1
NURS 251 Pharmacology Module 6 Exam Portage
Learning Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | Pass
Guaranteed – A+ Graded
[SECTION 1: CNS Pharmacology (Antidepressants, Antipsychotics, Anxiolytics) — Questions 1-15]
Q1: A patient is prescribed fluoxetine (Prozac) for major depressive disorder. The nurse monitors
for which common side effect associated with the increased availability of serotonin in the
gastrointestinal tract?
A. Dry mouth and blurred vision
B. Nausea, diarrhea, and GI upset
C. Orthostatic hypotension
D. Weight loss and insomnia
Correct Answer: B
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine increase serotonin
levels, which are abundant in the gut. This stimulation often leads to gastrointestinal side effects
such as nausea, diarrhea, and dyspepsia. While weight changes (D) can occur, GI upset is the
most immediate and common complaint. Dry mouth (A) is more typical of anticholinergics
(TCAs). Orthostatic hypotension (C) is associated with alpha-1 blockade seen in TCAs or some
atypical antipsychotics.
Q2: A patient with depression is switched to a tricyclic antidepressant (TCA), amitriptyline.
Which side effect should the nurse prioritize in teaching due to its potential impact on safety?
A. Sexual dysfunction
B. Anticholinergic effects (dry mouth, constipation, urinary retention, blurred vision)
C. Serotonin syndrome
D. Weight loss
Correct Answer: B
,2
Rationale: TCAs block muscarinic, histaminergic, and alpha-1 adrenergic receptors. The
anticholinergic effects (dry mouth, constipation, urinary retention, blurred vision) and sedation
(histamine blockade) are prominent and can lead to safety risks like falls (especially in the
elderly) or urinary retention. While sexual dysfunction (A) occurs with SSRIs, the
anticholinergic burden of TCAs is a major distinguishing feature. Serotonin syndrome (C) is a
risk but less common than with serotonergic combinations.
Q3: A patient taking an MAOI (phenelzine) reports consuming cheddar cheese and red wine at a
party and now presents with a severe headache, palpitations, and neck stiffness. The nurse
recognizes this as:
A. Neuroleptic Malignant Syndrome (NMS)
B. Hypertensive Crisis
C. Serotonin Syndrome
D. Extrapyramidal Symptoms (EPS)
Correct Answer: B
Rationale: MAOIs inhibit the breakdown of tyramine. Ingesting tyramine-rich foods (aged
cheeses, cured meats, wine) leads to a massive release of stored catecholamines, causing a
hypertensive crisis. Symptoms include severe occipital headache, palpitations, chest pain, neck
stiffness, and hypertension. NMS (A) is caused by antipsychotics. Serotonin Syndrome (C) is
caused by excess serotonin, not tyramine.
Q4: A patient on clozapine for treatment-resistant schizophrenia requires mandatory blood
monitoring. What is the specific purpose of this monitoring?
A. To monitor for hepatotoxicity
B. To detect Agranulocytosis
C. To monitor lithium levels
D. To check for Stevens-Johnson Syndrome
Correct Answer: B
, 3
Rationale: Clozapine carries a risk of agranulocytosis, a life-threatening drop in white blood
cells. Patients must be enrolled in a REMS program and have their Absolute Neutrophil Count
(ANC) monitored weekly for the first 6 months, then biweekly, and finally monthly. Early
detection is crucial to prevent fatal infections. While hepatotoxicity (A) is also monitored,
agranulocytosis is the primary safety mandate.
Q5: A patient with depression is concerned about the sexual side effects of their current SSRI.
Which medication, classified as an NDRI, is known for having a low risk of sexual dysfunction
and causing weight loss?
A. Mirtazapine
B. Bupropion (Wellbutrin)
C. Venlafaxine (Effexor)
D. Paroxetine (Paxil)
Correct Answer: B
Rationale: Bupropion is a Norepinephrine-Dopamine Reuptake Inhibitor (NDRI). Unlike SSRIs
and SNRIs, it does not impair sexual function and is often associated with weight loss rather than
gain. It is also used for smoking cessation (Zyban). Venlafaxine (C) is an SNRI and carries
sexual side effects. Mirtazapine (A) causes weight gain and sedation.
Q6: A patient develops stiffness, a pill-rolling tremor, and shuffling gait after starting an
antipsychotic. The nurse identifies these as:
A. Acute dystonia
B. Parkinsonism (a type of Extrapyramidal Symptom)
C. Akathisia
D. Tardive dyskinesia
Correct Answer: B
Rationale: Antipsychotic-induced parkinsonism mimics idiopathic Parkinson's disease,
presenting with bradykinesia, rigidity, tremor, and shuffling gait. It is caused by D2 blockade in
the nigrostriatal pathway. Acute dystonia (A) involves sustained muscle spasms (e.g., torticollis).
