NRNP 6675-15 Week 11 Final
Exam Solutions
Course
NRNP 6675 (NRNP6675)
1. A patient with major depressive disorder reports sleeping 3 hours nightly, loss of appetite,
and hopelessness for 2 months. Which neurotransmitter imbalance is most associated
with these symptoms?
A. Increased dopamine
B. Decreased serotonin and norepinephrine
C. Increased acetylcholine
D. Excess GABA
Answer: B. Decreased serotonin and norepinephrine
Rationale: Major depressive disorder is strongly linked to deficiencies in serotonin and
norepinephrine, contributing to mood disturbances, appetite changes, and sleep impairment.
2. A psychiatric nurse practitioner is assessing a patient with bipolar I disorder experiencing
mania. Which symptom is most characteristic of mania?
A. Hypersomnia
B. Flat affect
C. Grandiosity
D. Social withdrawal
Answer: C. Grandiosity
Rationale: Mania commonly presents with inflated self-esteem, grandiosity, decreased need for
sleep, pressured speech, impulsivity, and risky behavior.
3. A patient taking lithium reports severe diarrhea, tremors, and confusion. What is the
priority action?
A. Continue medication and monitor
B. Encourage increased caffeine intake
C. Hold lithium and obtain serum lithium level
D. Administer next dose with food
Answer: C. Hold lithium and obtain serum lithium level
Rationale: These are signs of lithium toxicity. Immediate withholding of lithium and serum level
evaluation are critical to prevent severe neurologic complications.
4. Which medication requires dietary tyramine restrictions?
,A. Fluoxetine
B. Sertraline
C. Phenelzine
D. Escitalopram
Answer: C. Phenelzine
Rationale: Phenelzine is an MAOI. Tyramine-containing foods may trigger hypertensive crisis
when combined with MAOIs.
5. A patient diagnosed with schizophrenia states, “The FBI implanted a chip in my brain.”
This is an example of:
A. Hallucination
B. Thought blocking
C. Delusion
D. Echolalia
Answer: C. Delusion
Rationale: Delusions are fixed false beliefs not based in reality. Persecutory delusions are
common in schizophrenia.
6. Which laboratory test should routinely be monitored in patients taking clozapine?
A. Liver enzymes
B. White blood cell count
C. Potassium level
D. Blood glucose only
Answer: B. White blood cell count
Rationale: Clozapine can cause agranulocytosis, making regular WBC and ANC monitoring
mandatory.
7. A patient with generalized anxiety disorder asks how benzodiazepines work. The best
response is:
A. They block dopamine receptors
B. They enhance GABA activity
C. They increase serotonin synthesis
D. They suppress norepinephrine release completely
Answer: B. They enhance GABA activity
Rationale: Benzodiazepines potentiate GABA, the primary inhibitory neurotransmitter,
producing anxiolytic and sedative effects.
, 8. Which symptom differentiates obsessive-compulsive disorder from generalized anxiety
disorder?
A. Excessive worrying
B. Restlessness
C. Presence of compulsions
D. Sleep disturbance
Answer: C. Presence of compulsions
Rationale: OCD involves obsessions and compulsions, whereas GAD primarily involves chronic
excessive worry without ritualistic behaviors.
9. A patient taking haloperidol develops muscle rigidity, fever, and autonomic instability.
What condition should the provider suspect?
A. Serotonin syndrome
B. Acute dystonia
C. Neuroleptic malignant syndrome
D. Tardive dyskinesia
Answer: C. Neuroleptic malignant syndrome
Rationale: NMS is a life-threatening adverse effect of antipsychotics characterized by
hyperthermia, rigidity, altered mental status, and autonomic dysfunction.
10. During a suicide risk assessment, which factor places a patient at highest risk?
A. Strong family support
B. Future-oriented thinking
C. Detailed suicide plan with access to means
D. Mild anxiety symptoms
Answer: C. Detailed suicide plan with access to means
Rationale: Suicide risk significantly increases when a patient has a specific plan, intent, and
available means to carry it out.
11. A patient with panic disorder suddenly experiences chest pain, palpitations, and fear of
dying. The priority initial intervention is:
A. Encourage caffeine intake
B. Maintain calm communication and reduce stimuli
C. Leave the patient alone
D. Begin deep psychoanalysis immediately
Answer: B. Maintain calm communication and reduce stimuli
, Rationale: Panic attacks require reassurance, calm communication, and environmental control to
reduce escalating anxiety.
12. Which medication is considered first-line treatment for generalized anxiety disorder?
A. Haloperidol
B. Alprazolam
C. Sertraline
D. Lithium
Answer: C. Sertraline
Rationale: SSRIs such as sertraline are first-line long-term treatments for GAD due to safety and
efficacy.
13. A patient diagnosed with borderline personality disorder is most likely to exhibit:
A. Emotional instability and fear of abandonment
B. Grandiose self-importance
C. Persistent disregard for laws
D. Lack of emotional expression
Answer: A. Emotional instability and fear of abandonment
Rationale: Borderline personality disorder commonly includes unstable relationships,
impulsivity, and intense fear of abandonment.
14. Which symptom is most associated with serotonin syndrome?
A. Bradykinesia
B. Lead-pipe rigidity
C. Hyperreflexia and clonus
D. Flat affect
Answer: C. Hyperreflexia and clonus
Rationale: Serotonin syndrome presents with hyperreflexia, clonus, agitation, fever, and
autonomic instability.
