Mental Health Medications for NCLEX – Comprehensive
Review Guide
The client with a major depressive disorder taking the selective serotonin reuptake
inhibitor (SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling
confused and restless and having an elevated temperature. Which action should the
psychiatric nurse take?
1. Determine if the client has flulike symptoms
2. Instruct the client to stop taking the SSRI
3. Recommend the client take the medication at night.
4. Explain that these are expected side effects - Answer2. Instruct the client to stop
taking the SSRI
Serotonin syndrome is a serious complication of SSRIs that produces mental changes
(confusion, anxiety, and restlessness), hypertension, tremors, sweating, hyperpyrexia
(elevated temperature), and ataxia. Conservation treatment includes stopping the SSRI
and supportive treatment. If untreated, ESE can lead to death
The client diagnosed with a major depressive disorder asks the nurse, "Why did my
psychiatrist prescribe an SSRI medication rather than one of the other types of anti-
depressants?" Which statement by the nurse would be most appropriate?
1. "Probably it is the medication that your insurance will pay for"
2. "You should ask your psychiatrist why the SSRI was ordered"
3. "SSRIs have fewer side effects than the other classifications"
4. "The SSRI medications work faster than the other medications" - Answer3. "SSRIs
have fewer side effects than the other classifications."
SSRIs have the same efficacy as MAO inhibitors and tricyclics, but SSRIs are safer
because they do not have the sympathomimetic effects (tachycardia and hypertension)
and anticholinergic effects (dry mouth, blurred vision, urinary retention, and
constipation) of the MAO inhibitors and tricyclics.
The client diagnosed with pneumonia is admitted to the medical unit. The nurse notes
the client is taking an antidepressant medication. Which data best indicate the
antidepressant therapy is effective?
1. The client reports a "2" on a 1-10 scale, with 10 being very depressed
2. The client reports not feeling very depressed today
3. The client gets out of bed and completes activities of daily living
4. The client eats 90% of all meals that are served during the shift - Answer1. The
client reports a "2" on a 1-10 scale, with 10 being very depressed
,Depression is subjective and the nurse does not know this client; therefore, asking the
client to rate the depression on a scale best indicates the effectiveness of the
medication. Any subjective data can be put on a scale to make it objective
The client diagnosed with depression is prescribed phenelzine (Nardil), a monoamine
oxidase (MAO) inhibitor. Which statement by the client indicates to the nurse the
medication teaching is effective?
1. "I am taking the herb ginseng to help my attention span"
2. "I drink extra fluids, especially coffee and iced tea"
3. "I am eating three well-balanced meals a day"
4. "At a family cookout I had chicken instead of a hotdog" - Answer4. "At a family
cookout I had chicken instead of a hotdog."
Taking MAOIs requires adherence to strict dietary restrictions concerning tyramine-
containing foods, such as processed meat (hot dogs, bologna, and salami), yeast
products, beer, and red wines. Eating these foods can cause a life-threatening
hypertensive crisis
The client with major depressive disorder is suicidal. The client was prescribed the
tricyclic antidepressant imipramine (Tofranil) 3 weeks ago. Which priority intervention
should the nurse implement?
1. Determine if the client has a plan to commit suicide
2. Assess if the client is sleeping better at night
3. Ask the family if the client still wants to kill himself or herself
4. Observe the client for signs of wanting to commit suicide - Answer1. Determine if
the client has a plan to commit suicide
The nurse should ask if the client has a plan to commit suicide. As the client begins to
recover from both psychological and physical depression, the client's energy level
increases, making the client more prone to commit suicide during this time. It takes 2-6
weeks for therapeutic effects of tricyclic antidepressants to be effective
The client with major depressive disorder has been taking amitriptyline (Elavil), a
tricyclic antidepressant, for more than 1 year. The client tells the psychiatric clinic nurse
that the client wants to quit taking the antidepressant. Which intervention is most
important for the nurse to discuss with the client?
1. Ask questions to determine if the client is still depressed
2. Ask the client why he or she wants to stop taking the medication
3. Tell the client to notify the HCP before stopping medication
4. Explain the importance of tapering off the medication - Answer4. Explain the
importance of tapering off the medication
, The client must first know the importance of needing to taper off the medication
because rebound dysphoria, irritability, or sleepiness may occur if the medication is
discontinued abruptly. Then the client should see the HCP to determine what action
doesn't want to take the medication.