NURS 251 Pharmacology Module 6 Exam Portage
Learning Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | Pass
Guaranteed – A+ Graded
[SECTION 1: CNS Pharmacology (Antidepressants, Antipsychotics, Anxiolytics) — Questions 1-15]
Q1: A patient is prescribed fluoxetine (Prozac) for major depressive disorder. The nurse monitors
for which common side effect associated with the increased availability of serotonin in the
gastrointestinal tract?
A. Dry mouth and blurred vision
B. Nausea, diarrhea, and GI upset
C. Orthostatic hypotension
D. Weight loss and insomnia
Correct Answer: B
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine increase serotonin
levels, which are abundant in the gut. This stimulation often leads to gastrointestinal side effects
such as nausea, diarrhea, and dyspepsia. While weight changes (D) can occur, GI upset is the
most immediate and common complaint. Dry mouth (A) is more typical of anticholinergics
(TCAs). Orthostatic hypotension (C) is associated with alpha-1 blockade seen in TCAs or some
atypical antipsychotics.
Q2: A patient with depression is switched to a tricyclic antidepressant (TCA), amitriptyline.
Which side effect should the nurse prioritize in teaching due to its potential impact on safety?
A. Sexual dysfunction
B. Anticholinergic effects (dry mouth, constipation, urinary retention, blurred vision)
C. Serotonin syndrome
D. Weight loss
Correct Answer: B
,2
Rationale: TCAs block muscarinic, histaminergic, and alpha-1 adrenergic receptors. The
anticholinergic effects (dry mouth, constipation, urinary retention, blurred vision) and sedation
(histamine blockade) are prominent and can lead to safety risks like falls (especially in the
elderly) or urinary retention. While sexual dysfunction (A) occurs with SSRIs, the
anticholinergic burden of TCAs is a major distinguishing feature. Serotonin syndrome (C) is a
risk but less common than with serotonergic combinations.
Q3: A patient taking an MAOI (phenelzine) reports consuming cheddar cheese and red wine at a
party and now presents with a severe headache, palpitations, and neck stiffness. The nurse
recognizes this as:
A. Neuroleptic Malignant Syndrome (NMS)
B. Hypertensive Crisis
C. Serotonin Syndrome
D. Extrapyramidal Symptoms (EPS)
Correct Answer: B
Rationale: MAOIs inhibit the breakdown of tyramine. Ingesting tyramine-rich foods (aged
cheeses, cured meats, wine) leads to a massive release of stored catecholamines, causing a
hypertensive crisis. Symptoms include severe occipital headache, palpitations, chest pain, neck
stiffness, and hypertension. NMS (A) is caused by antipsychotics. Serotonin Syndrome (C) is
caused by excess serotonin, not tyramine.
Q4: A patient on clozapine for treatment-resistant schizophrenia requires mandatory blood
monitoring. What is the specific purpose of this monitoring?
A. To monitor for hepatotoxicity
B. To detect Agranulocytosis
C. To monitor lithium levels
D. To check for Stevens-Johnson Syndrome
Correct Answer: B
, 3
Rationale: Clozapine carries a risk of agranulocytosis, a life-threatening drop in white blood
cells. Patients must be enrolled in a REMS program and have their Absolute Neutrophil Count
(ANC) monitored weekly for the first 6 months, then biweekly, and finally monthly. Early
detection is crucial to prevent fatal infections. While hepatotoxicity (A) is also monitored,
agranulocytosis is the primary safety mandate.
Q5: A patient with depression is concerned about the sexual side effects of their current SSRI.
Which medication, classified as an NDRI, is known for having a low risk of sexual dysfunction
and causing weight loss?
A. Mirtazapine
B. Bupropion (Wellbutrin)
C. Venlafaxine (Effexor)
D. Paroxetine (Paxil)
Correct Answer: B
Rationale: Bupropion is a Norepinephrine-Dopamine Reuptake Inhibitor (NDRI). Unlike SSRIs
and SNRIs, it does not impair sexual function and is often associated with weight loss rather than
gain. It is also used for smoking cessation (Zyban). Venlafaxine (C) is an SNRI and carries
sexual side effects. Mirtazapine (A) causes weight gain and sedation.
Q6: A patient develops stiffness, a pill-rolling tremor, and shuffling gait after starting an
antipsychotic. The nurse identifies these as:
A. Acute dystonia
B. Parkinsonism (a type of Extrapyramidal Symptom)
C. Akathisia
D. Tardive dyskinesia
Correct Answer: B
Rationale: Antipsychotic-induced parkinsonism mimics idiopathic Parkinson's disease,
presenting with bradykinesia, rigidity, tremor, and shuffling gait. It is caused by D2 blockade in
the nigrostriatal pathway. Acute dystonia (A) involves sustained muscle spasms (e.g., torticollis).
