PSYCH MEDS EXAM 3 PHARM

A patient is prescribed sertraline for depression and anxiety symptoms. Which medication class does sertraline belong to? A. Tricyclic antidepressant B. Selective serotonin reuptake inhibitor C. Benzodiazepine D. Mood stabilizer

Correct: B. Selective serotonin reuptake inhibitor. Why: Sertraline is an SSRI used for depression and anxiety-related disorders. Know it cold: Sertraline = SSRI = depression/anxiety + GI upset/sexual dysfunction + serotonin syndrome risk.

A medication increases serotonin availability in the synaptic space by blocking serotonin reuptake. Which drug/class matches this physiologic action? A. Sertraline / SSRI B. Lithium / mood stabilizer C. Haloperidol / antipsychotic D. Diazepam / benzodiazepine

Correct: A. Sertraline / SSRI. Why: SSRIs block serotonin reuptake, increasing serotonin activity. Know it cold: SSRIs block serotonin reuptake → increased serotonin activity.

A medication increases serotonin activity in the CNS and GI tract. Which side effect pattern is most consistent with this mechanism? A. Nausea, diarrhea, headache, and sexual dysfunction B. Bronchodilation, tremors, and palpitations C. Severe dry mouth and urinary retention only D. Cough suppression and respiratory depression

Correct: A. Nausea, diarrhea, headache, and sexual dysfunction. Why: Increased serotonin commonly affects the GI tract and sexual function. Know it cold: More serotonin can cause GI upset and sexual dysfunction.

A patient taking escitalopram reports nausea, mild diarrhea, headache, and decreased sexual desire. What should the nurse recognize? A. Common SSRI side effects B. Lithium toxicity C. Extrapyramidal symptoms D. Theophylline toxicity

Correct: A. Common SSRI side effects. Why: Escitalopram is an SSRI; GI upset, headache, and sexual dysfunction are common. Know it cold: Escitalopram = SSRI = nausea/headache/sexual dysfunction are common.

A patient taking sertraline develops fever, sweating, tremors, diarrhea, agitation, and confusion. Which complication should the nurse suspect? A. Serotonin syndrome B. Lithium toxicity C. Anticholinergic toxicity D. Beta-agonist stimulation

Correct: A. Serotonin syndrome. Why: SSRI use plus fever, sweating, tremor, diarrhea, agitation, and confusion suggests serotonin syndrome. Know it cold: SSRI + fever/sweating/tremor/diarrhea/confusion = serotonin syndrome.

A patient presents with fever, diaphoresis, agitation, tremors, diarrhea, and confusion after starting a new antidepressant. Which medication class is most likely involved? A. SSRI B. Benzodiazepine C. Antitubercular D. Anticholinergic antihistamine

Correct: A. SSRI. Why: The cue cluster points to serotonin syndrome from a serotonergic drug such as an SSRI. Know it cold: Symptoms first: fever + tremor + diarrhea + confusion after antidepressant = SSRI serotonin syndrome.

A patient taking sertraline reports nausea, decreased sexual desire, mild headache, fever, tremors, diarrhea, and new confusion. Which finding is most concerning? A. Nausea B. Decreased sexual desire C. Mild headache D. Fever, tremors, diarrhea, and confusion

Correct: D. Fever, tremors, diarrhea, and confusion. Why: Those findings suggest serotonin syndrome, not routine SSRI side effects. Know it cold: Common SSRI effects are not priority; serotonin syndrome cues are priority.

A patient taking sertraline has fever, sweating, tremors, diarrhea, agitation, and confusion. What should the nurse do first? A. Give the next dose with food B. Hold the medication and notify the provider C. Teach that symptoms are expected during the first week D. Encourage the patient to take St. John’s wort

Correct: B. Hold the medication and notify the provider. Why: These findings suggest serotonin syndrome, requiring prompt action. Know it cold: Suspected serotonin syndrome = hold serotonergic med + notify provider.

Which statement by a patient taking sertraline shows correct understanding? A. “I can stop taking it suddenly once I feel better.” B. “I should report fever, sweating, tremors, diarrhea, or confusion.” C. “I should take St. John’s wort with it to improve mood faster.” D. “This medication has no interaction risks.”

