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NR 668 FINAL EXAM | PSYCHIATRIC-MENTAL
HEALTH CAPSTONE PRACTICUM & INTENSIVE
FINAL EXAM (Latest Update 2026) UPDATE!!
A 52-year-old obese man with type 2 diabetes reports dozing off while driving, watching TV, or
reading, with increased apathy and fatigue. The PMHNP ordered a sleep study, which revealed 10
episodes of apnea lasting 15 to 20 seconds each per hour of sleep. Based on these findings, what
should the PMHNP prescribe for his condition?
a. Continuous positive airway pressure
b. Referral to otolaryngology for rhinoplasty
c. Referral to otolaryngology for uvuloplasty
d. Antidepressant medications - correct answer -a. Continuous positive airway pressure
When providing psychoeducation to a patient with treatment-resistant depression about
electroconvulsive therapy (ECT), you tell the patient that the most common adverse effect of treatment
is which of the following?
a. Arrhythmia
b. Respiratory depression
c. Amnesia
d. Psychosis - correct answer -c. Amnesia
A 42-year-old female recalls a brief episode of chest tightness with no radiation or chest wall injury
during her new taekwondo martial arts class. This pain subsided during "the cool down period" of her
class. Which of the following is most likely given her presentation? a. Pericarditis
b. Angina pectoris
c. Acute myocardial infarction
d. Hiatal hernia - correct answer -b. Angina pectoris
Chest pain with activity and relieved at rest in a middle-aged adult should prompt concern for
myocardial ischemia. Although acute myocardial infarction is a possibility, it is less likely given the
scenario mentioned above.
,Which of the following is true regarding the influenza vaccination?
a. Anyone 6 months of age or older should obtain the influenza vaccine
b. Those who currently have cold-like symptoms with a temperature of 101.6 should not receive the
vaccine
c. A history of Guillain Barre 4 weeks after a previous influenza injection would be a contraindication for
future influenza vaccination
d. All of the statements are true - correct answer -d. All of the statements are true
Which of the following would be considered a risk factor for melanoma?
a. A mole with symmetrical borders
b. A dark covered mole approximately 5mm in size
c. Female gender
d. A history of melanoma - correct answer -d. A history of melanoma
An 81-year-old female is found in acute respiratory distress after choking on a hotdog during lunch. On
exam, which of the following lungs sounds are you most likely to hear? a. Crackles
b. Egophony
c. Bronchophony
d. Stridor - correct answer -d. Stridor
Stridor is the result of an upper airway obstruction, such as when there is a sudden acute aspiration of
an object.
A 43-year-old man was involved in a motor vehicle collision in which he was found to have a blood
alcohol concentration of 0.200. He was observed wandering around the crash site, slurring his words,
and unable to provide a clear history. Emergency Medical Services brought him to the emergency
department. The nurse triaged him to psychiatry for acute alcohol intoxication. What is the first priority
for the PMHNP?
a. Ask the patient when he had his last drink
b. C-spine stabilization and head imaging
c. Explore the client's willingness to enter rehab
d. IV hydration - correct answer -b. C-spine stabilization and head imaging
,A patient who is considering electroconvulsive therapy (ECT) for resistant depression inquires as to the
number of sessions she would likely require. Based on the best evidence currently available what is the
best response?
a. 4
b. 40
c. 20
d. 10 - correct answer -d. 10
The S2 heart sound is a result of what?
a. Opening of the atrioventricular valves
b. Opening of the semilunar valves
c. Closure of the semilunar valves
d. Closure of the atrioventricular valves - correct answer -c. Closure of the semilunar valves
The closure of the semilunar valves results in the second heart sound. The semilunar valves are the
aortic and pulmonary valves.
