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Psychopharmacology Nursing Worksheet

Total questions: 100

Worksheet time: 50mins

Name
Class
Date
1.

Which statement by a client taking carbidopa-levodopa indicates more teaching is needed?

a)

“I know I need to take this drug once a day.”

b)

“I know I shouldn’t stop taking this drug abruptly.”

c)

“I understand my urine may become dark.”

d)

“It may take weeks to control my symptoms.”

2.

A patient taking anticholinergics for Parkinson’s reports blurred vision. What should the nurse advise?

a)

“This is a life-threatening emergency.”

b)

“Routine eye exams are important.”

c)

“Decrease your fluid intake.”

d)

“Stop the medication immediately.”

3.

Which patient needs more teaching about cyclobenzaprine?

a)

Takes it for muscle spasm after injury for 5 days

b)

Mixes with alcohol for better sleep

c)

Avoids driving due to drowsiness

d)

Takes the med with food

4.

A nurse counsels a patient on SSRIs. Which patient statement means further teaching is needed?

a)

“I should report any suicidal thoughts.”

b)

“It could take weeks for my mood to improve.”

c)

“I should stop taking it if I feel better after three days.”

d)

“Grapefruit juice can increase my risk for toxicity.”

5.

When teaching about lithium, which diet should a nurse recommend?

a)

Low sodium, high fluid intake

b)

High sodium, low potassium

c)

High sodium, high fluid intake

d)

No need for dietary changes

6.

Which client taking an MAOI requires further teaching?

a)

“I can have pizza with pepperoni and aged cheese.”

b)

“I’ll check food labels for soy sauce.”

c)

“I avoid red wine and beer.”

d)

“I will report headache or palpitations.”

7.

The nurse evaluates a client with Alzheimer’s disease on rivastigmine. Which finding shows effectiveness?

a)

Improvement in memory

b)

Decreased blood sugar

c)

Greater muscle strength

d)

Increased appetite

8.

Which complaint by a patient on anticholinergics would concern the nurse most?

a)

Dry mouth

b)

Blurred vision

c)

Trouble urinating

d)

Constipation

9.

Which symptoms require the nurse to seek immediate care for a patient taking an antipsychotic?

a)

Tremor, shuffling gait, masked face

b)

Sudden muscle stiffness, high fever, confusion

c)

Sedation and dry mouth

d)

Headache and blurred vision

10.

Which of the following nursing actions is priority for a client beginning carbidopa-levodopa?

a)

Obtain baseline vital signs

b)

Encourage early morning exercise

c)

Ask about night sweats

d)

Monitor blood sugar

11.

Which is a correct instruction for a patient with muscle spasms prescribed cyclobenzaprine?

a)

“You can stop this medication abruptly.”

b)

“Limit use to three weeks unless told otherwise.”

c)

“Take with alcohol for pain relief.”

d)

“Drive only if you feel alert.”

12.

Which assessment finding would make the nurse question a carbidopa-levodopa order?

a)

Diabetes mellitus

b)

Narrow-angle glaucoma

c)

Mild hypertension

d)

Constipation

13.

Which client statement indicates good understanding of haloperidol side effects?

a)

“I may get drowsy or have a dry mouth.”

b)

“I will not need blood tests after starting medicine.”

c)

“I can drink with this medication.”

d)

“I should ignore any significant weight gain.”

14.

Which side effect of rivastigmine should the nurse report promptly?

a)

Dizziness

b)

Weight loss

c)

Confusion

d)

Severe GI distress

15.

What should a nurse teach about buspirone?

a)

“Relief is immediate after your first dose.”

b)

“Limit grapefruit juice.”

c)

“Dependence is common.”

d)

“It will make you drowsy like a benzodiazepine.”

16.

A client on lorazepam asks about stopping the drug. What’s the nurse’s best response?

a)

“Stop right away if you like.”

b)

“You don’t need to taper down.”

c)

“We will gradually reduce your dose.”

d)

“Take extra before stressful events.”

17.

Which statement about lithium use is correct?

a)

Lithium levels must be monitored regularly.

b)

It’s safe to double a missed dose.

c)

There’s no risk of toxicity.

d)

Diet doesn’t matter

18.

