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NCLEX RN Exam Bank: Psychopharmacology,
Monitoring, Education & Side Effects
Table of Contents
Subtopic 1: Antidepressants—Classes, Effects, and Patient Safety .................................. 2
Subtopic 2: Antipsychotics—EPS, Monitoring, and Nursing Interventions ........................ 10
Subtopic 3: Mood Stabilizers—Lithium, Anticonvulsants, and Electrolyte Balance ........... 19
Subtopic 4: Anxiolytics—Benzodiazepines, Buspirone, and Safety Monitoring ................. 28
Subtopic 5: Mood Stabilizers—Lithium, Anticonvulsants & Serum Level Monitoring ......... 37
Subtopic 6: Antidepressant Classes—SSRIs, SNRIs, MAOIs, TCAs (Mechanisms,
Interactions, Side Effects) ............................................................................................ 45
Subtopic 7: Psychopharmacology in the Elderly and Special Populations (Geriatric,
Pregnancy, Pediatrics) ................................................................................................. 52
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Subtopic 1: Antidepressants—Classes, Effects, and
Patient Safety
Question 1:
A patient newly prescribed sertraline reports increased anxiety and restlessness on day
three of therapy. What is the nurse's best response?
A. Encourage the patient to discontinue the medication
B. Report this immediately as serotonin syndrome
C. Reassure the patient that this may be a temporary side effect
D. Recommend switching to a tricyclic antidepressant
Correct Answer: C
Rationale: SSRIs like sertraline may initially cause increased anxiety or restlessness, which
typically subsides within 1–2 weeks. The nurse should provide reassurance unless
symptoms worsen or become dangerous.
Question 2:
A patient taking amitriptyline complains of dry mouth, constipation, and blurred vision. The
nurse recognizes these symptoms as:
A. Signs of serotonin syndrome
B. Anticholinergic side effects
C. Indications of overdose
D. Signs of depression worsening
Correct Answer: B
Rationale: Tricyclic antidepressants like amitriptyline often cause anticholinergic effects,
including dry mouth, constipation, and blurred vision. Monitoring and supportive care are
essential.
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Question 3:
Which food should be avoided in a patient taking phenelzine?
A. Milk
B. Aged cheese
C. Chicken breast
D. Bananas
Correct Answer: B
Rationale: MAOIs like phenelzine can cause hypertensive crisis when taken with tyramine-
rich foods like aged cheese. Patient education on dietary restrictions is critical.
Question 4:
A patient taking fluoxetine reports experiencing sexual dysfunction. The nurse should
anticipate which possible intervention?
A. Increase the dosage of fluoxetine
B. Discontinue fluoxetine immediately
C. Notify the provider to consider adding or switching to bupropion
D. Recommend ginseng without consulting provider
Correct Answer: C
Rationale: Sexual dysfunction is a common side effect of SSRIs. Bupropion, which has a
lower incidence of sexual side effects, may be used as an adjunct or substitute.
Question 5:
Which of the following is a life-threatening adverse effect of antidepressants that requires
immediate medical attention?
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A. Fatigue
B. Serotonin syndrome
C. Weight gain
D. Mild insomnia
Correct Answer: B
Rationale: Serotonin syndrome is a potentially fatal condition characterized by
hyperreflexia, agitation, and autonomic instability. Immediate intervention is required.
Question 6:
Which of the following should be included in the discharge teaching for a patient
prescribed duloxetine?
A. “Do not stop this medication abruptly.”
B. “You may drink alcohol freely while on this drug.”
C. “You’ll feel better within 24 hours.”
D. “There are no dietary restrictions with this drug.”
Correct Answer: A
Rationale: SNRIs like duloxetine should be tapered slowly to avoid withdrawal symptoms
such as dizziness, irritability, and nausea.
Question 7:
A nurse is monitoring a patient for signs of serotonin syndrome. Which of the following
findings would be most concerning?
