NRNP 6635 MIDTERM Comprehensive Examination
in Psychiatric Nursing QUESTIONS AND ANSWERS
REAL!!!! 2026
I
QUESTION 1
What is the most IMMEDIATE consideration in assessing depression in adolescents?
A. Sleep
B. Safety
C. Appetite
D. Anger
ANSWER✔✨-: B. Safety
Rationale:
A. Sleep: While sleep disturbances are important in depression assessment, they are not the most
immediate concern. Sleep changes are secondary to safety concerns.
B. Safety: Correct. Safety is always the priority in psychiatric assessment. Adolescents with depression
are at risk for self-harm and suicide, making safety the most immediate consideration.
C. Appetite: Appetite changes are significant symptoms but not the primary immediate concern.
D. Anger: Anger can be a symptom but does not take precedence over safety in the assessment
hierarchy.
,QUESTION 2
Select the neurotransmitter that is most involved in the pathophysiology of schizophrenia.
A. Norepinephrine
B. Dopamine
C. Serotonin
D. Acetylcholine
ANSWER✔✨-: B. Dopamine
Rationale:
A. Norepinephrine: Primarily involved in mood regulation and the fight-or-flight response, not the
primary neurotransmitter in schizophrenia.
B. Dopamine: Correct. The dopamine hypothesis suggests that hyperactivity of dopamine transmission
in the brain, particularly in the mesolimbic pathway, is central to the pathophysiology of schizophrenia.
C. Serotonin: While involved in mood disorders and some psychotic symptoms, dopamine is the primary
neurotransmitter implicated.
D. Acetylcholine: Involved in memory and learning, particularly in Alzheimer's disease, not primarily in
schizophrenia.
QUESTION 3
A client with major depressive disorder is prescribed fluoxetine. The nurse should teach the client that
therapeutic effects may not be fully realized until what timeframe?
A. 24-48 hours
B. 3-5 days
,C. 1-2 weeks
D. 4-6 weeks
ANSWER✔✨-: D. 4-6 weeks
Rationale:
A. 24-48 hours: Too short. SSRIs require longer to achieve full therapeutic effect.
B. 3-5 days: Insufficient time for neurotransmitter receptor adaptation.
C. 1-2 weeks: Some initial improvement may occur, but full therapeutic effect requires more time.
D. 4-6 weeks: Correct. SSRIs like fluoxetine typically require 4-6 weeks to reach full therapeutic efficacy
due to downstream effects on receptor sensitivity and gene expression.
QUESTION 4
Which nursing diagnosis should receive the highest priority for a client experiencing acute mania?
A. Imbalanced Nutrition: Less Than Body Requirements
B. Risk for Injury
C. Disturbed Thought Processes
D. Sleep Deprivation
ANSWER✔✨-: B. Risk for Injury
Rationale:
A. Imbalanced Nutrition: Important but not the immediate priority during acute mania.
, B. Risk for Injury: Correct. Clients in acute mania engage in impulsive, reckless behaviors and have poor
judgment, placing them at high risk for physical injury.
C. Disturbed Thought Processes: Important but secondary to safety concerns.
D. Sleep Deprivation: Significant but not the highest priority.
QUESTION 5
A client with borderline personality disorder frequently self-harms. Which intervention should the nurse
implement first?
A. Explore the underlying emotional triggers
B. Place the client on suicide precautions
C. Administer prescribed PRN medication
D. Establish a no-harm contract
ANSWER✔✨-: B. Place the client on suicide precautions
Rationale:
A. Explore the underlying emotional triggers: Important for long-term treatment but not the first
intervention.
B. Place the client on suicide precautions: Correct. Safety is the priority; the nurse must first ensure the
client is physically safe.
C. Administer prescribed PRN medication: May be needed but not the initial priority.
D. Establish a no-harm contract: Contracts are controversial and should not replace safety measures.
in Psychiatric Nursing QUESTIONS AND ANSWERS
REAL!!!! 2026
I
QUESTION 1
What is the most IMMEDIATE consideration in assessing depression in adolescents?
A. Sleep
B. Safety
C. Appetite
D. Anger
ANSWER✔✨-: B. Safety
Rationale:
A. Sleep: While sleep disturbances are important in depression assessment, they are not the most
immediate concern. Sleep changes are secondary to safety concerns.
B. Safety: Correct. Safety is always the priority in psychiatric assessment. Adolescents with depression
are at risk for self-harm and suicide, making safety the most immediate consideration.
C. Appetite: Appetite changes are significant symptoms but not the primary immediate concern.
D. Anger: Anger can be a symptom but does not take precedence over safety in the assessment
hierarchy.
,QUESTION 2
Select the neurotransmitter that is most involved in the pathophysiology of schizophrenia.
A. Norepinephrine
B. Dopamine
C. Serotonin
D. Acetylcholine
ANSWER✔✨-: B. Dopamine
Rationale:
A. Norepinephrine: Primarily involved in mood regulation and the fight-or-flight response, not the
primary neurotransmitter in schizophrenia.
B. Dopamine: Correct. The dopamine hypothesis suggests that hyperactivity of dopamine transmission
in the brain, particularly in the mesolimbic pathway, is central to the pathophysiology of schizophrenia.
C. Serotonin: While involved in mood disorders and some psychotic symptoms, dopamine is the primary
neurotransmitter implicated.
D. Acetylcholine: Involved in memory and learning, particularly in Alzheimer's disease, not primarily in
schizophrenia.
QUESTION 3
A client with major depressive disorder is prescribed fluoxetine. The nurse should teach the client that
therapeutic effects may not be fully realized until what timeframe?
A. 24-48 hours
B. 3-5 days
,C. 1-2 weeks
D. 4-6 weeks
ANSWER✔✨-: D. 4-6 weeks
Rationale:
A. 24-48 hours: Too short. SSRIs require longer to achieve full therapeutic effect.
B. 3-5 days: Insufficient time for neurotransmitter receptor adaptation.
C. 1-2 weeks: Some initial improvement may occur, but full therapeutic effect requires more time.
D. 4-6 weeks: Correct. SSRIs like fluoxetine typically require 4-6 weeks to reach full therapeutic efficacy
due to downstream effects on receptor sensitivity and gene expression.
QUESTION 4
Which nursing diagnosis should receive the highest priority for a client experiencing acute mania?
A. Imbalanced Nutrition: Less Than Body Requirements
B. Risk for Injury
C. Disturbed Thought Processes
D. Sleep Deprivation
ANSWER✔✨-: B. Risk for Injury
Rationale:
A. Imbalanced Nutrition: Important but not the immediate priority during acute mania.
, B. Risk for Injury: Correct. Clients in acute mania engage in impulsive, reckless behaviors and have poor
judgment, placing them at high risk for physical injury.
C. Disturbed Thought Processes: Important but secondary to safety concerns.
D. Sleep Deprivation: Significant but not the highest priority.
QUESTION 5
A client with borderline personality disorder frequently self-harms. Which intervention should the nurse
implement first?
A. Explore the underlying emotional triggers
B. Place the client on suicide precautions
C. Administer prescribed PRN medication
D. Establish a no-harm contract
ANSWER✔✨-: B. Place the client on suicide precautions
Rationale:
A. Explore the underlying emotional triggers: Important for long-term treatment but not the first
intervention.
B. Place the client on suicide precautions: Correct. Safety is the priority; the nurse must first ensure the
client is physically safe.
C. Administer prescribed PRN medication: May be needed but not the initial priority.
D. Establish a no-harm contract: Contracts are controversial and should not replace safety measures.
