1|Page
GALEN NUR 253 EXAM 3 STUDY GUIDE 2026: 300
QUESTIONS WITH ANSWERS & RATIONALES |
MENTAL HEALTH NURSING
# Table of Contents
| Section | Topic | Question Count |
|---------|-------|----------------|
| 1 | Comprehensive Psychopharmacology (Antidepressants,
Antipsychotics, Mood Stabilizers, Anxiolytics) | 60 |
| 2 | Somatic Therapies (ECT, TMS, VNS, Light Therapy) | 25 |
| 3 | Psychotherapy & Treatment Modalities (CBT, DBT, MI, Group,
Family) | 40 |
| 4 | Community Mental Health & Recovery Model | 30 |
| 5 | Psychosocial Rehabilitation & Vocational Support | 20 |
| 6 | Legal & Ethical Issues (Advanced: Informed Consent,
Guardianship, Criminal Justice) | 35 |
| 7 | Cultural Competence & Health Disparities | 20 |
| 8 | Integrated Care & Collaborative Practice | 20 |
| 9 | Complementary & Integrative Health (CAM) | 15 |
| 10 | High-Yield Clinical Case Questions | 35 |
| **Total** | | **300** |
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# SECTION 1: Comprehensive Psychopharmacology (Antidepressants,
Antipsychotics, Mood Stabilizers, Anxiolytics) – 60 Questions
**1. A patient with major depressive disorder and comorbid anxiety is
started on sertraline. The nurse explains that the full antidepressant
effect may take:**
A. 1-2 days
B. 1-2 weeks
C. 4-8 weeks
D. 6 months
**Answer: C – 4-8 weeks**
*Rationale:* SSRIs take 4-8 weeks for full antidepressant effect.
Anxiety symptoms may improve earlier (2-4 weeks). Early side effects
(nausea, activation) may occur first.
**2. Which SSRI has the shortest half-life and highest risk of
discontinuation syndrome?**
A. Fluoxetine (Prozac)
B. Paroxetine (Paxil)
C. Sertraline (Zoloft)
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D. Escitalopram (Lexapro)
**Answer: B – Paroxetine**
*Rationale:* Paroxetine has the shortest half-life (~24 hours) among
SSRIs and highest risk of discontinuation syndrome (dizziness,
paresthesias, flu-like symptoms). Fluoxetine has longest half-life (4-6
days).
**3. A patient on venlafaxine (Effexor XR) reports missing two doses
and now feels dizzy, nauseated, and has "brain zaps." This is:**
A. Discontinuation syndrome (common with SNRIs)
B. Serotonin syndrome
C. Neuroleptic malignant syndrome
D. Allergic reaction
**Answer: A – Discontinuation syndrome**
*Rationale:* Venlafaxine has a short half-life and causes severe
discontinuation syndrome (dizziness, nausea, paresthesias, "brain zaps")
even after missing one dose. Taper slowly.
**4. A patient with treatment-resistant depression is started on
vortioxetine (Trintellix). The nurse should monitor for:**
A. Nausea (common), no significant sexual dysfunction
B. Weight gain
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C. Sedation
D. QTc prolongation
**Answer: A – Nausea (common)**
*Rationale:* Vortioxetine is a multimodal antidepressant (5-HT1A
agonist, SERT inhibitor). Nausea is most common side effect (take with
food). Lower sexual dysfunction than SSRIs.
**5. Which antidepressant is a norepinephrine-dopamine reuptake
inhibitor (NDRI) and is also used for smoking cessation?**
A. Bupropion (Wellbutrin, Zyban)
B. Mirtazapine
C. Trazodone
D. Vilazodone
**Answer: A – Bupropion**
*Rationale:* Bupropion inhibits NE and DA reuptake. Also FDA-
approved for smoking cessation (Zyban). Lowers seizure threshold –
contraindicated in eating disorders.
