NU664C Exam 2: Family Psychiatric Mental Health I
2026/2027 |Newly Released| Regis College
60 Questions & Answers | Grade A | 100% Correct Rationales
Guaranteed Pass
Q1: A 22-year-old male presents with auditory hallucinations, persecutory delusions, and
disorganized speech lasting 4 months with gradual functional decline. His symptoms began after
a period of social withdrawal and declining academic performance. The psychiatric nurse
practitioner recognizes that the duration of symptoms meets criteria for which diagnosis?
A. Brief psychotic disorder with full return to baseline expected
B. Schizophreniform disorder as a provisional diagnosis
C. Schizophrenia with continuous disturbance for at least 6 months
D. Schizoaffective disorder requiring prominent mood symptoms
Correct Answer: B
Rationale: Correct because the patient has psychotic symptoms lasting 4 months, which falls
within the 1-6 month timeframe for schizophreniform disorder, a provisional diagnosis that may
convert to schizophrenia if symptoms persist beyond 6 months or resolve if full recovery occurs.
Brief psychotic disorder lasts less than 1 month; schizophrenia requires 6 months of continuous
disturbance including 1 month of active-phase symptoms; schizoaffective disorder requires a
major mood episode concurrent with psychotic symptoms and mood symptoms present for the
majority of the illness duration.
Q2: A patient with schizophrenia is prescribed haloperidol 10 mg daily. After 3 days, the patient
develops acute torticollis, oculogyric crisis, and tongue protrusion. The psychiatric nurse
practitioner recognizes these symptoms as indicating which condition?
A. Tardive dyskinesia from chronic D2 receptor blockade
B. Acute dystonia from nigrostriatal pathway D2 antagonism
C. Akathisia presenting as subjective restlessness
D. Neuroleptic malignant syndrome with autonomic instability
Correct Answer: D
,Rationale: Correct because acute dystonia—characterized by sudden onset muscle spasms
including torticollis, oculogyric crisis, and tongue protrusion—is an extrapyramidal symptom
resulting from acute D2 receptor blockade in the nigrostriatal pathway, typically occurring within
hours to days of initiating or increasing high-potency typical antipsychotics such as haloperidol.
Tardive dyskinesia develops after months to years of chronic treatment; akathisia presents as
subjective restlessness without sustained muscle spasms; neuroleptic malignant syndrome
involves hyperthermia, rigidity, and autonomic instability, not isolated dystonic reactions.
Q3: A patient with treatment-resistant schizophrenia has failed trials of risperidone, olanzapine,
and aripiprazole. The psychiatric nurse practitioner considers initiating clozapine. Which
monitoring requirement is mandatory before starting this medication?
A. Baseline electrocardiogram to assess QT interval
B. Absolute neutrophil count through the REMS program
C. Liver function tests for hepatotoxicity screening
D. Thyroid function tests for hypothyroidism detection
Correct Answer: A
Rationale: Correct because clozapine requires mandatory monitoring of absolute neutrophil
count (ANC) through the Risk Evaluation and Mitigation Strategy (REMS) program due to the
risk of agranulocytosis, with weekly monitoring for the first 6 months, then biweekly if stable, to
detect life-threatening neutropenia before clinical infection develops. QT monitoring is important
for ziprasidone and haloperidol; hepatotoxicity monitoring is standard for valproate; thyroid
monitoring is specific to lithium.
Q4: A 19-year-old college student presents with sudden onset of delusions, hallucinations, and
disorganized behavior following the death of a parent. Symptoms resolve completely within 2
weeks with supportive care. The psychiatric nurse practitioner recognizes this presentation as
consistent with which disorder?
A. Schizophrenia with early onset and poor prognosis
B. Brief psychotic disorder triggered by severe psychosocial stressor
C. Schizoaffective disorder with depressive features
D. Delusional disorder with non-bizarre delusions
Correct Answer: C
, Rationale: Correct because brief psychotic disorder is characterized by the sudden onset of
delusions, hallucinations, disorganized speech, or grossly disorganized behavior lasting at least 1
day but less than 1 month, with eventual full return to premorbid functioning, often triggered by
severe psychosocial stressors such as bereavement. Schizophrenia requires 6 months of
symptoms; schizoaffective disorder requires mood episodes concurrent with psychotic symptoms
and does not show complete resolution within 1 month; delusional disorder involves non-bizarre
delusions without prominent hallucinations or disorganized behavior.
Q5: A patient with catatonia presents with waxy flexibility, mutism, posturing, and refusal to eat.
The psychiatric nurse practitioner orders the lorazepam challenge test. Which response indicates
a positive test and predicts treatment responsiveness?
A. No change in catatonic symptoms after lorazepam administration
B. Rapid and dramatic improvement in catatonic features within hours
C. Development of paradoxical agitation and increased motor activity
D. Onset of respiratory depression requiring reversal with flumazenil
Correct Answer: B
Rationale: Correct because the lorazepam challenge test involves administering lorazepam 1-2
mg intravenously or intramuscularly, and a positive response—defined as rapid and dramatic
improvement in catatonic symptoms within hours—predicts responsiveness to benzodiazepine
treatment and guides ongoing therapy. No change suggests benzodiazepine resistance and need
for ECT; paradoxical agitation is not a positive test; respiratory depression is an adverse effect,
not a therapeutic response.
Q6: A patient with schizophrenia is prescribed aripiprazole 15 mg daily. The psychiatric nurse
practitioner explains that aripiprazole's mechanism differs from other atypical antipsychotics
primarily due to which property?
