NU 674
Psychiatric Mental Healthcare II
Latest Midterm Exam Review
(With Solutions)
2026
1
,1. Case: A 40-year-old patient with schizoaffective disorder presents with
auditory hallucinations and mood instability.
Question: Which treatment plan is most appropriate?
- A. Antipsychotic monotherapy
- B. Mood stabilizer plus antipsychotic
- C. SSRI monotherapy
- D. Benzodiazepine monotherapy
Answer: B
Rationale: Schizoaffective disorder requires both mood stabilization
and antipsychotic therapy.
---
2. Case: A patient with severe depression is started on fluoxetine. Two
weeks later, they report increased energy but persistent suicidal
thoughts.
Question: What is the clinical concern?
- A. Normal SSRI response
- B. Increased suicide risk due to early activation
- C. Lithium toxicity
- D. Serotonin syndrome
Answer: B
Rationale: SSRIs may increase energy before mood improves, elevating
suicide risk.
---
3. Case: A patient with bipolar disorder is prescribed valproate.
Question: Which lab test is most critical for monitoring?
- A. CBC
- B. Liver function tests
- C. Thyroid function tests
2
, - D. Vitamin B12 levels
Answer: B
Rationale: Valproate carries risk of hepatotoxicity.
---
4. Case: A patient with panic disorder requests alprazolam for long-term
use.
Question: What is the best nursing response?
- A. Approve request
- B. Educate on dependence risk and suggest SSRIs
- C. Ignore request
- D. Increase dose
Answer: B
Rationale: SSRIs are safer for long-term management; benzodiazepines
risk dependence.
---
5. Case: A patient with schizophrenia develops tardive dyskinesia.
Question: Which medication is most appropriate?
- A. Clozapine
- B. Valbenazine
- C. Lithium
- D. Fluoxetine
Answer: B
Rationale: VMAT2 inhibitors (valbenazine) treat tardive dyskinesia.
---
6. Case: A patient with PTSD reports hyperarousal and insomnia.
Question: Which intervention is most effective?
- A. Benzodiazepines
- B. Trauma-focused CBT plus SSRI
3
Psychiatric Mental Healthcare II
Latest Midterm Exam Review
(With Solutions)
2026
1
,1. Case: A 40-year-old patient with schizoaffective disorder presents with
auditory hallucinations and mood instability.
Question: Which treatment plan is most appropriate?
- A. Antipsychotic monotherapy
- B. Mood stabilizer plus antipsychotic
- C. SSRI monotherapy
- D. Benzodiazepine monotherapy
Answer: B
Rationale: Schizoaffective disorder requires both mood stabilization
and antipsychotic therapy.
---
2. Case: A patient with severe depression is started on fluoxetine. Two
weeks later, they report increased energy but persistent suicidal
thoughts.
Question: What is the clinical concern?
- A. Normal SSRI response
- B. Increased suicide risk due to early activation
- C. Lithium toxicity
- D. Serotonin syndrome
Answer: B
Rationale: SSRIs may increase energy before mood improves, elevating
suicide risk.
---
3. Case: A patient with bipolar disorder is prescribed valproate.
Question: Which lab test is most critical for monitoring?
- A. CBC
- B. Liver function tests
- C. Thyroid function tests
2
, - D. Vitamin B12 levels
Answer: B
Rationale: Valproate carries risk of hepatotoxicity.
---
4. Case: A patient with panic disorder requests alprazolam for long-term
use.
Question: What is the best nursing response?
- A. Approve request
- B. Educate on dependence risk and suggest SSRIs
- C. Ignore request
- D. Increase dose
Answer: B
Rationale: SSRIs are safer for long-term management; benzodiazepines
risk dependence.
---
5. Case: A patient with schizophrenia develops tardive dyskinesia.
Question: Which medication is most appropriate?
- A. Clozapine
- B. Valbenazine
- C. Lithium
- D. Fluoxetine
Answer: B
Rationale: VMAT2 inhibitors (valbenazine) treat tardive dyskinesia.
---
6. Case: A patient with PTSD reports hyperarousal and insomnia.
Question: Which intervention is most effective?
- A. Benzodiazepines
- B. Trauma-focused CBT plus SSRI
3
