NRNP 6675 FINAL EXAM QS AND ANS
WITH EXPLANATION (LATEST 2026): MOST
COMPREHENSIVE TO PASS THE EXAM,
100% VERIFIED - UPDATED
QUESTION 1
Which pharmacokinetic change most significantly increases the risk of medication
toxicity in older adults?
A. Increased gastric acidity
B. Decreased renal clearance
C. Increased hepatic blood flow
D. Increased protein binding
Correct Answer: B
Rationale:
Renal clearance declines with age due to reduced glomerular filtration rate and renal
blood flow. Many psychotropic medications or their metabolites are excreted renally,
leading to accumulation and toxicity if doses are not adjusted. Creatinine levels may
appear normal despite reduced kidney function, masking risk. Therefore, dose
reduction and careful monitoring are essential in geriatric patients.
QUESTION 2
Which ethical principle supports disclosing potential side effects of antipsychotic
medications to patients?
,A. Beneficence
B. Autonomy
C. Fidelity
D. Justice
Correct Answer: B
Rationale:
Autonomy refers to a patient’s right to make informed decisions about their care.
Providing complete information about risks, benefits, and alternatives allows patients
to consent meaningfully to treatment. Failure to disclose relevant information
undermines informed consent. Respecting autonomy is a foundational principle in
psychiatric and ethical practice.
QUESTION 3
A patient exhibits chronic feelings of emptiness, unstable relationships, fear of
abandonment, and recurrent self-injurious behavior. Which diagnosis is most
consistent?
A. Dependent personality disorder
B. Histrionic personality disorder
C. Borderline personality disorder
D. Avoidant personality disorder
Correct Answer: C
Rationale:
Borderline personality disorder is characterized by emotional instability, intense
interpersonal relationships, fear of abandonment, impulsivity, and self-harm
behaviors. Chronic feelings of emptiness are a hallmark symptom. These individuals
often experience rapid mood shifts and difficulty regulating emotions. Early
recognition is critical for appropriate therapeutic interventions such as dialectical
behavior therapy.
,QUESTION 4
According to Erikson’s psychosocial stages, the primary developmental task of
adolescence is:
A. Industry vs. inferiority
B. Identity vs. role confusion
C. Intimacy vs. isolation
D. Generativity vs. stagnation
Correct Answer: B
Rationale:
During adolescence, individuals work to establish a stable sense of identity, including
values, beliefs, and future goals. Failure to resolve this stage can result in role
confusion and difficulty forming long-term commitments. This stage significantly
influences mental health outcomes and vulnerability to psychiatric disorders. PMHNPs
must consider developmental context when assessing adolescents.
QUESTION 5
Which disorder is most strongly associated with chronic childhood illness and
overprotective caregiving?
A. Avoidant personality disorder
B. Dependent personality disorder
C. Antisocial personality disorder
D. Obsessive-compulsive personality disorder
Correct Answer: B
Rationale:
Dependent personality disorder is linked to experiences that limit autonomy, such as
chronic illness or overprotective parenting. These individuals rely excessively on
others for decision-making and emotional support. They often fear separation and
struggle with independence. Early life experiences significantly shape dependency
patterns in adulthood.
, QUESTION 6
Which medication requires routine monitoring of thyroid and renal function?
A. Valproate
B. Carbamazepine
C. Lithium
D. Lamotrigine
Correct Answer: C
Rationale:
Lithium can impair renal concentrating ability and affect thyroid hormone synthesis,
leading to hypothyroidism. Long-term use increases the risk of chronic kidney disease.
Regular monitoring of serum lithium levels, creatinine, BUN, and TSH is mandatory.
Failure to monitor can result in serious toxicity or organ damage.
QUESTION 7
Which social determinant of health most directly influences medication adherence in
psychiatric patients?
A. Genetics
B. Age
C. Health literacy
D. Neurotransmitter imbalance
Correct Answer: C
Rationale:
Health literacy affects a patient’s ability to understand medication instructions, side
effects, and treatment importance. Low health literacy is associated with poor
adherence, increased hospitalization, and worse outcomes. PMHNPs must tailor
education to the patient’s comprehension level. Addressing health literacy is a
modifiable determinant of health.
