NURS 6675 Week 11 Final Exam Actual Questions
and Verified Answers: PMHNP Care Across the
Lifespan II Practicum (Latest 2026/2027) – Walden
University PMHNP Program
SECTION 1: Psychopharmacology & Pharmacokinetics (12 Questions)
Q1: The half-life of lithium is approximately:
A. 12 hours
B. 24 hours [CORRECT]
C. 48 hours
D. 72 hours
Correct Answer: B
Rationale: Lithium has a half-life of approximately 24 hours in most individuals with
normal renal function. This means that steady state is achieved after approximately 5-7
days (5 half-lives). Dosing adjustments must account for this delayed steady state to
avoid toxicity from premature dose increases.
Q2: A patient has been taking lithium 600 mg daily for 3 days. When should the nurse
schedule the first trough blood level?
,A. Immediately (day 3)
B. Day 5-7 [CORRECT]
C. Day 10-14
D. After 1 month
Correct Answer: B
Rationale: Lithium reaches steady state after approximately 5 half-lives (5 × 24 hours =
5 days). Checking a trough level before steady state is achieved will underestimate the
actual therapeutic level, potentially leading to premature dose increases and toxicity.
Day 3 is too early; day 10-14 is unnecessarily delayed.
Q3: Which SSRI has the lowest risk of withdrawal symptoms due to its long half-life?
A. Paroxetine (Paxil)
B. Sertraline (Zoloft)
C. Fluoxetine (Prozac) [CORRECT]
D. Escitalopram (Lexapro)
Correct Answer: C
Rationale: Fluoxetine has a half-life of approximately 2 weeks (and its active metabolite
norfluoxetine persists for 4-16 days), taking about 2.5 months to reach steady state.
This long half-life creates a "self-tapering" effect when discontinued, minimizing
discontinuation syndrome compared to SSRIs with shorter half-lives like paroxetine (21
hours) or sertraline (26 hours).
, Q4: Which antipsychotic would be most appropriate for a patient with known
non-adherence to daily medications?
A. Haloperidol (Haldol)
B. Cariprazine (Vraylar) [CORRECT]
C. Quetiapine (Seroquel)
D. Risperidone (Risperdal)
Correct Answer: B
Rationale: Cariprazine (Vraylar) has a long half-life of 2-4 days (active metabolites
persist up to 3 weeks), providing therapeutic coverage even with missed doses. Other
long half-life options include aripiprazole (Abilify, 3 days), brexpiprazole (Rexulti, 4 days),
and pimozide (Orap, 4-5 days). Short half-life antipsychotics require strict adherence.
Q5: Disulfiram (Antabuse) interacts with alcohol for up to how long after the medication
is stopped?
A. 24 hours
B. 3-4 days
C. 2 weeks [CORRECT]
D. 1 month
Correct Answer: C
Rationale: Disulfiram irreversibly inhibits aldehyde dehydrogenase, and its effects
persist for up to 14 days after discontinuation due to slow enzyme regeneration.
and Verified Answers: PMHNP Care Across the
Lifespan II Practicum (Latest 2026/2027) – Walden
University PMHNP Program
SECTION 1: Psychopharmacology & Pharmacokinetics (12 Questions)
Q1: The half-life of lithium is approximately:
A. 12 hours
B. 24 hours [CORRECT]
C. 48 hours
D. 72 hours
Correct Answer: B
Rationale: Lithium has a half-life of approximately 24 hours in most individuals with
normal renal function. This means that steady state is achieved after approximately 5-7
days (5 half-lives). Dosing adjustments must account for this delayed steady state to
avoid toxicity from premature dose increases.
Q2: A patient has been taking lithium 600 mg daily for 3 days. When should the nurse
schedule the first trough blood level?
,A. Immediately (day 3)
B. Day 5-7 [CORRECT]
C. Day 10-14
D. After 1 month
Correct Answer: B
Rationale: Lithium reaches steady state after approximately 5 half-lives (5 × 24 hours =
5 days). Checking a trough level before steady state is achieved will underestimate the
actual therapeutic level, potentially leading to premature dose increases and toxicity.
Day 3 is too early; day 10-14 is unnecessarily delayed.
Q3: Which SSRI has the lowest risk of withdrawal symptoms due to its long half-life?
A. Paroxetine (Paxil)
B. Sertraline (Zoloft)
C. Fluoxetine (Prozac) [CORRECT]
D. Escitalopram (Lexapro)
Correct Answer: C
Rationale: Fluoxetine has a half-life of approximately 2 weeks (and its active metabolite
norfluoxetine persists for 4-16 days), taking about 2.5 months to reach steady state.
This long half-life creates a "self-tapering" effect when discontinued, minimizing
discontinuation syndrome compared to SSRIs with shorter half-lives like paroxetine (21
hours) or sertraline (26 hours).
, Q4: Which antipsychotic would be most appropriate for a patient with known
non-adherence to daily medications?
A. Haloperidol (Haldol)
B. Cariprazine (Vraylar) [CORRECT]
C. Quetiapine (Seroquel)
D. Risperidone (Risperdal)
Correct Answer: B
Rationale: Cariprazine (Vraylar) has a long half-life of 2-4 days (active metabolites
persist up to 3 weeks), providing therapeutic coverage even with missed doses. Other
long half-life options include aripiprazole (Abilify, 3 days), brexpiprazole (Rexulti, 4 days),
and pimozide (Orap, 4-5 days). Short half-life antipsychotics require strict adherence.
Q5: Disulfiram (Antabuse) interacts with alcohol for up to how long after the medication
is stopped?
A. 24 hours
B. 3-4 days
C. 2 weeks [CORRECT]
D. 1 month
Correct Answer: C
Rationale: Disulfiram irreversibly inhibits aldehyde dehydrogenase, and its effects
persist for up to 14 days after discontinuation due to slow enzyme regeneration.