In observing the appearance of the patient with depression and a history of systemic lupus
erythematosus, the PMHNP notices a lesion on the neck of the patient about the size of a pencil eraser,
flush with the skin, uniformly colored, with discrete borders, and consistent texture. The PMHNP should:
a. Refer the patient to rheumatology
b. Refer the patient to dermatology
c. Refer the patient to oncology
d. Watch and wait - correct answer -d. Watch and wait
The PMHNP is consulted to see a 70-year-old female who was admitted to the skilled nursing facility 3
days ago from the hospital, where she was treated for urinary tract infection, pneumonia, and
dehydration. The staff reports that the patient is restless and agitated, awake most of the night,
intermittently sleeping during the day, and has poor PO intake. What should the PPMHNP do first?
a. Call family members for collateral information on her baseline functioning
b. Transfer the patient to the ED
c. Prescribe quetiapine 12.5mg PO at bedtime and every 6 hours as needed for agitation
, d. Physical exam and diagnostic tests (complete blood count, basic metabolic profile, and urinalysis) -
correct answer -d. Physical exam and diagnostic tests (complete blood count, basic metabolic
profile, and urinalysis)
The condition in which the patient is unable to discriminate between objects based on touching is
known as:
a. Dysdiadochokinesia
b. Astereognosis
c. Agraphesthesia
d. Choreiform - correct answer -b. Astereognosis
A 66-year-old registered nurse, who retired from psychiatry 3 years ago, spends much of her time
watching television. She is easily irritated by those interrupting her shows and has no desire to engage
in any activities or identify with a broader community. Which developmental stage did she fail to
master? a. Generativity versus Stagnation
b. Industry versus inferiority
c. Initiative versus guilt
d. Ego integrity versus despair - correct answer -a. Generativity versus Stagnation
A 68-year-old man with no past psychiatric history but with a history of poly substance use disorder is
admitted for psychosis (disorganized thoughts, rapid pressured speech, persistent rumination, paranoid
delusions, and apathy). Which of the following tests would be most important in determining the
etiology of his new onset symptoms?
a. HIV testing
b. Urine culture
c. Mental state exam
d. Urine toxicology screening - correct answer -a. HIV testing
A 72-year-old female presents to the emergency department for altered mental status. Her urine
analysis is negative, and her labs are normal. She has been referred to psychiatry for dementia. The
patient's husband reports increasing forgetfulness over the last 6 months, walking as if her feet are
stuck to the ground, and most recently episodes of urinary incontinence. Based on the signs and
symptoms which of the following diagnostic tests should the PMHNP order to rule out an underlying
condition? a. Arterial blood gas
NR 668 FINAL EXAM | PSYCHIATRIC-MENTAL
HEALTH CAPSTONE PRACTICUM & INTENSIVE
FINAL EXAM (Latest Update 2026) UPDATE!!
A 52-year-old obese man with type 2 diabetes reports dozing off while driving, watching TV, or
reading, with increased apathy and fatigue. The PMHNP ordered a sleep study, which revealed 10
episodes of apnea lasting 15 to 20 seconds each per hour of sleep. Based on these findings, what
should the PMHNP prescribe for his condition?
a. Continuous positive airway pressure
b. Referral to otolaryngology for rhinoplasty
c. Referral to otolaryngology for uvuloplasty
d. Antidepressant medications - correct answer -a. Continuous positive airway pressure
When providing psychoeducation to a patient with treatment-resistant depression about
electroconvulsive therapy (ECT), you tell the patient that the most common adverse effect of treatment
is which of the following?
a. Arrhythmia
b. Respiratory depression
c. Amnesia
d. Psychosis - correct answer -c. Amnesia
A 42-year-old female recalls a brief episode of chest tightness with no radiation or chest wall injury
during her new taekwondo martial arts class. This pain subsided during "the cool down period" of her
class. Which of the following is most likely given her presentation? a. Pericarditis
b. Angina pectoris
c. Acute myocardial infarction
d. Hiatal hernia - correct answer -b. Angina pectoris
Chest pain with activity and relieved at rest in a middle-aged adult should prompt concern for
myocardial ischemia. Although acute myocardial infarction is a possibility, it is less likely given the
scenario mentioned above.
,Which of the following is true regarding the influenza vaccination?
a. Anyone 6 months of age or older should obtain the influenza vaccine
b. Those who currently have cold-like symptoms with a temperature of 101.6 should not receive the
vaccine
c. A history of Guillain Barre 4 weeks after a previous influenza injection would be a contraindication for
future influenza vaccination
d. All of the statements are true - correct answer -d. All of the statements are true
Which of the following would be considered a risk factor for melanoma?
a. A mole with symmetrical borders
b. A dark covered mole approximately 5mm in size
c. Female gender
d. A history of melanoma - correct answer -d. A history of melanoma
An 81-year-old female is found in acute respiratory distress after choking on a hotdog during lunch. On
exam, which of the following lungs sounds are you most likely to hear? a. Crackles
b. Egophony
c. Bronchophony
d. Stridor - correct answer -d. Stridor
Stridor is the result of an upper airway obstruction, such as when there is a sudden acute aspiration of
an object.