A. Sedation and hypotension
B. Clonus and hyperreflexia
C. Constipation and dry skin
NCLEX RN Exam Bank: Psychopharmacology,
Monitoring, Education & Side Effects
Table of Contents
Subtopic 1: Antidepressants—Classes, Effects, and Patient Safety .................................. 2
Subtopic 2: Antipsychotics—EPS, Monitoring, and Nursing Interventions ........................ 10
Subtopic 3: Mood Stabilizers—Lithium, Anticonvulsants, and Electrolyte Balance ........... 19
Subtopic 4: Anxiolytics—Benzodiazepines, Buspirone, and Safety Monitoring ................. 28
Subtopic 5: Mood Stabilizers—Lithium, Anticonvulsants & Serum Level Monitoring ......... 37
Subtopic 6: Antidepressant Classes—SSRIs, SNRIs, MAOIs, TCAs (Mechanisms,
Interactions, Side Effects) ............................................................................................ 45
Subtopic 7: Psychopharmacology in the Elderly and Special Populations (Geriatric,
Pregnancy, Pediatrics) ................................................................................................. 52
, 2
Subtopic 1: Antidepressants—Classes, Effects, and
Patient Safety
Question 1:
A patient newly prescribed sertraline reports increased anxiety and restlessness on day
three of therapy. What is the nurse's best response?
A. Encourage the patient to discontinue the medication
B. Report this immediately as serotonin syndrome
C. Reassure the patient that this may be a temporary side effect
D. Recommend switching to a tricyclic antidepressant
Correct Answer: C
Rationale: SSRIs like sertraline may initially cause increased anxiety or restlessness, which
typically subsides within 1–2 weeks. The nurse should provide reassurance unless
symptoms worsen or become dangerous.
Question 2:
A patient taking amitriptyline complains of dry mouth, constipation, and blurred vision. The
nurse recognizes these symptoms as:
A. Signs of serotonin syndrome
B. Anticholinergic side effects
C. Indications of overdose
D. Signs of depression worsening
Correct Answer: B
Rationale: Tricyclic antidepressants like amitriptyline often cause anticholinergic effects,
including dry mouth, constipation, and blurred vision. Monitoring and supportive care are
essential.
, 3
Question 3:
Which food should be avoided in a patient taking phenelzine?
A. Milk
B. Aged cheese
C. Chicken breast
D. Bananas
Correct Answer: B
Rationale: MAOIs like phenelzine can cause hypertensive crisis when taken with tyramine-
rich foods like aged cheese. Patient education on dietary restrictions is critical.
Question 4:
A patient taking fluoxetine reports experiencing sexual dysfunction. The nurse should
anticipate which possible intervention?
A. Increase the dosage of fluoxetine
B. Discontinue fluoxetine immediately
C. Notify the provider to consider adding or switching to bupropion
D. Recommend ginseng without consulting provider
Correct Answer: C
Rationale: Sexual dysfunction is a common side effect of SSRIs. Bupropion, which has a
lower incidence of sexual side effects, may be used as an adjunct or substitute.
Question 5:
Which of the following is a life-threatening adverse effect of antidepressants that requires
immediate medical attention?
, 4
A. Fatigue
B. Serotonin syndrome
C. Weight gain
D. Mild insomnia
Correct Answer: B
Rationale: Serotonin syndrome is a potentially fatal condition characterized by
hyperreflexia, agitation, and autonomic instability. Immediate intervention is required.
Question 6:
Which of the following should be included in the discharge teaching for a patient
prescribed duloxetine?
A. “Do not stop this medication abruptly.”
B. “You may drink alcohol freely while on this drug.”
C. “You’ll feel better within 24 hours.”
D. “There are no dietary restrictions with this drug.”
Correct Answer: A
Rationale: SNRIs like duloxetine should be tapered slowly to avoid withdrawal symptoms
such as dizziness, irritability, and nausea.
Question 7:
A nurse is monitoring a patient for signs of serotonin syndrome. Which of the following
findings would be most concerning?
A. Sedation and hypotension
B. Clonus and hyperreflexia
C. Constipation and dry skin
