NURS 6630 FINAL EXAM 5 LATEST VERSIONS (VERSION V1,
V2, V3, V4, &V5) ACTUAL EXAM EACH EXAM CONTAINS 75
QUESTIONS
Question 1
A 45-year-old client with Major Depressive Disorder (MDD) has been taking
an SSRI for 6 weeks and reports improved mood but is experiencing
persistent sexual dysfunction. Which of the following strategies would the
Psychiatric-Mental Health Nurse Practitioner (PMHNP) consider FIRST?
A) Immediately switch to a different class of antidepressant.
B) Increase the dose of the current SSRI.
C) Augment with bupropion.
D) Recommend stopping the medication.
E) Refer for sex therapy without medication adjustment.
Correct Answer: C) Augment with bupropion.
Rationale: Bupropion, an atypical antidepressant, has a different
mechanism of action (norepinephrine and dopamine reuptake
inhibition) and is often used to augment SSRIs to counteract sexual
dysfunction without compromising antidepressant efficacy.
Question 2
A client with Generalized Anxiety Disorder (GAD) is initiating treatment with
buspirone. The PMHNP should educate the client about which of the following
characteristics of this medication?
A) It provides immediate anxiolytic effects.
B) It has a high potential for physical dependence.
C) It has a delayed onset of action, typically taking 2-4 weeks for full
therapeutic effect.
D) It is typically prescribed PRN for acute anxiety attacks.
E) It is contraindicated with SSRIs.
Correct Answer: C) It has a delayed onset of action, typically taking 2-
4 weeks for full therapeutic effect.
Rationale: Buspirone is a non-benzodiazepine anxiolytic that works
through serotonin receptors. It requires consistent use and takes
,several weeks for its full anxiolytic effects to manifest, making it
unsuitable for acute anxiety.
Question 3
A client with Bipolar I Disorder is in a manic episode and is prescribed
lithium. The PMHNP should prioritize monitoring for which of the following
adverse effects that may indicate toxicity?
A) Weight gain and constipation.
B) Fine hand tremors, polyuria/polydipsia, and mild nausea.
C) Severe muscle weakness, coarse tremors, confusion, and ataxia.
D) Hypertension and hyperglycemia.
E) Hypothyroidism.
Correct Answer: C) Severe muscle weakness, coarse tremors,
confusion, and ataxia.
Rationale: While fine tremors and polyuria/polydipsia are common
side effects, severe muscle weakness, coarse tremors, confusion,
gastrointestinal upset, and ataxia are classic signs of lithium
toxicity, requiring immediate intervention.
Question 4
When assessing a client suspected of having Schizophrenia, which of the
following symptoms is considered a "negative symptom"?
A) Delusions of persecution.
B) Auditory hallucinations.
C) Disorganized speech.
D) Apathy (avolition).
E) Bizarre behavior.
Correct Answer: D) Apathy (avolition).
Rationale: Negative symptoms of schizophrenia represent a reduction
or absence of normal functions, including avolition (lack of
motivation), alogia (poverty of speech), anhedonia (inability to
,experience pleasure), and affective flattening (reduced emotional
expression).
Question 5
A PMHNP is conducting a diagnostic interview for a client reporting
symptoms of Post-Traumatic Stress Disorder (PTSD). Which of the following is
a core diagnostic criterion for PTSD?
A) Persistent depressive mood.
B) Recurrent, intrusive distressing memories, flashbacks, or nightmares
related to the traumatic event.
C) Manic episodes.
D) Obsessive thoughts about cleanliness.
E) Extreme social anxiety only.
Correct Answer: B) Recurrent, intrusive distressing memories,
flashbacks, or nightmares related to the traumatic event.
Rationale: Intrusive symptoms (e.g., flashbacks, nightmares,
distressing memories) are one of the essential symptom clusters for
diagnosing PTSD according to DSM-5 criteria.
Question 6
A client with Alcohol Use Disorder is experiencing moderate alcohol
withdrawal. The PMHNP should anticipate administering which of the
following medications as first-line treatment?
A) Haloperidol (Haldol).
B) Lorazepam (Ativan).
C) Phenobarbital.
D) Disulfiram (Antabuse).
E) Acamprosate.
Correct Answer: B) Lorazepam (Ativan).
Rationale: Benzodiazepines (e.g., lorazepam, diazepam,
chlordiazepoxide) are the cornerstone of alcohol withdrawal
, treatment, used to prevent and treat seizures and delirium by
potentiating GABA activity.
Question 7
A PMHNP is initiating an SSRI for a client with MDD. Which of the following
adverse effects is the client at risk for, particularly in the initial weeks of
treatment?
A) Weight gain.
B) Orthostatic hypotension.
C) Increased anxiety and insomnia.
D) Sexual dysfunction.
E) Dry mouth and constipation.
Correct Answer: C) Increased anxiety and insomnia.
Rationale: In the initial weeks of SSRI treatment, some clients may
experience transient side effects such as increased anxiety,
agitation, insomnia, and gastrointestinal upset, before the full
antidepressant effects manifest.
Question 8
Which of the following is a common extrapyramidal symptom (EPS)
associated with typical (first-generation) antipsychotics, characterized by an
inner restlessness and inability to sit still?
A) Dystonia
B) Tardive dyskinesia
C) Akathisia
D) Parkinsonism
E) Neuroleptic Malignant Syndrome (NMS)
Correct Answer: C) Akathisia
Rationale: Akathisia is an uncomfortable sensation of inner
restlessness, often manifesting as repetitive movements like
pacing, fidgeting, or an urge to constantly move.