The client with major depressive disorder is prescribed nefazodone (Serzone), an
atypical antidepressant. The client tells the nurse, "I am going to take my medication at
night instead of in the morning." Which statement would be the nurse's best response?
1. "You really should take the medication in the morning for the best results"
2. "It is all right to take the medication at night. It may help you sleep at night"
3. "The medication should be taken with food so you should not take it at night"
4. "Have you discussed taking the medication at night with your psychiatrist?" -
Answer2. "It is all right to take the medication at night. It may help you sleep at night"
Antidepressants may cause central nervous depression, which causes drowsiness.
Therefore, taking the medication at night may help the client sleep at night and relieve
daytime sedation. This is the nurse's best response.
The client admitted to the psychiatric unit for major depressive disorder with an
attempted suicide is prescribed an antidepressant medication. Which interventions
should the psychiatric nurse implement? SELECT ALL THAT APPLY.
1. Assess the client's apical pulse and blood pressure
2. Check the client's serum antidepressant level
3. Monitor the client's liver function status
4. Provide for and ensure the client's safety
5. Evaluate the effectiveness of the medication - Answer1. Assess the client's apical
pulse and blood pressure
3. Monitor the client's liver function status
4. Provide for and ensure the client's safety
Antidepressant medications may cause orthostatic hypotension, and the nurse should
question administering the medication if the blood pressure is less than 90/60.
Many antidepressants may cause hepatotoxicity; therefore, the nurse should monitor
the client's liver function tests.
The nurse should ensure the client's safety. Many antidepressants may cause
orthostatic hypotension and increase the risk for dizziness, falls, and injuries
The client diagnosed with major depression who attempted suicide is being discharged
from the psychiatric facility after a 2-week stay. Which discharge intervention is most
important for the nurse to implement?
1. Provide the family with the phone number to call if the client needs assistance
2. Encourage the client to keep all follow-up appointments with the psychiatric clinic
3. Ensure the client has no more than a 7-day supply of antidepressants
Review Guide
The client with a major depressive disorder taking the selective serotonin reuptake
inhibitor (SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling
confused and restless and having an elevated temperature. Which action should the
psychiatric nurse take?
1. Determine if the client has flulike symptoms
2. Instruct the client to stop taking the SSRI
3. Recommend the client take the medication at night.
4. Explain that these are expected side effects - Answer2. Instruct the client to stop
taking the SSRI
Serotonin syndrome is a serious complication of SSRIs that produces mental changes
(confusion, anxiety, and restlessness), hypertension, tremors, sweating, hyperpyrexia
(elevated temperature), and ataxia. Conservation treatment includes stopping the SSRI
and supportive treatment. If untreated, ESE can lead to death
The client diagnosed with a major depressive disorder asks the nurse, "Why did my
psychiatrist prescribe an SSRI medication rather than one of the other types of anti-
depressants?" Which statement by the nurse would be most appropriate?
1. "Probably it is the medication that your insurance will pay for"
2. "You should ask your psychiatrist why the SSRI was ordered"
3. "SSRIs have fewer side effects than the other classifications"
4. "The SSRI medications work faster than the other medications" - Answer3. "SSRIs
have fewer side effects than the other classifications."
SSRIs have the same efficacy as MAO inhibitors and tricyclics, but SSRIs are safer
because they do not have the sympathomimetic effects (tachycardia and hypertension)
and anticholinergic effects (dry mouth, blurred vision, urinary retention, and
constipation) of the MAO inhibitors and tricyclics.
The client diagnosed with pneumonia is admitted to the medical unit. The nurse notes
the client is taking an antidepressant medication. Which data best indicate the
antidepressant therapy is effective?
1. The client reports a "2" on a 1-10 scale, with 10 being very depressed
2. The client reports not feeling very depressed today
3. The client gets out of bed and completes activities of daily living
4. The client eats 90% of all meals that are served during the shift - Answer1. The
client reports a "2" on a 1-10 scale, with 10 being very depressed
,Depression is subjective and the nurse does not know this client; therefore, asking the
client to rate the depression on a scale best indicates the effectiveness of the
medication. Any subjective data can be put on a scale to make it objective
The client diagnosed with depression is prescribed phenelzine (Nardil), a monoamine
oxidase (MAO) inhibitor. Which statement by the client indicates to the nurse the
medication teaching is effective?
