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Quizzes > Health & Medicine > Psychology & Mental Health

Take the Psychiatric Nursing Practice Test and Boost Your Skills

Master haloperidol agitation scenarios - start your scored practice quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for a free psychiatric nursing quiz on a coral background

Calling all aspiring and practicing nurses: elevate your psychiatric nursing skills and ace your next exam! Dive into our free psychiatric nursing practice test and tackle realistic, scored scenarios designed to deepen clinical judgment and build confidence. Confront key moments - like when a client is receiving haloperidol for agitation - to sharpen your assessment, safety planning, and intervention strategies. Ready for targeted drills? Access curated psychiatric nursing questions or browse our comprehensive mental health nursing practice questions . Begin now to track your performance, identify knowledge gaps, and master your nursing journey!

What pharmacologic class does haloperidol belong to?
Typical antipsychotic
Atypical antipsychotic
Benzodiazepine
Selective serotonin reuptake inhibitor
Haloperidol is a high-potency first-generation or typical antipsychotic that primarily antagonizes D2 dopamine receptors, distinguishing it from atypicals which also target serotonin. NCBI Reference
Which receptor blockade is primarily responsible for haloperidol's antipsychotic effect?
D2 dopamine receptor
5-HT2A serotonin receptor
GABA-A receptor
NMDA receptor
Haloperidol exerts its antipsychotic action mainly by antagonizing D2 receptors in the mesolimbic pathway, reducing positive symptoms. Serotonin blockade is more characteristic of atypicals. PMC Article
What is the typical onset of action when haloperidol is administered intramuscularly for acute agitation?
20–30 minutes
1–2 hours
5–10 minutes
4–6 hours
IM haloperidol generally begins to reduce agitation in 20–30 minutes, making it useful in emergency settings. Oral forms take longer to act. NCBI Emergency Psych
Which extrapyramidal side effect is most likely with haloperidol?
Acute dystonia
Bradykinesia
Neuroleptic malignant syndrome
Orthostatic hypotension
High-potency typical antipsychotics like haloperidol commonly cause acute dystonic reactions due to potent D2 blockade in the nigrostriatal pathway. UpToDate EPS
Which medication is first-line for managing haloperidol-induced acute dystonia?
Benztropine
Propranolol
Lorazepam
Metoclopramide
Benztropine, an anticholinergic, rapidly reverses acute dystonia by restoring cholinergic–dopaminergic balance in the basal ganglia. NCBI Dystonia Mgmt
In which condition is haloperidol contraindicated?
Parkinson’s disease
Schizophrenia
Acute psychosis
Agitation in delirium
Haloperidol’s strong D2 antagonism exacerbates parkinsonian symptoms; it is contraindicated in Parkinson’s disease. NCBI Parkinson’s
What is the approximate half-life of oral haloperidol?
21 hours
4 hours
72 hours
8 hours
Haloperidol has a mean elimination half-life of about 21 hours, which supports once-daily dosing in many patients. PubChem Data
Under what brand name is haloperidol most commonly marketed?
Haldol
Zyprexa
Risperdal
Seroquel
Haloperidol is marketed under the brand name Haldol and is widely used in its generic form. Drugs.com Haldol
Which cardiac parameter must be monitored due to haloperidol’s risk?
QT interval on ECG
PR interval on ECG
ST segment elevation
T-wave amplitude
Haloperidol can prolong the QT interval, increasing risk of torsades de pointes, so baseline and periodic ECG monitoring is recommended. FDA Safety
Which formulation of haloperidol provides a long-acting depot effect?
Haloperidol decanoate IM
Haloperidol oral solution
Haloperidol IV bolus
Haloperidol sublingual tablet
Haloperidol decanoate is a prodrug administered intramuscularly every 4 weeks to ensure sustained levels in chronic schizophrenia. NCBI Depot
Which adverse effect is LESS common with haloperidol compared to atypical antipsychotics?
Metabolic syndrome
Extrapyramidal symptoms
Acute dystonia
Akathisia
Haloperidol has minimal effects on metabolic parameters, unlike atypicals which commonly cause weight gain and diabetes. Its main risks are EPS. PMC Metabolic Effects
Which serious syndrome can develop with high-dose haloperidol leading to hyperthermia and rigidity?
Neuroleptic malignant syndrome
Serotonin syndrome
Malignant hyperthermia
Serious acute dystonia
Neuroleptic malignant syndrome is a life-threatening reaction to antipsychotics, characterized by rigidity, fever, autonomic instability, and elevated CK. UpToDate NMS
What black box warning does haloperidol carry for elderly patients?
Increased mortality in dementia-related psychosis
Higher risk of liver failure
Severe renal impairment
Elevated stroke risk in young adults
Haloperidol, like other antipsychotics, carries a warning for increased mortality when used in elderly patients with dementia-related psychosis. FDA Warning
