1
NURS 6670 FINAL EXAM PRACTICE QUESTIONS (2026 UPDATE) | 200
PMHNP QUESTIONS & ANSWERS 100% CORRECT ALREADY A+
1.
A 40-year-old client reports constant worrying, muscle tension, and difficulty
concentrating for the past eight months. She denies panic attacks but feels “on
edge” most days. Which diagnosis best fits this presentation?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Adjustment Disorder
Answer: B – Generalized Anxiety Disorder
Rationale: GAD involves excessive, uncontrollable worry for at least six months,
with symptoms such as restlessness, fatigue, and muscle tension, without discrete
panic attacks.
2.
A 27-year-old woman presents with low mood, insomnia, loss of interest in
activities, and poor concentration for two weeks. She denies past episodes and has
no history of mania. What is the most likely diagnosis?
A. Dysthymia
B. Bipolar II Disorder
C. Major Depressive Disorder
D. Cyclothymic Disorder
Answer: C – Major Depressive Disorder
Rationale: MDD requires at least two weeks of depressed mood or anhedonia with
associated symptoms such as insomnia, poor appetite, or low energy.
, 2
3.
A patient with schizophrenia has been stable for several months on risperidone. He
now presents with muscle rigidity, elevated temperature, and autonomic instability.
What should the PMHNP suspect?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome
C. Tardive Dyskinesia
D. Dystonic Reaction
Answer: B – Neuroleptic Malignant Syndrome
Rationale: NMS is a rare, life-threatening reaction to antipsychotics characterized
by rigidity, fever, altered mental status, and autonomic dysfunction.
4.
A 45-year-old male with major depression is prescribed phenelzine. He calls the
clinic reporting a severe headache after eating aged cheese. What is the nurse
practitioner’s first concern?
A. Hypoglycemia
B. Hypertensive Crisis
C. Migraine Reaction
D. Serotonin Syndrome
Answer: B – Hypertensive Crisis
Rationale: MAOIs interact with tyramine-rich foods, causing excessive
norepinephrine release and hypertensive emergencies.
5.
A client recently diagnosed with bipolar I disorder presents with pressured speech,
decreased need for sleep, and impulsive spending. Which medication class is most
appropriate for initial stabilization?
A. Selective Serotonin Reuptake Inhibitors
B. Benzodiazepines
C. Mood Stabilizers
D. Atypical Antipsychotics
, 3
Answer: C – Mood Stabilizers
Rationale: Lithium, valproate, or carbamazepine are first-line for acute mania and
maintenance of bipolar I disorder.
6.
A 19-year-old college student reports recurrent intrusive thoughts of contamination
and washes her hands up to 50 times daily. Which psychotherapy is most effective
for her condition?
A. Supportive Therapy
B. Dialectical Behavior Therapy
C. Cognitive Behavioral Therapy with Exposure and Response Prevention
D. Psychoanalysis
Answer: C – CBT with Exposure and Response Prevention
Rationale: ERP is the gold-standard treatment for obsessive-compulsive disorder
by gradually reducing avoidance behaviors.
7.
A patient on fluoxetine reports restlessness, confusion, and muscle rigidity after
starting tramadol. What is the most likely cause?
A. Anticholinergic Toxicity
B. Serotonin Syndrome
C. Lithium Toxicity
D. Akathisia
Answer: B – Serotonin Syndrome
Rationale: Combined serotonergic drugs increase serotonin levels, leading to
hyperreflexia, confusion, and autonomic instability.
8.
A 34-year-old mother reports irritability, insomnia, and poor concentration that
began two weeks after childbirth. She denies thoughts of harming herself or the
baby. What is the most likely diagnosis?
, 4
A. Postpartum Depression
B. Baby Blues
C. Postpartum Psychosis
D. Adjustment Disorder
Answer: B – Baby Blues
Rationale: Transient mood changes within two weeks of delivery are common;
symptoms resolve without treatment.
9.
A client with schizophrenia has been on haloperidol for several months. She
presents with involuntary lip smacking and tongue protrusion. What is the best
nursing action?
A. Increase haloperidol dose
B. Add benzodiazepine
C. Discontinue haloperidol and consider clozapine
D. Add anticholinergic medication
Answer: C – Discontinue haloperidol and consider clozapine
Rationale: These are signs of tardive dyskinesia; switching to clozapine minimizes
extrapyramidal effects.
10.
A 29-year-old reports difficulty sleeping after a car accident two weeks ago. She
has recurrent nightmares and avoids driving. Which intervention is most
appropriate initially?
A. Prescribe long-term benzodiazepine
B. Begin trauma-focused cognitive behavioral therapy
C. Initiate SSRI therapy immediately
D. Recommend inpatient hospitalization
Answer: B – Trauma-Focused CBT
Rationale: Early psychotherapy focusing on trauma processing prevents
progression to PTSD; pharmacotherapy may be added if symptoms persist beyond
one month.