Correct: B. “I should report fever, sweating, tremors, diarrhea, or confusion.”. Why: These are possible serotonin syndrome cues. Know it cold: SSRI teaching: report serotonin syndrome symptoms and avoid unsafe serotonergic combinations.

A patient has been taking sertraline as prescribed for several weeks. Which finding best indicates the medication is effective? A. Improved mood and decreased anxiety B. Shallow respirations C. Muscle rigidity and fever D. Worsening confusion and diarrhea

Correct: A. Improved mood and decreased anxiety. Why: Improvement in depression/anxiety symptoms indicates therapeutic effect. Know it cold: SSRI effectiveness = mood/anxiety improves without serious adverse effects.

A patient is prescribed amitriptyline for depression. Which medication class does amitriptyline belong to? A. SSRI B. Tricyclic antidepressant C. Benzodiazepine D. Atypical antipsychotic

Correct: B. Tricyclic antidepressant. Why: Amitriptyline is a tricyclic antidepressant. Know it cold: Amitriptyline = TCA = depression/neuropathic pain + anticholinergic/sedation/cardiac toxicity risk.

A medication blocks reuptake of norepinephrine and serotonin but also has strong anticholinergic effects. Which drug/class matches this action? A. Amitriptyline / TCA B. Lorazepam / benzodiazepine C. Methylphenidate / stimulant D. Montelukast / leukotriene modifier

Correct: A. Amitriptyline / TCA. Why: TCAs increase norepinephrine/serotonin but commonly block muscarinic receptors. Know it cold: TCAs = ↑NE/serotonin + anticholinergic burden.

A patient taking imipramine has dry mouth, blurred vision, constipation, urinary retention, and drowsiness. What should the nurse recognize? A. Anticholinergic/sedating TCA effects B. Serotonin syndrome C. Lithium toxicity D. Beta-agonist stimulation

Correct: A. Anticholinergic/sedating TCA effects. Why: TCAs commonly cause anticholinergic effects and sedation. Know it cold: Dry mouth + blurred vision + constipation + urinary retention = anticholinergic effects.

A patient taking amitriptyline develops dizziness when standing, palpitations, and an abnormal heart rhythm after taking extra tablets. Which complication is the priority concern? A. Cardiac toxicity B. Bronchospasm C. Tardive dyskinesia only D. Tyramine reaction

Correct: A. Cardiac toxicity. Why: TCAs can cause dangerous cardiac conduction problems, especially in overdose. Know it cold: TCA overdose = cardiac toxicity risk.

A patient has dry mouth, constipation, urinary retention, blurred vision, confusion, and drowsiness after starting a new antidepressant. Which medication is most likely responsible? A. Amitriptyline B. Albuterol C. Montelukast D. Acetylcysteine

Correct: A. Amitriptyline. Why: Amitriptyline is a TCA with strong anticholinergic effects. Know it cold: Symptoms first: anticholinergic cluster = TCA or diphenhydramine pattern.

A patient taking amitriptyline reports dry mouth, constipation, mild drowsiness, chest pain, and feeling faint. Which finding is most concerning? A. Dry mouth B. Constipation C. Mild drowsiness D. Chest pain and feeling faint

Correct: D. Chest pain and feeling faint. Why: Chest pain/faintness may indicate cardiovascular toxicity or severe orthostatic hypotension. Know it cold: TCA danger cues = cardiac symptoms, severe sedation, overdose concerns.

A patient taking amitriptyline is very sedated and reports feeling dizzy when standing. What safety intervention is most important? A. Encourage sudden position changes B. Implement fall precautions and teach slow position changes C. Give extra doses at bedtime D. Restrict all fluids

Correct: B. Implement fall precautions and teach slow position changes. Why: Sedation and orthostatic hypotension increase fall risk. Know it cold: TCA sedation/orthostasis = fall precautions.

Which statement by a patient taking amitriptyline needs more teaching? A. “I may feel drowsy.” B. “I should rise slowly from sitting.” C. “I will report chest pain or fainting.” D. “If I feel very depressed, I can take several extra tablets.”

