NSG 526 ADVANCED PSYCHIATRIC NURSING EXAM 3 EXAM PRACTICE | STUDY
GUIDE | TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION |
LATEST UPDATE 2026/2027 | ADVANCED REVIEW | COMPREHENSIVE PRACTICE
EXAM
Examiner:
Course faculty or school of nursing administering NSG 526 Advanced Psychiatric
Nursing (institution-specific).
TABLE OF CONTENTS
1. Advanced Psychiatric Assessment
2. Differential Diagnosis
3. Psychopharmacology
4. Mood Disorders
5. Anxiety and Trauma-Related Disorders
6. Psychotic Disorders
7. Personality Disorders
8. Psychiatric Emergencies
9. Psychotherapy Principles
10. Ethics, Legal Issues, and Professional Practice
ADVANCED PSYCHIATRIC NURSING || PSYCHIATRIC ASSESSMENT || DSM-5-TR
CONCEPTS || DIFFERENTIAL DIAGNOSIS || PSYCHOPHARMACOLOGY || MOOD
DISORDERS || SCHIZOPHRENIA || BIPOLAR DISORDER || SUICIDE RISK
ASSESSMENT || PSYCHOTHERAPY || ETHICS || PROFESSIONAL JUDGMENT ||
CRISIS INTERVENTION || PSYCHIATRIC EMERGENCIES || COMPREHENSIVE
REVIEW || CERTIFICATION EXAM PREPARATION
QUESTION 1.
A psychiatric nurse practitioner evaluates a patient with severe depression who
reports increased energy, decreased need for sleep, and impulsive spending after
initiating an antidepressant two weeks ago. Which interpretation is most
appropriate?
,A. The symptoms most likely indicate antidepressant-induced hypomania requiring
reassessment of diagnosis.
B. The patient is experiencing normal improvement from depression.
C. The patient has developed delirium.
D. The symptoms indicate treatment resistance.
🔴 Correct Answer: A. The symptoms most likely indicate antidepressant-induced
hypomania requiring reassessment of diagnosis.
🔵 Explanation: The emergence of hypomanic symptoms shortly after antidepressant
initiation raises concern for bipolar spectrum illness or antidepressant-induced
hypomania. Diagnostic reassessment is appropriate before continuing antidepressant
monotherapy. The presentation is not typical of delirium or simple recovery from
depression.
QUESTION 2.
A patient with schizophrenia develops fever, generalized muscle rigidity, autonomic
instability, and elevated creatine kinase after receiving a high-potency
antipsychotic. What is the priority clinical action?
A. Increase the antipsychotic dose.
B. Immediately discontinue the antipsychotic and initiate emergency treatment for
neuroleptic malignant syndrome.
C. Add benztropine and continue therapy.
D. Observe for 48 hours before changing treatment.
🔴 Correct Answer: B. Immediately discontinue the antipsychotic and initiate
emergency treatment for neuroleptic malignant syndrome.
🔵 Explanation: Neuroleptic malignant syndrome is a rare but life-threatening
emergency characterized by hyperthermia, rigidity, altered mental status, and
autonomic dysfunction. Prompt discontinuation of the offending medication and
supportive management are essential. Observation or dose escalation would
significantly increase patient risk.
,QUESTION 3.
A patient repeatedly presents with excessive worry involving multiple life domains
for over one year, accompanied by muscle tension, insomnia, and difficulty
concentrating. Which diagnosis best fits this presentation?
A. Panic disorder
B. Obsessive-compulsive disorder
C. Generalized anxiety disorder
D. Adjustment disorder
🔴 Correct Answer: C. Generalized anxiety disorder
🔵 Explanation: Generalized anxiety disorder involves persistent, excessive anxiety
across multiple domains lasting at least six months with associated physical and
cognitive symptoms. Panic disorder is characterized by recurrent panic attacks, while
OCD centers on obsessions and compulsions. Adjustment disorder follows an
identifiable stressor and does not usually persist in this manner.