A patient receiving SSRIs asks about side effects. Which statement needs more nurse teaching?

a)

“I could have GI upset and headaches at first.”

b)

“My depression will be cured within days.”

c)

“I’ll let you know if I feel suicidal.”

d)

“Sexual dysfunction is sometimes possible.”

19.

Which would indicate NMS (neuroleptic malignant syndrome)?

a)

Sudden high fever, severe muscle rigidity, and confusion

b)

Gradual mood improvement over several weeks

c)

Mild tremor without autonomic changes

d)

Low blood pressure alone after starting therapy

20.

Patients on anticholinergics should use hard candy for dry mouth and increase fluids and fiber for constipation.

a)

True

b)

False

21.

A patient taking benzodiazepines should avoid:

a)

Alcohol

b)

NSAIDs

c)

Stimulants

d)

Statins

22.

Which intervention is most important for a client with moderate Alzheimer’s disease on rivastigmine?

a)

Teach self-administration of IM injections

b)

Provide a safe home environment

c)

Suggest doubling the dose if memory fades

d)

Taper off the drug abruptly if there is no change

23.

What is the best action if a client experiences sudden onset of severe headache after taking MAOIs?

a)

Give over-the-counter pain medication

b)

Assess for hypertensive crisis and notify provider

c)

Instruct to rest in a dark room

d)

Increase fluid intake

24.

A client on typical antipsychotics develops a tremor. What should the nurse do first?

a)

Document and continue medication

b)

Assess for EPS and notify provider

c)

Suggest using caffeine

d)

Have patient avoid protein at meals

25.

Which drug combination is risky due to serotonin syndrome?

a)

SSRI and anticholinergic

b)

SSRI and MAOI

c)

Carbidopa-levodopa and NSAID

d)

Benzodiazepine and anti-hypertensive

26.

Which finding is most critical for a patient on carbidopa-levodopa?

a)

Dark-colored urine

b)

Agranulocytosis

c)

Nausea

d)

Loss of appetite

27.

What is a priority teaching point for cyclobenzaprine?

a)

Increase activity and take on empty stomach

b)

Do not combine with CNS depressants

c)

Take for chronic spasticity due to MS

d)

Doubledose if pain continues

28.

Which adverse effect requires immediate reporting by a client on antipsychotic therapy?

a)

Sexual dysfunction

b)

Muscle rigidity with fever

c)

Weight gain

d)

Sedation

29.

What lab test is a priority for a patient taking clozapine?

a)

Liver enzymes

b)

White blood cell counts

c)

Potassium level

d)

Coagulation profile

30.

Anticholinergics are safe for patients with narrow-angle glaucoma.

a)

True

b)

False

31.

The nurse is reviewing a medication list and notes a new prescription for a centrally acting muscle relaxant. Which finding is a concern?

a)

Occasional constipation

b)

Current use of alcohol

c)

Diet high in sodium

d)

No prior muscle injuries

32.

Which side effect most likely requires stopping an MAOI?

a)

Mild headache

b)

Edema of the hands

c)

Hypertensive crisis after eating aged cheese

d)

Drowsiness

33.

A patient says, “I feel confused, have muscle twitching, and sweating” after starting sertraline and St. John’s Wort. What is the likely concern?

a)

Beginning withdrawal

b)

Serotonin syndrome

c)

Anticholinergic toxicity

d)

NMS

34.

Which statement indicates effective teaching for a client with Alzheimer’s on rivastigmine?

a)

“The medicine will cure my Alzheimer’s.”

b)

“It may slow down my symptoms.”

c)

“I can double my dose if memory worsens.”

d)

“I can stop abruptly when I feel better.”

35.

What teaching is needed for a patient prescribed lorazepam for sleep?

a)

Alcohol will not interfere with the drug.

b)

Take the drug with a high-protein meal nightly.

c)

Avoid using machinery or driving.

d)

Discontinue abruptly after two days.

36.

Dysphagia is a sign of EPS in patients taking antipsychotic medications.

a)

True

b)

False

37.

A patient’s family member asks why both carbidopa and levodopa are used. The nurse says:

a)

“Carbidopa helps levodopa reach the brain.”

b)

“Carbidopa causes fewer side effects.”

c)

“Levodopa increases dopamine on its own.”

d)

“They work for different symptoms.”

