1
NCLEX PN Exam Bank Common Psychotropic
Medications and Nursing Implications
Table of Contents
Subtopic 1: Antidepressants – SSRIs, SNRIs, TCAs, MAOIs, and Atypical Agents ................ 2
Subtopic 2: Antipsychotics – Typical and Atypical Agents ................................................. 9
Subtopic 3: Anxiolytics – Benzodiazepines, Buspirone, and Non-Benzodiazepine Agents . 16
Subtopic 4: Mood Stabilizers – Lithium and Anticonvulsants .......................................... 23
Subtopic 5: Antidepressants – Side Effects, Safety, and Patient Teaching (Questions 81–
100) ........................................................................................................................... 30
Subtopic 6: Psychostimulants and Cognitive Enhancers (Questions 101–120) ................. 38
Subtopic 7: Antiparkinsonian Agents and Extrapyramidal Symptom (EPS) Management ... 47
Subtopic 8: Psychotropic Medications in Special Populations (Geriatric, Pediatric,
Pregnancy) ................................................................................................................. 55
Subtopic 9: Psychotropic Medications and Drug Interactions ......................................... 62
Subtopic 10: Adverse Effects, Overdose Management, and Emergency Response in
Psychotropic Use ........................................................................................................ 70
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Subtopic 1: Antidepressants – SSRIs, SNRIs, TCAs,
MAOIs, and Atypical Agents
1. A patient is started on fluoxetine. Which adverse effect should the nurse prioritize when
educating the patient and family about this SSRI?
A. Weight gain
B. Suicidal thoughts in early treatment
C. Urinary retention
D. Orthostatic hypotension
Correct Answer: B
Rationale: SSRIs like fluoxetine may increase the risk of suicidal ideation in children,
adolescents, and young adults, especially during the initial weeks of treatment. Close
monitoring is crucial.
2. What is the primary mechanism of action of selective serotonin reuptake inhibitors
(SSRIs)?
A. Inhibits dopamine reuptake
B. Blocks norepinephrine release
C. Inhibits serotonin reuptake in the synaptic cleft
D. Stimulates GABA receptors
Correct Answer: C
Rationale: SSRIs increase serotonin levels by preventing its reabsorption into the
presynaptic cell, thus enhancing mood and reducing depressive symptoms.
3. A client taking amitriptyline for depression complains of dry mouth and constipation.
These effects are most likely due to:
A. Dopaminergic stimulation
B. Anticholinergic side effects
, 3
C. Excess serotonin
D. Beta-blockade
Correct Answer: B
Rationale: Tricyclic antidepressants (TCAs) like amitriptyline have strong anticholinergic
effects, leading to dry mouth, constipation, blurred vision, and urinary retention.
4. Which food should be avoided by a patient taking phenelzine (a monoamine oxidase
inhibitor)?
A. Eggs
B. Aged cheese
C. Apples
D. Rice
Correct Answer: B
Rationale: MAOIs like phenelzine can interact with tyramine-rich foods (aged cheese,
fermented products), leading to hypertensive crisis.
5. A patient is prescribed sertraline. The nurse should instruct the patient to report which
symptom immediately?
A. Headache
B. Mild nausea
C. Increased agitation or suicidal thoughts
D. Fatigue
Correct Answer: C
Rationale: Emergent symptoms such as suicidal ideation or severe agitation should be
reported immediately during SSRI therapy.
6. A nurse should hold the dose and notify the provider if a patient taking duloxetine
reports:
, 4
A. Dry mouth
B. Hepatic pain or dark urine
C. Insomnia
D. Dizziness
Correct Answer: B
Rationale: Duloxetine is hepatotoxic in rare cases. Signs of liver injury (right upper quadrant
pain, jaundice, dark urine) warrant immediate intervention.
7. Bupropion is contraindicated in patients with:
A. Insomnia
B. Hypertension
C. Seizure disorders
D. Obesity
Correct Answer: C
Rationale: Bupropion lowers the seizure threshold and is contraindicated in individuals
with seizure disorders or eating disorders like bulimia.
8. Which antidepressant class is most likely to cause hypertensive crisis if taken with
tyramine-containing foods?
A. SSRI
B. SNRI
C. MAOI
D. TCA
Correct Answer: C
Rationale: MAOIs inhibit the breakdown of tyramine, a naturally occurring amine,
increasing norepinephrine and leading to hypertensive crisis.
