1|Page
NURS 6670 FINAL EXAM 2026/2027
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER (PMHNP) COMPREHENSIVE
REVIEW 200+ NCLEX-STYLE QUESTIONS WITH
VERIFIED ANSWERS & RATIONALES GRADED
A+
Table of Contents
Section | Topic | Questions |
| 1 | Foundations of Psychiatric-Mental Health Nursing | 20 |
| 2 | Neurobiology and Psychopharmacology | 25 |
| 3 | Depressive Disorders & Suicide Risk Assessment | 20 |
| 4 | Bipolar and Related Disorders | 15 |
| 5 | Schizophrenia Spectrum & Psychotic Disorders | 20 |
| 6 | Anxiety Disorders, OCD, & Trauma-Related Disorders | 20 |
| 7 | Personality Disorders | 15 |
| 8 | Substance Use & Addictive Disorders | 15 |
| 9 | Sleep-Wake Disorders | 10 |
| 10 | Neurocognitive Disorders & Delirium | 15 |
| 11 | Eating, Gender, & Paraphilic Disorders | 10 |
| 12 | Legal & Ethical Aspects in Psychiatric Care | 10 |
| 13 | Psychotherapy & Therapeutic Modalities | 10 |
| 14 | Comprehensive/Mixed High-Yield Review | 15 |
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Section 1: Foundations of Psychiatric-Mental Health Nursing (20
questions)
**1. A 25-year-old female client with depression is prescribed
fluoxetine. She reports being in a healthy relationship and is considering
pregnancy. What is the most appropriate response from the PMHNP?**
A. "Fluoxetine is completely safe and you can continue it throughout
pregnancy."
B. "You should stop the medication immediately if you plan to become
pregnant."
C. "Let's discuss the risks and benefits of continuing versus switching
antidepressants during pregnancy."
D. "Only benzodiazepines are safe during pregnancy, so we should
switch you."
**Answer: C**
**Rationale:** Shared decision-making is essential. Fluoxetine (SSRI)
has risks and benefits that must be discussed. Abrupt discontinuation
risks relapse. Some SSRIs (sertraline) are often preferred in pregnancy
due to more data.
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**2. A psychiatric-mental health nurse practitioner (PMHNP) is
evaluating a new client. Which action best demonstrates the therapeutic
alliance?**
A. Completing a comprehensive diagnostic interview in the first session.
B. Prescribing medication within the first 15 minutes.
C. Demonstrating empathy, active listening, and collaborating on
treatment goals.
D. Referring the client to another provider for psychotherapy.
**Answer: C**
**Rationale:** The therapeutic alliance is built on empathy,
collaboration, and trust. Rushing to diagnosis or medication undermines
this foundation.
**3. A client with schizophrenia refuses medication, stating, "The pills
are poison." What is the PMHNP's best initial response?**
A. "You must take your medication or you will be hospitalized."
B. "I understand you feel that way. Can you tell me more about your
concerns?"
C. "That's not true. These medications help you."
D. Call security to administer the medication involuntarily.
, 4|Page
**Answer: B**
**Rationale:** Validating the client's feeling while exploring concerns
is therapeutic. Arguing or forcing medication damages trust. Involuntary
administration requires legal criteria (danger to self/others).
**4. A PMHNP is conducting a mental status examination (MSE).
Which finding would be documented as a disorder of thought content?**
A. Pressured speech.
B. Echolalia.
C. Delusion that the CIA is monitoring the client's thoughts.
D. Blocking.
**Answer: C**
**Rationale:** Thought content disorders include delusions, obsessions,
phobias, and suicidal/homicidal ideation. Pressured speech and blocking
are disorders of thought form/process. Echolalia is a speech abnormality.