38.

What action should be avoided to minimize EPS in antipsychotic treatment?

a)

Starting with high doses

b)

Gradual dose titration

c)

Monitoring for tremor

d)

Using lowest effective dose

39.

What is the best intervention for a client who reports blurred vision and urinary retention while on anticholinergic therapy?

a)

Increase medication dose

b)

Encourage water intake, consult provider

c)

Abruptly stop the medication

d)

Wait and see if it resolves

40.

True or False: Routine eye exams are recommended in patients on anticholinergics.

a)

True

b)

False

41.

Which food is restricted for a patient on MAOIs?

a)

Fresh fruit

b)

Aged cheese and cured meats

c)

Canned vegetables

d)

White bread

42.

A client taking cyclobenzaprine should be instructed to:

a)

Stop abruptly after one week of use

b)

Avoid CNS depressants including alcohol

c)

Take an extra dose when spasms occur

d)

Skip doses when symptoms improve

43.

In a patient taking antipsychotics, what finding is most concerning?

a)

Headache

b)

Urinary retention

c)

High fever and rigidity

d)

Drowsiness

44.

What is the priority nursing action if a client on lithium reports severe diarrhea and weakness?

a)

Hold next dose and notify provider

b)

Administer antacids

c)

Advise increased salt intake

d)

Suggest over-the-counter loperamide

45.

A patient taking antidepressants is at increased risk for bleeding when also taking:

a)

NSAIDs or aspirin

b)

Statins

c)

Beta blockers

d)

ACE inhibitors

46.

Which symptom is an EPS adverse effect of antipsychotics?

a)

Tardive dyskinesia

b)

Hypertension

c)

Polydipsia

d)

Acne

47.

A client with history of alcohol use is prescribed a muscle relaxant. What should the nurse explain?

a)

These drugs are safe with alcohol.

b)

Combining alcohol and muscle relaxants increases CNS depression.

c)

Drinking alcohol will reduce side effects.

d)

Tolerance prevents overdose.

48.

Which is appropriate teaching for a patient prescribed an SSRI?

a)

Sexual dysfunction is very rare

b)

Effects are not seen for several weeks

c)

Take with aged cheeses for effectiveness

d)

Stop the drug if you develop a headache

49.

Which new symptom in a client on typical antipsychotics calls for immediate action?

a)

Mild dizziness

b)

Yellowing of skin and sclera

c)

Slight drowsiness

d)

Constipation

50.

True or False: Tardive dyskinesia can require discontinuation of the antipsychotic.

a)

True

b)

False

51.

When reviewing a discharge teaching for depression, the nurse knows to emphasize:

a)

Suicidal thoughts must be reported immediately.

b)

Missing several doses is acceptable.

c)

Antidepressants should be stopped when you feel better.

d)

You can take St. John’s Wort for extra effect.

52.

Which patient on benzodiazepines is at greatest risk for respiratory depression?

a)

Young adult with no comorbidities

b)

Client using alcohol with medication

c)

25-year-old on vitamin supplements

d)

Elderly woman only taking benzodiazepines

53.

A patient on lithium must avoid:

a)

Consistent fluid intake

b)

Sudden reductions in sodium

c)

Routine exercise

d)

Eating fresh vegetables

54.

True or False: Anticholinergic therapy may worsen symptoms in clients with urinary retention or GI obstruction.

a)

True

b)

False

55.

Why should MAOI therapy be discontinued before surgery?

a)

Avoid anesthetic allergy

b)

Prevent hypertensive crisis due to food or med interactions

c)

Increase anesthesia depth

d)

Reduce drowsiness

56.

Which scenario best reflects effective nursing teaching about serotonin syndrome?

a)

“I should seek help for confusion and rapid heart rate after starting a new antidepressant.”

b)

“If I develop dry mouth, I can double my dose.”

c)

“Sleepiness means the drugs aren’t working.”

d)

“It’s okay to take SSRIs and St. John’s Wort together.”

57.

Which patient statement indicates risk for tardive dyskinesia while on antipsychotics?

a)

“I just started this medication yesterday.”

b)

“I’ve been on this medication for over a year.”

c)

“I take my antipsychotic only PRN.”

d)

“I take the medication with food.”