Correct: D. “If I feel very depressed, I can take several extra tablets.”. Why: Taking extra TCA tablets can cause life-threatening toxicity. Know it cold: TCA overdose is dangerous, especially for cardiac toxicity.

Which finding best shows amitriptyline is effective when prescribed for depression? A. The patient reports improved mood and sleep over time B. The patient has urinary retention C. The patient becomes confused D. The patient develops chest pain

Correct: A. The patient reports improved mood and sleep over time. Why: Improved depressive symptoms show therapeutic effect. Know it cold: TCA effectiveness = depression symptoms improve without toxicity.

A patient is prescribed lorazepam for severe anxiety. Which medication class is lorazepam? A. Benzodiazepine B. SSRI C. TCA D. CNS stimulant

Correct: A. Benzodiazepine. Why: Lorazepam is a benzodiazepine used for anxiety, sedation, seizures, and withdrawal depending on context. Know it cold: Lorazepam/diazepam/clonazepam = benzodiazepines.

A medication enhances the effect of GABA, causing CNS slowing, sedation, and anxiety reduction. Which drug/class matches this action? A. Diazepam / benzodiazepine B. Sertraline / SSRI C. Haloperidol / antipsychotic D. Methylphenidate / stimulant

Correct: A. Diazepam / benzodiazepine. Why: Benzodiazepines enhance GABA activity in the CNS. Know it cold: Benzo MOA = enhance GABA → calm/sedation but respiratory depression risk.

A medication enhances GABA activity in the CNS. Which side effect pattern is most consistent with this mechanism? A. Sedation, dizziness, impaired coordination, and slowed respirations B. Diarrhea, tremor, fever, and sweating C. Dry cough and hypoglycemia D. Bronchodilation and tachycardia

Correct: A. Sedation, dizziness, impaired coordination, and slowed respirations. Why: GABA enhancement slows CNS activity. Know it cold: Benzos can cause sedation, falls, and respiratory depression.

A patient taking clonazepam is sleepy, unsteady when walking, and has slurred speech. What should the nurse recognize? A. Benzodiazepine CNS effects B. SSRI activation C. Antitubercular toxicity D. Leukotriene blockade

Correct: A. Benzodiazepine CNS effects. Why: Clonazepam can cause sedation, impaired coordination, and slurred speech. Know it cold: Benzo common effects = sedation + impaired coordination + fall risk.

A patient taking diazepam is difficult to arouse, has shallow respirations, and an oxygen saturation of 88%. Which complication is the priority concern? A. Respiratory depression B. Serotonin syndrome C. Anticholinergic toxicity D. Hypertensive crisis

Correct: A. Respiratory depression. Why: Benzodiazepines can depress the CNS and respirations, especially with other depressants. Know it cold: Benzo + hard to wake + shallow breathing = respiratory depression priority.

A patient has severe drowsiness, slurred speech, poor coordination, and shallow respirations after taking a medication for anxiety. Which drug is most likely responsible? A. Lorazepam B. Montelukast C. Albuterol D. Fluticasone

Correct: A. Lorazepam. Why: Lorazepam is a benzodiazepine and can cause CNS/respiratory depression. Know it cold: Symptoms first: sedation + shallow breathing after anxiety med = benzo concern.

A patient taking lorazepam reports mild drowsiness, dizziness, difficulty walking, and shallow respirations. Which finding is most concerning? A. Mild drowsiness B. Dizziness C. Difficulty walking D. Shallow respirations

Correct: D. Shallow respirations. Why: Respiratory depression is the priority safety concern. Know it cold: Airway/breathing cues outrank expected sedation.

A patient taking diazepam is difficult to wake and has shallow respirations. What should the nurse do first? A. Assess airway and breathing B. Encourage caffeine C. Give the next dose early D. Teach about diet

Correct: A. Assess airway and breathing. Why: Airway and breathing are the immediate priority. Know it cold: Benzo respiratory depression = assess ABCs first.

