NR-607 FINAL EXAM REVIEWER FINAL EXAM QUESTIONS AND
CORRECT ANSWERS RATED 100% | 350 QUESTIONS | GRADED A+
NR-607 Diagnosis & Management in Psychiatric Mental Health III Final Examination | Core Domains: Advanced Psychiatric
Assessment, DSM-5-TR Diagnostic Criteria, Psychopharmacology (Antidepressants, Antipsychotics, Mood Stabilizers,
Anxiolytics), Psychiatric Emergencies (Suicide Risk Assessment, NMS, Serotonin Syndrome, Lithium Toxicity), Legal &
Ethical Issues (Voluntary/Involuntary Admission, Seclusion/Restraints, Capacity Evaluation, Informed Consent), Somatic
Symptom Disorders, Personality Disorders (Cluster B, C), Trauma-Related Disorders, Substance Use Disorders, Cultural
Competence in Mental Health, and Evidence-Based Treatment Planning | Chamberlain University PMHNP Focus | Exam-
Aligned Format
Exam Structure
The NR-607 Final Examination is a comprehensive assessment consisting of:
• 350 multiple-choice and case-based questions with verified answers and detailed rationales
• Clinical reasoning and diagnostic scenarios
• Psychopharmacologic management questions
• DSM-5-TR diagnostic criteria application
• Legal and ethical decision-making
• Suicide risk assessment and safety planning
• Psychiatric emergency identification and intervention
• Cultural competence and structural competency
Introduction
This NR-607 Final Exam Reviewer for the 2026/2027 academic cycle reflects the official Chamberlain University Psychiatric
Mental Health Nurse Practitioner (PMHNP) curriculum requirements. The final examination evaluates comprehensive
understanding of advanced psychiatric assessment, psychopharmacology, diagnostic reasoning, legal and ethical principles,
and evidence-based treatment strategies essential for PMHNP certification and clinical practice.
Answer Format
All correct answers must be presented in bold and green, followed by clearly defined, clinically focused rationales that
reinforce DSM-5-TR diagnostic criteria, evidence-based psychopharmacology, legal-ethical principles, and safe psychiatric-
mental health nursing practice.
1. A 45-year-old patient presents with symptoms of Neuroleptic Malignant Syndrome (NMS). Which of the
following is the priority intervention for this patient?
A. Administer a second-generation antipsychotic
B. Discontinue the offending agent and initiate cooling measures
C. Increase the dose of the current medication
D. Administer a high-dose SSRI
Rationale: NMS is a psychiatric emergency characterized by "lead-pipe" muscle rigidity, hyperthermia, and autonomic
instability. The first step is to stop the dopamine antagonist and provide supportive care, including cooling and hydration
(American Psychiatric Association [APA], 2022).
2. A patient being treated with Clozapine (Clozaril) presents for a routine follow-up. Which laboratory
value is the most critical for the PMHNP to monitor to prevent life-threatening complications?
A. Serum Potassium
B. Absolute Neutrophil Count (ANC)
C. Hemoglobin A1C
D. Liver Function Tests (LFTs)
Rationale: Clozapine carries a black box warning for severe neutropenia (agranulocytosis). Monitoring the ANC is
mandatory per the Clozapine REMS program to ensure the patient's immune system is not compromised (Stahl, 2021).
3. A patient with Bipolar I Disorder is taking Lithium Carbonate. They report nausea, vomiting, ataxia, and
coarse tremors. The PMHNP suspects Lithium toxicity. What is the most likely serum lithium level for this
patient?
A. 0.6 mEq/L
B. 1.0 mEq/L
C. 2.0 mEq/L or higher
D. 0.8 mEq/L
Rationale: The therapeutic range for lithium is generally 0.6 to 1.2 mEq/L. Symptoms such as ataxia, coarse tremors, and
,severe GI upset typically appear when levels exceed 1.5 mEq/L, with levels above 2.0 mEq/L considered severely toxic
(American Nurses Association [ANA], 2023).
4. A 28-year-old female patient with a history of Major Depressive Disorder (MDD) is started on Phenelzine
(Nardil). Which dietary choice indicates the patient needs further education?
A. Fresh chicken and steamed broccoli
B. Pepperoni pizza and a glass of red wine
C. Scrambled eggs and toast
D. Grilled salmon and asparagus
Rationale: Phenelzine is an MAOI. Consumption of tyramine-rich foods (aged cheeses, cured meats like pepperoni, and
fermented beverages like red wine) can trigger a hypertensive crisis due to the inhibition of MAO-A (Stahl, 2021).
