ATI Psychiatric Pharmacology Practice Exam
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1. A client with major depressive disorder is started on fluoxetine. The
nurse should instruct the client that the full therapeutic effect may not
be achieved for which duration?
A. 1–3 days
B. 1–2 weeks
C. 4–6 weeks
D. 8–12 weeks
Answer: C
Rationale: SSRIs like fluoxetine typically require 4–6 weeks to achieve
full therapeutic effect, although some improvement may be seen
earlier. Educating the client about this timeline promotes adherence
and prevents premature discontinuation. Options A and B are too short;
option D is longer than typical onset.
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2. A client on phenelzine develops a severe headache, palpitations, and
blood pressure of 210/120 mmHg after consuming pepperoni pizza. The
nurse should anticipate administration of which medication?
A. Naloxone
B. Phentolamine IV
C. Flumazenil
D. Diphenhydramine
Answer: B
Rationale: This is a hypertensive crisis due to tyramine ingestion.
Phentolamine, an alpha-adrenergic blocker, is the antidote for
hypertensive crisis associated with MAOI use. Naloxone is for opioid
overdose, flumazenil for benzodiazepine reversal, and diphenhydramine
for allergic reactions.
3. A nurse is providing teaching to a client starting fluoxetine. Which
statement should the nurse include?
A. Take this medication at bedtime to promote sleep.
B. This medication will start working within 24 hours.
C. You may experience a decrease in libido while taking this medication.
D. Stop taking the medication immediately if you feel better.
Answer: C
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Rationale: SSRIs like fluoxetine commonly cause sexual dysfunction,
including decreased libido. Fluoxetine should be taken in the morning to
avoid insomnia, and it takes 1–4 weeks for therapeutic effects. Clients
should not stop antidepressants abruptly.
4. Which food should a client taking phenelzine avoid to prevent a
hypertensive crisis?
A. Fresh green beans
B. Cottage cheese
C. Aged cheddar cheese
D. Whole grain bread
Answer: C
Rationale: Phenelzine is an MAOI. Clients must avoid tyramine-rich
foods such as aged cheeses, cured meats, and red wine to prevent a
hypertensive crisis. Fresh green beans, cottage cheese, and whole grain
bread are low in tyramine and safe.
5. A client is prescribed lithium carbonate for bipolar disorder. Which
lab value should the nurse monitor to prevent toxicity?
A. Serum glucose
B. Prothrombin time
C. Serum sodium
D. Serum calcium
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Answer: C
Rationale: Low sodium levels lead to decreased lithium excretion, which
increases the risk of lithium toxicity. Lithium competes with sodium for
reabsorption in the kidneys; hyponatremia causes lithium retention.
Glucose, PT, and calcium are not directly related to lithium toxicity risk.
6. A nurse is caring for a client taking clozapine. Which laboratory result
is the priority to monitor?
A. Blood urea nitrogen (BUN)
B. White blood cell (WBC) count
C. Platelet count
D. Serum potassium
Answer: B
Rationale: Clozapine can cause agranulocytosis, a life-threatening
decrease in WBCs. Weekly or bi-weekly monitoring is required. BUN,
platelets, and potassium are not the priority for clozapine monitoring.
7. A client taking haloperidol develops acute dystonia. Which
medication should the nurse expect to administer?
A. Benztropine
B. Diazepam
C. Fluoxetine