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NR 607 FINAL COMPREHENSIVE EXAM 2026
ALL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED
1. A 29-year-old client presents with persistent sadness,
hopelessness, difficulty sleeping, and decreased appetite for the past
two months. Which of the following is the most appropriate initial
screening tool to assess for depression?
A. AUDIT
B. CAGE questionnaire
C. PHQ-9
D. GAD-7
*Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a
validated screening tool specifically designed to assess the severity of
depressive symptoms. The AUDIT and CAGE are used for alcohol
use disorders, and the GAD-7 is used for anxiety disorders. *
2. The PMHNP is conducting a neurological examination on a
patient with altered mental status. The inability to perform rapidly
alternating hand movements is known as:
A. Ataxia
B. Dysmetria
C. Dysdiadochokinesia
D. Akathisia
*Rationale: Dysdiadochokinesia is the inability to perform rapid,
alternating movements, such as rapidly pronating and supinating
the hands. Ataxia refers to lack of coordination, dysmetria is the
inability to control the range of movement, and akathisia is a
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movement disorder characterized by a feeling of inner
restlessness. *
3. A 45-year-old male with a history of schizophrenia has been
maintained on risperidone 6 mg daily. During a routine visit, he
exhibits involuntary, repetitive movements of the tongue and face.
His AIMS score is 2. Which of the following is the most appropriate
next step in management?
A. Discontinue risperidone immediately
B. Switch to aripiprazole 10 mg daily
C. Continue risperidone and add valbenazine 40 mg daily
D. Increase risperidone to 8 mg daily
*Rationale: The patient is demonstrating symptoms of tardive
dyskinesia (TD) as evidenced by an AIMS score of 2 or greater. The
APA recommends continuing the antipsychotic if symptom control
is good and adding a VMAT2 inhibitor such as valbenazine to treat
TD symptoms. *
4. Which of the following ICD-10-CM codes should be assigned for a
patient with schizophrenia who is also diagnosed with tardive
dyskinesia?
A. F20.9 and G24.9
B. F20.9 and G24.01
C. F20.9 and G24.09
D. F25.9 and G24.09
*Rationale: F20.9 is the code for schizophrenia, unspecified. G24.09
is the code for other drug-induced dystonia, which includes tardive
dyskinesia. G24.9 is unspecified dystonia, and G24.01 is drug-
induced subacute dyskinesia. *
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5. A 68-year-old female with treatment-resistant depression (TRD)
has failed multiple antidepressant trials. Which of the following is
considered a first-line somatic therapy for TRD?
A. Transcranial magnetic stimulation (TMS)
B. Electroconvulsive therapy (ECT)
C. Deep brain stimulation (DBS)
D. Vagus nerve stimulation (VNS)
*Rationale: ECT is considered a first-line treatment for TRD,
particularly in patients who have not responded to multiple
medications. TMS is also used but is often considered after ECT or
for less severe cases. DBS and VNS are typically reserved for more
refractory cases. *
6. A 25-year-old woman reports frequently falling asleep during the
day for the last 6 months. She sometimes nods off during calls at
work and also during times of high volume. This is most consistent
with which of the following?
A. Insomnia disorder
B. Narcolepsy
C. Hypersomnolence disorder
D. Circadian rhythm sleep-wake disorder
*Rationale: Narcolepsy is characterized by excessive daytime
sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations.
The patient's symptoms of falling asleep during the day, especially
during work, are consistent with narcolepsy. *
7. Which of the following is the best example of secondary
prevention in psychiatric-mental health nursing?
A. Providing education about mental health to the general public
B. Screening for depression in a primary care clinic
C. Providing rehabilitation services to patients with chronic
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schizophrenia
D. Administering antipsychotic medications to a patient in an acute
psychotic episode
*Rationale: Secondary prevention focuses on early detection and
intervention to prevent the progression of disease. Screening for
depression in a primary care clinic is an example of secondary
prevention. Primary prevention includes education and health
promotion. Tertiary prevention includes rehabilitation and
management of chronic conditions. *
8. A 52-year-old male with a history of alcohol use disorder presents
with confusion, ataxia, and ophthalmoplegia. Which of the following
is the most likely diagnosis?
A. Korsakoff's syndrome
B. Wernicke's encephalopathy
C. Delirium tremens
D. Hepatic encephalopathy
*Rationale: The classic triad of Wernicke's encephalopathy is
confusion, ataxia, and ophthalmoplegia, caused by thiamine
deficiency, commonly seen in alcohol use disorder. *
9. A 34-year-old female presents with recurrent, unexpected panic
attacks and persistent worry about having additional attacks. She
has avoided driving on the highway for fear of having a panic attack
while driving. Which of the following is the most appropriate
diagnosis?