5. Which of the following is a primary DSM-5-TR requirement for a diagnosis of Schizophrenia?
A. Symptoms must be present for at least 1 month only
B. Two or more characteristic symptoms (e.g., delusions, hallucinations) present for a significant portion
of time during a 1-month period, with continuous signs of disturbance for at least 6 months
C. Evidence of a manic episode prior to the onset of psychotic symptoms
D. Presence of a personality disorder prior to psychotic symptoms
Rationale: According to the DSM-5-TR, Schizophrenia requires at least two active-phase symptoms for one month, and the
total duration of the illness must be at least six months to distinguish it from Schizophreniform Disorder (APA, 2022).
6. A PMHNP is assessing a 19-year-old male who presents with a 2-week history of inflated self-esteem,
decreased need for sleep (3 hours per night), pressured speech, and excessive involvement in high-risk
investments. He has no previous psychiatric history. What is the most likely diagnosis?
A. Major Depressive Disorder
B. Bipolar I Disorder, Single Manic Episode
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
Rationale: The patient meets the DSM-5-TR criteria for a Manic Episode: a distinct period of abnormally elevated mood
and increased energy lasting at least 1 week. A single manic episode is sufficient for a Bipolar I diagnosis (APA, 2022).
7. When initiating Lamotrigine (Lamictal) for mood stabilization, what is the most important teaching
point to prevent a life-threatening emergency?
A. Monitor for weight gain
B. Report any new skin rash immediately
C. Take the medication only with fatty meals
D. Expect immediate relief within 24 hours
Rationale: Lamotrigine titration must be slow to reduce the risk of Stevens-Johnson Syndrome (SJS), a life-threatening
dermatological emergency. Any rash requires immediate evaluation (Stahl, 2021).
8. A patient is diagnosed with Borderline Personality Disorder. During the session, the patient tells the
PMHNP, "You are the only person who has ever truly understood me. All the other doctors were
incompetent and mean." This is an example of:
A. Projection
B. Splitting
C. Intellectualization
D. Sublimation
Rationale: Splitting is a common defense mechanism in Borderline Personality Disorder where individuals view others as
"all good" or "all bad," reflecting an inability to integrate positive and negative qualities (APA, 2022).
9. A 65-year-old patient with depression is started on an SSRI. The PMHNP should be particularly mindful
of which electrolyte abnormality in the geriatric population?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypernatremia
Rationale: SSRIs can cause Syndrome of Inappropriate Antidiuretic Hormone (SIADH), leading to hyponatremia,
particularly in elderly patients. Monitoring sodium levels is recommended (ANA, 2023).
10. In the treatment of Alcohol Use Disorder, which medication acts by creating an unpleasant physical
reaction when alcohol is consumed?
A. Naltrexone
B. Acamprosate
C. Disulfiram
,D. Lorazepam
Rationale: Disulfiram (Antabuse) is an aldehyde dehydrogenase inhibitor. If alcohol is ingested, acetaldehyde builds up,
causing flushing, nausea, and palpitations (Stahl, 2021).
11. A PMHNP is evaluating a patient for ADHD. According to the DSM-5-TR, at what age must symptoms
have been present prior to?
A. Age 5
B. Age 7
C. Age 12
D. Age 18
Rationale: The DSM-5-TR specifies that several inattentive or hyperactive-impulsive symptoms must have been present
prior to age 12 for an ADHD diagnosis (APA, 2022).
12. Which of the following is considered a "positive symptom" of Schizophrenia?
A. Avolition
B. Auditory Hallucinations
C. Alogia
D. Anhedonia
Rationale: Positive symptoms refer to an excess or distortion of normal function, such as hallucinations and delusions.
Avolition, alogia, and anhedonia are negative symptoms (APA, 2022).
13. A patient with Panic Disorder is prescribed Alprazolam for acute symptom management. What is the
primary concern with long-term use of this medication?
A. Kidney failure
B. Tolerance, dependence, and withdrawal seizures
C. Hypertensive crisis
D. Tardive Dyskinesia
Rationale: Benzodiazepines like Alprazolam carry a high risk for physiological dependence. Abrupt cessation after long-
term use can lead to life-threatening seizures (Stahl, 2021).