Which teaching is most important for a patient prescribed clonazepam? A. Avoid alcohol and other sedatives unless approved B. Take extra doses for faster relief C. Stop suddenly when anxiety improves D. Drive immediately after the first dose

Correct: A. Avoid alcohol and other sedatives unless approved. Why: Combining CNS depressants increases sedation and respiratory depression risk. Know it cold: Benzo teaching = avoid alcohol/opioids/sedatives; fall precautions; do not stop abruptly.

A patient prescribed lorazepam for acute anxiety reports feeling calmer and is less agitated. Which evaluation is most appropriate? A. Medication is producing the intended effect B. Medication caused serotonin syndrome C. Medication failed because sedation is impossible D. Medication caused EPS

Correct: A. Medication is producing the intended effect. Why: Reduced acute anxiety/agitation is an expected therapeutic outcome. Know it cold: Benzo effectiveness = decreased acute anxiety/agitation without oversedation.

A patient with bipolar disorder is prescribed lithium. Which medication category best describes lithium? A. Mood stabilizer B. Benzodiazepine C. SSRI D. Beta-agonist

Correct: A. Mood stabilizer. Why: Lithium is a mood stabilizer used in bipolar disorder. Know it cold: Lithium = mood stabilizer for bipolar disorder, especially mania prevention/control.

A medication used for bipolar disorder affects neuronal signaling and helps stabilize mood over time. Which medication matches this description? A. Lithium B. Albuterol C. Diphenhydramine D. Codeine

Correct: A. Lithium. Why: Lithium stabilizes mood through effects on intracellular signaling and neurotransmission. Know it cold: Lithium MOA is complex; know outcome and toxicity cues cold.

A patient taking lithium has mild thirst, increased urination, and a fine hand tremor. What should the nurse recognize? A. Common lithium effects that still require monitoring B. Serotonin syndrome C. Beta-agonist stimulation D. Opioid toxicity

Correct: A. Common lithium effects that still require monitoring. Why: Fine tremor, thirst, and polyuria can occur with lithium but must be monitored. Know it cold: Lithium common = fine tremor, thirst, polyuria, GI upset; monitor levels/renal function.

A patient taking lithium has vomiting, diarrhea, coarse tremors, confusion, and trouble walking. Which complication should the nurse suspect? A. Lithium toxicity B. Serotonin syndrome C. Anticholinergic toxicity D. EPS

Correct: A. Lithium toxicity. Why: GI symptoms plus coarse tremor, confusion, and ataxia are toxicity cues. Know it cold: Lithium + vomiting/diarrhea + coarse tremor + confusion/ataxia = toxicity.

A patient presents with vomiting, diarrhea, coarse hand tremor, confusion, and ataxia. Which medication is most likely responsible? A. Sertraline B. Lithium C. Albuterol D. Montelukast

Correct: B. Lithium. Why: The symptom pattern is classic for lithium toxicity. Know it cold: Symptoms first: GI distress + coarse tremor + confusion/ataxia = lithium toxicity.

A patient taking lithium reports increased thirst, increased urination, fine tremor, vomiting, diarrhea, and new confusion. Which finding is most concerning? A. Increased thirst B. Increased urination C. Fine tremor D. Vomiting, diarrhea, and new confusion

Correct: D. Vomiting, diarrhea, and new confusion. Why: These are concerning for toxicity and require follow-up. Know it cold: Lithium danger = GI symptoms + neuro changes.

A patient taking lithium develops vomiting, diarrhea, coarse tremor, and confusion. What should the nurse do first? A. Hold lithium and notify the provider B. Give the next dose with food C. Restrict sodium D. Encourage the patient to ignore symptoms

Correct: A. Hold lithium and notify the provider. Why: These are lithium toxicity cues. Know it cold: Suspected lithium toxicity = hold medication, notify provider, anticipate level/renal labs.

Which teaching is correct for a patient taking lithium? A. Keep fluid intake and sodium intake consistent B. Avoid all sodium C. Double the dose if mood worsens D. Ignore vomiting and diarrhea

Correct: A. Keep fluid intake and sodium intake consistent. Why: Fluid/sodium changes can affect lithium levels. Know it cold: Lithium teaching = hydration + consistent sodium + report GI/neuro toxicity cues.

