Free Psychopharmacology MCQs with Answers

• A. Place the patient in a quiet room and reassess later
• B. Administer prescribed benztropine and assess the airway
• C. Encourage oral fluids and provide a high-fibre meal
• D. Teach the patient that the reaction will resolve without treatment

Explanation: These findings indicate acute dystonia, an extrapyramidal reaction that can involve the laryngeal muscles and obstruct the airway.

• A. Pacing with inability to remain still
• B. Fine hand tremor with muscular rigidity
• C. Repetitive chewing movements and tongue protrusion
• D. Sudden neck spasm with upward eye deviation

Explanation: Tardive dyskinesia causes involuntary, repetitive movements, especially of the mouth, tongue, and face, after prolonged antipsychotic…

• A. Give the next dose with food to reduce stomach upset
• B. Stop the antipsychotic and notify the prescriber urgently
• C. Encourage ambulation to reduce the muscle stiffness
• D. Offer reassurance and place the patient in group therapy

Explanation: The combination of high fever, severe rigidity, altered mental status, and autonomic changes suggests neuroleptic malignant syndrome.

• A. Administer the next sertraline dose with additional water
• B. Withhold serotonergic medicines and notify the prescriber urgently
• C. Encourage exercise to reduce restlessness and improve sleep
• D. Give an over-the-counter cough medicine for symptom relief

Explanation: This presentation is consistent with serotonin syndrome caused by excessive serotonergic activity.

• A. Withhold lithium and contact the prescriber immediately
• B. Give the dose with milk and reassess after one hour
• C. Encourage a low-salt diet to reduce lithium absorption
• D. Tell the patient to take an extra dose after the symptoms stop

Explanation: Severe gastrointestinal symptoms, coarse tremor, and ataxia are warning signs of lithium toxicity.

• A. Leave the patient alone to promote independent coping
• B. Assess the suicide plan and provide immediate safety precautions
• C. Explain that suicidal thoughts are expected until treatment ends
• D. Suggest stopping fluoxetine without discussing it with the prescriber

Explanation: Energy may improve before depressed mood and suicidal thinking improve, increasing the risk of self-harm early in antidepressant…

• A. “I will avoid alcohol while taking this medicine.”
• B. “I will ask before driving or operating machinery.”
• C. “I can stop the medicine suddenly when I feel better.”
• D. “I will report extreme sleepiness or slowed breathing.”

Explanation: Benzodiazepines can cause physical dependence, so sudden discontinuation may produce withdrawal, including anxiety, insomnia, seizures, or…

• A. Naloxone
• B. Flumazenil
• C. Benztropine
• D. Protamine sulfate

Explanation: Flumazenil is a benzodiazepine receptor antagonist used in selected cases of benzodiazepine-induced sedation or respiratory depression.

• A. Weight and appetite
• B. Urine colour and bowel sounds
• C. Serum calcium and skin moisture
• D. Visual acuity and abdominal girth

Explanation: Methylphenidate may reduce appetite and cause weight loss, and it can increase heart rate and blood pressure.

• A. Give the medicine with fruit juice and continue observation
• B. Withhold the medicine and notify the prescriber promptly
• C. Encourage strenuous activity to improve liver circulation
• D. Reassure the patient that these effects indicate therapeutic response

Explanation: Abdominal pain, vomiting, and jaundice may indicate serious hepatotoxicity from valproate.

• A. Serum amylase level
• B. Complete blood count with neutrophil count
• C. Serum calcium level
• D. Urine ketone test

Explanation: Clozapine can cause severe neutropenia or agranulocytosis, so fever and sore throat require an urgent complete blood count with neutrophil…

• A. Severe hypoglycaemia
• B. Weight gain and increased blood glucose
• C. Permanent hearing loss
• D. Marked loss of bowel control

Explanation: Olanzapine may cause weight gain, dyslipidaemia, and hyperglycaemia, so weight, blood glucose, and metabolic health require monitoring.

• A. Mood usually improves after the first dose
• B. Some improvement may take several weeks
• C. The medicine works only after the dose is doubled
• D. Mood improves only when sleep becomes normal

Explanation: Most antidepressants require several weeks before a clear improvement in mood is seen, although some symptoms may change earlier.

• A. Fresh apples
• B. Aged cheese
• C. Boiled rice
• D. Steamed carrots

Explanation: Phenelzine is a monoamine oxidase inhibitor, and aged cheese contains tyramine that can cause a dangerous hypertensive reaction.

• A. White blood cell count
• B. Serum amylase only
• C. Blood group and Rh factor
• D. Urine specific gravity only

Explanation: Carbamazepine can cause bone marrow suppression, so the nurse reviews the complete blood count, including the white blood cell count.

• A. Give the next dose with food
• B. Withhold the medicine and notify the prescriber urgently
• C. Apply moisturising lotion and reassess tomorrow
• D. Encourage extra fluids and continue treatment

Explanation: A blistering rash and mucosal ulcers may indicate Stevens-Johnson syndrome, a life-threatening reaction associated with lamotrigine.

• A. I will use it only when a panic attack begins
• B. I should expect an immediate sedative effect
• C. I should take it regularly because benefit may be delayed
• D. I can stop it as soon as I feel calm for one day

Explanation: Buspirone is taken regularly and its anxiolytic effect develops gradually rather than immediately.

• A. Bowel sounds
• B. Respiratory rate and depth
• C. Daily body weight
• D. Pupil colour

Explanation: Benzodiazepines can depress the central nervous system and cause respiratory depression, especially when given intravenously.

• A. The patient reports fewer auditory hallucinations
• B. The patient gains two kilograms in one week
• C. The patient develops a dry mouth
• D. The patient sleeps after receiving a dose

Explanation: A reduction in auditory hallucinations is a direct therapeutic response in a patient with psychosis.

• A. Immediately after the dose is swallowed
• B. At the peak of the patient's nausea
• C. Just before the next scheduled dose
• D. Only after the patient exercises

Explanation: Routine lithium monitoring commonly uses a trough level collected immediately before the next dose, after the medicine has reached a…