14. Which antidepressant is most likely to cause a dose-dependent increase in blood pressure?
A. Mirtazapine
B. Sertraline
C. Venlafaxine
D. Bupropion
Rationale: Venlafaxine, an SNRI, can cause increases in diastolic blood pressure due to its norepinephrine reuptake
inhibition, especially at doses higher than 150 mg (Stahl, 2021).
15. A PMHNP is treating a patient with Anorexia Nervosa. Which physical exam finding is most consistent
with this diagnosis?
A. Tachycardia
B. Lanugo
C. Hypertension
D. Hyperthermia
Rationale: Lanugo (fine, downy hair) is a physiological response to extreme weight loss and malnutrition seen in Anorexia
Nervosa as the body attempts to insulate itself (APA, 2022).
16. A 30-year-old male veteran presents with intrusive memories, nightmares, and hypervigilance
following combat exposure 6 months ago. He avoids crowds and feels emotionally numb. What is the most
likely diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Adjustment Disorder
D. Social Anxiety Disorder
Rationale: PTSD is diagnosed when symptoms of intrusion, avoidance, negative alterations in cognition/mood, and
hyperarousal persist for more than one month following a traumatic event (APA, 2022).
17. Which medication is considered first-line for the treatment of Obsessive-Compulsive Disorder (OCD)?
A. Risperidone
B. Sertraline (or other SSRIs)
C. Lorazepam
D. Amitriptyline
Rationale: High-dose SSRIs are the first-line pharmacological treatment for OCD, often requiring higher doses than those
used for depression (Stahl, 2021).
, 18. A patient presents with "lead-pipe" rigidity, high fever, and elevated Creatine Phosphokinase (CPK)
after starting Haloperidol. What is the most appropriate medication to administer?
A. Benztropine
B. Dantrolene or Bromocriptine
C. Propranolol
D. Diphenhydramine
Rationale: In cases of NMS, Dantrolene (a muscle relaxant) or Bromocriptine (a dopamine agonist) are used to reverse the
muscle rigidity and dopamine blockade (ANA, 2023).
19. The "Duty to Warn" principle originated from which landmark legal case?
A. Roe v. Wade
B. Tarasoff v. Regents of the University of California
C. O'Connor v. Donaldson
D. M'Naghten Rule
Rationale: The Tarasoff case established that mental health professionals have a duty to warn and protect identifiable
third parties when a patient makes a specific threat of harm (ANA, 2023).
20. A PMHNP is assessing a child for possible Autism Spectrum Disorder (ASD). Which of the following is a
core diagnostic feature?
A. High intelligence scores
B. Persistent deficits in social communication and social interaction across multiple contexts
C. Excessive need for social attention
D. Advanced verbal skills
Rationale: ASD is characterized by two main domains: social communication/interaction deficits and restricted, repetitive
patterns of behavior or interests (APA, 2022).
21. Which antipsychotic medication is most likely to cause significant weight gain and metabolic syndrome?
A. Ziprasidone
B. Aripiprazole
C. Olanzapine
D. Lurasidone
Rationale: Olanzapine and Clozapine carry the highest risk for weight gain, dyslipidemia, and insulin resistance among
the second-generation antipsychotics (Stahl, 2021).
22. A patient with Bipolar II Disorder is characterized by having:
A. At least one manic episode
B. At least one hypomanic episode and at least one major depressive episode
C. Only depressive episodes with no history of elevated mood
D. Psychotic symptoms without mood symptoms
Rationale: Bipolar II requires the presence of at least one hypomanic episode and one major depressive episode, but no full
manic episodes (APA, 2022).
23. What is the black box warning associated with all SSRI medications?
A. Risk of liver failure
B. Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults
C. Risk of cardiac arrest
D. Risk of permanent hair loss
Rationale: The FDA requires a black box warning on all antidepressants regarding the increased risk of suicidal ideation
and behavior in individuals under age 25 (Stahl, 2021).
24. Which neurotransmitter is primarily targeted by most first-generation antipsychotics (FGAs)?
A. Serotonin
B. GABA
C. Dopamine (D2 receptor)
D. Acetylcholine
Rationale: FGAs work primarily by blocking D2 dopamine receptors in the mesolimbic pathway to reduce positive
symptoms of psychosis (Stahl, 2021).
