NCLEX RN Exam Bank: Neurologic Pharmacology, Anticonvulsants, Psychotropics & Safety Monitoring

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NCLEX RN Exam Bank: Neurologic Pharmacology,
Anticonvulsants & Psychotropics




Table of Contents
Subtopic 1: Anticonvulsants, Mechanisms, Indications & Safety Monitoring ...................... 2
Subtopic 2: Antidepressants, SSRIs, and Serotonin Syndrome, Recognition & Management
(Q21–Q40) .................................................................................................................. 11
Subtopic 3: Antipsychotics, Typical, Atypical, and Extrapyramidal Effects (Q41–Q60)....... 20
Subtopic 4: Mood Stabilizers, Lithium, Valproates & Nursing Considerations (Q61–Q80) .. 30
Subtopic 5: Psychotropic Medications, Side Effects, Black Box Warnings & Nursing Actions
(Q81–Q100) ................................................................................................................ 39
Subtopic 6: Benzodiazepines, Sedative-Hypnotics, and Withdrawal Management ........... 47
Subtopic 7: Lithium Therapy, Monitoring, Toxicity & Nursing Implications (Questions 121–
140) ........................................................................................................................... 56
Subtopic 8: Medication Reconciliation, Black Box Warnings, and Lifespan Considerations
.................................................................................................................................. 63

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Subtopic 1: Anticonvulsants, Mechanisms, Indications &
Safety Monitoring
Question 1

A client newly diagnosed with epilepsy is started on phenytoin. Which statement by the
client indicates a need for further teaching?



A. "I will have regular blood tests to monitor my phenytoin levels."

B. "I can stop taking the medication once my seizures are controlled."

C. "I will notify my provider if I develop a rash or swollen gums."

D. "I will avoid alcohol while on this medication."



Correct Answer: B

Rationale: Anticonvulsants must be taken consistently to prevent seizures. Discontinuing
the drug abruptly can trigger status epilepticus.



Question 2

Which lab value is most important to monitor in a patient taking valproic acid?



A. Serum calcium

B. Liver function tests

C. Creatinine clearance

D. Hemoglobin



Correct Answer: B

Rationale: Valproic acid can cause hepatotoxicity; monitoring liver enzymes (AST, ALT) is
essential.

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Question 3

Carbamazepine is prescribed for a patient with seizures. Which potential adverse effect
should the nurse monitor for?



A. Hypokalemia

B. Agranulocytosis

C. Hypertension

D. Weight loss



Correct Answer: B

Rationale: Carbamazepine may cause bone marrow suppression, including
agranulocytosis. Monitor CBC regularly.



Question 4

A nurse is educating a client on lamotrigine therapy. Which adverse reaction should prompt
immediate medical attention?



A. Dizziness

B. Rash

C. Headache

D. Drowsiness



Correct Answer: B

Rationale: Rash with lamotrigine can progress to Stevens-Johnson syndrome, a potentially
life-threatening condition.

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Question 5

What is the primary mechanism of action of levetiracetam?



A. Enhances GABA activity

B. Blocks sodium channels

C. Modulates synaptic neurotransmitter release

D. Inhibits calcium influx



Correct Answer: C

Rationale: Levetiracetam binds to SV2A, a synaptic vesicle protein, to regulate
neurotransmitter release.



Question 6

Which anticonvulsant is most likely to interfere with the effectiveness of oral
contraceptives?



A. Valproic acid

B. Phenytoin

C. Gabapentin

D. Levetiracetam



Correct Answer: B

Rationale: Phenytoin induces hepatic enzymes, which can reduce the effectiveness of
hormonal contraceptives.



Question 7