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NR 546 /NR 546
ADVANCED PSYCHOPHARMACOLOGY
FINAL EXAM 2025
(Module 1, 2, 3, 4 & 5) |Comprehensive Exam Questions and Correct
Detailed Answers with Rationales (100% Verified) |A+ Grade.
MODULE 1
MULTIPLE CHOICES
The nurse is caring for a client with bipolar disorder whose medication regimen includes lithium and who will
soon be discharged. What health education should the nurse prioritize?
A. Strategies for managing anticholinergic effects
B. The need to avoid driving or operating machinery during therapy
C. The need to avoid high-potassium foods and salt substitutes
D. The need to have follow-up blood samples drawn on schedule - CORRECT ✓✓ D
Serum levels of lithium must be carefully monitored to ensure effectiveness and prevent toxicity. The need for
blood work is consequently a priority. The client does not necessarily have to avoid driving, and there is no need
to strictly avoid potassium. Lithium does not cause anticholinergic effects.
The nurse is caring for a young female client who is 5 weeks pregnant. What statement made by the nurse about
the use of antidepressants during pregnancy is most accurate?
A. "Antidepressants must be chosen carefully because only a few are safe during pregnancy."
B. "Antidepressants are used very cautiously during pregnancy and only when benefit outweighs risk."
C. "Antidepressants are contraindicated and must be discontinued if pregnancy occurs."
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D. "Most antidepressants are safe during pregnancy but those that are contraindicated should be avoided." -
CORRECT ✓✓ B
Antidepressants should be used very cautiously during pregnancy and lactation because of the potential for
adverse effects on the fetus and possible neurological effects on the baby. Use should be reserved for situations
in which the benefits to the mother far outweigh the potential risks to the neonate.
The nurse is caring for a client who is taking lithium for the treatment of bipolar disorder. The client's most
recent laboratory findings reveal a serum lithium level of 1.4 mEq/L. What assessment findings should the nurse
attribute to the client's lithium level?
A. The client is lethargic and weak.
B. Lung auscultation reveals rales, and the client is short of breath on exertion.
C. The client has decreased bowel sounds and has had no bowel movement for 3 days.
D. The nurse observes personality changes, and the client is disoriented to time. - CORRECT ✓✓ A
Lethargy and weakness are early indications of excessive of lithium levels. Diarrhea would be much more likely
than constipation, and personality changes are not expected. Similarly, respiratory complications are atypical.
The nurse is caring for a client who has not been able to sleep. The physician orders a barbiturate medication for
this client. What health education should the nurse provide?
A. Teaching the client to report tinnitus promptly
B. Teaching the client about the need for follow-up blood work
C. Warning the client about the possibility of double vision
D. Warning the client about the possibility of thought abnormalities - CORRECT ✓✓ D
The most common adverse effects are related to general central nervous system (CNS) depression. CNS effects
may include drowsiness, somnolence, lethargy, ataxia, vertigo, a resembling a "hangover," thinking
abnormalities, paradoxical excitement, anxiety, and hallucinations. Barbiturate drugs generally do not cause
double vision or tinnitus. Blood levels are not normally needed.
The client presents to the emergency department with a headache in the back of the head, diaphoresis, and neck
stiffness. The client's blood pressure measures 180/124 mm Hg, and heart rate is 168 beats/minute. The spouse
says that the client is currently prescribed "something for depression" and denies any history of cardiac disease.
The nurse should suspect the use of what medication?
, Page |3
A. A monoamine oxidase inhibitor (MAOI)
B. A selective serotonin reuptake inhibitor (SSRI)
C. A tricyclic antidepressant (TCA)
D. An atypical antipsychotic - CORRECT ✓✓ A
MAOIs have several serious adverse effects that can be fatal. This client's symptoms indicate fatal hypertensive
crisis characterized by occipital headache, palpitations, neck stiffness, nausea, vomiting, sweating, dilated
pupils, photophobia, tachycardia, and chest pain. It may progress to intracranial bleeding and fatal stroke. SSRIs
and TCAs are not associated with these particular symptoms. Antipsychotics do not have this effect.
A nurse is about to administer a parenteral benzodiazepine to a female client in the hospital before the
performance of an invasive diagnostic procedure. What action should the nurse prioritize before administration
of the drug?
A. Close the blinds and ensure appropriate room temperature for the client.
B. Auscultate the client's lungs and set up pulse oximetry monitoring.
C. Ask all visitors to leave the room and remain in the waiting area.
D. Help the client out of bed to the bathroom and encourage the client to void - CORRECT ✓✓ D
The priority action would be to help the client up to void. After the medication is administered, the client should
not get out of bed because of possibly injury due to drowsiness. Safety should always be the priority concern.
Respiratory assessment is not a priority, since respiratory depression does not normally occur. Creating a calm
environment and asking visitors to leave may be necessary for the diagnostic procedure, but these actions do not
have to precede benzodiazepine administration.