QUESTION 4.
Which patient characteristic most strongly supports inpatient psychiatric
hospitalization despite refusal of treatment?
A. Stable depressive symptoms without suicidal ideation
B. Chronic insomnia despite medication
C. Imminent risk of serious harm to self or others because of acute psychiatric
illness
D. Mild anxiety interfering with work performance
🔴 Correct Answer: C. Imminent risk of serious harm to self or others because of
acute psychiatric illness
🔵 Explanation: Involuntary hospitalization is generally reserved for patients who
present an imminent danger to themselves or others or are unable to provide for their
basic needs because of mental illness, according to applicable laws. Functional
impairment alone is insufficient without meeting legal criteria for emergency
detention.
, QUESTION 5.
A patient with bipolar I disorder stabilized on lithium develops coarse tremor,
confusion, vomiting, and ataxia after beginning a thiazide diuretic. Which
explanation is most appropriate?
A. The symptoms reflect expected lithium adaptation.
B. The thiazide likely increased lithium concentrations, resulting in toxicity.
C. The patient is experiencing serotonin syndrome.
D. Lithium has become ineffective.
🔴 Correct Answer: B. The thiazide likely increased lithium concentrations,
resulting in toxicity.
🔵 Explanation: Thiazide diuretics reduce renal lithium clearance, substantially
increasing serum lithium levels and the risk of toxicity. Neurologic and
gastrointestinal manifestations are classic findings. This interaction requires prompt
evaluation and treatment.
QUESTION 6.
A patient reports hearing a voice commenting continuously on their actions while
maintaining intact orientation and attention. Which symptom category is
demonstrated?
A. Delusion
B. Illusion
C. Auditory hallucination
D. Depersonalization
🔴 Correct Answer: C. Auditory hallucination
🔵 Explanation: Hearing voices without an external stimulus is an auditory
hallucination. Delusions are fixed false beliefs, illusions are misinterpretations of real
sensory stimuli, and depersonalization involves altered self-perception rather than
hearing voices.
GUIDE | TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION |
LATEST UPDATE 2026/2027 | ADVANCED REVIEW | COMPREHENSIVE PRACTICE
EXAM
Examiner:
Course faculty or school of nursing administering NSG 526 Advanced Psychiatric
Nursing (institution-specific).
TABLE OF CONTENTS
1. Advanced Psychiatric Assessment
2. Differential Diagnosis
3. Psychopharmacology
4. Mood Disorders
5. Anxiety and Trauma-Related Disorders
6. Psychotic Disorders
7. Personality Disorders
8. Psychiatric Emergencies
9. Psychotherapy Principles
10. Ethics, Legal Issues, and Professional Practice
ADVANCED PSYCHIATRIC NURSING || PSYCHIATRIC ASSESSMENT || DSM-5-TR
CONCEPTS || DIFFERENTIAL DIAGNOSIS || PSYCHOPHARMACOLOGY || MOOD
DISORDERS || SCHIZOPHRENIA || BIPOLAR DISORDER || SUICIDE RISK
ASSESSMENT || PSYCHOTHERAPY || ETHICS || PROFESSIONAL JUDGMENT ||
CRISIS INTERVENTION || PSYCHIATRIC EMERGENCIES || COMPREHENSIVE
REVIEW || CERTIFICATION EXAM PREPARATION
QUESTION 1.
A psychiatric nurse practitioner evaluates a patient with severe depression who
reports increased energy, decreased need for sleep, and impulsive spending after
initiating an antidepressant two weeks ago. Which interpretation is most
appropriate?
,A. The symptoms most likely indicate antidepressant-induced hypomania requiring
reassessment of diagnosis.
B. The patient is experiencing normal improvement from depression.
C. The patient has developed delirium.
D. The symptoms indicate treatment resistance.
🔴 Correct Answer: A. The symptoms most likely indicate antidepressant-induced
hypomania requiring reassessment of diagnosis.