A patient taking lithium has fewer manic episodes, more stable mood, and no signs of toxicity. What does this suggest? A. Lithium is effective B. Lithium is causing serotonin syndrome C. Lithium should be stopped immediately by the patient D. Lithium is causing EPS

Correct: A. Lithium is effective. Why: Mood stabilization without toxicity is the desired outcome. Know it cold: Lithium effectiveness = mood stability/fewer manic episodes without toxicity.

A patient with bipolar disorder is prescribed valproic acid. Which medication category best fits this drug? A. Mood stabilizer/antiepileptic B. SSRI C. Benzodiazepine only D. Beta-agonist

Correct: A. Mood stabilizer/antiepileptic. Why: Valproic acid is used for seizures and mood stabilization. Know it cold: Valproic acid = anticonvulsant mood stabilizer.

A medication increases inhibitory CNS effects and is used for seizures and mood stabilization. Which drug best matches? A. Valproic acid B. Sertraline C. Albuterol D. Diphenhydramine

Correct: A. Valproic acid. Why: Valproic acid has anticonvulsant/mood-stabilizing effects through CNS mechanisms including increased GABA activity. Know it cold: Valproic acid helps stabilize mood/seizures; monitor liver/platelets.

A patient taking valproic acid reports nausea, tremor, weight gain, and drowsiness. What should the nurse recognize? A. Possible valproic acid side effects B. Beta-agonist rescue effect C. Antitubercular teaching success D. MAOI hypertensive crisis

Correct: A. Possible valproic acid side effects. Why: GI upset, tremor, weight gain, and sedation can occur with valproic acid. Know it cold: Valproic acid common = GI upset, tremor, sedation, weight gain.

A patient taking valproic acid develops right upper quadrant abdominal pain, unusual bruising, severe fatigue, and yellowing of the skin. Which complication is the priority concern? A. Hepatotoxicity or blood dyscrasia B. Bronchodilation C. Serotonin syndrome D. EPS

Correct: A. Hepatotoxicity or blood dyscrasia. Why: Valproic acid can affect the liver and platelets. Know it cold: Valproic danger = liver injury signs + unusual bleeding/bruising.

A patient has new jaundice, abdominal pain, severe fatigue, and easy bruising after starting a mood stabilizer. Which medication is most likely involved? A. Valproic acid B. Lorazepam C. Montelukast D. Oxymetazoline

Correct: A. Valproic acid. Why: These cues suggest valproic acid liver/bleeding complications. Know it cold: Symptoms first: jaundice/RUQ pain/bruising on mood stabilizer = valproic acid concern.

A patient taking valproic acid reports mild nausea, weight gain, easy bruising, and yellow skin. Which finding is most concerning? A. Mild nausea B. Weight gain C. Easy bruising and yellow skin D. Mild drowsiness

Correct: C. Easy bruising and yellow skin. Why: These findings suggest possible platelet/liver problems. Know it cold: Valproic acid red flags = jaundice, RUQ pain, severe fatigue, bruising/bleeding.

A patient taking valproic acid develops jaundice and unusual bruising. What should the nurse do first? A. Hold medication and notify the provider B. Give an extra dose C. Tell the patient it is expected D. Encourage alcohol intake

Correct: A. Hold medication and notify the provider. Why: Potential serious liver or bleeding complications require provider notification. Know it cold: Valproic serious cues require follow-up, labs, and provider notification.

Which teaching is most appropriate for a patient taking valproic acid? A. Report yellow skin, severe abdominal pain, or unusual bruising B. Stop suddenly once mood improves C. Avoid all fluids D. Take with alcohol to reduce nausea

Correct: A. Report yellow skin, severe abdominal pain, or unusual bruising. Why: These are serious adverse effect cues. Know it cold: Valproic teaching = report liver injury or bleeding signs.

