1
NR 547 PMHNP Exam 2026/2027 Actual Exam |
Latest Test Bank for Midterm & Final Exam Review
with Detailed Rationales | NR547 Chamberlain | Pass
Guaranteed - A+ Graded
Section 1: Neurobiology and Psychopharmacology (50 Questions)
Q1
A patient is started on fluoxetine (Prozac) for major depressive disorder. The PMHNP
understands that the therapeutic effect of SSRIs is primarily due to:
• A. Blocking dopamine D2 receptors
• B. Inhibiting the reuptake of serotonin at the presynaptic neuron [CORRECT]
• C. Blocking acetylcholinesterase
• D. Enhancing GABA activity
Correct Answer: B
Rationale: SSRIs work by selectively inhibiting the reuptake of serotonin at the presynaptic
neuron, increasing serotonin availability in the synaptic cleft. Option A describes antipsychotics.
Option C describes Alzheimer's medications (e.g., donepezil). Option D describes
benzodiazepines and other GABAergic drugs.
Q2
A patient with schizophrenia is prescribed aripiprazole (Abilify). The PMHNP explains that
this medication is classified as a:
• A. Typical antipsychotic
• B. Dopamine partial agonist [CORRECT]
• C. MAO inhibitor
• D. Tricyclic antidepressant
Correct Answer: B
Rationale: Aripiprazole is a second-generation (atypical) antipsychotic that acts as a dopamine
,2
D2 partial agonist and serotonin 5-HT1A partial agonist. Option A is incorrect (typical
antipsychotics are first-generation, e.g., haloperidol). Options C and D are unrelated classes.
Q3
A patient with bipolar disorder is prescribed lithium carbonate. The PMHNP should monitor
which of the following laboratory values to assess for toxicity?
• A. Liver function tests (LFTs)
• B. Serum lithium level [CORRECT]
• C. Complete blood count (CBC)
• D. Thyroid-stimulating hormone (TSH)
Correct Answer: B
Rationale: *Lithium has a narrow therapeutic index (0.6-1.2 mEq/L); levels >1.5 mEq/L risk
toxicity (e.g., tremor, confusion, seizures). Options A, C, and D are monitored for other reasons
but are not primary for lithium toxicity.*
Q4
A patient with generalized anxiety disorder (GAD) is prescribed buspirone (Buspar). The
PMHNP explains that the onset of therapeutic effect typically occurs within:
• A. 1-3 days
• B. 1-2 weeks [CORRECT]
• C. 4-6 weeks
• D. 6-8 weeks
Correct Answer: B
Rationale: Buspirone’s anxiolytic effects begin in 1-2 weeks (unlike benzodiazepines, which act
immediately). Options A, C, and D are incorrect.
Q5
A patient with major depressive disorder (MDD) is prescribed bupropion (Wellbutrin). The
PMHNP should counsel the patient about which of the following potential side effects?
• A. Sedation
,3
• B. Weight gain
• C. Insomnia [CORRECT]
• D. Sexual dysfunction
Correct Answer: C
Rationale: Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) that commonly
causes insomnia, agitation, or dry mouth. Options A, B, and D are more typical of SSRIs/TCAs.
Q6
A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine (Luvox). The
PMHNP explains that this medication is a:
• A. Selective serotonin reuptake inhibitor (SSRI) [CORRECT]
• B. Tricyclic antidepressant (TCA)
• C. Monoamine oxidase inhibitor (MAOI)
• D. Norepinephrine-dopamine reuptake inhibitor (NDRI)
Correct Answer: A
Rationale: Fluvoxamine is an SSRI approved for OCD. Options B, C, and D are incorrect
classes.
Q7
A patient with treatment-resistant depression is prescribed ketamine (Spravato). The PMHNP
should monitor for which of the following adverse effects?
• A. Hypertension and dissociation [CORRECT]
• B. Hypotension and bradycardia
• C. Sedation and weight gain
• D. Extrapyramidal symptoms (EPS)
Correct Answer: A
Rationale: Ketamine can cause transient hypertension and dissociation during/after
administration. Options B, C, and D are not typical.
Q8
, 4
A patient with schizophrenia is prescribed clozapine (Clozaril). The PMHNP should monitor
for which of the following life-threatening adverse effects?
• A. Agranulocytosis [CORRECT]
• B. Hypertensive crisis
• C. Serotonin syndrome
• D. Neuroleptic malignant syndrome (NMS)
Correct Answer: A
Rationale: Clozapine carries a black-box warning for agranulocytosis (1-2% risk); weekly
CBCs are required for the first 6 months. Options B, C, and D are risks with other medications.
Q9
A patient with panic disorder is prescribed alprazolam (Xanax). The PMHNP should counsel
the patient about the risk of:
• A. Hypertensive crisis
• B. Dependence and withdrawal [CORRECT]
• C. Extrapyramidal symptoms (EPS)
• D. Weight gain
Correct Answer: B
Rationale: Benzodiazepines (e.g., alprazolam) carry risks of tolerance, dependence, and
withdrawal (e.g., seizures, rebound anxiety). Options A, C, and D are not primary risks.
Q10
A patient with bipolar disorder is prescribed valproate (Depakote). The PMHNP should
monitor for which of the following adverse effects?