🔵 Explanation: The emergence of hypomanic symptoms shortly after antidepressant
initiation raises concern for bipolar spectrum illness or antidepressant-induced
hypomania. Diagnostic reassessment is appropriate before continuing antidepressant
monotherapy. The presentation is not typical of delirium or simple recovery from
depression.
QUESTION 2.
A patient with schizophrenia develops fever, generalized muscle rigidity, autonomic
instability, and elevated creatine kinase after receiving a high-potency
antipsychotic. What is the priority clinical action?
A. Increase the antipsychotic dose.
B. Immediately discontinue the antipsychotic and initiate emergency treatment for
neuroleptic malignant syndrome.
C. Add benztropine and continue therapy.
D. Observe for 48 hours before changing treatment.
🔴 Correct Answer: B. Immediately discontinue the antipsychotic and initiate
emergency treatment for neuroleptic malignant syndrome.
🔵 Explanation: Neuroleptic malignant syndrome is a rare but life-threatening
emergency characterized by hyperthermia, rigidity, altered mental status, and
autonomic dysfunction. Prompt discontinuation of the offending medication and
supportive management are essential. Observation or dose escalation would
significantly increase patient risk.
,QUESTION 3.
A patient repeatedly presents with excessive worry involving multiple life domains
for over one year, accompanied by muscle tension, insomnia, and difficulty
concentrating. Which diagnosis best fits this presentation?
A. Panic disorder
B. Obsessive-compulsive disorder
C. Generalized anxiety disorder
D. Adjustment disorder
🔴 Correct Answer: C. Generalized anxiety disorder
🔵 Explanation: Generalized anxiety disorder involves persistent, excessive anxiety
across multiple domains lasting at least six months with associated physical and
cognitive symptoms. Panic disorder is characterized by recurrent panic attacks, while
OCD centers on obsessions and compulsions. Adjustment disorder follows an
identifiable stressor and does not usually persist in this manner.
QUESTION 4.
Which patient characteristic most strongly supports inpatient psychiatric
hospitalization despite refusal of treatment?
A. Stable depressive symptoms without suicidal ideation
B. Chronic insomnia despite medication
C. Imminent risk of serious harm to self or others because of acute psychiatric
illness
D. Mild anxiety interfering with work performance
🔴 Correct Answer: C. Imminent risk of serious harm to self or others because of
acute psychiatric illness
🔵 Explanation: Involuntary hospitalization is generally reserved for patients who
present an imminent danger to themselves or others or are unable to provide for their
basic needs because of mental illness, according to applicable laws. Functional
impairment alone is insufficient without meeting legal criteria for emergency
detention.
, QUESTION 5.
A patient with bipolar I disorder stabilized on lithium develops coarse tremor,
confusion, vomiting, and ataxia after beginning a thiazide diuretic. Which
explanation is most appropriate?
A. The symptoms reflect expected lithium adaptation.
B. The thiazide likely increased lithium concentrations, resulting in toxicity.
C. The patient is experiencing serotonin syndrome.
D. Lithium has become ineffective.
🔴 Correct Answer: B. The thiazide likely increased lithium concentrations,
resulting in toxicity.
🔵 Explanation: Thiazide diuretics reduce renal lithium clearance, substantially
increasing serum lithium levels and the risk of toxicity. Neurologic and
gastrointestinal manifestations are classic findings. This interaction requires prompt
evaluation and treatment.
QUESTION 6.
A patient reports hearing a voice commenting continuously on their actions while
maintaining intact orientation and attention. Which symptom category is
demonstrated?
A. Delusion
B. Illusion
C. Auditory hallucination
D. Depersonalization
🔴 Correct Answer: C. Auditory hallucination
🔵 Explanation: Hearing voices without an external stimulus is an auditory
hallucination. Delusions are fixed false beliefs, illusions are misinterpretations of real
sensory stimuli, and depersonalization involves altered self-perception rather than
hearing voices.