A. Pure D2 receptor antagonism with high affinity
B. Partial D2 receptor agonism with lower metabolic risk
C. Pure 5-HT2A receptor antagonism without dopamine activity
D. NMDA receptor antagonism similar to ketamine
Correct Answer: D
2026/2027 |Newly Released| Regis College
60 Questions & Answers | Grade A | 100% Correct Rationales
Guaranteed Pass
Q1: A 22-year-old male presents with auditory hallucinations, persecutory delusions, and
disorganized speech lasting 4 months with gradual functional decline. His symptoms began after
a period of social withdrawal and declining academic performance. The psychiatric nurse
practitioner recognizes that the duration of symptoms meets criteria for which diagnosis?
A. Brief psychotic disorder with full return to baseline expected
B. Schizophreniform disorder as a provisional diagnosis
C. Schizophrenia with continuous disturbance for at least 6 months
D. Schizoaffective disorder requiring prominent mood symptoms
Correct Answer: B
Rationale: Correct because the patient has psychotic symptoms lasting 4 months, which falls
within the 1-6 month timeframe for schizophreniform disorder, a provisional diagnosis that may
convert to schizophrenia if symptoms persist beyond 6 months or resolve if full recovery occurs.
Brief psychotic disorder lasts less than 1 month; schizophrenia requires 6 months of continuous
disturbance including 1 month of active-phase symptoms; schizoaffective disorder requires a
major mood episode concurrent with psychotic symptoms and mood symptoms present for the
majority of the illness duration.
Q2: A patient with schizophrenia is prescribed haloperidol 10 mg daily. After 3 days, the patient
develops acute torticollis, oculogyric crisis, and tongue protrusion. The psychiatric nurse
practitioner recognizes these symptoms as indicating which condition?
A. Tardive dyskinesia from chronic D2 receptor blockade
B. Acute dystonia from nigrostriatal pathway D2 antagonism
C. Akathisia presenting as subjective restlessness
D. Neuroleptic malignant syndrome with autonomic instability
Correct Answer: D
,Rationale: Correct because acute dystonia—characterized by sudden onset muscle spasms
including torticollis, oculogyric crisis, and tongue protrusion—is an extrapyramidal symptom
resulting from acute D2 receptor blockade in the nigrostriatal pathway, typically occurring within
hours to days of initiating or increasing high-potency typical antipsychotics such as haloperidol.
Tardive dyskinesia develops after months to years of chronic treatment; akathisia presents as
subjective restlessness without sustained muscle spasms; neuroleptic malignant syndrome
involves hyperthermia, rigidity, and autonomic instability, not isolated dystonic reactions.
Q3: A patient with treatment-resistant schizophrenia has failed trials of risperidone, olanzapine,
and aripiprazole. The psychiatric nurse practitioner considers initiating clozapine. Which
monitoring requirement is mandatory before starting this medication?
A. Baseline electrocardiogram to assess QT interval
B. Absolute neutrophil count through the REMS program
C. Liver function tests for hepatotoxicity screening
D. Thyroid function tests for hypothyroidism detection
Correct Answer: A
Rationale: Correct because clozapine requires mandatory monitoring of absolute neutrophil
count (ANC) through the Risk Evaluation and Mitigation Strategy (REMS) program due to the
risk of agranulocytosis, with weekly monitoring for the first 6 months, then biweekly if stable, to
detect life-threatening neutropenia before clinical infection develops. QT monitoring is important
for ziprasidone and haloperidol; hepatotoxicity monitoring is standard for valproate; thyroid
monitoring is specific to lithium.
Q4: A 19-year-old college student presents with sudden onset of delusions, hallucinations, and
disorganized behavior following the death of a parent. Symptoms resolve completely within 2
weeks with supportive care. The psychiatric nurse practitioner recognizes this presentation as
consistent with which disorder?
A. Schizophrenia with early onset and poor prognosis
B. Brief psychotic disorder triggered by severe psychosocial stressor
C. Schizoaffective disorder with depressive features
D. Delusional disorder with non-bizarre delusions
Correct Answer: C
, Rationale: Correct because brief psychotic disorder is characterized by the sudden onset of
delusions, hallucinations, disorganized speech, or grossly disorganized behavior lasting at least 1
day but less than 1 month, with eventual full return to premorbid functioning, often triggered by
severe psychosocial stressors such as bereavement. Schizophrenia requires 6 months of
symptoms; schizoaffective disorder requires mood episodes concurrent with psychotic symptoms
and does not show complete resolution within 1 month; delusional disorder involves non-bizarre
delusions without prominent hallucinations or disorganized behavior.
Q5: A patient with catatonia presents with waxy flexibility, mutism, posturing, and refusal to eat.
The psychiatric nurse practitioner orders the lorazepam challenge test. Which response indicates
a positive test and predicts treatment responsiveness?
A. No change in catatonic symptoms after lorazepam administration
B. Rapid and dramatic improvement in catatonic features within hours
C. Development of paradoxical agitation and increased motor activity
D. Onset of respiratory depression requiring reversal with flumazenil
Correct Answer: B
Rationale: Correct because the lorazepam challenge test involves administering lorazepam 1-2
mg intravenously or intramuscularly, and a positive response—defined as rapid and dramatic
improvement in catatonic symptoms within hours—predicts responsiveness to benzodiazepine
treatment and guides ongoing therapy. No change suggests benzodiazepine resistance and need
for ECT; paradoxical agitation is not a positive test; respiratory depression is an adverse effect,
not a therapeutic response.
Q6: A patient with schizophrenia is prescribed aripiprazole 15 mg daily. The psychiatric nurse
practitioner explains that aripiprazole's mechanism differs from other atypical antipsychotics
primarily due to which property?
A. Pure D2 receptor antagonism with high affinity
B. Partial D2 receptor agonism with lower metabolic risk
C. Pure 5-HT2A receptor antagonism without dopamine activity
D. NMDA receptor antagonism similar to ketamine
Correct Answer: D
