NUR 334 EXAM 4: PHARMACOLOGY I
(PSYCHOTROPIC AND NEUROLOGICAL
MEDICATIONS) QUESTIONS AND
DETAILED ANSWERS 2026/2027
1. A patient taking Lithium Carbonate for Bipolar Disorder reports a new onset of coarse hand
tremors, nausea, and vomiting. Which action should the nurse take first?
A. Administer the next scheduled dose as ordered.
B. Encourage the patient to increase caffeine intake to offset sedation.
C. Request a stat serum lithium level and withhold the dose.
D. Advise the patient that these are expected early side effects.
Answer: C
Conceptual Explanation: Coarse hand tremors, nausea, and vomiting are signs of
moderate to severe lithium toxicity. The nurse must withhold the dose and obtain a serum
level to ensure patient safety.
2. Which dietary instruction is essential for a patient prescribed Phenelzine (Nardil)?
A. Increase intake of aged cheeses and cured meats.
B. Maintain a low-sodium diet to prevent hypertension.
C. Avoid foods containing high amounts of tyramine.
,D. Restrict fluids to 1000 mL per day.
Answer: C
Conceptual Explanation: Phenelzine is an MAOI. Ingesting tyramine-rich foods (aged
cheese, cured meats, wine) can lead to a hypertensive crisis.
3. A patient is prescribed Clozapine (Clozaril). Which laboratory value is the priority for the
nurse to monitor regularly?
A. Serum Potassium levels
B. Alanine Aminotransferase (ALT)
C. Absolute Neutrophil Count (ANC)
D. Blood Urea Nitrogen (BUN)
Answer: C
Conceptual Explanation: Clozapine carries a high risk of agranulocytosis. Weekly or bi-
weekly monitoring of ANC is required to detect life-threatening bone marrow suppression.
4. A patient taking Haloperidol (Haldol) develops a high fever, muscle rigidity, and
tachycardia. What complication does the nurse suspect?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Anticholinergic Toxicity
D. Acute Dystonic Reaction
, Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead pipe’ rigidity, hyperpyrexia, and autonomic instability.
5. Which statement by the patient indicates a need for further teaching regarding Fluoxetine
(Prozac)?
A. I will take my medication in the morning to prevent insomnia.
B. I should stop taking the medicine immediately if I feel better.
C. It may take 4 to 6 weeks to feel the full effects of this drug.
D. I will report any increased thoughts of self-harm to my doctor.
Answer: B
Conceptual Explanation: SSRIs should never be stopped abruptly due to the risk of
discontinuation syndrome. Patients must taper the medication under medical supervision.
6. What is the primary mechanism of action for Benzodiazepines such as Diazepam (Valium)?
A. Inhibition of serotonin reuptake
B. Increasing the release of norepinephrine
C. Blocking dopamine receptors in the mesolimbic pathway
D. Potentiating the effects of GABA
Answer: D
(PSYCHOTROPIC AND NEUROLOGICAL
MEDICATIONS) QUESTIONS AND
DETAILED ANSWERS 2026/2027
1. A patient taking Lithium Carbonate for Bipolar Disorder reports a new onset of coarse hand
tremors, nausea, and vomiting. Which action should the nurse take first?
A. Administer the next scheduled dose as ordered.
B. Encourage the patient to increase caffeine intake to offset sedation.
C. Request a stat serum lithium level and withhold the dose.
D. Advise the patient that these are expected early side effects.
Answer: C
Conceptual Explanation: Coarse hand tremors, nausea, and vomiting are signs of
moderate to severe lithium toxicity. The nurse must withhold the dose and obtain a serum
level to ensure patient safety.
2. Which dietary instruction is essential for a patient prescribed Phenelzine (Nardil)?
A. Increase intake of aged cheeses and cured meats.
B. Maintain a low-sodium diet to prevent hypertension.
C. Avoid foods containing high amounts of tyramine.
,D. Restrict fluids to 1000 mL per day.
Answer: C
Conceptual Explanation: Phenelzine is an MAOI. Ingesting tyramine-rich foods (aged
cheese, cured meats, wine) can lead to a hypertensive crisis.
3. A patient is prescribed Clozapine (Clozaril). Which laboratory value is the priority for the
nurse to monitor regularly?
A. Serum Potassium levels
B. Alanine Aminotransferase (ALT)
C. Absolute Neutrophil Count (ANC)
D. Blood Urea Nitrogen (BUN)
Answer: C
Conceptual Explanation: Clozapine carries a high risk of agranulocytosis. Weekly or bi-
weekly monitoring of ANC is required to detect life-threatening bone marrow suppression.
4. A patient taking Haloperidol (Haldol) develops a high fever, muscle rigidity, and
tachycardia. What complication does the nurse suspect?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Anticholinergic Toxicity
D. Acute Dystonic Reaction
, Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead pipe’ rigidity, hyperpyrexia, and autonomic instability.
5. Which statement by the patient indicates a need for further teaching regarding Fluoxetine
(Prozac)?
A. I will take my medication in the morning to prevent insomnia.
B. I should stop taking the medicine immediately if I feel better.
C. It may take 4 to 6 weeks to feel the full effects of this drug.
D. I will report any increased thoughts of self-harm to my doctor.
Answer: B
Conceptual Explanation: SSRIs should never be stopped abruptly due to the risk of
discontinuation syndrome. Patients must taper the medication under medical supervision.
6. What is the primary mechanism of action for Benzodiazepines such as Diazepam (Valium)?
A. Inhibition of serotonin reuptake
B. Increasing the release of norepinephrine
C. Blocking dopamine receptors in the mesolimbic pathway
D. Potentiating the effects of GABA
Answer: D
