SSRI Quiz: Can You Catch Serotonin Syndrome?

1. The Hunter Criteria help diagnose serotonin syndrome. Which finding is part of this assessment?

Presence of serotonergic agent plus spontaneous clonus

Only elevated temperature

Absence of other causes

Both a and c

2. Which finding would indicate improvement in a patient with serotonin syndrome?

Continued fever and rigidity

Decreased reflexes and normalized temperature

Increased agitation

Development of seizures

3. In serotonin syndrome, muscle rigidity is primarily due to which mechanism?

Excess acetylcholine

Excess serotonergic activity in spinal cord

Dopamine depletion

GABA inhibition

4. Which CNS manifestation is a hallmark sign of serotonin syndrome?

Sedation and lethargy

Agitation, confusion, and altered mental status

Seizures only

Coma

5. A patient on citalopram is prescribed linezolid (antibiotic with MAOI properties). What should the nurse do?

Administer both drugs as prescribed

Notify provider of potential interaction

Decrease citalopram dose

Switch to doxycycline instead

6. Which vital sign abnormality is most characteristic of moderate-to-severe serotonin syndrome?

Bradycardia

Hypotension

Tachycardia and hypertension

Respiratory depression

7. Mild serotonin syndrome typically resolves within how long after drug discontinuation?

Hours

24-72 hours

1-2 weeks

Several months

8. A patient develops serotonin syndrome. Which medication may be used for symptom management?

Cyproheptadine (serotonin antagonist)

Propranolol

Dantrolene

Lorazepam for agitation only

9. Which herbal supplement can interact with SSRIs and increase serotonin syndrome risk?

Ginger

St. John's Wort

Echinacea

Garlic

10. What is the washout period recommended before switching from fluoxetine to an MAOI?

24 hours

1 week

2-3 weeks

1-2 months or longer

11. Which class of antidepressants works primarily by inhibiting serotonin reuptake?

SSRIs

Tricyclic antidepressants

Monoamine oxidase inhibitors

Atypical antipsychotics

12. A patient taking fluoxetine requires pain management. Which analgesic is CONTRAINDICATED?

Acetaminophen

Tramadol

Ibuprofen

Morphine

13. Which SSRI is most commonly implicated in serotonin syndrome cases?

Fluoxetine

Paroxetine

Sertraline

All SSRIs carry equal risk

14. How soon after starting an SSRI can serotonin syndrome develop?

Only after several months

Within hours to days of initiation or dose increase

Only during drug withdrawal

Never with single-agent SSRI therapy

15. Serotonin syndrome is a medical emergency. What is the primary treatment approach?

Immediate intubation

Supportive care and discontinuation of serotonergic agents

High-dose antibiotics

Immediate dialysis

16. Which drug interaction with SSRIs most commonly precipitates serotonin syndrome?

Tramadol and SSRIs

NSAIDs and SSRIs

Antihistamines and SSRIs

Antacids and SSRIs

17. A patient on sertraline presents with tremor, hyperreflexia, and fever. What is the priority nursing action?

Administer antipyretics immediately

Discontinue SSRI and notify provider

Increase fluid intake

Administer benzodiazepines only

18. Which symptom is NOT typically associated with serotonin syndrome?

Hyperreflexia and clonus

Agitation and confusion

Bradycardia and hypotension

Hyperthermia and muscle rigidity

19. What is the classic triad of serotonin syndrome symptoms?

Tremor, rigidity, hyperthermia

Bradycardia, miosis, hypotension

Tachypnea, cyanosis, stridor

Jaundice, hepatomegaly, ascites

20. Serotonin syndrome occurs due to excess serotonergic activity. Which medication combination carries the highest risk?

SSRI + oral contraceptive

SSRI + MAOI

SSRI + acetaminophen

SSRI + aspirin