WITH EXPLANATION (LATEST 2026): MOST
COMPREHENSIVE TO PASS THE EXAM,
100% VERIFIED - UPDATED
QUESTION 1
Which pharmacokinetic change most significantly increases the risk of medication
toxicity in older adults?
A. Increased gastric acidity
B. Decreased renal clearance
C. Increased hepatic blood flow
D. Increased protein binding
Correct Answer: B
Rationale:
Renal clearance declines with age due to reduced glomerular filtration rate and renal
blood flow. Many psychotropic medications or their metabolites are excreted renally,
leading to accumulation and toxicity if doses are not adjusted. Creatinine levels may
appear normal despite reduced kidney function, masking risk. Therefore, dose
reduction and careful monitoring are essential in geriatric patients.
QUESTION 2
Which ethical principle supports disclosing potential side effects of antipsychotic
medications to patients?
,A. Beneficence
B. Autonomy
C. Fidelity
D. Justice
Correct Answer: B
Rationale:
Autonomy refers to a patient’s right to make informed decisions about their care.
Providing complete information about risks, benefits, and alternatives allows patients
to consent meaningfully to treatment. Failure to disclose relevant information
undermines informed consent. Respecting autonomy is a foundational principle in
psychiatric and ethical practice.
QUESTION 3
A patient exhibits chronic feelings of emptiness, unstable relationships, fear of
abandonment, and recurrent self-injurious behavior. Which diagnosis is most
consistent?
A. Dependent personality disorder
B. Histrionic personality disorder
C. Borderline personality disorder
D. Avoidant personality disorder
Correct Answer: C
Rationale:
Borderline personality disorder is characterized by emotional instability, intense
interpersonal relationships, fear of abandonment, impulsivity, and self-harm
behaviors. Chronic feelings of emptiness are a hallmark symptom. These individuals
often experience rapid mood shifts and difficulty regulating emotions. Early
recognition is critical for appropriate therapeutic interventions such as dialectical
behavior therapy.
,QUESTION 4
According to Erikson’s psychosocial stages, the primary developmental task of
adolescence is:
A. Industry vs. inferiority
B. Identity vs. role confusion
C. Intimacy vs. isolation
D. Generativity vs. stagnation
Correct Answer: B
Rationale:
During adolescence, individuals work to establish a stable sense of identity, including
values, beliefs, and future goals. Failure to resolve this stage can result in role
confusion and difficulty forming long-term commitments. This stage significantly
influences mental health outcomes and vulnerability to psychiatric disorders. PMHNPs
must consider developmental context when assessing adolescents.
QUESTION 5
Which disorder is most strongly associated with chronic childhood illness and
overprotective caregiving?
A. Avoidant personality disorder
B. Dependent personality disorder
C. Antisocial personality disorder
D. Obsessive-compulsive personality disorder
Correct Answer: B
Rationale:
Dependent personality disorder is linked to experiences that limit autonomy, such as
chronic illness or overprotective parenting. These individuals rely excessively on
others for decision-making and emotional support. They often fear separation and
struggle with independence. Early life experiences significantly shape dependency
patterns in adulthood.
, QUESTION 6
Which medication requires routine monitoring of thyroid and renal function?
A. Valproate
B. Carbamazepine
C. Lithium
D. Lamotrigine
Correct Answer: C
Rationale:
Lithium can impair renal concentrating ability and affect thyroid hormone synthesis,
leading to hypothyroidism. Long-term use increases the risk of chronic kidney disease.
Regular monitoring of serum lithium levels, creatinine, BUN, and TSH is mandatory.
Failure to monitor can result in serious toxicity or organ damage.
QUESTION 7
Which social determinant of health most directly influences medication adherence in
psychiatric patients?
A. Genetics
B. Age
C. Health literacy
D. Neurotransmitter imbalance
Correct Answer: C
Rationale:
Health literacy affects a patient’s ability to understand medication instructions, side
effects, and treatment importance. Low health literacy is associated with poor
adherence, increased hospitalization, and worse outcomes. PMHNPs must tailor
education to the patient’s comprehension level. Addressing health literacy is a
modifiable determinant of health.