• A. Thrombocytopenia [CORRECT]
• B. Hypertensive crisis
• C. QTc prolongation
• D. Akathisia
NR 547 PMHNP Exam 2026/2027 Actual Exam |
Latest Test Bank for Midterm & Final Exam Review
with Detailed Rationales | NR547 Chamberlain | Pass
Guaranteed - A+ Graded
Section 1: Neurobiology and Psychopharmacology (50 Questions)
Q1
A patient is started on fluoxetine (Prozac) for major depressive disorder. The PMHNP
understands that the therapeutic effect of SSRIs is primarily due to:
• A. Blocking dopamine D2 receptors
• B. Inhibiting the reuptake of serotonin at the presynaptic neuron [CORRECT]
• C. Blocking acetylcholinesterase
• D. Enhancing GABA activity
Correct Answer: B
Rationale: SSRIs work by selectively inhibiting the reuptake of serotonin at the presynaptic
neuron, increasing serotonin availability in the synaptic cleft. Option A describes antipsychotics.
Option C describes Alzheimer's medications (e.g., donepezil). Option D describes
benzodiazepines and other GABAergic drugs.
Q2
A patient with schizophrenia is prescribed aripiprazole (Abilify). The PMHNP explains that
this medication is classified as a:
• A. Typical antipsychotic
• B. Dopamine partial agonist [CORRECT]
• C. MAO inhibitor
• D. Tricyclic antidepressant
Correct Answer: B
Rationale: Aripiprazole is a second-generation (atypical) antipsychotic that acts as a dopamine
,2
D2 partial agonist and serotonin 5-HT1A partial agonist. Option A is incorrect (typical
antipsychotics are first-generation, e.g., haloperidol). Options C and D are unrelated classes.
Q3
A patient with bipolar disorder is prescribed lithium carbonate. The PMHNP should monitor
which of the following laboratory values to assess for toxicity?
• A. Liver function tests (LFTs)
• B. Serum lithium level [CORRECT]
• C. Complete blood count (CBC)
• D. Thyroid-stimulating hormone (TSH)
Correct Answer: B
Rationale: *Lithium has a narrow therapeutic index (0.6-1.2 mEq/L); levels >1.5 mEq/L risk
toxicity (e.g., tremor, confusion, seizures). Options A, C, and D are monitored for other reasons
but are not primary for lithium toxicity.*
Q4
A patient with generalized anxiety disorder (GAD) is prescribed buspirone (Buspar). The
PMHNP explains that the onset of therapeutic effect typically occurs within:
• A. 1-3 days
• B. 1-2 weeks [CORRECT]
• C. 4-6 weeks
• D. 6-8 weeks
Correct Answer: B
Rationale: Buspirone’s anxiolytic effects begin in 1-2 weeks (unlike benzodiazepines, which act
immediately). Options A, C, and D are incorrect.
Q5
A patient with major depressive disorder (MDD) is prescribed bupropion (Wellbutrin). The
PMHNP should counsel the patient about which of the following potential side effects?
• A. Sedation
,3
• B. Weight gain
• C. Insomnia [CORRECT]
• D. Sexual dysfunction
Correct Answer: C
Rationale: Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) that commonly
causes insomnia, agitation, or dry mouth. Options A, B, and D are more typical of SSRIs/TCAs.
Q6
A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine (Luvox). The
PMHNP explains that this medication is a:
• A. Selective serotonin reuptake inhibitor (SSRI) [CORRECT]
• B. Tricyclic antidepressant (TCA)
• C. Monoamine oxidase inhibitor (MAOI)
• D. Norepinephrine-dopamine reuptake inhibitor (NDRI)
Correct Answer: A
Rationale: Fluvoxamine is an SSRI approved for OCD. Options B, C, and D are incorrect
classes.
Q7
A patient with treatment-resistant depression is prescribed ketamine (Spravato). The PMHNP
should monitor for which of the following adverse effects?
• A. Hypertension and dissociation [CORRECT]
• B. Hypotension and bradycardia
• C. Sedation and weight gain
• D. Extrapyramidal symptoms (EPS)
Correct Answer: A
Rationale: Ketamine can cause transient hypertension and dissociation during/after
administration. Options B, C, and D are not typical.
Q8
, 4
A patient with schizophrenia is prescribed clozapine (Clozaril). The PMHNP should monitor
for which of the following life-threatening adverse effects?
• A. Agranulocytosis [CORRECT]
• B. Hypertensive crisis
• C. Serotonin syndrome
• D. Neuroleptic malignant syndrome (NMS)
Correct Answer: A
Rationale: Clozapine carries a black-box warning for agranulocytosis (1-2% risk); weekly
CBCs are required for the first 6 months. Options B, C, and D are risks with other medications.
Q9
A patient with panic disorder is prescribed alprazolam (Xanax). The PMHNP should counsel
the patient about the risk of:
• A. Hypertensive crisis
• B. Dependence and withdrawal [CORRECT]
• C. Extrapyramidal symptoms (EPS)
• D. Weight gain
Correct Answer: B
Rationale: Benzodiazepines (e.g., alprazolam) carry risks of tolerance, dependence, and
withdrawal (e.g., seizures, rebound anxiety). Options A, C, and D are not primary risks.
Q10
A patient with bipolar disorder is prescribed valproate (Depakote). The PMHNP should
monitor for which of the following adverse effects?
• A. Thrombocytopenia [CORRECT]
• B. Hypertensive crisis
• C. QTc prolongation
• D. Akathisia