25. A patient reports feeling restless and "unable to sit still" after starting Prochlorperazine. The PMHNP
observes the patient pacing. This extrapyramidal side effect (EPS) is known as:
A. Dystonia
B. Akathisia
C. Pseudoparkinsonism
D. Tardive Dyskinesia
CORRECT ANSWERS RATED 100% | 350 QUESTIONS | GRADED A+
NR-607 Diagnosis & Management in Psychiatric Mental Health III Final Examination | Core Domains: Advanced Psychiatric
Assessment, DSM-5-TR Diagnostic Criteria, Psychopharmacology (Antidepressants, Antipsychotics, Mood Stabilizers,
Anxiolytics), Psychiatric Emergencies (Suicide Risk Assessment, NMS, Serotonin Syndrome, Lithium Toxicity), Legal &
Ethical Issues (Voluntary/Involuntary Admission, Seclusion/Restraints, Capacity Evaluation, Informed Consent), Somatic
Symptom Disorders, Personality Disorders (Cluster B, C), Trauma-Related Disorders, Substance Use Disorders, Cultural
Competence in Mental Health, and Evidence-Based Treatment Planning | Chamberlain University PMHNP Focus | Exam-
Aligned Format
Exam Structure
The NR-607 Final Examination is a comprehensive assessment consisting of:
• 350 multiple-choice and case-based questions with verified answers and detailed rationales
• Clinical reasoning and diagnostic scenarios
• Psychopharmacologic management questions
• DSM-5-TR diagnostic criteria application
• Legal and ethical decision-making
• Suicide risk assessment and safety planning
• Psychiatric emergency identification and intervention
• Cultural competence and structural competency
Introduction
This NR-607 Final Exam Reviewer for the 2026/2027 academic cycle reflects the official Chamberlain University Psychiatric
Mental Health Nurse Practitioner (PMHNP) curriculum requirements. The final examination evaluates comprehensive
understanding of advanced psychiatric assessment, psychopharmacology, diagnostic reasoning, legal and ethical principles,
and evidence-based treatment strategies essential for PMHNP certification and clinical practice.
Answer Format
All correct answers must be presented in bold and green, followed by clearly defined, clinically focused rationales that
reinforce DSM-5-TR diagnostic criteria, evidence-based psychopharmacology, legal-ethical principles, and safe psychiatric-
mental health nursing practice.
1. A 45-year-old patient presents with symptoms of Neuroleptic Malignant Syndrome (NMS). Which of the
following is the priority intervention for this patient?
A. Administer a second-generation antipsychotic
B. Discontinue the offending agent and initiate cooling measures
C. Increase the dose of the current medication
D. Administer a high-dose SSRI
Rationale: NMS is a psychiatric emergency characterized by "lead-pipe" muscle rigidity, hyperthermia, and autonomic
instability. The first step is to stop the dopamine antagonist and provide supportive care, including cooling and hydration
(American Psychiatric Association [APA], 2022).
2. A patient being treated with Clozapine (Clozaril) presents for a routine follow-up. Which laboratory
value is the most critical for the PMHNP to monitor to prevent life-threatening complications?
A. Serum Potassium
B. Absolute Neutrophil Count (ANC)
C. Hemoglobin A1C
D. Liver Function Tests (LFTs)
Rationale: Clozapine carries a black box warning for severe neutropenia (agranulocytosis). Monitoring the ANC is
mandatory per the Clozapine REMS program to ensure the patient's immune system is not compromised (Stahl, 2021).
3. A patient with Bipolar I Disorder is taking Lithium Carbonate. They report nausea, vomiting, ataxia, and
coarse tremors. The PMHNP suspects Lithium toxicity. What is the most likely serum lithium level for this
patient?
A. 0.6 mEq/L
B. 1.0 mEq/L
C. 2.0 mEq/L or higher
D. 0.8 mEq/L
Rationale: The therapeutic range for lithium is generally 0.6 to 1.2 mEq/L. Symptoms such as ataxia, coarse tremors, and
,severe GI upset typically appear when levels exceed 1.5 mEq/L, with levels above 2.0 mEq/L considered severely toxic
(American Nurses Association [ANA], 2023).
4. A 28-year-old female patient with a history of Major Depressive Disorder (MDD) is started on Phenelzine
(Nardil). Which dietary choice indicates the patient needs further education?
A. Fresh chicken and steamed broccoli
B. Pepperoni pizza and a glass of red wine
C. Scrambled eggs and toast
D. Grilled salmon and asparagus
Rationale: Phenelzine is an MAOI. Consumption of tyramine-rich foods (aged cheeses, cured meats like pepperoni, and
fermented beverages like red wine) can trigger a hypertensive crisis due to the inhibition of MAO-A (Stahl, 2021).