A patient is prescribed haloperidol for acute psychosis. Which medication class is haloperidol? A. First-generation antipsychotic B. SSRI C. Benzodiazepine D. Leukotriene modifier

Correct: A. First-generation antipsychotic. Why: Haloperidol is a high-potency first-generation antipsychotic. Know it cold: Haloperidol = high-potency typical antipsychotic = EPS risk.

A medication blocks dopamine D2 receptors in the CNS to reduce psychotic symptoms. Which drug/class matches this action? A. Haloperidol / antipsychotic B. Sertraline / SSRI C. Diazepam / benzodiazepine D. Albuterol / beta-agonist

Correct: A. Haloperidol / antipsychotic. Why: Antipsychotics reduce psychotic symptoms largely through dopamine blockade. Know it cold: Antipsychotic MOA = dopamine blockade → psychosis improvement + EPS risk.

A medication blocks dopamine receptors. Which side effect pattern is most consistent with this mechanism? A. Muscle stiffness, tremor, restlessness, and abnormal movements B. Bronchodilation and palpitations C. Increased urination and thirst only D. Cough suppression and respiratory depression

Correct: A. Muscle stiffness, tremor, restlessness, and abnormal movements. Why: Dopamine blockade can cause extrapyramidal symptoms. Know it cold: Dopamine blockade = EPS risk.

A patient taking haloperidol develops acute neck stiffness, muscle spasms, tremors, and restlessness. What should the nurse suspect? A. Extrapyramidal symptoms B. Serotonin syndrome C. Lithium toxicity D. Antitubercular reaction

Correct: A. Extrapyramidal symptoms. Why: Haloperidol can cause EPS such as dystonia, parkinsonism, and akathisia. Know it cold: Haloperidol + stiffness/tremor/restlessness = EPS.

A patient has sudden neck muscle spasms, jaw tightness, and abnormal eye movements after receiving an antipsychotic. Which medication is most likely involved? A. Haloperidol B. Montelukast C. Acetylcysteine D. Fluticasone

Correct: A. Haloperidol. Why: Acute dystonia is associated with dopamine-blocking antipsychotics. Know it cold: Symptoms first: dystonia after antipsychotic = haloperidol/EPS.

A patient taking haloperidol reports mild dry mouth, restlessness, muscle rigidity, fever, and confusion. Which finding is most concerning? A. Mild dry mouth B. Restlessness C. Muscle rigidity, fever, and confusion D. Mild sleepiness

Correct: C. Muscle rigidity, fever, and confusion. Why: This may suggest neuroleptic malignant syndrome, a medical emergency. Know it cold: Antipsychotic + rigidity + fever + mental status change = NMS concern.

A patient taking haloperidol develops severe muscle rigidity, high fever, autonomic instability, and confusion. What should the nurse do first? A. Hold the medication and notify the provider immediately B. Give the next dose early C. Teach that EPS is always harmless D. Encourage tyramine-rich foods

Correct: A. Hold the medication and notify the provider immediately. Why: These cues suggest possible neuroleptic malignant syndrome. Know it cold: NMS cues = emergency: hold antipsychotic + notify provider.

Which teaching is most important for a patient taking risperidone? A. Report muscle stiffness, tremors, uncontrolled movements, fever, or confusion B. Stop the medication suddenly when symptoms improve C. Take aged cheese to prevent side effects D. Expect no movement-related side effects

Correct: A. Report muscle stiffness, tremors, uncontrolled movements, fever, or confusion. Why: Antipsychotics can cause EPS and rare NMS. Know it cold: Antipsychotic teaching = report EPS/NMS cues.

A patient taking risperidone has fewer hallucinations, more organized thoughts, and no severe movement symptoms. Which evaluation is most appropriate? A. The medication is having the intended effect B. The patient has serotonin syndrome C. The patient has lithium toxicity D. The medication is ineffective because sedation is absent

Correct: A. The medication is having the intended effect. Why: Reduced psychotic symptoms indicate effectiveness. Know it cold: Antipsychotic effectiveness = decreased hallucinations/delusions/disorganized thinking.