58.

When educating about muscle relaxant use, what should be included?

a)

Most appropriate for chronic spasticity

b)

Use only for a short-term, acute muscle spasm

c)

Should be continued even if drowsiness occurs

d)

Always combine with CNS depressants

59.

What is the most critical lab to monitor for a client on clozapine?

a)

Absolute neutrophil count (ANC)

b)

Liver function tests

c)

Serum lithium level

d)

Fasting blood glucose

60.

Which is a correct safety teaching for anticholinergics and dry mouth?

a)

Drink less fluid to reduce saliva

b)

Use hard candy and ice chips

c)

Chew tobacco for moistening

d)

Avoid all oral care

61.

Instruct patients taking lithium to:

a)

Take extra doses for missed doses

b)

Report diarrhea, vomiting, and loss of coordination

c)

Reduce fluid intake on hot days

d)

Avoid exercise

62.

MAOIs interact with many foods and drugs and should not be first-line therapy in most cases.

a)

True

b)

False

63.

Which statement indicates a need for more education about antidepressant therapy?

a)

“I know I have to take medication for several weeks before seeing results.”

b)

“If I stop SSRI abruptly, I won’t have any symptoms.”

c)

“I should avoid taking herbal supplements without talking to my provider.”

d)

“I need to keep my followup appointments even if I feel better.”

64.

Which adverse effect is expected and should be included in teaching with typical antipsychotics?

a)

Orthostatic hypotension and drowsiness

b)

Anaphylaxis and hives

c)

Severe diarrhea

d)

Decreased urination

65.

Which action is inappropriate for a client with muscle spasms on cyclobenzaprine?

a)

Taper off after multiple weeks of use

b)

Drive after first dose

c)

Use with alcohol

d)

Both B and C

66.

What should a client taking buspirone avoid?

a)

Grapefruit juice in large amounts

b)

Caffeinated coffee

c)

Orange juice

d)

Yogurt

67.

Sedation and anticholinergic effects are seen with many antidepressant drugs.

a)

True

b)

False

68.

Which client on an SSRI is at highest risk for suicidal thoughts?

a)

Elder adult

b)

Child or young adult

c)

Pregnant patient

d)

Postpartum female

69.

Which medication should be assessed for in a client on an atypical antipsychotic?

a)

Over-the-counter cold tablets

b)

St. John’s wort

c)

Both A and B

d)

None

70.

For a patient experiencing restlessness and “ants in the pants” after an antipsychotic, what is this?

a)

Tardive dyskinesia

b)

Akathisia

c)

Toxic reaction

d)

Usual side effect

71.

Flumazenil is an antidote for lorazepam overdose.

a)

True

b)

False

72.

Which foods should a client on MAOIs avoid? (Select all that apply)

a)

Bananas

b)

Beer

c)

Aged cheeses

d)

Sausages

73.

Which client is at highest risk for dehydration with lithium therapy?

a)

High fluid intake

b)

Works outside on hot days

c)

No exercise

d)

Low protein diet

74.

What is the priority for a nurse caring for a client on long-acting antipsychotic injections?

a)

Keep injection sites confidential

b)

Educate about regular follow-up and EPS signs

c)

Advise to skip a dose if side effects occur

d)

Stop immediately if symptoms resolve

75.

Which is a priority teaching point for a client on tricyclic antidepressants?

a)

Interacts with alcohol and other CNS depressants

b)

Take double dose for missed dose

c)

Safe in pregnancy

d)

Should never cause drowsiness

76.

Blood pressure fluctuations are a sign of NMS.

a)

True

b)

False

77.

Which scenario describes correct use for centrally acting muscle relaxant?

a)

Elderly patient with chronic spasticity due to MS, on long term

b)

Adult with acute lower back pain after lifting, used for 2 weeks

c)

Athlete uses it every day for muscle fatigue

d)

Child prescribed for muscle cramps after sports

78.

Which teaching is correct for benzodiazepine use?

a)

Combine with alcohol for relaxation

b)

Use as prescribed to minimize dependence risk

c)

Abrupt withdrawal is safe

d)

Drive after first dose

79.

