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Psychotropic Medications Exam Questions and Answers, Exams of Nursing

Chamberlain College of NursingNursing

A collection of exam questions and answers related to psychotropic medications. It covers various aspects of psychopharmacology, including the mechanisms of action, side effects, and clinical uses of different classes of psychotropic drugs. The questions are designed to test knowledge of drug interactions, monitoring parameters, and appropriate prescribing practices. This resource is valuable for students and healthcare professionals seeking to enhance their understanding of psychotropic medications and their applications in clinical settings. It includes questions about antidepressants, antipsychotics, mood stabilizers, and other medications used in psychiatry. The document also addresses important considerations such as teratogenic risks, metabolic side effects, and drug interactions.

Typology: Exams

2025/2026

Available from 11/23/2025

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Psychotropic Medications Exam
Collection
1. Which antidepressant is most strongly associated with
hypertensive crisis when taken with tyramine-rich foods?
A. Sertraline
B. Phenelzine
C. Fluoxetine
D. Bupropion
Rationale: MAO inhibitors like phenelzine inhibit monoamine
oxidase, risking tyramine-induced hypertensive crisis.
2. Which medication is first-line for bipolar I disorder mania?
A. Fluoxetine
B. Lithium
C. Sertraline
D. Buspirone
Rationale: Lithium is a first-line mood stabilizer with strong
evidence for acute mania and long-term mood stabilization.
3. Which antipsychotic has the highest risk of extrapyramidal
symptoms (EPS)?
A. Clozapine
B. Olanzapine
C. Haloperidol
D. Quetiapine
Rationale: High-potency first-generation antipsychotics like
haloperidol have a high EPS risk.
4. Which SSRI is associated with the longest elimination half-life and
is less likely to cause withdrawal symptoms?
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Download Psychotropic Medications Exam Questions and Answers and more Exams Nursing in PDF only on Docsity!

Psychotropic Medications Exam

Collection

  1. Which antidepressant is most strongly associated with hypertensive crisis when taken with tyramine-rich foods? A. Sertraline B. Phenelzine C. Fluoxetine D. Bupropion Rationale: MAO inhibitors like phenelzine inhibit monoamine oxidase, risking tyramine-induced hypertensive crisis.
  2. Which medication is first-line for bipolar I disorder mania? A. Fluoxetine B. Lithium C. Sertraline D. Buspirone Rationale: Lithium is a first-line mood stabilizer with strong evidence for acute mania and long-term mood stabilization.
  3. Which antipsychotic has the highest risk of extrapyramidal symptoms (EPS)? A. Clozapine B. Olanzapine C. Haloperidol D. Quetiapine Rationale: High-potency first-generation antipsychotics like haloperidol have a high EPS risk.
  4. Which SSRI is associated with the longest elimination half-life and is less likely to cause withdrawal symptoms?

A. Fluoxetine B. Paroxetine C. Sertraline D. Citalopram Rationale: Fluoxetine’s active metabolite norfluoxetine has a long half-life, reducing discontinuation syndrome risk.

  1. For a patient on lithium, which laboratory should be monitored regularly? A. ALT and AST only B. CBC only C. Serum creatinine and TSH D. Serum potassium Rationale: Lithium is renally excreted and can affect thyroid function, so creatinine and TSH should be monitored.
  2. Which medication is indicated for treatment-resistant schizophrenia and requires regular ANC monitoring? A. Risperidone B. Haloperidol C. Clozapine D. Aripiprazole Rationale: Clozapine treats treatment-resistant schizophrenia but can cause agranulocytosis; ANC monitoring is mandatory.
  3. What is the main mechanism of action of benzodiazepines? A. D2 receptor antagonism B. NMDA receptor blockade C. Potentiation of GABA_A receptor activity D. Serotonin reuptake inhibition Rationale: Benzodiazepines enhance GABA_A receptor-mediated chloride influx, increasing inhibitory neurotransmission.

C. Add lorazepam D. Add lithium Rationale: Bupropion has a low risk of sexual dysfunction and can be used when SSRIs cause sexual side effects.

