NRNP 6665 FINAL EXAM 3/300 ACTUAL QUESTIONS
AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
The NRNP 6665 final exam is a comprehensive assessment in a psychiatric-mental
health nurse practitioner (PMHNP) course, evaluating advanced knowledge of
psychiatric assessment, diagnosis, and treatment across the lifespan. It covers
neurodevelopmental disorders, schizophrenia, mood and anxiety disorders,
substance use disorders, neurocognitive disorders, and psychopharmacology. The
exam tests understanding of the Mental Status Examination, diagnostic criteria
from the DSM-5-TR, evidence-based psychotherapeutic interventions, medication
management (including antidepressants, antipsychotics, mood stabilizers, and
anxiolytics), and ethical-legal issues such as informed consent, confidentiality, and
mandatory reporting. Students must demonstrate clinical reasoning, differential
diagnosis skills, and integration of biopsychosocial principles to formulate
comprehensive treatment plans and promote recovery-oriented care.
Section 1: Assessment, Diagnosis, and Therapeutic Communication
This section covers foundational psychiatric-mental health nurse practitioner
(PMHNP) competencies, including patient evaluation, the Mental Status
Examination (MSE), diagnostic formulations, and professional communication.
Question 1: Christine is a 9-year-old female who presents for care after having
been placed in the local foster care system. She has been in and out of foster care
for the last 4 years after her parents were killed in an automobile accident.
Christine has been placed in a variety of homes and residential care facilities. The
PMHNP recognizes that Christine is at high risk for which of the following
conditions?
A) Dissociative disorders
B) Post-traumatic stress disorder
C) Impulse-control disorder
D) Attachment disorder
Answer: D) Attachment disorder
,Detailed Rationale: Children with histories of multiple placements, disrupted
caregiving, and loss of parents are at high risk for attachment disorders. The
repeated disruption of caregiving relationships interferes with the development of
secure attachments, leading to difficulties forming healthy emotional bonds with
caregivers.
Question 2: Caylee is a 5-year-old girl who is referred for evaluation by child
protective services. She was recently removed from her biological family and
placed in foster care, as her home environment was reportedly unsafe due to
conditions of extreme neglect. Her foster mother reports that Caylee is very quiet
and withdrawn and always appears sad and disinterested in her surroundings;
however, she becomes very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it appeared that Caylee
was hallucinating. The PMHNP considers that:
A) Caylee is at high risk for suicide and precautions should be taken
B) The hallucinations are consistent with brief psychotic disorder or schizophrenia
C) The history and reported symptoms are typical of depressive disorder in young
children
D) This is a common situation when prepubertal children are removed from the
biological parents regardless of how dysfunctional they are
Answer: C) The history and reported symptoms are typical of depressive disorder
in young children
Detailed Rationale: In young children, depressive disorders can present with
irritability, withdrawal, and sadness rather than classic depressed mood.
Hallucinations may also occur in young children with severe depression as a
manifestation of significant distress or trauma.
Question 3: In which demographic is depression twice as prevalent in girls as
compared to boys?
A) Preschoolers
B) School-aged children
C) Adolescents
D) All children
Answer: C) Adolescents
,Detailed Rationale: During adolescence, depression becomes twice as prevalent in
females compared to males. This discrepancy is not present in prepubertal children,
where depression rates are more equal between sexes.
Question 4: A 15-year-old girl is currently being treated for depression. Her
parents have been proactive and involved in her care, and she achieved remission 2
months after beginning treatment with pharmacotherapy and cognitive behavioral
therapy. While counseling her parents about important issues in management, the
PMHNP advises that:
A) There is a > 50% likelihood that her younger sibling will develop depressive
symptoms
B) The mean length of major depressive episode in adolescents is 4 months
C) 20 to 40% of adolescents who have major depressive disorder will develop
bipolar I within 5 years
D) Adolescent-onset depression typically needs long-term pharmacologic
management to prevent relapses
Answer: D) Adolescent-onset depression typically needs long-term pharmacologic
management to prevent relapses
Detailed Rationale: Adolescent depression has a high rate of recurrence, and
continuation of pharmacotherapy for at least 6-12 months after remission is
recommended to prevent relapse. Long-term management is often necessary.
