NSG 552 PSYCHOPHARMACOLOGY — FINAL EXAM
COMPLETE TEST BANK COMPREHENSIVE FINAL EXAM
300 QUESTIONS WITH NGN CASE SCENARIOS &
DETAILED RATIONALES 2026/2027 UPDATE
1. A client is started on fluoxetine for major depressive disorder. Which
instruction should the nurse include?
A) “You will feel the full effect within 24 hours.”
B) “It may take 4–6 weeks for full therapeutic effect.”
C) “You can stop the medication once you feel better.”
D) “Avoid all dairy products while taking this medication.”
Answer: B
Rationale: SSRIs have delayed onset; full antidepressant effect takes several
weeks. Do not stop abruptly.
2. Which adverse effect is most characteristic of SSRIs?
A) Hypertension
B) Sexual dysfunction
C) Bradycardia
D) Weight loss
Answer: B
Rationale: SSRIs commonly cause sexual side effects (decreased libido, delayed
ejaculation, anorgasmia).
,3. A client on sertraline reports nausea and headache during the first week.
What is the nurse’s best response?
A) “Stop the medication immediately.”
B) “These side effects often improve after 1–2 weeks. Try taking it with food.”
C) “You need a higher dose.”
D) “This means the medication is not working.”
Answer: B
Rationale: Early GI and CNS side effects are common and often transient.
Encourage adherence.
4. Which SSRI has the highest risk of discontinuation syndrome if stopped
abruptly?
A) Fluoxetine
B) Paroxetine
C) Sertraline
D) Escitalopram
Answer: B
Rationale: Paroxetine has a short half-life and is associated with a higher risk of
discontinuation syndrome.
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,5. A client on fluoxetine reports agitation, tremor, and hyperreflexia after
starting tramadol. Which condition should the nurse suspect?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome
C) Malignant hyperthermia
D) Anticholinergic toxicity
Answer: B
Rationale: Serotonin syndrome presents with mental status changes, autonomic
instability, and neuromuscular hyperexcitability.
6. Which medication is an SNRI?
A) Fluoxetine
B) Venlafaxine
C) Bupropion
D) Mirtazapine
Answer: B
Rationale: Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI).
7. A client on venlafaxine should have which parameter monitored at higher
doses?
A) Blood glucose
B) Blood pressure
C) Serum potassium
3
, D) INR
Answer: B
Rationale: Venlafaxine can cause dose-dependent hypertension; monitor BP
regularly.
8. Which antidepressant is least likely to cause sexual dysfunction?
A) Paroxetine
B) Sertraline
C) Bupropion
D) Fluoxetine
Answer: C
Rationale: Bupropion (NDRI) has a low risk of sexual side effects and is weight-
neutral.
9. A client with depression and insomnia is started on mirtazapine. Which
side effect can be beneficial?
A) Weight loss
B) Sedation and increased appetite
C) Insomnia
D) Diarrhea
Answer: B
Rationale: Mirtazapine is sedating and increases appetite, helpful for depressed
clients with insomnia and anorexia.
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COMPLETE TEST BANK COMPREHENSIVE FINAL EXAM
300 QUESTIONS WITH NGN CASE SCENARIOS &
DETAILED RATIONALES 2026/2027 UPDATE
1. A client is started on fluoxetine for major depressive disorder. Which
instruction should the nurse include?
A) “You will feel the full effect within 24 hours.”
B) “It may take 4–6 weeks for full therapeutic effect.”
C) “You can stop the medication once you feel better.”
D) “Avoid all dairy products while taking this medication.”
Answer: B
Rationale: SSRIs have delayed onset; full antidepressant effect takes several
weeks. Do not stop abruptly.
2. Which adverse effect is most characteristic of SSRIs?
A) Hypertension
B) Sexual dysfunction
C) Bradycardia
D) Weight loss
Answer: B
Rationale: SSRIs commonly cause sexual side effects (decreased libido, delayed
ejaculation, anorgasmia).
,3. A client on sertraline reports nausea and headache during the first week.
What is the nurse’s best response?
A) “Stop the medication immediately.”
B) “These side effects often improve after 1–2 weeks. Try taking it with food.”
C) “You need a higher dose.”
D) “This means the medication is not working.”
Answer: B
Rationale: Early GI and CNS side effects are common and often transient.
Encourage adherence.
4. Which SSRI has the highest risk of discontinuation syndrome if stopped
abruptly?
A) Fluoxetine
B) Paroxetine
C) Sertraline
D) Escitalopram
Answer: B
Rationale: Paroxetine has a short half-life and is associated with a higher risk of
discontinuation syndrome.
2
,5. A client on fluoxetine reports agitation, tremor, and hyperreflexia after
starting tramadol. Which condition should the nurse suspect?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome
C) Malignant hyperthermia
D) Anticholinergic toxicity
Answer: B
Rationale: Serotonin syndrome presents with mental status changes, autonomic
instability, and neuromuscular hyperexcitability.
6. Which medication is an SNRI?
A) Fluoxetine
B) Venlafaxine
C) Bupropion
D) Mirtazapine
Answer: B
Rationale: Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI).
7. A client on venlafaxine should have which parameter monitored at higher
doses?
A) Blood glucose
B) Blood pressure
C) Serum potassium
3
, D) INR
Answer: B
Rationale: Venlafaxine can cause dose-dependent hypertension; monitor BP
regularly.
8. Which antidepressant is least likely to cause sexual dysfunction?
A) Paroxetine
B) Sertraline
C) Bupropion
D) Fluoxetine
Answer: C
Rationale: Bupropion (NDRI) has a low risk of sexual side effects and is weight-
neutral.
9. A client with depression and insomnia is started on mirtazapine. Which
side effect can be beneficial?
A) Weight loss
B) Sedation and increased appetite
C) Insomnia
D) Diarrhea
Answer: B
Rationale: Mirtazapine is sedating and increases appetite, helpful for depressed
clients with insomnia and anorexia.
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