A patient is prescribed chlorpromazine. Which statement best describes this medication? A. Low-potency first-generation antipsychotic B. SSRI C. Rescue bronchodilator D. MAOI

Correct: A. Low-potency first-generation antipsychotic. Why: Chlorpromazine is a first-generation antipsychotic with more anticholinergic/sedating effects than high-potency agents. Know it cold: Chlorpromazine = typical antipsychotic with sedation/anticholinergic/orthostatic effects.

A patient taking chlorpromazine has sedation, dry mouth, blurred vision, constipation, and dizziness on standing. What should the nurse recognize? A. Common low-potency antipsychotic effects B. Theophylline toxicity C. SSRI serotonin syndrome D. Albuterol rescue effect

Correct: A. Common low-potency antipsychotic effects. Why: Chlorpromazine can cause sedation, anticholinergic effects, and orthostatic hypotension. Know it cold: Chlorpromazine common = sedation + anticholinergic effects + orthostasis.

A patient taking chlorpromazine develops fever, severe muscle rigidity, confusion, and unstable blood pressure. Which complication should the nurse suspect? A. Neuroleptic malignant syndrome B. Lithium toxicity C. Hypertensive crisis from tyramine D. Beta-agonist side effect

Correct: A. Neuroleptic malignant syndrome. Why: Antipsychotic use plus fever, rigidity, autonomic instability, and confusion suggests NMS. Know it cold: Antipsychotic + fever + rigidity + confusion = NMS.

A patient is prescribed phenelzine for depression. Which medication class is phenelzine? A. MAOI B. SSRI C. Benzodiazepine D. TCA

Correct: A. MAOI. Why: Phenelzine is a monoamine oxidase inhibitor. Know it cold: Phenelzine = MAOI = tyramine food interaction risk.

A medication inhibits monoamine oxidase, increasing availability of norepinephrine, serotonin, and dopamine. Which drug/class matches this action? A. Phenelzine / MAOI B. Lithium / mood stabilizer C. Ipratropium / anticholinergic bronchodilator D. Codeine / opioid antitussive

Correct: A. Phenelzine / MAOI. Why: MAOIs inhibit monoamine oxidase, increasing monoamine neurotransmitters. Know it cold: MAOIs increase monoamines but have major food/drug interaction risk.

A patient taking phenelzine eats aged cheese and cured meats, then develops a severe headache, chest pain, and very high blood pressure. What should the nurse suspect? A. Hypertensive crisis B. Lithium toxicity C. EPS D. Respiratory depression

Correct: A. Hypertensive crisis. Why: Tyramine foods with MAOIs can trigger a dangerous BP increase. Know it cold: MAOI + tyramine foods + severe headache/high BP = hypertensive crisis.

A patient has severe headache, palpitations, chest pain, and very high blood pressure after eating aged cheese while taking an antidepressant. Which medication is most likely involved? A. Phenelzine B. Sertraline C. Lorazepam D. Zolpidem

Correct: A. Phenelzine. Why: Phenelzine is an MAOI; tyramine foods can trigger hypertensive crisis. Know it cold: Symptoms first: tyramine food + high BP crisis = MAOI/phenelzine.

Which food choice by a patient taking phenelzine requires follow-up teaching? A. Aged cheese and cured meats B. Fresh fruit C. Plain rice D. Fresh cooked chicken

Correct: A. Aged cheese and cured meats. Why: Tyramine-containing foods must be avoided with MAOIs. Know it cold: MAOI teaching = avoid tyramine foods.

A patient taking phenelzine reports severe headache and chest pain after eating cured meats. What should the nurse do first? A. Assess blood pressure and notify the provider B. Give the next dose C. Tell the patient it is expected D. Encourage more tyramine foods

Correct: A. Assess blood pressure and notify the provider. Why: These symptoms suggest hypertensive crisis. Know it cold: Possible MAOI hypertensive crisis = assess BP + notify provider.

A child is prescribed methylphenidate for ADHD. Which class best describes methylphenidate? A. CNS stimulant B. Benzodiazepine C. Antipsychotic D. TCA

Correct: A. CNS stimulant. Why: Methylphenidate is a CNS stimulant used for ADHD. Know it cold: Methylphenidate = stimulant for ADHD.