A 43-year-old man was involved in a motor vehicle collision in which he was found to have a blood
alcohol concentration of 0.200. He was observed wandering around the crash site, slurring his words,
and unable to provide a clear history. Emergency Medical Services brought him to the emergency
department. The nurse triaged him to psychiatry for acute alcohol intoxication. What is the first priority
for the PMHNP?
a. Ask the patient when he had his last drink
b. C-spine stabilization and head imaging
c. Explore the client's willingness to enter rehab
d. IV hydration - correct answer -b. C-spine stabilization and head imaging
,A patient who is considering electroconvulsive therapy (ECT) for resistant depression inquires as to the
number of sessions she would likely require. Based on the best evidence currently available what is the
best response?
a. 4
b. 40
c. 20
d. 10 - correct answer -d. 10
The S2 heart sound is a result of what?
a. Opening of the atrioventricular valves
b. Opening of the semilunar valves
c. Closure of the semilunar valves
d. Closure of the atrioventricular valves - correct answer -c. Closure of the semilunar valves
The closure of the semilunar valves results in the second heart sound. The semilunar valves are the
aortic and pulmonary valves.
In observing the appearance of the patient with depression and a history of systemic lupus
erythematosus, the PMHNP notices a lesion on the neck of the patient about the size of a pencil eraser,
flush with the skin, uniformly colored, with discrete borders, and consistent texture. The PMHNP should:
a. Refer the patient to rheumatology
b. Refer the patient to dermatology
c. Refer the patient to oncology
d. Watch and wait - correct answer -d. Watch and wait
The PMHNP is consulted to see a 70-year-old female who was admitted to the skilled nursing facility 3
days ago from the hospital, where she was treated for urinary tract infection, pneumonia, and
dehydration. The staff reports that the patient is restless and agitated, awake most of the night,
intermittently sleeping during the day, and has poor PO intake. What should the PPMHNP do first?
a. Call family members for collateral information on her baseline functioning
b. Transfer the patient to the ED
c. Prescribe quetiapine 12.5mg PO at bedtime and every 6 hours as needed for agitation
, d. Physical exam and diagnostic tests (complete blood count, basic metabolic profile, and urinalysis) -
correct answer -d. Physical exam and diagnostic tests (complete blood count, basic metabolic
profile, and urinalysis)
The condition in which the patient is unable to discriminate between objects based on touching is
known as:
a. Dysdiadochokinesia
b. Astereognosis
c. Agraphesthesia
d. Choreiform - correct answer -b. Astereognosis
A 66-year-old registered nurse, who retired from psychiatry 3 years ago, spends much of her time
watching television. She is easily irritated by those interrupting her shows and has no desire to engage
in any activities or identify with a broader community. Which developmental stage did she fail to
master? a. Generativity versus Stagnation
b. Industry versus inferiority
c. Initiative versus guilt
d. Ego integrity versus despair - correct answer -a. Generativity versus Stagnation
A 68-year-old man with no past psychiatric history but with a history of poly substance use disorder is
admitted for psychosis (disorganized thoughts, rapid pressured speech, persistent rumination, paranoid
delusions, and apathy). Which of the following tests would be most important in determining the
etiology of his new onset symptoms?
a. HIV testing
b. Urine culture
c. Mental state exam
d. Urine toxicology screening - correct answer -a. HIV testing
A 72-year-old female presents to the emergency department for altered mental status. Her urine
analysis is negative, and her labs are normal. She has been referred to psychiatry for dementia. The
patient's husband reports increasing forgetfulness over the last 6 months, walking as if her feet are
stuck to the ground, and most recently episodes of urinary incontinence. Based on the signs and
symptoms which of the following diagnostic tests should the PMHNP order to rule out an underlying
condition? a. Arterial blood gas