The nurse is caring for a 6-year-old who is being treated with methylphenidate. What assessments should the
nurse prioritize in the care of this client?
A. Monitoring the client's urine output and creatinine clearance
B. Assessing the client's weight and monitoring complete blood counts
C. Monitoring rates of long bone growth
D. Assessment of visual acuity and assessment for tinnitus - CORRECT ✓✓ B
Methylphenidate is associated with weight loss, bone marrow suppression, and cardiac arrhythmias. Weight,
blood count, and cardiac function should be monitored regularly. The drug is not associated with renal
, Page |4
dysfunction, visual changes, tinnitus, or growth retardation, so those values would not need to be regularly
evaluated as part of drug therapy.
The nurse is creating a care plan for a client taking a selective serotonin reuptake inhibitor (SSRI). What would
be an appropriate nursing diagnosis for this client?
A. Risk for autonomic dysreflexia related to CNS effects of medication
B. Risk for impaired skin integrity related to vasodilation and delayed wound healing
C. Disturbed thought processes related to CNS effects of medication
D. Risk for infection related to immunosuppressant effects of medication - CORRECT ✓✓ C
Nursing diagnoses related to SSRI therapy might include disturbed thought processes related to central nervous
system effects because adverse effects of SSRIs include headache, drowsiness, dizziness, insomnia, anxiety,
tremor, agitation, and seizures. There would be no reason to expect the client is at increased risk for infection.
Autonomic dysreflexia applies to clients with spinal cord injury. SSRIs do not affect skin integrity, immunity, or
wound healing.
The nurse is caring for a client who has a sedative hypnotic ordered. The nurse should consider this drug
contraindicated if the client had what disorder?
A. Liver failure
B. Endocrine disorders
C. Neurological diseases
D. Heart disease - CORRECT ✓✓ A
Benzodiazepines undergo extensive hepatic metabolism. In the presence of liver disease, the metabolism of
most benzodiazepines is slowed, with resultant accumulation and increased risk of adverse effects. Neurological
disorders, endocrine disorders, and heart disease are not contraindications for the use of benzodiazepines.
An 11-year-old client has been hospitalized on the adolescent psychiatry unit with severe depression. For the
past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the
priority nursing action?
A. Implement suicide precautions.
B. Monitor the client for migraines.
C. Assess for weight loss and difficulty sleeping.
NR 546 /NR 546
ADVANCED PSYCHOPHARMACOLOGY
FINAL EXAM 2025
(Module 1, 2, 3, 4 & 5) |Comprehensive Exam Questions and Correct
Detailed Answers with Rationales (100% Verified) |A+ Grade.
MODULE 1
MULTIPLE CHOICES
The nurse is caring for a client with bipolar disorder whose medication regimen includes lithium and who will
soon be discharged. What health education should the nurse prioritize?
A. Strategies for managing anticholinergic effects
B. The need to avoid driving or operating machinery during therapy
C. The need to avoid high-potassium foods and salt substitutes
D. The need to have follow-up blood samples drawn on schedule - CORRECT ✓✓ D
Serum levels of lithium must be carefully monitored to ensure effectiveness and prevent toxicity. The need for
blood work is consequently a priority. The client does not necessarily have to avoid driving, and there is no need
to strictly avoid potassium. Lithium does not cause anticholinergic effects.
The nurse is caring for a young female client who is 5 weeks pregnant. What statement made by the nurse about
the use of antidepressants during pregnancy is most accurate?
A. "Antidepressants must be chosen carefully because only a few are safe during pregnancy."
B. "Antidepressants are used very cautiously during pregnancy and only when benefit outweighs risk."
C. "Antidepressants are contraindicated and must be discontinued if pregnancy occurs."
, Page |2
D. "Most antidepressants are safe during pregnancy but those that are contraindicated should be avoided." -
CORRECT ✓✓ B
Antidepressants should be used very cautiously during pregnancy and lactation because of the potential for
adverse effects on the fetus and possible neurological effects on the baby. Use should be reserved for situations
in which the benefits to the mother far outweigh the potential risks to the neonate.
The nurse is caring for a client who is taking lithium for the treatment of bipolar disorder. The client's most
recent laboratory findings reveal a serum lithium level of 1.4 mEq/L. What assessment findings should the nurse
attribute to the client's lithium level?
A. The client is lethargic and weak.
B. Lung auscultation reveals rales, and the client is short of breath on exertion.
C. The client has decreased bowel sounds and has had no bowel movement for 3 days.
D. The nurse observes personality changes, and the client is disoriented to time. - CORRECT ✓✓ A
Lethargy and weakness are early indications of excessive of lithium levels. Diarrhea would be much more likely
than constipation, and personality changes are not expected. Similarly, respiratory complications are atypical.