Which substance should be avoided or used cautiously with haloperidol due to additive sedation?
Alcohol
Vitamin C
Ibuprofen
Metformin
Alcohol enhances CNS depression when combined with haloperidol, increasing sedation and risk of respiratory depression. NCBI Alcohol Interaction
Which enzyme primarily metabolizes haloperidol in the liver?
CYP3A4
CYP2D6
MAO-A
CYP1A2
Haloperidol is extensively metabolized by CYP3A4 and to a lesser extent by CYP2D6. Inhibitors of CYP3A4 can raise haloperidol levels. NCBI Metabolism
What is an appropriate starting intramuscular dose of haloperidol for acute agitation in adults?
2–5 mg IM
10–20 mg IM
0.5–1 mg IM
30–50 mg IM
The recommended IM dose for acute agitation is 2–5 mg, which may be repeated every 4–8 hours as needed. NCBI Emergency Dosing
Which scale is commonly used to monitor extrapyramidal symptoms in patients on haloperidol?
AIMS (Abnormal Involuntary Movement Scale)
HAM-D (Hamilton Depression Rating Scale)
MMSE (Mini-Mental State Exam)
PANSS (Positive and Negative Syndrome Scale)
The AIMS is a standardized tool for assessing involuntary movements and screening for tardive dyskinesia in antipsychotic-treated patients. NCBI AIMS
In a patient with delirium tremens, why is haloperidol preferred over benzodiazepines for agitation?
Less risk of respiratory depression
Stronger anticonvulsant effect
Better anxiolytic action
Longer half-life
Haloperidol manages severe agitation with minimal respiratory depression risk, making it safer than benzodiazepines in delirium tremens. PMC DT Management
Which electrolyte abnormality can potentiate haloperidol-induced QT prolongation?
Hypokalemia
Hypercalcemia
Hypermagnesemia
Hypophosphatemia
Low potassium levels increase the risk of QT prolongation when taking haloperidol, predisposing to torsades de pointes. NCBI QT
For long-term therapy, how can risk of tardive dyskinesia be minimized when prescribing haloperidol?
Use the lowest effective dose
Combine with lithium
Add high-dose benztropine prophylactically
Switch to haloperidol decanoate
Minimizing dose exposure to the lowest effective dose of haloperidol reduces dopamine receptor supersensitivity and tardive dyskinesia risk. NCBI TD Prevention
Which co-administered drug can significantly increase haloperidol plasma levels by inhibiting CYP3A4?
Ketoconazole
Carbamazepine
Rifampin
Phenobarbital
Ketoconazole is a potent CYP3A4 inhibitor, raising haloperidol levels and risk of adverse effects. NCBI Drug Interactions
What pregnancy risk category is haloperidol assigned by the FDA?
Category C
Category A
Category B
Category D
Haloperidol is FDA pregnancy category C due to animal studies showing adverse fetal effects and lack of well-controlled human studies. NCBI Pregnancy
Which sign differentiates akathisia from anxiety in a patient on haloperidol?
Repetitive rocking and inability to sit still
Rapid speech and worry
Muscle rigidity
Excessive sweating
Akathisia presents as objective restlessness (rocking, pacing), distinct from subjective anxiety which lacks these repetitive movements. UpToDate Akathisia
How does phenytoin affect haloperidol levels when co-administered?
Decreases levels by inducing metabolism
Increases levels by inhibiting metabolism
No effect
Causes unpredictable fluctuations
Phenytoin induces CYP3A4 and CYP2D6, accelerating haloperidol metabolism and reducing its plasma concentration. NCBI Interactions
When switching from oral haloperidol to decanoate, when is the first IM injection typically given?
After one week of oral therapy
Within 24 hours of first oral dose
At the end of the first month
Only if oral fails
Haloperidol decanoate is often started after the patient tolerates oral haloperidol for 1 week, ensuring safety before depot initiation. NCBI Depot Dosing
Which monitoring parameter is essential in hepatic impairment when prescribing haloperidol?
Liver function tests
Renal ultrasound
Serum calcium
Thyroid function
Haloperidol is hepatically metabolized; baseline and periodic LFTs help detect toxicity in liver impairment. NCBI Hepatic
What pathophysiologic mechanism underlies neuroleptic malignant syndrome caused by haloperidol?
Abrupt D2 receptor blockade in nigrostriatal and hypothalamic pathways
Excess serotonin accumulation
Autoimmune antibody formation
Excess GABA inhibition
NMS arises from sudden, profound D2 blockade leading to muscle rigidity, hyperthermia, and autonomic dysfunction. UpToDate NMS Pathophysiology
A patient on haloperidol develops intermittent, repetitive movements of the tongue and lips months into therapy. This is most consistent with:
Tardive dyskinesia
Akathisia
Acute dystonia
Bradykinesia
Tardive dyskinesia typically appears after months of therapy as involuntary choreoathetoid movements of face and tongue. NCBI Tardive Dyskinesia
Which genetic polymorphism most significantly affects haloperidol clearance?
CYP2D6 poor metabolizer status
CYP1A2 ultra-rapid metabolizer
MAO-B gene variant
COMT val158met
CYP2D6 poor metabolizers have slower haloperidol clearance and higher plasma levels, increasing adverse effect risk. PMC Pharmacogenetics