**6. A patient on bupropion has a seizure. The nurse should recognize
that bupropion lowers seizure threshold, especially at doses >450
mg/day. Which patient is at highest risk?**
A. Patient with anorexia nervosa (contraindicated)
GALEN NUR 253 EXAM 3 STUDY GUIDE 2026: 300
QUESTIONS WITH ANSWERS & RATIONALES |
MENTAL HEALTH NURSING
# Table of Contents
| Section | Topic | Question Count |
|---------|-------|----------------|
| 1 | Comprehensive Psychopharmacology (Antidepressants,
Antipsychotics, Mood Stabilizers, Anxiolytics) | 60 |
| 2 | Somatic Therapies (ECT, TMS, VNS, Light Therapy) | 25 |
| 3 | Psychotherapy & Treatment Modalities (CBT, DBT, MI, Group,
Family) | 40 |
| 4 | Community Mental Health & Recovery Model | 30 |
| 5 | Psychosocial Rehabilitation & Vocational Support | 20 |
| 6 | Legal & Ethical Issues (Advanced: Informed Consent,
Guardianship, Criminal Justice) | 35 |
| 7 | Cultural Competence & Health Disparities | 20 |
| 8 | Integrated Care & Collaborative Practice | 20 |
| 9 | Complementary & Integrative Health (CAM) | 15 |
| 10 | High-Yield Clinical Case Questions | 35 |
| **Total** | | **300** |
,2|Page
---
# SECTION 1: Comprehensive Psychopharmacology (Antidepressants,
Antipsychotics, Mood Stabilizers, Anxiolytics) – 60 Questions
**1. A patient with major depressive disorder and comorbid anxiety is
started on sertraline. The nurse explains that the full antidepressant
effect may take:**
A. 1-2 days
B. 1-2 weeks
C. 4-8 weeks
D. 6 months
**Answer: C – 4-8 weeks**
*Rationale:* SSRIs take 4-8 weeks for full antidepressant effect.
Anxiety symptoms may improve earlier (2-4 weeks). Early side effects
(nausea, activation) may occur first.
**2. Which SSRI has the shortest half-life and highest risk of
discontinuation syndrome?**
A. Fluoxetine (Prozac)
B. Paroxetine (Paxil)
C. Sertraline (Zoloft)
,3|Page
D. Escitalopram (Lexapro)
**Answer: B – Paroxetine**
*Rationale:* Paroxetine has the shortest half-life (~24 hours) among
SSRIs and highest risk of discontinuation syndrome (dizziness,
paresthesias, flu-like symptoms). Fluoxetine has longest half-life (4-6
days).
**3. A patient on venlafaxine (Effexor XR) reports missing two doses
and now feels dizzy, nauseated, and has "brain zaps." This is:**
A. Discontinuation syndrome (common with SNRIs)
B. Serotonin syndrome
C. Neuroleptic malignant syndrome
D. Allergic reaction
**Answer: A – Discontinuation syndrome**
*Rationale:* Venlafaxine has a short half-life and causes severe
discontinuation syndrome (dizziness, nausea, paresthesias, "brain zaps")
even after missing one dose. Taper slowly.
**4. A patient with treatment-resistant depression is started on
vortioxetine (Trintellix). The nurse should monitor for:**
A. Nausea (common), no significant sexual dysfunction
B. Weight gain
, 4|Page
C. Sedation
D. QTc prolongation
**Answer: A – Nausea (common)**
*Rationale:* Vortioxetine is a multimodal antidepressant (5-HT1A
agonist, SERT inhibitor). Nausea is most common side effect (take with
food). Lower sexual dysfunction than SSRIs.
**5. Which antidepressant is a norepinephrine-dopamine reuptake
inhibitor (NDRI) and is also used for smoking cessation?**
A. Bupropion (Wellbutrin, Zyban)
B. Mirtazapine
C. Trazodone
D. Vilazodone
**Answer: A – Bupropion**
*Rationale:* Bupropion inhibits NE and DA reuptake. Also FDA-
approved for smoking cessation (Zyban). Lowers seizure threshold –
contraindicated in eating disorders.
**6. A patient on bupropion has a seizure. The nurse should recognize
that bupropion lowers seizure threshold, especially at doses >450
mg/day. Which patient is at highest risk?**
A. Patient with anorexia nervosa (contraindicated)