V2, V3, V4, &V5) ACTUAL EXAM EACH EXAM CONTAINS 75
QUESTIONS
Question 1
A 45-year-old client with Major Depressive Disorder (MDD) has been taking
an SSRI for 6 weeks and reports improved mood but is experiencing
persistent sexual dysfunction. Which of the following strategies would the
Psychiatric-Mental Health Nurse Practitioner (PMHNP) consider FIRST?
A) Immediately switch to a different class of antidepressant.
B) Increase the dose of the current SSRI.
C) Augment with bupropion.
D) Recommend stopping the medication.
E) Refer for sex therapy without medication adjustment.
Correct Answer: C) Augment with bupropion.
Rationale: Bupropion, an atypical antidepressant, has a different
mechanism of action (norepinephrine and dopamine reuptake
inhibition) and is often used to augment SSRIs to counteract sexual
dysfunction without compromising antidepressant efficacy.
Question 2
A client with Generalized Anxiety Disorder (GAD) is initiating treatment with
buspirone. The PMHNP should educate the client about which of the following
characteristics of this medication?
A) It provides immediate anxiolytic effects.
B) It has a high potential for physical dependence.
C) It has a delayed onset of action, typically taking 2-4 weeks for full
therapeutic effect.
D) It is typically prescribed PRN for acute anxiety attacks.
E) It is contraindicated with SSRIs.
Correct Answer: C) It has a delayed onset of action, typically taking 2-
4 weeks for full therapeutic effect.
Rationale: Buspirone is a non-benzodiazepine anxiolytic that works
through serotonin receptors. It requires consistent use and takes
,several weeks for its full anxiolytic effects to manifest, making it
unsuitable for acute anxiety.
Question 3
A client with Bipolar I Disorder is in a manic episode and is prescribed
lithium. The PMHNP should prioritize monitoring for which of the following
adverse effects that may indicate toxicity?
A) Weight gain and constipation.
B) Fine hand tremors, polyuria/polydipsia, and mild nausea.
C) Severe muscle weakness, coarse tremors, confusion, and ataxia.
D) Hypertension and hyperglycemia.
E) Hypothyroidism.
Correct Answer: C) Severe muscle weakness, coarse tremors,
confusion, and ataxia.
Rationale: While fine tremors and polyuria/polydipsia are common
side effects, severe muscle weakness, coarse tremors, confusion,
gastrointestinal upset, and ataxia are classic signs of lithium
toxicity, requiring immediate intervention.
Question 4
When assessing a client suspected of having Schizophrenia, which of the
following symptoms is considered a "negative symptom"?
A) Delusions of persecution.
B) Auditory hallucinations.
C) Disorganized speech.
D) Apathy (avolition).
E) Bizarre behavior.
Correct Answer: D) Apathy (avolition).
Rationale: Negative symptoms of schizophrenia represent a reduction
or absence of normal functions, including avolition (lack of
motivation), alogia (poverty of speech), anhedonia (inability to
,experience pleasure), and affective flattening (reduced emotional
expression).
Question 5
A PMHNP is conducting a diagnostic interview for a client reporting
symptoms of Post-Traumatic Stress Disorder (PTSD). Which of the following is
a core diagnostic criterion for PTSD?
A) Persistent depressive mood.
B) Recurrent, intrusive distressing memories, flashbacks, or nightmares
related to the traumatic event.
C) Manic episodes.
D) Obsessive thoughts about cleanliness.
E) Extreme social anxiety only.
Correct Answer: B) Recurrent, intrusive distressing memories,
flashbacks, or nightmares related to the traumatic event.
Rationale: Intrusive symptoms (e.g., flashbacks, nightmares,
distressing memories) are one of the essential symptom clusters for
diagnosing PTSD according to DSM-5 criteria.
Question 6
A client with Alcohol Use Disorder is experiencing moderate alcohol
withdrawal. The PMHNP should anticipate administering which of the
following medications as first-line treatment?
A) Haloperidol (Haldol).
B) Lorazepam (Ativan).
C) Phenobarbital.
D) Disulfiram (Antabuse).
E) Acamprosate.
Correct Answer: B) Lorazepam (Ativan).
Rationale: Benzodiazepines (e.g., lorazepam, diazepam,
chlordiazepoxide) are the cornerstone of alcohol withdrawal
, treatment, used to prevent and treat seizures and delirium by
potentiating GABA activity.
Question 7
A PMHNP is initiating an SSRI for a client with MDD. Which of the following
adverse effects is the client at risk for, particularly in the initial weeks of
treatment?
A) Weight gain.
B) Orthostatic hypotension.
C) Increased anxiety and insomnia.
D) Sexual dysfunction.
E) Dry mouth and constipation.
Correct Answer: C) Increased anxiety and insomnia.
Rationale: In the initial weeks of SSRI treatment, some clients may
experience transient side effects such as increased anxiety,
agitation, insomnia, and gastrointestinal upset, before the full
antidepressant effects manifest.
Question 8
Which of the following is a common extrapyramidal symptom (EPS)
associated with typical (first-generation) antipsychotics, characterized by an
inner restlessness and inability to sit still?
A) Dystonia
B) Tardive dyskinesia
C) Akathisia
D) Parkinsonism
E) Neuroleptic Malignant Syndrome (NMS)
Correct Answer: C) Akathisia
Rationale: Akathisia is an uncomfortable sensation of inner
restlessness, often manifesting as repetitive movements like
pacing, fidgeting, or an urge to constantly move.
