NSG 552 Psychopharmacology Practice Exam 2
Questions and Answers Latest Versions Top
Rated A+
Question 1
A patient taking sertraline reports headache, confusion, weakness, and
nausea. Which laboratory abnormality should the nurse suspect?
A. Hyperkalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hyponatremia
Rationale: SSRIs can cause SIADH and hyponatremia, particularly in
older adults. Symptoms may include headache, confusion, weakness,
nausea, and seizures when severe.
Question 2
A patient taking citalopram should be monitored particularly closely for
which cardiac adverse effect?
A. QT prolongation
B. Complete heart block
C. Severe hypertension
D. Ventricular hypertrophy
Answer: A. QT prolongation
,Rationale: Citalopram can prolong the QT interval, especially at higher
doses or in patients with risk factors such as electrolyte abnormalities or
other QT-prolonging medications.
Question 3
A patient taking an SSRI develops agitation, sweating, diarrhea, tremor,
hyperreflexia, and clonus. What is the priority concern?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Acute dystonia
D. Anticholinergic toxicity
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is characterized by altered mental status,
autonomic instability, gastrointestinal symptoms, tremor, hyperreflexia,
and particularly clonus.
Question 4
Which medication combination places a patient at greatest risk for
serotonin syndrome?
A. Sertraline and linezolid
B. Lithium and levothyroxine
C. Bupropion and nicotine replacement
D. Lamotrigine and calcium carbonate
Answer: A. Sertraline and linezolid
Rationale: Linezolid has MAOI activity and can significantly increase
serotonergic activity when combined with serotonergic antidepressants.
,Question 5
A patient taking phenelzine asks which food should be avoided.
A. Fresh apples
B. Aged cheddar cheese
C. White rice
D. Fresh lettuce
Answer: B. Aged cheddar cheese
Rationale: Aged cheeses contain high levels of tyramine. In patients
taking MAOIs, excessive tyramine can cause a potentially dangerous
hypertensive reaction.
Question 6
A patient taking an MAOI develops severe headache, palpitations, chest
pain, and markedly elevated blood pressure after eating a large amount
of aged cheese. What is the priority action?
A. Have the patient lie down and reassess in 30 minutes
B. Administer the next antidepressant dose
C. Treat this as a hypertensive emergency
D. Encourage oral fluids
Answer: C. Treat this as a hypertensive emergency
Rationale: MAOI-related tyramine reactions can produce severe
hypertension and require urgent evaluation and treatment.
Question 7
, Before switching a patient from fluoxetine to an MAOI, the prescriber
should be particularly concerned about:
A. Fluoxetine's long half-life
B. Fluoxetine's low protein binding
C. Fluoxetine's renal elimination
D. Fluoxetine's lack of serotonergic activity
Answer: A. Fluoxetine's long half-life
Rationale: Fluoxetine and its active metabolite persist in the body for an
extended period. A longer washout period is generally required before
initiating an MAOI to reduce serotonin syndrome risk.
Question 8
Which adverse effect is particularly associated with tricyclic
antidepressants?
A. Severe diarrhea
B. Anticholinergic effects
C. Excessive salivation
D. Hypoglycemia
Answer: B. Anticholinergic effects
Rationale: TCAs can cause dry mouth, constipation, urinary retention,
blurred vision, and other anticholinergic effects.
Question 9
A patient overdoses on amitriptyline. Which complication is especially
concerning?
Questions and Answers Latest Versions Top
Rated A+
Question 1
A patient taking sertraline reports headache, confusion, weakness, and
nausea. Which laboratory abnormality should the nurse suspect?
A. Hyperkalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hyponatremia
Rationale: SSRIs can cause SIADH and hyponatremia, particularly in
older adults. Symptoms may include headache, confusion, weakness,
nausea, and seizures when severe.
Question 2
A patient taking citalopram should be monitored particularly closely for
which cardiac adverse effect?
A. QT prolongation
B. Complete heart block
C. Severe hypertension
D. Ventricular hypertrophy
Answer: A. QT prolongation
,Rationale: Citalopram can prolong the QT interval, especially at higher
doses or in patients with risk factors such as electrolyte abnormalities or
other QT-prolonging medications.
Question 3
A patient taking an SSRI develops agitation, sweating, diarrhea, tremor,
hyperreflexia, and clonus. What is the priority concern?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Acute dystonia
D. Anticholinergic toxicity
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is characterized by altered mental status,
autonomic instability, gastrointestinal symptoms, tremor, hyperreflexia,
and particularly clonus.
Question 4
Which medication combination places a patient at greatest risk for
serotonin syndrome?
A. Sertraline and linezolid
B. Lithium and levothyroxine
C. Bupropion and nicotine replacement
D. Lamotrigine and calcium carbonate
Answer: A. Sertraline and linezolid
Rationale: Linezolid has MAOI activity and can significantly increase
serotonergic activity when combined with serotonergic antidepressants.
,Question 5
A patient taking phenelzine asks which food should be avoided.
A. Fresh apples
B. Aged cheddar cheese
C. White rice
D. Fresh lettuce
Answer: B. Aged cheddar cheese
Rationale: Aged cheeses contain high levels of tyramine. In patients
taking MAOIs, excessive tyramine can cause a potentially dangerous
hypertensive reaction.
Question 6
A patient taking an MAOI develops severe headache, palpitations, chest
pain, and markedly elevated blood pressure after eating a large amount
of aged cheese. What is the priority action?
A. Have the patient lie down and reassess in 30 minutes
B. Administer the next antidepressant dose
C. Treat this as a hypertensive emergency
D. Encourage oral fluids
Answer: C. Treat this as a hypertensive emergency
Rationale: MAOI-related tyramine reactions can produce severe
hypertension and require urgent evaluation and treatment.
Question 7
, Before switching a patient from fluoxetine to an MAOI, the prescriber
should be particularly concerned about:
A. Fluoxetine's long half-life
B. Fluoxetine's low protein binding
C. Fluoxetine's renal elimination
D. Fluoxetine's lack of serotonergic activity
Answer: A. Fluoxetine's long half-life
Rationale: Fluoxetine and its active metabolite persist in the body for an
extended period. A longer washout period is generally required before
initiating an MAOI to reduce serotonin syndrome risk.
Question 8
Which adverse effect is particularly associated with tricyclic
antidepressants?
A. Severe diarrhea
B. Anticholinergic effects
C. Excessive salivation
D. Hypoglycemia
Answer: B. Anticholinergic effects
Rationale: TCAs can cause dry mouth, constipation, urinary retention,
blurred vision, and other anticholinergic effects.
Question 9
A patient overdoses on amitriptyline. Which complication is especially
concerning?