NURS 6670 FINAL EXAM PRACTICE QUESTIONS (2026 UPDATE) | 200
PMHNP QUESTIONS & ANSWERS 100% CORRECT ALREADY A+
1.
A 40-year-old client reports constant worrying, muscle tension, and difficulty
concentrating for the past eight months. She denies panic attacks but feels “on
edge” most days. Which diagnosis best fits this presentation?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Adjustment Disorder
Answer: B – Generalized Anxiety Disorder
Rationale: GAD involves excessive, uncontrollable worry for at least six months,
with symptoms such as restlessness, fatigue, and muscle tension, without discrete
panic attacks.
2.
A 27-year-old woman presents with low mood, insomnia, loss of interest in
activities, and poor concentration for two weeks. She denies past episodes and has
no history of mania. What is the most likely diagnosis?
A. Dysthymia
B. Bipolar II Disorder
C. Major Depressive Disorder
D. Cyclothymic Disorder
Answer: C – Major Depressive Disorder
Rationale: MDD requires at least two weeks of depressed mood or anhedonia with
associated symptoms such as insomnia, poor appetite, or low energy.
, 2
3.
A patient with schizophrenia has been stable for several months on risperidone. He
now presents with muscle rigidity, elevated temperature, and autonomic instability.
What should the PMHNP suspect?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome
C. Tardive Dyskinesia
D. Dystonic Reaction
Answer: B – Neuroleptic Malignant Syndrome
Rationale: NMS is a rare, life-threatening reaction to antipsychotics characterized
by rigidity, fever, altered mental status, and autonomic dysfunction.
4.
A 45-year-old male with major depression is prescribed phenelzine. He calls the
clinic reporting a severe headache after eating aged cheese. What is the nurse
practitioner’s first concern?
A. Hypoglycemia
B. Hypertensive Crisis
C. Migraine Reaction
D. Serotonin Syndrome
Answer: B – Hypertensive Crisis
Rationale: MAOIs interact with tyramine-rich foods, causing excessive
norepinephrine release and hypertensive emergencies.
5.
A client recently diagnosed with bipolar I disorder presents with pressured speech,
decreased need for sleep, and impulsive spending. Which medication class is most
appropriate for initial stabilization?
A. Selective Serotonin Reuptake Inhibitors
B. Benzodiazepines
C. Mood Stabilizers
D. Atypical Antipsychotics
, 3
Answer: C – Mood Stabilizers
Rationale: Lithium, valproate, or carbamazepine are first-line for acute mania and
maintenance of bipolar I disorder.
6.
A 19-year-old college student reports recurrent intrusive thoughts of contamination
and washes her hands up to 50 times daily. Which psychotherapy is most effective
for her condition?
A. Supportive Therapy
B. Dialectical Behavior Therapy
C. Cognitive Behavioral Therapy with Exposure and Response Prevention
D. Psychoanalysis
Answer: C – CBT with Exposure and Response Prevention
Rationale: ERP is the gold-standard treatment for obsessive-compulsive disorder
by gradually reducing avoidance behaviors.
7.
A patient on fluoxetine reports restlessness, confusion, and muscle rigidity after
starting tramadol. What is the most likely cause?
A. Anticholinergic Toxicity
B. Serotonin Syndrome
C. Lithium Toxicity
D. Akathisia
Answer: B – Serotonin Syndrome
Rationale: Combined serotonergic drugs increase serotonin levels, leading to
hyperreflexia, confusion, and autonomic instability.
8.
A 34-year-old mother reports irritability, insomnia, and poor concentration that
began two weeks after childbirth. She denies thoughts of harming herself or the
baby. What is the most likely diagnosis?
, 4
A. Postpartum Depression
B. Baby Blues
C. Postpartum Psychosis
D. Adjustment Disorder
Answer: B – Baby Blues
Rationale: Transient mood changes within two weeks of delivery are common;
symptoms resolve without treatment.
9.
A client with schizophrenia has been on haloperidol for several months. She
presents with involuntary lip smacking and tongue protrusion. What is the best
nursing action?
A. Increase haloperidol dose
B. Add benzodiazepine
C. Discontinue haloperidol and consider clozapine
D. Add anticholinergic medication
Answer: C – Discontinue haloperidol and consider clozapine
Rationale: These are signs of tardive dyskinesia; switching to clozapine minimizes
extrapyramidal effects.
10.
A 29-year-old reports difficulty sleeping after a car accident two weeks ago. She
has recurrent nightmares and avoids driving. Which intervention is most
appropriate initially?
A. Prescribe long-term benzodiazepine
B. Begin trauma-focused cognitive behavioral therapy
C. Initiate SSRI therapy immediately
D. Recommend inpatient hospitalization
Answer: B – Trauma-Focused CBT
Rationale: Early psychotherapy focusing on trauma processing prevents
progression to PTSD; pharmacotherapy may be added if symptoms persist beyond
one month.