5. Which of the following is a primary DSM-5-TR requirement for a diagnosis of Schizophrenia?
A. Symptoms must be present for at least 1 month only
B. Two or more characteristic symptoms (e.g., delusions, hallucinations) present for a significant portion
of time during a 1-month period, with continuous signs of disturbance for at least 6 months
C. Evidence of a manic episode prior to the onset of psychotic symptoms
D. Presence of a personality disorder prior to psychotic symptoms
Rationale: According to the DSM-5-TR, Schizophrenia requires at least two active-phase symptoms for one month, and the
total duration of the illness must be at least six months to distinguish it from Schizophreniform Disorder (APA, 2022).
6. A PMHNP is assessing a 19-year-old male who presents with a 2-week history of inflated self-esteem,
decreased need for sleep (3 hours per night), pressured speech, and excessive involvement in high-risk
investments. He has no previous psychiatric history. What is the most likely diagnosis?
A. Major Depressive Disorder
B. Bipolar I Disorder, Single Manic Episode
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
Rationale: The patient meets the DSM-5-TR criteria for a Manic Episode: a distinct period of abnormally elevated mood
and increased energy lasting at least 1 week. A single manic episode is sufficient for a Bipolar I diagnosis (APA, 2022).
7. When initiating Lamotrigine (Lamictal) for mood stabilization, what is the most important teaching
point to prevent a life-threatening emergency?
A. Monitor for weight gain
B. Report any new skin rash immediately
C. Take the medication only with fatty meals
D. Expect immediate relief within 24 hours
Rationale: Lamotrigine titration must be slow to reduce the risk of Stevens-Johnson Syndrome (SJS), a life-threatening
dermatological emergency. Any rash requires immediate evaluation (Stahl, 2021).
8. A patient is diagnosed with Borderline Personality Disorder. During the session, the patient tells the
PMHNP, "You are the only person who has ever truly understood me. All the other doctors were
incompetent and mean." This is an example of:
A. Projection
B. Splitting
C. Intellectualization
D. Sublimation
Rationale: Splitting is a common defense mechanism in Borderline Personality Disorder where individuals view others as
"all good" or "all bad," reflecting an inability to integrate positive and negative qualities (APA, 2022).
9. A 65-year-old patient with depression is started on an SSRI. The PMHNP should be particularly mindful
of which electrolyte abnormality in the geriatric population?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypernatremia
Rationale: SSRIs can cause Syndrome of Inappropriate Antidiuretic Hormone (SIADH), leading to hyponatremia,
particularly in elderly patients. Monitoring sodium levels is recommended (ANA, 2023).
10. In the treatment of Alcohol Use Disorder, which medication acts by creating an unpleasant physical
reaction when alcohol is consumed?
A. Naltrexone
B. Acamprosate
C. Disulfiram
,D. Lorazepam
Rationale: Disulfiram (Antabuse) is an aldehyde dehydrogenase inhibitor. If alcohol is ingested, acetaldehyde builds up,
causing flushing, nausea, and palpitations (Stahl, 2021).
11. A PMHNP is evaluating a patient for ADHD. According to the DSM-5-TR, at what age must symptoms
have been present prior to?
A. Age 5
B. Age 7
C. Age 12
D. Age 18
Rationale: The DSM-5-TR specifies that several inattentive or hyperactive-impulsive symptoms must have been present
prior to age 12 for an ADHD diagnosis (APA, 2022).
12. Which of the following is considered a "positive symptom" of Schizophrenia?
A. Avolition
B. Auditory Hallucinations
C. Alogia
D. Anhedonia
Rationale: Positive symptoms refer to an excess or distortion of normal function, such as hallucinations and delusions.
Avolition, alogia, and anhedonia are negative symptoms (APA, 2022).
13. A patient with Panic Disorder is prescribed Alprazolam for acute symptom management. What is the
primary concern with long-term use of this medication?
A. Kidney failure
B. Tolerance, dependence, and withdrawal seizures
C. Hypertensive crisis
D. Tardive Dyskinesia
Rationale: Benzodiazepines like Alprazolam carry a high risk for physiological dependence. Abrupt cessation after long-
term use can lead to life-threatening seizures (Stahl, 2021).
