WGU D345 NURS 6438 Psychopharmacology Comprehensive
Final OA ACTUAL EXAM 2026/2027 | Objective Assessment
Guide with Questions and Correct Verified Answers
(GUARANTEED PASS)
An older adult client has been taking zolpidem as a sleep aid for the past 2
months. On admission to the assisted living facility, it is determined that
the drug is no longer needed. What guideline should be included in the
nurse's care?
A. The client has a risk of hallucinations when the dosage is adjusted.
B. Sundowning is common with withdrawal from this drug.
C. There is a risk of excessive sedation when the drug is discontinued.
D. The drug needs to be withdrawn gradually - VERIFIED ANSWER - D
It is important for the nurse to understand that zolpidem must be
withdrawn gradually over a 2-week period after prolonged use.
Hallucinations and sundowning are not common with withdrawal of the
drug. Agitation and insomnia would be risks, not sedation.
When compared with benzodiazepines, buspirone stands out as unique
among antianxiety drugs because of what therapeutic advantage?
A. Lacks muscle relaxant and sedative effects.
,B. No risk of psychological dependence.
C. OTC availability.
D. Increases the central nervous system (CNS) depression of alcohol and
other drugs. - VERIFIED ANSWER - A
Buspirone, a newer antianxiety agent, has no sedative, anticonvulsant, or
muscle relaxant properties, and its mechanism of action is unknown.
However, it reduces the signs and symptoms of anxiety without many of
the central nervous system effects and severe adverse effects
associated with other anxiolytic drugs. Most of the antianxiety drugs are
rapidly absorbed from the GI tract, metabolized in the liver, have a
significant drug-drug interaction with alcohol and other drugs, and can
result in psychological dependence. Buspirone is not available over the
counter.
A client presents to the mental health clinic for a regular appointment.
The client tells the nurse he has been taking oral fluoxetine 20 mg daily
for the past 3 weeks and that he has lost 3 lbs during that time due to a
loss of appetite. What action should the nurse take?
A. Reassuring the client that the weight loss is due to diuresis and will
resolve once fluid balance is restored
B. Recommending the use of over-the-counter multivitamin supplements
,C. Encouraging the client to increase fat intake to avoid further weight
loss
D. Reassuring the client that this is a common adverse effect with this
medication - VERIFIED ANSWER - D
Adverse effects of fluoxetine include anorexia and weight loss. This
client's weight loss is modest and would not likely necessitate a change in
drug therapy. Although teaching about healthy eating is a good idea, it is
more important to teach the client how to take the medication in a way
that will reduce adverse effects as well as how to optimize healthy
calories to maintain weight. The client should increase caloric intake, not
just fluid intake. It would not be healthy to recommend exclusively
increasing fat intake. The client should continue the medication to see
whether therapeutic effects are obtained and adjust nutritional intake if
necessary. This weight loss is not solely due to fluid loss. Multivitamins
will not reduce weight loss.
The nurse is providing care for a 72-year-old female client whose
diagnosis of bipolar disorder is treated with lithium. What nursing
responsibility should be prioritized?
A. Monitor the client's fluid balance and sodium intake
B. Educate the client about the signs and symptoms of tardive dyskinesia
C. Teach the client how to safely adjust doses based on symptoms
, D. Monitor the client's blood glucose levels and cognition - VERIFIED
ANSWER - A
Older clients, and especially those with renal impairment, should be
encouraged to maintain adequate hydration and salt intake. Decreased
dosages may also be necessary with the elderly. These drugs alone do not
affect glucose levels, though cognition should be monitored. Lithium
therapy is not associated with tardive dyskinesia. Clients should not
unilaterally adjust their doses.
The nurse has provided health education related to the use of alprazolam
with a 78-year-old client. What statement best suggests that the client
has an accurate understanding of the drug?
A. "As soon as I stop having panic attacks, I can stop taking the drug."
B. "This drug will calm me down at around half an hour after I take it."
C. "I should expect one dose to keep me calm for about 12 hours."
D. "I am taking a slightly increased dose because of my age." - VERIFIED
ANSWER - B
The onset of alprazolam is about 30 minutes. The drug must be tapered
after long-term use, and the duration is approximately 4 to 6 hours.