What is the recommended management of neuroleptic malignant syndrome?
Immediate discontinuation of haloperidol and dantrolene administration
Increase haloperidol dose to stabilize dopamine
Switch to an atypical antipsychotic
Add a high-dose SSRI
Treatment involves stopping all antipsychotics, providing supportive care, and using dantrolene or bromocriptine to reverse muscle rigidity and hyperthermia. UpToDate NMS Treatment
Which of the following best explains haloperidol’s low anticholinergic side effects?
Minimal muscarinic receptor affinity
Strong blockade of histamine receptors
High alpha-adrenergic antagonism
Serotonin receptor agonism
Haloperidol lacks significant affinity for muscarinic receptors, causing fewer anticholinergic effects such as dry mouth or urinary retention. NCBI Receptor Profile
How does hypoalbuminemia affect haloperidol pharmacokinetics?
Increases free drug fraction and enhances effects
Reduces total half-life
Causes drug accumulation in fat
Decreases volume of distribution
Low albumin raises the unbound fraction of haloperidol, potentially increasing clinical effects and toxicity. NCBI Protein Binding
In treating acute agitation, combining haloperidol with which medication reduces the risk of akathisia?
Lorazepam
Fluoxetine
Lithium
Valproate
Benzodiazepines like lorazepam can mitigate akathisia and enhance sedation when added to haloperidol for acute agitation. PMC Combined Therapy
Which cardiac condition is an absolute contraindication to IV haloperidol?
Torsades de pointes
Left bundle branch block
Controlled atrial fibrillation
Stable angina
IV haloperidol prolongs QT and can precipitate torsades; it is contraindicated in patients with a history of torsades de pointes. FDA IV Haloperidol
Which factor increases the risk of haloperidol-induced QT prolongation most significantly?
Concurrent hypomagnesemia
Elevated white blood cell count
Hyperglycemia
Hypocalcemia
Hypomagnesemia enhances susceptibility to QT prolongation and torsades when on haloperidol. PMC QT Factors
Which of these is NOT a proposed mechanism of tardive dyskinesia from haloperidol?
Serotonin receptor supersensitivity
Dopamine receptor supersensitivity
Oxidative stress
GABAergic dysfunction
Tardive dyskinesia is linked to dopamine supersensitivity, oxidative stress, and GABA changes; serotonin supersensitivity is not a primary mechanism. NCBI TD Mechanisms
In a patient with renal failure, how should haloperidol dosing be adjusted?
No adjustment is necessary
Halve the dose
Avoid use entirely
Double the interval between doses
Haloperidol is not renally excreted to a significant extent, so no dose adjustment is required in renal failure. NCBI Renal
Which advanced pharmacokinetic property explains haloperidol’s wide tissue distribution?
High lipophilicity
Low protein binding
Rapid renal clearance
Minimal blood–brain barrier penetration
Haloperidol is highly lipophilic, facilitating extensive distribution into fatty tissues and the CNS. DrugBank Data
Compared to high-potency atypical antipsychotics, haloperidol has a higher risk of:
Extrapyramidal symptoms
Metabolic syndrome
Weight gain
Prolonged QT only in IV form
Haloperidol’s potent D2 antagonism confers a notably higher EPS incidence compared to atypicals, which carry greater metabolic risk. PMC Antipsychotic Comparison
Which pharmacogenetic test could guide dosing of haloperidol in a patient with variable response?
CYP2D6 genotyping
HLA-B*1502 screening
VKORC1 polymorphism
CYP1A2 phenotyping
CYP2D6 genotyping identifies poor or ultra-rapid metabolizers of haloperidol, informing dose adjustments. PMC Pharmacogenetics
In refractory neuroleptic malignant syndrome, which adjunctive therapy may be considered?
Electroconvulsive therapy (ECT)
High-dose haloperidol
Continued anticholinergics
Switch to chlorpromazine
ECT can rapidly reverse refractory NMS by resetting central neurotransmitter pathways. PMC ECT in NMS
How does hypoalbuminemia specifically alter haloperidol’s pharmacodynamics?
Increases free fraction leading to intensified effects
Lowers free fraction reducing efficacy
Accelerates clearance
Shifts elimination to renal pathway
Reduced albumin raises the unbound haloperidol fraction, enhancing CNS penetration and side effects. NCBI Pharmacodynamics
When used perioperatively, haloperidol can interact with which anesthetic agent to increase hypotension risk?
Propofol
Ketamine
Succinylcholine
Cisatracurium
Both haloperidol and propofol cause vasodilation; together they potentiate hypotension during anesthesia. PMC Anesthesia Interaction
Which off-label use of haloperidol requires special pediatric dosing considerations?
Acute pediatric delirium
ADHD management
Pediatric depression
Tourette’s vocal tics exclusively
Haloperidol is sometimes used off-label for severe pediatric delirium requiring careful weight-based dosing and monitoring. NCBI Pediatric Use
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Study Outcomes