  1. Which antipsychotic is most associated with metabolic syndrome (weight gain, dyslipidemia)? A. Haloperidol B. Ziprasidone C. Olanzapine D. Aripiprazole Rationale: Olanzapine and clozapine have high metabolic risk, causing weight gain and metabolic disturbances.
  2. Which medication increases the risk of serotonin syndrome when combined with an SSRI? A. Lithium B. Haloperidol C. Tramadol D. Valproate Rationale: Tramadol has serotonergic activity and can precipitate serotonin syndrome when combined with SSRIs.
  3. Which drug is FDA-approved for ADHD in adults with a lower abuse potential due to prodrug formulation? A. Methylphenidate immediate release B. Lisdexamfetamine C. Amphetamine IR D. Atomoxetine Rationale: Lisdexamfetamine is a prodrug converted to dextroamphetamine, which reduces immediate abuse potential compared with IR stimulants.
  1. Which agent is most effective for obsessive-compulsive disorder (OCD)? A. Bupropion B. Buspirone C. Clomipramine D. Mirtazapine Rationale: Clomipramine (a TCA with potent serotonergic activity) and SSRIs are effective for OCD; clomipramine is especially potent.
  2. A patient on lithium presents with coarse tremor, ataxia, and confusion. What is the likely cause? A. Hypothyroidism B. Lithium toxicity C. Serotonin syndrome D. Neuroleptic malignant syndrome Rationale: Neurological symptoms like coarse tremor, ataxia, and confusion are classic for lithium toxicity.
  3. Which antipsychotic is considered the safest regarding prolactin elevation? A. Risperidone B. Paliperidone C. Aripiprazole D. Amisulpride Rationale: Aripiprazole is a partial D2 agonist and often reduces or normalizes prolactin compared with full antagonists.
  4. Which medication is most likely to lower seizure threshold among antidepressants? A. Sertraline B. Escitalopram
  1. Which medication is contraindicated with MAO inhibitors due to hypertensive risk? A. Paroxetine B. Bupropion C. Meperidine D. Sertraline Rationale: Meperidine can precipitate serotonin syndrome and hypertensive crisis with MAOIs and is contraindicated.
  2. Which benzodiazepine is preferred in elderly patients due to shorter half-life and lower accumulation? A. Diazepam B. Chlordiazepoxide C. Lorazepam D. Clonazepam Rationale: Lorazepam has an intermediate half-life and lacks active metabolites, making it preferable in elderly patients.
  3. Which antidepressant is associated with QT prolongation at high doses? A. Sertraline B. Fluoxetine C. Citalopram D. Bupropion Rationale: Citalopram is linked to dose-dependent QT prolongation; dose limits are recommended.
  4. What is the best treatment for acute dystonic reaction from an antipsychotic? A. Benzodiazepine PO B. IV/IM benztropine or diphenhydramine C. Beta-blocker

D. Increase antipsychotic dose Rationale: Anticholinergics like benztropine or antihistamines like diphenhydramine rapidly reverse acute dystonia.

  1. Which antidepressant is a norepinephrine-dopamine reuptake inhibitor (NDRI)? A. Venlafaxine B. Bupropion C. Mirtazapine D. Duloxetine Rationale: Bupropion inhibits norepinephrine and dopamine reuptake (NDRI mechanism).
  2. A patient on antipsychotic develops fever, rigidity, autonomic instability, and elevated CK. Diagnosis? A. Serotonin syndrome B. Malignant hyperthermia C. Neuroleptic malignant syndrome (NMS) D. Acute dystonia Rationale: NMS is associated with antipsychotics and presents with rigidity, fever, autonomic instability, and high CK.
  3. Which medication is most appropriate for generalized anxiety disorder with a non-sedating profile and no dependence risk? A. Alprazolam B. Buspirone C. Diazepam D. Zolpidem Rationale: Buspirone is anxiolytic without sedative or dependence properties, effective for GAD with delayed onset.