1. "I am taking the herb ginseng to help my attention span"
2. "I drink extra fluids, especially coffee and iced tea"
3. "I am eating three well-balanced meals a day"
4. "At a family cookout I had chicken instead of a hotdog" - Answer4. "At a family
cookout I had chicken instead of a hotdog."
Taking MAOIs requires adherence to strict dietary restrictions concerning tyramine-
containing foods, such as processed meat (hot dogs, bologna, and salami), yeast
products, beer, and red wines. Eating these foods can cause a life-threatening
hypertensive crisis
The client with major depressive disorder is suicidal. The client was prescribed the
tricyclic antidepressant imipramine (Tofranil) 3 weeks ago. Which priority intervention
should the nurse implement?
1. Determine if the client has a plan to commit suicide
2. Assess if the client is sleeping better at night
3. Ask the family if the client still wants to kill himself or herself
4. Observe the client for signs of wanting to commit suicide - Answer1. Determine if
the client has a plan to commit suicide
The nurse should ask if the client has a plan to commit suicide. As the client begins to
recover from both psychological and physical depression, the client's energy level
increases, making the client more prone to commit suicide during this time. It takes 2-6
weeks for therapeutic effects of tricyclic antidepressants to be effective
The client with major depressive disorder has been taking amitriptyline (Elavil), a
tricyclic antidepressant, for more than 1 year. The client tells the psychiatric clinic nurse
that the client wants to quit taking the antidepressant. Which intervention is most
important for the nurse to discuss with the client?
1. Ask questions to determine if the client is still depressed
2. Ask the client why he or she wants to stop taking the medication
3. Tell the client to notify the HCP before stopping medication
4. Explain the importance of tapering off the medication - Answer4. Explain the
importance of tapering off the medication
, The client must first know the importance of needing to taper off the medication
because rebound dysphoria, irritability, or sleepiness may occur if the medication is
discontinued abruptly. Then the client should see the HCP to determine what action
doesn't want to take the medication.
The client with major depressive disorder is prescribed nefazodone (Serzone), an
atypical antidepressant. The client tells the nurse, "I am going to take my medication at
night instead of in the morning." Which statement would be the nurse's best response?
1. "You really should take the medication in the morning for the best results"
2. "It is all right to take the medication at night. It may help you sleep at night"
3. "The medication should be taken with food so you should not take it at night"
4. "Have you discussed taking the medication at night with your psychiatrist?" -
Answer2. "It is all right to take the medication at night. It may help you sleep at night"
Antidepressants may cause central nervous depression, which causes drowsiness.
Therefore, taking the medication at night may help the client sleep at night and relieve
daytime sedation. This is the nurse's best response.
The client admitted to the psychiatric unit for major depressive disorder with an
attempted suicide is prescribed an antidepressant medication. Which interventions
should the psychiatric nurse implement? SELECT ALL THAT APPLY.
1. Assess the client's apical pulse and blood pressure
2. Check the client's serum antidepressant level
3. Monitor the client's liver function status
4. Provide for and ensure the client's safety
5. Evaluate the effectiveness of the medication - Answer1. Assess the client's apical
pulse and blood pressure
3. Monitor the client's liver function status
4. Provide for and ensure the client's safety
Antidepressant medications may cause orthostatic hypotension, and the nurse should
question administering the medication if the blood pressure is less than 90/60.
Many antidepressants may cause hepatotoxicity; therefore, the nurse should monitor
the client's liver function tests.
The nurse should ensure the client's safety. Many antidepressants may cause
orthostatic hypotension and increase the risk for dizziness, falls, and injuries
The client diagnosed with major depression who attempted suicide is being discharged
from the psychiatric facility after a 2-week stay. Which discharge intervention is most
important for the nurse to implement?
1. Provide the family with the phone number to call if the client needs assistance
2. Encourage the client to keep all follow-up appointments with the psychiatric clinic
3. Ensure the client has no more than a 7-day supply of antidepressants