NCLEX PN Exam Bank Common Psychotropic
Medications and Nursing Implications
Table of Contents
Subtopic 1: Antidepressants – SSRIs, SNRIs, TCAs, MAOIs, and Atypical Agents ................ 2
Subtopic 2: Antipsychotics – Typical and Atypical Agents ................................................. 9
Subtopic 3: Anxiolytics – Benzodiazepines, Buspirone, and Non-Benzodiazepine Agents . 16
Subtopic 4: Mood Stabilizers – Lithium and Anticonvulsants .......................................... 23
Subtopic 5: Antidepressants – Side Effects, Safety, and Patient Teaching (Questions 81–
100) ........................................................................................................................... 30
Subtopic 6: Psychostimulants and Cognitive Enhancers (Questions 101–120) ................. 38
Subtopic 7: Antiparkinsonian Agents and Extrapyramidal Symptom (EPS) Management ... 47
Subtopic 8: Psychotropic Medications in Special Populations (Geriatric, Pediatric,
Pregnancy) ................................................................................................................. 55
Subtopic 9: Psychotropic Medications and Drug Interactions ......................................... 62
Subtopic 10: Adverse Effects, Overdose Management, and Emergency Response in
Psychotropic Use ........................................................................................................ 70
, 2
Subtopic 1: Antidepressants – SSRIs, SNRIs, TCAs,
MAOIs, and Atypical Agents
1. A patient is started on fluoxetine. Which adverse effect should the nurse prioritize when
educating the patient and family about this SSRI?
A. Weight gain
B. Suicidal thoughts in early treatment
C. Urinary retention
D. Orthostatic hypotension
Correct Answer: B
Rationale: SSRIs like fluoxetine may increase the risk of suicidal ideation in children,
adolescents, and young adults, especially during the initial weeks of treatment. Close
monitoring is crucial.
2. What is the primary mechanism of action of selective serotonin reuptake inhibitors
(SSRIs)?
A. Inhibits dopamine reuptake
B. Blocks norepinephrine release
C. Inhibits serotonin reuptake in the synaptic cleft
D. Stimulates GABA receptors
Correct Answer: C
Rationale: SSRIs increase serotonin levels by preventing its reabsorption into the
presynaptic cell, thus enhancing mood and reducing depressive symptoms.
3. A client taking amitriptyline for depression complains of dry mouth and constipation.
These effects are most likely due to:
A. Dopaminergic stimulation
B. Anticholinergic side effects
, 3
C. Excess serotonin
D. Beta-blockade
Correct Answer: B
Rationale: Tricyclic antidepressants (TCAs) like amitriptyline have strong anticholinergic
effects, leading to dry mouth, constipation, blurred vision, and urinary retention.
4. Which food should be avoided by a patient taking phenelzine (a monoamine oxidase
inhibitor)?
A. Eggs
B. Aged cheese
C. Apples
D. Rice
Correct Answer: B
Rationale: MAOIs like phenelzine can interact with tyramine-rich foods (aged cheese,
fermented products), leading to hypertensive crisis.
5. A patient is prescribed sertraline. The nurse should instruct the patient to report which
symptom immediately?
A. Headache
B. Mild nausea
C. Increased agitation or suicidal thoughts
D. Fatigue
Correct Answer: C
Rationale: Emergent symptoms such as suicidal ideation or severe agitation should be
reported immediately during SSRI therapy.
6. A nurse should hold the dose and notify the provider if a patient taking duloxetine
reports:
, 4
A. Dry mouth
B. Hepatic pain or dark urine
C. Insomnia
D. Dizziness
Correct Answer: B
Rationale: Duloxetine is hepatotoxic in rare cases. Signs of liver injury (right upper quadrant
pain, jaundice, dark urine) warrant immediate intervention.
7. Bupropion is contraindicated in patients with:
A. Insomnia
B. Hypertension
C. Seizure disorders
D. Obesity
Correct Answer: C
Rationale: Bupropion lowers the seizure threshold and is contraindicated in individuals
with seizure disorders or eating disorders like bulimia.
8. Which antidepressant class is most likely to cause hypertensive crisis if taken with
tyramine-containing foods?
A. SSRI
B. SNRI
C. MAOI
D. TCA
Correct Answer: C
Rationale: MAOIs inhibit the breakdown of tyramine, a naturally occurring amine,
increasing norepinephrine and leading to hypertensive crisis.