C. Bupropion D. Mirtazapine Rationale: Venlafaxine inhibits reuptake of both serotonin and norepinephrine (SNRI).

  1. What is the recommended monitoring before initiating valproate in women of childbearing potential? A. Urine pregnancy test only B. Pregnancy counseling and contraception discussion; baseline LFTs and pregnancy test C. Baseline TSH only D. Baseline CBC only Rationale: Valproate is teratogenic; counsel about risks and ensure pregnancy testing and baseline LFTs before initiation.
  2. Which antipsychotic is associated with the highest risk of QT prolongation? A. Risperidone B. Haloperidol oral C. Ziprasidone D. Aripiprazole Rationale: Ziprasidone has a known risk of QT prolongation and may require ECG monitoring in some cases.
  3. Which pharmacologic action best describes mirtazapine? A. SSRI B. MAOI C. Noradrenergic and specific serotonergic antidepressant (NaSSA): alpha-2 antagonist & 5-HT2/3 antagonism D. NDRI Rationale: Mirtazapine is an alpha-2 antagonist that increases norepinephrine/serotonin and blocks 5-HT2/3 receptors.
  1. Which stimulant is nonstimulant alternative approved for ADHD and works via norepinephrine reuptake inhibition? A. Methylphenidate B. Amphetamine C. Atomoxetine D. Lisdexamfetamine Rationale: Atomoxetine is a selective norepinephrine reuptake inhibitor approved for ADHD without stimulant properties.
  2. Which antipsychotic is most associated with agranulocytosis aside from clozapine? A. Olanzapine B. Risperidone C. Agranulocytosis is primarily a concern with clozapine; others rarely cause it D. Quetiapine Rationale: Clozapine is the primary antipsychotic linked to agranulocytosis; other antipsychotics rarely cause it.
  3. What is the recommended treatment for antipsychotic- induced akathisia? A. Increase antipsychotic dose B. Beta-blocker (e.g., propranolol) or benzodiazepine or anticholinergic C. Antihistamine only D. Start bupropion Rationale: Akathisia responds to beta-blockers, benzodiazepines, or reducing/changing antipsychotic dose.
  4. Which agent is particularly useful for bipolar depression and has a favorable tolerability profile? A. Valproate

D. Clozapine Rationale: Aripiprazole is a D2 partial agonist and can be activating in some patients.

  1. Which medication requires monitoring of therapeutic levels to optimize dosing and avoid toxicity? A. Sertraline B. Lithium C. Fluoxetine D. Buspirone Rationale: Lithium levels correlate with efficacy and toxicity; therapeutic drug monitoring is standard.
  2. Which antidepressant is contraindicated in patients with a history of seizures? A. Sertraline B. Escitalopram C. Bupropion (use caution or avoid in seizure history) D. Mirtazapine Rationale: Bupropion lowers seizure threshold and should be avoided in seizure disorders.
  3. Which opioid analgesic is particularly risky to combine with MAO inhibitors due to serotonin interactions? A. Morphine B. Oxycodone C. Meperidine (pethidine) D. Fentanyl Rationale: Meperidine has serotonergic properties and can precipitate serotonin syndrome with MAOIs.
  4. Which antipsychotic is associated with salivary hypersecretion (sialorrhea)?

A. Risperidone B. Haloperidol C. Clozapine D. Aripiprazole Rationale: Clozapine commonly causes hypersalivation, possibly due to antimuscarinic and adrenergic effects.

  1. Which medication is effective for alcohol craving and is an NMDA antagonist in addition to other actions? A. Naltrexone B. Acamprosate C. Disulfiram D. Topiramate Rationale: Acamprosate modulates glutamatergic (NMDA) systems and is used to maintain abstinence; naltrexone is an opioid antagonist.
  2. Which antipsychotic is least likely to cause weight gain? A. Olanzapine B. Clozapine C. Ziprasidone D. Quetiapine Rationale: Ziprasidone has a lower propensity for weight gain compared with olanzapine or clozapine.
  3. Which agent is FDA-approved for smoking cessation and is a partial nicotinic receptor agonist? A. Nicotine patch B. Bupropion SR C. Varenicline D. Naltrexone

A. Naloxone B. Flumazenil C. Physostigmine D. Activated charcoal only Rationale: Flumazenil is a GABA_A benzodiazepine receptor antagonist used to reverse benzodiazepine effects in specific settings.