14. Which antidepressant is most likely to cause a dose-dependent increase in blood pressure?
A. Mirtazapine
B. Sertraline
C. Venlafaxine
D. Bupropion
Rationale: Venlafaxine, an SNRI, can cause increases in diastolic blood pressure due to its norepinephrine reuptake
inhibition, especially at doses higher than 150 mg (Stahl, 2021).
15. A PMHNP is treating a patient with Anorexia Nervosa. Which physical exam finding is most consistent
with this diagnosis?
A. Tachycardia
B. Lanugo
C. Hypertension
D. Hyperthermia
Rationale: Lanugo (fine, downy hair) is a physiological response to extreme weight loss and malnutrition seen in Anorexia
Nervosa as the body attempts to insulate itself (APA, 2022).
16. A 30-year-old male veteran presents with intrusive memories, nightmares, and hypervigilance
following combat exposure 6 months ago. He avoids crowds and feels emotionally numb. What is the most
likely diagnosis?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Adjustment Disorder
D. Social Anxiety Disorder
Rationale: PTSD is diagnosed when symptoms of intrusion, avoidance, negative alterations in cognition/mood, and
hyperarousal persist for more than one month following a traumatic event (APA, 2022).
17. Which medication is considered first-line for the treatment of Obsessive-Compulsive Disorder (OCD)?
A. Risperidone
B. Sertraline (or other SSRIs)
C. Lorazepam
D. Amitriptyline
Rationale: High-dose SSRIs are the first-line pharmacological treatment for OCD, often requiring higher doses than those
used for depression (Stahl, 2021).
, 18. A patient presents with "lead-pipe" rigidity, high fever, and elevated Creatine Phosphokinase (CPK)
after starting Haloperidol. What is the most appropriate medication to administer?
A. Benztropine
B. Dantrolene or Bromocriptine
C. Propranolol
D. Diphenhydramine
Rationale: In cases of NMS, Dantrolene (a muscle relaxant) or Bromocriptine (a dopamine agonist) are used to reverse the
muscle rigidity and dopamine blockade (ANA, 2023).
19. The "Duty to Warn" principle originated from which landmark legal case?
A. Roe v. Wade
B. Tarasoff v. Regents of the University of California
C. O'Connor v. Donaldson
D. M'Naghten Rule
Rationale: The Tarasoff case established that mental health professionals have a duty to warn and protect identifiable
third parties when a patient makes a specific threat of harm (ANA, 2023).
20. A PMHNP is assessing a child for possible Autism Spectrum Disorder (ASD). Which of the following is a
core diagnostic feature?
A. High intelligence scores
B. Persistent deficits in social communication and social interaction across multiple contexts
C. Excessive need for social attention
D. Advanced verbal skills
Rationale: ASD is characterized by two main domains: social communication/interaction deficits and restricted, repetitive
patterns of behavior or interests (APA, 2022).
21. Which antipsychotic medication is most likely to cause significant weight gain and metabolic syndrome?
A. Ziprasidone
B. Aripiprazole
C. Olanzapine
D. Lurasidone
Rationale: Olanzapine and Clozapine carry the highest risk for weight gain, dyslipidemia, and insulin resistance among
the second-generation antipsychotics (Stahl, 2021).
22. A patient with Bipolar II Disorder is characterized by having:
A. At least one manic episode
B. At least one hypomanic episode and at least one major depressive episode
C. Only depressive episodes with no history of elevated mood
D. Psychotic symptoms without mood symptoms
Rationale: Bipolar II requires the presence of at least one hypomanic episode and one major depressive episode, but no full
manic episodes (APA, 2022).
23. What is the black box warning associated with all SSRI medications?
A. Risk of liver failure
B. Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults
C. Risk of cardiac arrest
D. Risk of permanent hair loss
Rationale: The FDA requires a black box warning on all antidepressants regarding the increased risk of suicidal ideation
and behavior in individuals under age 25 (Stahl, 2021).
24. Which neurotransmitter is primarily targeted by most first-generation antipsychotics (FGAs)?
A. Serotonin
B. GABA
C. Dopamine (D2 receptor)
D. Acetylcholine
Rationale: FGAs work primarily by blocking D2 dopamine receptors in the mesolimbic pathway to reduce positive
symptoms of psychosis (Stahl, 2021).
25. A patient reports feeling restless and "unable to sit still" after starting Prochlorperazine. The PMHNP
observes the patient pacing. This extrapyramidal side effect (EPS) is known as:
A. Dystonia
B. Akathisia
C. Pseudoparkinsonism
D. Tardive Dyskinesia