  1. Apply Haloperidol Dosing Principles -

    Apply evidence-based dosing guidelines for haloperidol to manage acute agitation safely and effectively in a psychiatric nursing practice test scenario.

  2. Analyze Agitation Case Scenarios -

    Analyze a client is receiving haloperidol for agitation situations by interpreting vital signs, behavioral cues, and response timelines.

  3. Differentiate Antipsychotic Side Effects -

    Differentiate common and severe side effects of haloperidol to create targeted nursing interventions and patient education plans.

  4. Interpret Assessment Findings -

    Interpret psychiatric assessment data - such as mental status exams and lab values - to inform decision-making in nursing exam practice questions.

  5. Evaluate Crisis Intervention Strategies -

    Evaluate nonpharmacologic de-escalation techniques alongside pharmacologic options within a psychiatric nursing practice quiz format.

  6. Recall Safety and Documentation Protocols -

    Recall essential safety measures, documentation standards, and rnpedia best practices for administering antipsychotics in clinical settings.

Cheat Sheet

  1. Haloperidol Agitation Dosing Guidelines -

    In a psychiatric nursing practice test scenario, correct dosing for a client receiving haloperidol for agitation usually starts at 2 - 5 mg IM, repeated every 4 - 6 hours up to 20 mg/day per APA guidelines. Use the mnemonic "2-5-20 Rule" to recall starting and maximum doses quickly. Always adjust for age, liver function, and concurrent medications to ensure safety.

  2. Monitoring for Extrapyramidal Symptoms (EPS) -

    Early recognition of EPS - like acute dystonia, akathisia, and pseudoparkinsonism - is vital in any psychiatric nursing practice quiz or nursing exam practice questions. Perform regular assessments using tools such as the Simpson-Angus Scale and intervene promptly with anticholinergics if EPS emerges. For further strategies, explore rnpedia's EPS management guide.

  3. Assessing QT Prolongation Risk -

    Haloperidol can prolong the QT interval, so obtain a baseline ECG and monitor for QTc >450 ms in men or >470 ms in women according to ACC/AHA guidelines. Identify risk factors - like electrolyte imbalances or concurrent QT-prolonging drugs - and correct them before dosing. This proactive step often appears in high-yield psychiatric nursing practice test questions.

  4. Patient Education & Therapeutic Communication -

    Use clear, empathetic language to explain why haloperidol is prescribed and what side effects to expect, boosting adherence and trust in a psychiatric nursing practice quiz setting. Employ de-escalation techniques - open posture, calm voice - and validate feelings to reduce agitation safely. Encouraging questions fosters informed consent and patient engagement.

  5. Documentation & Legal/Ethical Considerations -

    Thorough charting of dose, route, patient response, and any adverse events is essential for legal protection and continuity of care in nursing exam practice questions. Confirm informed consent is documented, especially when administering IM haloperidol for agitation under emergency protocols. Regularly review institutional policies to align with best-practice standards.

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