  1. Which medication should be avoided with a known prolonged QTc? A. Aripiprazole B. Ziprasidone C. Olanzapine D. Clozapine Rationale: Ziprasidone has QTc prolongation risk and should be avoided in predisposed patients.
  2. Which mood stabilizer is associated with polyuria and polydipsia due to nephrogenic diabetes insipidus? A. Valproate B. Lithium C. Carbamazepine D. Lamotrigine Rationale: Lithium can cause nephrogenic diabetes insipidus leading to polyuria and polydipsia.
  3. Which agent is FDA-approved for postpartum depression? A. Sertraline only B. Fluoxetine only C. Brexanolone (and SSRIs are also used) D. Paroxetine only Rationale: Brexanolone is specifically approved for postpartum

depression; SSRIs are commonly used but not uniquely FDA- approved for that indication.

  1. A patient on an SSRI develops agitation, hyperthermia, autonomic instability, and myoclonus after adding an MAOI. Best immediate action? A. Increase dose of SSRI B. Start bromocriptine C. Discontinue serotonergic agents and provide supportive care for serotonin syndrome D. Give physostigmine Rationale: Serotonin syndrome requires stopping serotonergic agents and supportive treatment; severe cases may need sedation, paralysis, intubation.
  2. Which medication is an NMDA receptor antagonist used in treatment-resistant depression (IV or intranasal forms)? A. ECT only B. Ketamine/esketamine C. Lithium D. Trazodone Rationale: Ketamine and esketamine are NMDA antagonists with rapid antidepressant effects for treatment-resistant depression.
  3. Which antiepileptic used as a mood stabilizer is associated with weight loss and cognitive side effects like word-finding difficulty? A. Valproate B. Topiramate C. Carbamazepine D. Lamotrigine
  1. What is the mechanism of action of lithium in mood stabilization? A. Selective serotonin reuptake inhibition B. D2 receptor antagonism C. Multiple effects: modulates second messenger systems (e.g., inhibition of inositol monophosphatase, GSK-3), neuroprotective actions D. NMDA receptor antagonism Rationale: Lithium’s mood-stabilizing effects are thought to involve multiple intracellular signaling pathways rather than a single receptor mechanism.
  2. Which antidepressant is associated with weight loss rather than weight gain? A. Mirtazapine B. Bupropion C. Amitriptyline D. Paroxetine Rationale: Bupropion is often weight-neutral or associated with weight loss, unlike mirtazapine or TCAs that cause weight gain.
  3. Which antipsychotic requires lipid and glucose monitoring because of metabolic effects and also may improve negative symptoms? A. Haloperidol B. Fluphenazine C. Clozapine D. Perphenazine Rationale: Clozapine can improve negative symptoms but requires metabolic monitoring due to weight gain and dyslipidemia risk.
  1. Which medication used for insomnia is a non- benzodiazepine hypnotic acting on GABA_A receptor subtypes? A. Diazepam B. Zolpidem (benzodiazepine chemically) C. Zolpidem (a "Z-drug" acting at GABA_A benzodiazepine binding sites) D. Buspirone Rationale: Zolpidem is a non-benzodiazepine hypnotic ("Z-drug") that acts on GABA_A receptor complexes to promote sleep.
  2. Which medication for bipolar disorder is linked to aplastic anemia and requires blood monitoring? A. Valproate B. Carbamazepine C. Lithium D. Lamotrigine Rationale: Carbamazepine can cause aplastic anemia and agranulocytosis; CBC monitoring is recommended.
  3. Which antidepressant has anticholinergic and antihistaminic properties and is sometimes used for pain syndromes at low doses? A. Sertraline B. Amitriptyline C. Fluoxetine D. Escitalopram Rationale: TCAs like amitriptyline have anticholinergic and antihistaminic effects and are used off-label for neuropathic pain and insomnia.
  4. Which antipsychotic is associated with the highest risk of myocarditis, especially in the first months of treatment?