**5. A 32-year-old client presents with depressed mood, anhedonia, and
fatigue for the past month. Which additional symptom would support a
diagnosis of major depressive disorder (MDD)?**
NURS 6670 FINAL EXAM 2026/2027
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER (PMHNP) COMPREHENSIVE
REVIEW 200+ NCLEX-STYLE QUESTIONS WITH
VERIFIED ANSWERS & RATIONALES GRADED
A+
Table of Contents
Section | Topic | Questions |
| 1 | Foundations of Psychiatric-Mental Health Nursing | 20 |
| 2 | Neurobiology and Psychopharmacology | 25 |
| 3 | Depressive Disorders & Suicide Risk Assessment | 20 |
| 4 | Bipolar and Related Disorders | 15 |
| 5 | Schizophrenia Spectrum & Psychotic Disorders | 20 |
| 6 | Anxiety Disorders, OCD, & Trauma-Related Disorders | 20 |
| 7 | Personality Disorders | 15 |
| 8 | Substance Use & Addictive Disorders | 15 |
| 9 | Sleep-Wake Disorders | 10 |
| 10 | Neurocognitive Disorders & Delirium | 15 |
| 11 | Eating, Gender, & Paraphilic Disorders | 10 |
| 12 | Legal & Ethical Aspects in Psychiatric Care | 10 |
| 13 | Psychotherapy & Therapeutic Modalities | 10 |
| 14 | Comprehensive/Mixed High-Yield Review | 15 |
,2|Page
Section 1: Foundations of Psychiatric-Mental Health Nursing (20
questions)
**1. A 25-year-old female client with depression is prescribed
fluoxetine. She reports being in a healthy relationship and is considering
pregnancy. What is the most appropriate response from the PMHNP?**
A. "Fluoxetine is completely safe and you can continue it throughout
pregnancy."
B. "You should stop the medication immediately if you plan to become
pregnant."
C. "Let's discuss the risks and benefits of continuing versus switching
antidepressants during pregnancy."
D. "Only benzodiazepines are safe during pregnancy, so we should
switch you."
**Answer: C**
**Rationale:** Shared decision-making is essential. Fluoxetine (SSRI)
has risks and benefits that must be discussed. Abrupt discontinuation
risks relapse. Some SSRIs (sertraline) are often preferred in pregnancy
due to more data.
,3|Page
**2. A psychiatric-mental health nurse practitioner (PMHNP) is
evaluating a new client. Which action best demonstrates the therapeutic
alliance?**
A. Completing a comprehensive diagnostic interview in the first session.
B. Prescribing medication within the first 15 minutes.
C. Demonstrating empathy, active listening, and collaborating on
treatment goals.
D. Referring the client to another provider for psychotherapy.
**Answer: C**
**Rationale:** The therapeutic alliance is built on empathy,
collaboration, and trust. Rushing to diagnosis or medication undermines
this foundation.
**3. A client with schizophrenia refuses medication, stating, "The pills
are poison." What is the PMHNP's best initial response?**
A. "You must take your medication or you will be hospitalized."
B. "I understand you feel that way. Can you tell me more about your
concerns?"
C. "That's not true. These medications help you."
D. Call security to administer the medication involuntarily.
, 4|Page
**Answer: B**
**Rationale:** Validating the client's feeling while exploring concerns
is therapeutic. Arguing or forcing medication damages trust. Involuntary
administration requires legal criteria (danger to self/others).
**4. A PMHNP is conducting a mental status examination (MSE).
Which finding would be documented as a disorder of thought content?**
A. Pressured speech.
B. Echolalia.
C. Delusion that the CIA is monitoring the client's thoughts.
D. Blocking.
**Answer: C**
**Rationale:** Thought content disorders include delusions, obsessions,
phobias, and suicidal/homicidal ideation. Pressured speech and blocking
are disorders of thought form/process. Echolalia is a speech abnormality.
**5. A 32-year-old client presents with depressed mood, anhedonia, and
fatigue for the past month. Which additional symptom would support a
diagnosis of major depressive disorder (MDD)?**