Elderly clients usually have a reduced dosage.
Final OA ACTUAL EXAM 2026/2027 | Objective Assessment
Guide with Questions and Correct Verified Answers
(GUARANTEED PASS)
An older adult client has been taking zolpidem as a sleep aid for the past 2
months. On admission to the assisted living facility, it is determined that
the drug is no longer needed. What guideline should be included in the
nurse's care?
A. The client has a risk of hallucinations when the dosage is adjusted.
B. Sundowning is common with withdrawal from this drug.
C. There is a risk of excessive sedation when the drug is discontinued.
D. The drug needs to be withdrawn gradually - VERIFIED ANSWER - D
It is important for the nurse to understand that zolpidem must be
withdrawn gradually over a 2-week period after prolonged use.
Hallucinations and sundowning are not common with withdrawal of the
drug. Agitation and insomnia would be risks, not sedation.
When compared with benzodiazepines, buspirone stands out as unique
among antianxiety drugs because of what therapeutic advantage?
A. Lacks muscle relaxant and sedative effects.
,B. No risk of psychological dependence.
C. OTC availability.
D. Increases the central nervous system (CNS) depression of alcohol and
other drugs. - VERIFIED ANSWER - A
Buspirone, a newer antianxiety agent, has no sedative, anticonvulsant, or
muscle relaxant properties, and its mechanism of action is unknown.
However, it reduces the signs and symptoms of anxiety without many of
the central nervous system effects and severe adverse effects
associated with other anxiolytic drugs. Most of the antianxiety drugs are
rapidly absorbed from the GI tract, metabolized in the liver, have a
significant drug-drug interaction with alcohol and other drugs, and can
result in psychological dependence. Buspirone is not available over the
counter.
A client presents to the mental health clinic for a regular appointment.
The client tells the nurse he has been taking oral fluoxetine 20 mg daily
for the past 3 weeks and that he has lost 3 lbs during that time due to a
loss of appetite. What action should the nurse take?
A. Reassuring the client that the weight loss is due to diuresis and will
resolve once fluid balance is restored
B. Recommending the use of over-the-counter multivitamin supplements
,C. Encouraging the client to increase fat intake to avoid further weight
loss
D. Reassuring the client that this is a common adverse effect with this
medication - VERIFIED ANSWER - D
Adverse effects of fluoxetine include anorexia and weight loss. This
client's weight loss is modest and would not likely necessitate a change in
drug therapy. Although teaching about healthy eating is a good idea, it is
more important to teach the client how to take the medication in a way
that will reduce adverse effects as well as how to optimize healthy
calories to maintain weight. The client should increase caloric intake, not
just fluid intake. It would not be healthy to recommend exclusively
increasing fat intake. The client should continue the medication to see
whether therapeutic effects are obtained and adjust nutritional intake if
necessary. This weight loss is not solely due to fluid loss. Multivitamins
will not reduce weight loss.
The nurse is providing care for a 72-year-old female client whose
diagnosis of bipolar disorder is treated with lithium. What nursing
responsibility should be prioritized?
A. Monitor the client's fluid balance and sodium intake
B. Educate the client about the signs and symptoms of tardive dyskinesia
C. Teach the client how to safely adjust doses based on symptoms
, D. Monitor the client's blood glucose levels and cognition - VERIFIED
ANSWER - A
Older clients, and especially those with renal impairment, should be
encouraged to maintain adequate hydration and salt intake. Decreased
dosages may also be necessary with the elderly. These drugs alone do not
affect glucose levels, though cognition should be monitored. Lithium
therapy is not associated with tardive dyskinesia. Clients should not
unilaterally adjust their doses.
The nurse has provided health education related to the use of alprazolam
with a 78-year-old client. What statement best suggests that the client
has an accurate understanding of the drug?
A. "As soon as I stop having panic attacks, I can stop taking the drug."
B. "This drug will calm me down at around half an hour after I take it."
C. "I should expect one dose to keep me calm for about 12 hours."
D. "I am taking a slightly increased dose because of my age." - VERIFIED
ANSWER - B
The onset of alprazolam is about 30 minutes. The drug must be tapered
after long-term use, and the duration is approximately 4 to 6 hours.
Elderly clients usually have a reduced dosage.