A. Panic disorder with agoraphobia
B. Agoraphobia without panic disorder
C. Specific phobia
D. Generalized anxiety disorder
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NR 607 FINAL COMPREHENSIVE EXAM 2026
ALL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED
1. A 29-year-old client presents with persistent sadness,
hopelessness, difficulty sleeping, and decreased appetite for the past
two months. Which of the following is the most appropriate initial
screening tool to assess for depression?
A. AUDIT
B. CAGE questionnaire
C. PHQ-9
D. GAD-7
*Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a
validated screening tool specifically designed to assess the severity of
depressive symptoms. The AUDIT and CAGE are used for alcohol
use disorders, and the GAD-7 is used for anxiety disorders. *
2. The PMHNP is conducting a neurological examination on a
patient with altered mental status. The inability to perform rapidly
alternating hand movements is known as:
A. Ataxia
B. Dysmetria
C. Dysdiadochokinesia
D. Akathisia
*Rationale: Dysdiadochokinesia is the inability to perform rapid,
alternating movements, such as rapidly pronating and supinating
the hands. Ataxia refers to lack of coordination, dysmetria is the
inability to control the range of movement, and akathisia is a
1|Page
,2|Page
movement disorder characterized by a feeling of inner
restlessness. *
3. A 45-year-old male with a history of schizophrenia has been
maintained on risperidone 6 mg daily. During a routine visit, he
exhibits involuntary, repetitive movements of the tongue and face.
His AIMS score is 2. Which of the following is the most appropriate
next step in management?
A. Discontinue risperidone immediately
B. Switch to aripiprazole 10 mg daily
C. Continue risperidone and add valbenazine 40 mg daily
D. Increase risperidone to 8 mg daily
*Rationale: The patient is demonstrating symptoms of tardive
dyskinesia (TD) as evidenced by an AIMS score of 2 or greater. The
APA recommends continuing the antipsychotic if symptom control
is good and adding a VMAT2 inhibitor such as valbenazine to treat
TD symptoms. *
4. Which of the following ICD-10-CM codes should be assigned for a
patient with schizophrenia who is also diagnosed with tardive
dyskinesia?
A. F20.9 and G24.9
B. F20.9 and G24.01
C. F20.9 and G24.09
D. F25.9 and G24.09
*Rationale: F20.9 is the code for schizophrenia, unspecified. G24.09
is the code for other drug-induced dystonia, which includes tardive
dyskinesia. G24.9 is unspecified dystonia, and G24.01 is drug-
induced subacute dyskinesia. *
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,3|Page
5. A 68-year-old female with treatment-resistant depression (TRD)
has failed multiple antidepressant trials. Which of the following is
considered a first-line somatic therapy for TRD?
A. Transcranial magnetic stimulation (TMS)
B. Electroconvulsive therapy (ECT)
C. Deep brain stimulation (DBS)
D. Vagus nerve stimulation (VNS)
*Rationale: ECT is considered a first-line treatment for TRD,
particularly in patients who have not responded to multiple
medications. TMS is also used but is often considered after ECT or
for less severe cases. DBS and VNS are typically reserved for more
refractory cases. *
6. A 25-year-old woman reports frequently falling asleep during the
day for the last 6 months. She sometimes nods off during calls at
work and also during times of high volume. This is most consistent
with which of the following?
A. Insomnia disorder
B. Narcolepsy
C. Hypersomnolence disorder
D. Circadian rhythm sleep-wake disorder
*Rationale: Narcolepsy is characterized by excessive daytime
sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations.
The patient's symptoms of falling asleep during the day, especially
during work, are consistent with narcolepsy. *
7. Which of the following is the best example of secondary
prevention in psychiatric-mental health nursing?
A. Providing education about mental health to the general public
B. Screening for depression in a primary care clinic
C. Providing rehabilitation services to patients with chronic
3|Page
, 4|Page
schizophrenia
D. Administering antipsychotic medications to a patient in an acute
psychotic episode
*Rationale: Secondary prevention focuses on early detection and
intervention to prevent the progression of disease. Screening for
depression in a primary care clinic is an example of secondary
prevention. Primary prevention includes education and health
promotion. Tertiary prevention includes rehabilitation and
management of chronic conditions. *
8. A 52-year-old male with a history of alcohol use disorder presents
with confusion, ataxia, and ophthalmoplegia. Which of the following
is the most likely diagnosis?
A. Korsakoff's syndrome
B. Wernicke's encephalopathy
C. Delirium tremens
D. Hepatic encephalopathy
*Rationale: The classic triad of Wernicke's encephalopathy is
confusion, ataxia, and ophthalmoplegia, caused by thiamine
deficiency, commonly seen in alcohol use disorder. *
9. A 34-year-old female presents with recurrent, unexpected panic
attacks and persistent worry about having additional attacks. She
has avoided driving on the highway for fear of having a panic attack
while driving. Which of the following is the most appropriate
diagnosis?
A. Panic disorder with agoraphobia
B. Agoraphobia without panic disorder
C. Specific phobia
D. Generalized anxiety disorder
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