The nurse is caring for a client who has not been able to sleep. The physician orders a barbiturate medication for
this client. What health education should the nurse provide?
A. Teaching the client to report tinnitus promptly
B. Teaching the client about the need for follow-up blood work
C. Warning the client about the possibility of double vision
D. Warning the client about the possibility of thought abnormalities - CORRECT ✓✓ D
The most common adverse effects are related to general central nervous system (CNS) depression. CNS effects
may include drowsiness, somnolence, lethargy, ataxia, vertigo, a resembling a "hangover," thinking
abnormalities, paradoxical excitement, anxiety, and hallucinations. Barbiturate drugs generally do not cause
double vision or tinnitus. Blood levels are not normally needed.
The client presents to the emergency department with a headache in the back of the head, diaphoresis, and neck
stiffness. The client's blood pressure measures 180/124 mm Hg, and heart rate is 168 beats/minute. The spouse
says that the client is currently prescribed "something for depression" and denies any history of cardiac disease.
The nurse should suspect the use of what medication?
, Page |3
A. A monoamine oxidase inhibitor (MAOI)
B. A selective serotonin reuptake inhibitor (SSRI)
C. A tricyclic antidepressant (TCA)
D. An atypical antipsychotic - CORRECT ✓✓ A
MAOIs have several serious adverse effects that can be fatal. This client's symptoms indicate fatal hypertensive
crisis characterized by occipital headache, palpitations, neck stiffness, nausea, vomiting, sweating, dilated
pupils, photophobia, tachycardia, and chest pain. It may progress to intracranial bleeding and fatal stroke. SSRIs
and TCAs are not associated with these particular symptoms. Antipsychotics do not have this effect.
A nurse is about to administer a parenteral benzodiazepine to a female client in the hospital before the
performance of an invasive diagnostic procedure. What action should the nurse prioritize before administration
of the drug?
A. Close the blinds and ensure appropriate room temperature for the client.
B. Auscultate the client's lungs and set up pulse oximetry monitoring.
C. Ask all visitors to leave the room and remain in the waiting area.
D. Help the client out of bed to the bathroom and encourage the client to void - CORRECT ✓✓ D
The priority action would be to help the client up to void. After the medication is administered, the client should
not get out of bed because of possibly injury due to drowsiness. Safety should always be the priority concern.
Respiratory assessment is not a priority, since respiratory depression does not normally occur. Creating a calm
environment and asking visitors to leave may be necessary for the diagnostic procedure, but these actions do not
have to precede benzodiazepine administration.
The nurse is caring for a 6-year-old who is being treated with methylphenidate. What assessments should the
nurse prioritize in the care of this client?
A. Monitoring the client's urine output and creatinine clearance
B. Assessing the client's weight and monitoring complete blood counts
C. Monitoring rates of long bone growth
D. Assessment of visual acuity and assessment for tinnitus - CORRECT ✓✓ B
Methylphenidate is associated with weight loss, bone marrow suppression, and cardiac arrhythmias. Weight,
blood count, and cardiac function should be monitored regularly. The drug is not associated with renal
, Page |4
dysfunction, visual changes, tinnitus, or growth retardation, so those values would not need to be regularly
evaluated as part of drug therapy.
The nurse is creating a care plan for a client taking a selective serotonin reuptake inhibitor (SSRI). What would
be an appropriate nursing diagnosis for this client?
A. Risk for autonomic dysreflexia related to CNS effects of medication
B. Risk for impaired skin integrity related to vasodilation and delayed wound healing
C. Disturbed thought processes related to CNS effects of medication
D. Risk for infection related to immunosuppressant effects of medication - CORRECT ✓✓ C
Nursing diagnoses related to SSRI therapy might include disturbed thought processes related to central nervous
system effects because adverse effects of SSRIs include headache, drowsiness, dizziness, insomnia, anxiety,
tremor, agitation, and seizures. There would be no reason to expect the client is at increased risk for infection.
Autonomic dysreflexia applies to clients with spinal cord injury. SSRIs do not affect skin integrity, immunity, or
wound healing.
The nurse is caring for a client who has a sedative hypnotic ordered. The nurse should consider this drug
contraindicated if the client had what disorder?
A. Liver failure
B. Endocrine disorders
C. Neurological diseases
D. Heart disease - CORRECT ✓✓ A
Benzodiazepines undergo extensive hepatic metabolism. In the presence of liver disease, the metabolism of
most benzodiazepines is slowed, with resultant accumulation and increased risk of adverse effects. Neurological
disorders, endocrine disorders, and heart disease are not contraindications for the use of benzodiazepines.
An 11-year-old client has been hospitalized on the adolescent psychiatry unit with severe depression. For the
past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the
priority nursing action?
A. Implement suicide precautions.
B. Monitor the client for migraines.
C. Assess for weight loss and difficulty sleeping.
