect?
A. Serotonin withdrawal
B. Hypertensive crisis
, C. Hypoglycemia
D. Neuroleptic malignant syndrome
Answer: B
Rationale: Tyramine with MAOIs can cause dangerous elevations in
blood pressure.
11. Which medication combination creates a major risk for serotonin
syndrome?
A. SSRI plus another serotonergic medication
B. Antacid plus acetaminophen
C. Calcium plus vitamin D
D. Insulin plus glucose
Answer: A
Rationale: Combining serotonergic agents can excessively increase
serotonin activity.
12. Which assessment is most important when initiating an
antidepressant in a client with major depression?
A. Hair color
B. Suicide risk
C. Visual acuity only
D. Nail condition
Answer: B
Rationale: Changes in energy and activation can alter suicide risk,
particularly early in treatment.
13. Which medication is an SNRI?
A. Venlafaxine
B. Trazodone
C. Bupropion
D. Phenelzine
Answer: A
Management Exam – Complete Questions and Answers with
Rationales 2026/2027
Antidepressants
1. A client taking sertraline reports nausea during the first week of
treatment. Which response by the nurse is best?
A. “Stop taking the medication immediately.”
B. “Nausea can occur initially and may improve with continued
treatment.”
C. “Take twice the prescribed dose.”
D. “This indicates serotonin syndrome.”
Answer: B
Rationale: Mild gastrointestinal effects are common early with SSRIs
and often improve as the body adjusts.
2. Which finding in a client taking an SSRI requires the most immediate
intervention?
A. Dry mouth
B. Mild headache
C. Hyperreflexia, agitation, and fever
D. Decreased appetite
Answer: C
Rationale: These findings may indicate serotonin syndrome, a
potentially life-threatening reaction.
3. A client taking fluoxetine says, “I feel more energetic, but my
depression hasn't improved yet.” What is the priority nursing
consideration?
A. Increased energy can precede improvement in mood
B. Fluoxetine should always be stopped after one week
C. The client has developed psychosis
,D. The medication is ineffective
Answer: A
Rationale: Increased activation may occur before mood improves,
potentially increasing suicide risk in vulnerable clients.
4. Which medication is an SSRI?
A. Venlafaxine
B. Sertraline
C. Bupropion
D. Mirtazapine
Answer: B
Rationale: Sertraline is a selective serotonin reuptake inhibitor.
5. Which adverse effect is particularly associated with SSRIs?
A. Severe hypoglycemia
B. Sexual dysfunction
C. Permanent hearing loss
D. Gingival hyperplasia
Answer: B
Rationale: Decreased libido, delayed orgasm, and other sexual adverse
effects are common with SSRIs.
6. A client taking paroxetine asks why the medication should not be
stopped abruptly. What is the best response?
A. “Abrupt discontinuation can cause withdrawal-like symptoms.”
B. “Stopping suddenly causes permanent addiction.”
C. “The medication remains in your body for months.”
D. “Abrupt discontinuation causes immediate psychosis in everyone.”
Answer: A
Rationale: SSRI discontinuation can produce dizziness, irritability,
sensory disturbances, anxiety, and flu-like symptoms.
,7. Which antidepressant is also commonly used for smoking cessation?
A. Bupropion
B. Fluoxetine
C. Sertraline
D. Paroxetine
Answer: A
Rationale: Bupropion has antidepressant and smoking-cessation
indications.
8. Which client should generally avoid bupropion unless specifically
determined appropriate by the prescriber?
A. Client with seasonal depression
B. Client with a seizure disorder
C. Client with mild insomnia
D. Client with low appetite
Answer: B
Rationale: Bupropion can lower the seizure threshold.
9. Which instruction is appropriate for a client taking an MAOI?
A. Consume unlimited aged cheese
B. Avoid foods high in tyramine
C. Take pseudoephedrine freely
D. Stop all fluid intake
Answer: B
Rationale: Tyramine-rich foods can precipitate severe hypertension in
clients taking MAOIs.
10. A client taking phenelzine develops a severe headache and
palpitations after eating aged cheese. What complication should the
nurse suspect?
A. Serotonin withdrawal
B. Hypertensive crisis
, C. Hypoglycemia
D. Neuroleptic malignant syndrome
Answer: B
Rationale: Tyramine with MAOIs can cause dangerous elevations in
blood pressure.
11. Which medication combination creates a major risk for serotonin
syndrome?
A. SSRI plus another serotonergic medication
B. Antacid plus acetaminophen
C. Calcium plus vitamin D
D. Insulin plus glucose
Answer: A
Rationale: Combining serotonergic agents can excessively increase
serotonin activity.
12. Which assessment is most important when initiating an
antidepressant in a client with major depression?
A. Hair color
B. Suicide risk
C. Visual acuity only
D. Nail condition
Answer: B
Rationale: Changes in energy and activation can alter suicide risk,
particularly early in treatment.
13. Which medication is an SNRI?
A. Venlafaxine
B. Trazodone
C. Bupropion
D. Phenelzine
Answer: A
