NRNP 6675 WEEK 6 MIDTERM EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A
<br> <br>
Core Domains
- Psychiatric Assessment and Diagnosis
- Psychopharmacology and Pharmacological Management
- Psychotherapy and Therapeutic Modalities
- Legal, Ethical, and Regulatory Standards in PMHNP Practice
- Professional Role and Interprofessional Collaboration
- Safety, Crisis Intervention, and Suicide Risk Assessment
- Comorbid Medical and Psychiatric Conditions
- Cultural Competence and Health Equity in Mental Health
- Evidence-Based Practice and Clinical Decision-Making
- Quality Improvement and Systems-Based Care
Introduction
*This comprehensive assessment is designed to evaluate your readiness for the NRNP 6675 Week 6 Midterm
Exam. It measures foundational and applied knowledge in psychiatric mental health nurse practitioner practice,
including diagnostic reasoning, psychopharmacology, psychotherapy, ethics, legal standards, and crisis
intervention. Questions are structured as multiple-choice and scenario-based items that reflect real-world
clinical decision-making. Each question includes a verified correct answer and a detailed rationale to reinforce
,learning. Emphasis is placed on safety, evidence-based practice, cultural humility, and professional
accountability. Complete all items to identify strengths and areas for continued study.*
<br> <br>
SECTION ONE: QUESTIONS 1–100
Question 1
A 28-year-old female presents with depressed mood, anhedonia, hypersomnia, increased appetite, and leaden
paralysis. Symptoms worsen in winter and improve with light therapy. Which diagnosis is most consistent?
A. Persistent depressive disorder
B. Major depressive disorder with atypical features
C. Seasonal affective disorder
D. Bipolar II disorder, current episode depressed
🟢B
🔴 RATIONALE: The symptom complex of hypersomnia, increased appetite, leaden paralysis, and seasonal
pattern with response to light therapy best fits major depressive disorder with atypical features. Seasonal
affective disorder is not a standalone DSM-5 diagnosis but a specifier.
Question 2
,A PMHNP is evaluating a patient who reports taking St. John’s wort for mild depression. The patient is also
prescribed sertraline 100 mg daily. What is the most significant risk?
A. Hypertensive crisis
B. Serotonin syndrome
C. Hepatic failure
D. Sedation and falls
🟢B
🔴 RATIONALE: St. John’s wort (hypericum perforatum) increases serotonin activity and, when combined with
an SSRI like sertraline, significantly raises the risk of serotonin syndrome.
Question 3
Which laboratory finding is most consistent with antipsychotic-induced metabolic syndrome?
A. Elevated HDL and decreased triglycerides
B. Decreased fasting glucose and elevated LDL
C. Increased waist circumference and elevated fasting triglycerides
D. Decreased blood pressure and hyponatremia
🟢C
🔴 RATIONALE: Metabolic syndrome criteria include increased waist circumference, elevated triglycerides,
reduced HDL, elevated blood pressure, and elevated fasting glucose – antipsychotics commonly cause the
, pattern in C.
Question 4
A 45-year-old male with schizophrenia has been stable on haloperidol decanoate for 2 years. He now presents
with lip smacking, tongue protrusion, and choreiform movements of the fingers. What is the next best step?
A. Increase the haloperidol dose
B. Add benztropine
C. Switch to clozapine
D. Prescribe valbenazine
🟢D
🔴 RATIONALE: Tardive dyskinesia is suggested by orofacial and limb dyskinesias after long-term antipsychotic
use. Valbenazine and deutetrabenazine are FDA-approved for TD. Clozapine may reduce TD but is not first-line
treatment.
Question 5
Which ethical principle is primarily violated when a PMHNP discloses patient information without consent,
except when required by law?
A. Beneficence
B. Nonmaleficence
RATIONALES 2026 Q&A
<br> <br>
Core Domains
- Psychiatric Assessment and Diagnosis
- Psychopharmacology and Pharmacological Management
- Psychotherapy and Therapeutic Modalities
- Legal, Ethical, and Regulatory Standards in PMHNP Practice
- Professional Role and Interprofessional Collaboration
- Safety, Crisis Intervention, and Suicide Risk Assessment
- Comorbid Medical and Psychiatric Conditions
- Cultural Competence and Health Equity in Mental Health
- Evidence-Based Practice and Clinical Decision-Making
- Quality Improvement and Systems-Based Care
Introduction
*This comprehensive assessment is designed to evaluate your readiness for the NRNP 6675 Week 6 Midterm
Exam. It measures foundational and applied knowledge in psychiatric mental health nurse practitioner practice,
including diagnostic reasoning, psychopharmacology, psychotherapy, ethics, legal standards, and crisis
intervention. Questions are structured as multiple-choice and scenario-based items that reflect real-world
clinical decision-making. Each question includes a verified correct answer and a detailed rationale to reinforce
,learning. Emphasis is placed on safety, evidence-based practice, cultural humility, and professional
accountability. Complete all items to identify strengths and areas for continued study.*
<br> <br>
SECTION ONE: QUESTIONS 1–100
Question 1
A 28-year-old female presents with depressed mood, anhedonia, hypersomnia, increased appetite, and leaden
paralysis. Symptoms worsen in winter and improve with light therapy. Which diagnosis is most consistent?
A. Persistent depressive disorder
B. Major depressive disorder with atypical features
C. Seasonal affective disorder
D. Bipolar II disorder, current episode depressed
🟢B
🔴 RATIONALE: The symptom complex of hypersomnia, increased appetite, leaden paralysis, and seasonal
pattern with response to light therapy best fits major depressive disorder with atypical features. Seasonal
affective disorder is not a standalone DSM-5 diagnosis but a specifier.
Question 2
,A PMHNP is evaluating a patient who reports taking St. John’s wort for mild depression. The patient is also
prescribed sertraline 100 mg daily. What is the most significant risk?
A. Hypertensive crisis
B. Serotonin syndrome
C. Hepatic failure
D. Sedation and falls
🟢B
🔴 RATIONALE: St. John’s wort (hypericum perforatum) increases serotonin activity and, when combined with
an SSRI like sertraline, significantly raises the risk of serotonin syndrome.
Question 3
Which laboratory finding is most consistent with antipsychotic-induced metabolic syndrome?
A. Elevated HDL and decreased triglycerides
B. Decreased fasting glucose and elevated LDL
C. Increased waist circumference and elevated fasting triglycerides
D. Decreased blood pressure and hyponatremia
🟢C
🔴 RATIONALE: Metabolic syndrome criteria include increased waist circumference, elevated triglycerides,
reduced HDL, elevated blood pressure, and elevated fasting glucose – antipsychotics commonly cause the
, pattern in C.
Question 4
A 45-year-old male with schizophrenia has been stable on haloperidol decanoate for 2 years. He now presents
with lip smacking, tongue protrusion, and choreiform movements of the fingers. What is the next best step?
A. Increase the haloperidol dose
B. Add benztropine
C. Switch to clozapine
D. Prescribe valbenazine
🟢D
🔴 RATIONALE: Tardive dyskinesia is suggested by orofacial and limb dyskinesias after long-term antipsychotic
use. Valbenazine and deutetrabenazine are FDA-approved for TD. Clozapine may reduce TD but is not first-line
treatment.
Question 5
Which ethical principle is primarily violated when a PMHNP discloses patient information without consent,
except when required by law?
A. Beneficence
B. Nonmaleficence