15. A patient taking SSRIs reports sexual dysfunction. What is the best initial response?
A. Stop medication abruptly
B. Ignore the complaint
C. Assess severity and discuss management options
D. Double the medication dose
Answer: C. Assess severity and discuss management options
Exam Solutions
Course
NRNP 6675 (NRNP6675)
1. A patient with major depressive disorder reports sleeping 3 hours nightly, loss of appetite,
and hopelessness for 2 months. Which neurotransmitter imbalance is most associated
with these symptoms?
A. Increased dopamine
B. Decreased serotonin and norepinephrine
C. Increased acetylcholine
D. Excess GABA
Answer: B. Decreased serotonin and norepinephrine
Rationale: Major depressive disorder is strongly linked to deficiencies in serotonin and
norepinephrine, contributing to mood disturbances, appetite changes, and sleep impairment.
2. A psychiatric nurse practitioner is assessing a patient with bipolar I disorder experiencing
mania. Which symptom is most characteristic of mania?
A. Hypersomnia
B. Flat affect
C. Grandiosity
D. Social withdrawal
Answer: C. Grandiosity
Rationale: Mania commonly presents with inflated self-esteem, grandiosity, decreased need for
sleep, pressured speech, impulsivity, and risky behavior.
3. A patient taking lithium reports severe diarrhea, tremors, and confusion. What is the
priority action?
A. Continue medication and monitor
B. Encourage increased caffeine intake
C. Hold lithium and obtain serum lithium level
D. Administer next dose with food
Answer: C. Hold lithium and obtain serum lithium level
Rationale: These are signs of lithium toxicity. Immediate withholding of lithium and serum level
evaluation are critical to prevent severe neurologic complications.
4. Which medication requires dietary tyramine restrictions?
,A. Fluoxetine
B. Sertraline
C. Phenelzine
D. Escitalopram
Answer: C. Phenelzine
Rationale: Phenelzine is an MAOI. Tyramine-containing foods may trigger hypertensive crisis
when combined with MAOIs.
5. A patient diagnosed with schizophrenia states, “The FBI implanted a chip in my brain.”
This is an example of:
A. Hallucination
B. Thought blocking
C. Delusion
D. Echolalia
Answer: C. Delusion
Rationale: Delusions are fixed false beliefs not based in reality. Persecutory delusions are
common in schizophrenia.
6. Which laboratory test should routinely be monitored in patients taking clozapine?
A. Liver enzymes
B. White blood cell count
C. Potassium level
D. Blood glucose only
Answer: B. White blood cell count
Rationale: Clozapine can cause agranulocytosis, making regular WBC and ANC monitoring
mandatory.
7. A patient with generalized anxiety disorder asks how benzodiazepines work. The best
response is:
A. They block dopamine receptors
B. They enhance GABA activity
C. They increase serotonin synthesis
D. They suppress norepinephrine release completely
Answer: B. They enhance GABA activity
Rationale: Benzodiazepines potentiate GABA, the primary inhibitory neurotransmitter,
producing anxiolytic and sedative effects.
, 8. Which symptom differentiates obsessive-compulsive disorder from generalized anxiety
disorder?
A. Excessive worrying
B. Restlessness
C. Presence of compulsions
D. Sleep disturbance
Answer: C. Presence of compulsions
Rationale: OCD involves obsessions and compulsions, whereas GAD primarily involves chronic
excessive worry without ritualistic behaviors.
9. A patient taking haloperidol develops muscle rigidity, fever, and autonomic instability.
What condition should the provider suspect?
A. Serotonin syndrome
B. Acute dystonia
C. Neuroleptic malignant syndrome
D. Tardive dyskinesia
Answer: C. Neuroleptic malignant syndrome
Rationale: NMS is a life-threatening adverse effect of antipsychotics characterized by
hyperthermia, rigidity, altered mental status, and autonomic dysfunction.
10. During a suicide risk assessment, which factor places a patient at highest risk?
A. Strong family support
B. Future-oriented thinking
C. Detailed suicide plan with access to means
D. Mild anxiety symptoms
Answer: C. Detailed suicide plan with access to means
Rationale: Suicide risk significantly increases when a patient has a specific plan, intent, and
available means to carry it out.
11. A patient with panic disorder suddenly experiences chest pain, palpitations, and fear of
dying. The priority initial intervention is:
A. Encourage caffeine intake
B. Maintain calm communication and reduce stimuli
C. Leave the patient alone
D. Begin deep psychoanalysis immediately
Answer: B. Maintain calm communication and reduce stimuli
, Rationale: Panic attacks require reassurance, calm communication, and environmental control to
reduce escalating anxiety.
12. Which medication is considered first-line treatment for generalized anxiety disorder?
A. Haloperidol
B. Alprazolam
C. Sertraline
D. Lithium
Answer: C. Sertraline
Rationale: SSRIs such as sertraline are first-line long-term treatments for GAD due to safety and
efficacy.
13. A patient diagnosed with borderline personality disorder is most likely to exhibit:
A. Emotional instability and fear of abandonment
B. Grandiose self-importance
C. Persistent disregard for laws
D. Lack of emotional expression
Answer: A. Emotional instability and fear of abandonment
Rationale: Borderline personality disorder commonly includes unstable relationships,
impulsivity, and intense fear of abandonment.
14. Which symptom is most associated with serotonin syndrome?
A. Bradykinesia
B. Lead-pipe rigidity
C. Hyperreflexia and clonus
D. Flat affect
Answer: C. Hyperreflexia and clonus
Rationale: Serotonin syndrome presents with hyperreflexia, clonus, agitation, fever, and
autonomic instability.
15. A patient taking SSRIs reports sexual dysfunction. What is the best initial response?
A. Stop medication abruptly
B. Ignore the complaint
C. Assess severity and discuss management options
D. Double the medication dose
Answer: C. Assess severity and discuss management options