A medication increases norepinephrine and dopamine activity in the CNS to improve attention and impulse control. Which medication matches this action? A. Methylphenidate B. Lorazepam C. Lithium D. Diphenhydramine

Correct: A. Methylphenidate. Why: Methylphenidate increases catecholamine activity. Know it cold: Stimulant MOA = ↑dopamine/NE → improved attention but appetite/sleep/HR effects.

A patient taking methylphenidate has decreased appetite, insomnia, nervousness, and increased heart rate. What should the nurse recognize? A. Common stimulant effects B. Benzodiazepine toxicity C. Opioid respiratory depression D. Antitubercular reaction

Correct: A. Common stimulant effects. Why: Stimulants can reduce appetite, cause insomnia, and increase HR/BP. Know it cold: Methylphenidate common = appetite suppression + insomnia + ↑HR/BP.

A child taking methylphenidate has significant weight loss, persistent insomnia, chest pain, and palpitations. Which finding is most concerning? A. Mild appetite decrease B. Mild trouble falling asleep C. Chest pain and palpitations D. Better attention in class

Correct: C. Chest pain and palpitations. Why: Cardiovascular symptoms require prompt follow-up. Know it cold: Stimulant danger cues = chest pain, severe palpitations, major BP/HR changes.

A patient has decreased appetite, insomnia, increased focus, and tachycardia after starting an ADHD medication. Which drug is most likely responsible? A. Methylphenidate B. Zolpidem C. Chlorpromazine D. Valproic acid

Correct: A. Methylphenidate. Why: The cues match a stimulant medication. Know it cold: Symptoms first: ADHD med + appetite loss/insomnia/tachycardia = methylphenidate.

Which teaching is best for a patient taking methylphenidate? A. Take as prescribed and report chest pain, severe palpitations, or major weight loss B. Take it at bedtime to improve sleep C. Double the dose when studying D. Expect no appetite effects

Correct: A. Take as prescribed and report chest pain, severe palpitations, or major weight loss. Why: Stimulants can affect sleep, appetite, HR, and BP. Know it cold: Methylphenidate teaching = monitor appetite/weight/sleep/HR/BP.

A patient is prescribed zolpidem for insomnia. Which description best fits zolpidem? A. Sedative-hypnotic B. SSRI C. Mood stabilizer D. Beta-agonist

Correct: A. Sedative-hypnotic. Why: Zolpidem is used short-term for insomnia. Know it cold: Zolpidem = sleep medication with CNS depression/complex sleep behavior risk.

A medication enhances GABA-related inhibitory effects to promote sleep. Which medication best matches? A. Zolpidem B. Sertraline C. Methylphenidate D. Albuterol

Correct: A. Zolpidem. Why: Zolpidem acts on GABA-related receptors to promote sleep. Know it cold: Zolpidem promotes sleep but can cause next-day impairment and complex sleep behaviors.

A patient taking zolpidem reports sleepwalking, preparing food while not fully awake, and having no memory of the event. What is the priority concern? A. Complex sleep behavior B. Serotonin syndrome C. EPS D. Lithium toxicity

Correct: A. Complex sleep behavior. Why: Zolpidem can cause complex sleep behaviors and safety risk. Know it cold: Zolpidem danger cue = sleep activity with no memory.

A patient has next-day drowsiness, dizziness, and impaired coordination after taking a sleep medication. Which medication is most likely responsible? A. Zolpidem B. Montelukast C. Isoniazid D. Fluticasone

Correct: A. Zolpidem. Why: Zolpidem can cause CNS depression and next-day impairment. Know it cold: Symptoms first: sleep med + next-day impairment = zolpidem.

Which teaching is most important for a patient prescribed zolpidem? A. Take only when able to sleep a full night and avoid alcohol B. Take with alcohol to improve sleep C. Drive immediately after taking it D. Take extra doses if still awake after 10 minutes

Correct: A. Take only when able to sleep a full night and avoid alcohol. Why: Zolpidem causes sedation and impairment; alcohol increases risk. Know it cold: Zolpidem teaching = full night available, avoid alcohol, safety precautions.