Which action requires the nurse to stop an MAOI and notify the provider?

a)

Client wants to start over-the-counter cold meds

b)

Client develops a hypertensive crisis

c)

Client eats fresh greens

d)

Client checks blood pressure

80.

What should the nurse monitor in a patient on anticholinergic therapy?

a)

Bowel and bladder function

b)

Memory tests only

c)

Muscle strength

d)

Visual acuity only

81.

True or False: Increased risk for falls is a concern for elderly on benzodiazepines.

a)

True

b)

False

82.

Which finding means more teaching for a client starting lithium therapy?

a)

"I'll take it with meals."

b)

"I'll avoid strenuous activity."

c)

"I'll restrict fluids on hot days."

d)

"I'll monitor for tremors or weakness."

83.

A young adult on an SSRI with new onset of suicidal thoughts should:

a)

Ignore the feeling; it will pass

b)

Increase the dose independently

c)

Contact provider immediately

d)

Discontinue medication on their own

84.

Which adverse effect requires discontinuation of an antipsychotic?

a)

Mild tremor after first dose

b)

High fever and muscle rigidity

c)

Headache

d)

Nausea

85.

Which instructions are correct for tricyclic antidepressants?

a)

Take at bedtime to reduce daytime drowsiness

b)

Take on empty stomach

c)

Stop if dry mouth occurs

d)

Use with a high-tyramine diet

86.

A client on an MAOI tells the nurse “I can eat pizza with sausage and cheese, right?” The nurse should:

a)

Agree

b)

Correct and explain risks of tyramine foods

c)

Suggest double servings

d)

Ignore the comment

87.

Which patient statement means more education is needed about SSRI therapy?

a)

"I may feel better slowly over the next month."

b)

"I can stop whenever I want."

c)

"I'll tell you if I feel more depressed."

d)

"Headaches and nausea may happen at first."

88.

True or False: Sedation is a side effect of cyclobenzaprine.

a)

True

b)

False

89.

Tricyclic antidepressants should be used cautiously in clients with:

a)

Seizure disorders

b)

Seasonal allergies

c)

Lactose intolerance

d)

Migraines only

90.

Which scenario reflects a knowledge deficit about muscle relaxant therapy?

a)

"I'll avoid operating heavy machinery."

b)

"I'll drink wine in the evening while on the medication."

c)

"I'll take with meals to lessen GI upset."

d)

"I will taper off gradually if used more than a week."

91.

True or False: Benztropine is a centrally acting anticholinergic for Parkinson’s.

a)

True

b)

False

92.

For a patient diagnosed with severe schizophrenia and prescribed clozapine, what must be monitored frequently?

a)

Blood glucose

b)

Liver function

c)

White blood cell count

d)

Serum potassium

93.

A client starting sertraline should be told to:

a)

Report insomnia lasting more than a few days

b)

Stop the drug if GI upset occurs

c)

Take double dose for missed dose

d)

Ignore feelings of agitation

94.

A client taking anticholinergics for Parkinson’s should:

a)

Increase fiber and fluids to prevent constipation

b)

Avoid sun due to risk of sunburn

c)

Ignore any trouble urinating

d)

Skip eye exams

95.

What is NOT a first-line therapy for severe depression due to adverse effects and food/drug interactions?

a)

SSRI

b)

SNRI

c)

MAOI

d)

Therapy

96.

Which action should the nurse instruct an elderly patient to avoid while on benzodiazepines?

a)

Take medication with meals

b)

Rise slowly to prevent falls

c)

Drink alcohol with the medication

d)

Sleep at least 8 hours per night

97.

What statement by client taking antidepressants indicates understanding?

a)

"I'll call the provider if I feel worse or have thoughts of self-harm."

b)

"I can skip months of medication if I'm busy."

c)

"I may stop suddenly when I feel better."

d)

"There's no risk in combining with herbal remedies."

98.

Which dietary advice is most important for a patient on lithium?

a)

Maintain consistent sodium intake

b)

Increase vitamin C supplements

c)

Avoid dairy products

d)

Eat low carb

99.

A patient has started a new MAOI. Which should the nurse monitor closely?

a)

Blood pressure

b)

Urinalysis

c)

Temperature

d)

Muscle strength

100.

True or False: Muscle relaxants for acute injury should be used short term, not long term.

a)

True

b)

False