Question 5: Which of the following is NOT true with respect to confidentiality of
the child or adolescent client?
A) The PMHNP should not be concerned with consent for disclosure when child
abuse or maltreatment has occurred.
B) In 1979, the American Psychiatric Association (APA) stated that children 12
years of age or older can give consent for disclosure.
C) The American Academy of Child and Adolescent Psychiatry (AACAP) Code of
Ethics states that consent is not required for disclosure.
D) Regardless of code or position statement by any organization, the best approach
is when the child and PMHNP agree on disclosure.
Answer: A) The PMHNP should not be concerned with consent for disclosure
when child abuse or maltreatment has occurred.
Detailed Rationale: Even when child abuse or maltreatment has occurred, the
PMHNP must still be concerned with appropriate consent for disclosure.
, Mandatory reporting requirements override confidentiality, but the PMHNP must
still follow proper legal and ethical procedures for disclosure.
Question 6: What is the Confusion Assessment Method (CAM) instrument a
standardized assessment tool for?
A) Depression
B) Anxiety
C) Delirium
D) Schizophrenia
Answer: C) Delirium
Detailed Rationale: The Confusion Assessment Method (CAM) is a widely
recognized tool used to identify delirium in patients. Delirium is an acute
neuropsychiatric syndrome characterized by sudden changes in attention,
awareness, and cognition. CAM assesses key features such as acute onset and
fluctuating course, inattention, disorganized thinking, and altered level of
consciousness.
Question 7: Which of the following is a common sensory deficit of conversion
disorder?
A) Blindness
B) Deafness
C) Loss of limb
D) Paralysis
Answer: A) Blindness and B) Deafness (Select all that apply)
Detailed Rationale: Conversion disorder, now known as Functional Neurological
Symptom Disorder in the DSM-5, involves neurological symptoms that are not
explained by medical evaluation. Common sensory deficits include blindness and
deafness, which occur without any organic cause.
Question 8: During a physical exam on a patient with a paralyzed hand of
unknown etiology, the PMHNP raises and drops the patient's hand onto the
patient's face. Which patient response supports a finding of conversion disorder?
A) The patient's hand drops onto the patient's face
B) The patient's hand falls next to the patient's face
C) The patient's hand stays in the air when dropped
D) The patient moves their hand out of the way
AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
The NRNP 6665 final exam is a comprehensive assessment in a psychiatric-mental
health nurse practitioner (PMHNP) course, evaluating advanced knowledge of
psychiatric assessment, diagnosis, and treatment across the lifespan. It covers
neurodevelopmental disorders, schizophrenia, mood and anxiety disorders,
substance use disorders, neurocognitive disorders, and psychopharmacology. The
exam tests understanding of the Mental Status Examination, diagnostic criteria
from the DSM-5-TR, evidence-based psychotherapeutic interventions, medication
management (including antidepressants, antipsychotics, mood stabilizers, and
anxiolytics), and ethical-legal issues such as informed consent, confidentiality, and
mandatory reporting. Students must demonstrate clinical reasoning, differential
diagnosis skills, and integration of biopsychosocial principles to formulate
comprehensive treatment plans and promote recovery-oriented care.
Section 1: Assessment, Diagnosis, and Therapeutic Communication
This section covers foundational psychiatric-mental health nurse practitioner
(PMHNP) competencies, including patient evaluation, the Mental Status
Examination (MSE), diagnostic formulations, and professional communication.
Question 1: Christine is a 9-year-old female who presents for care after having
been placed in the local foster care system. She has been in and out of foster care
for the last 4 years after her parents were killed in an automobile accident.
Christine has been placed in a variety of homes and residential care facilities. The
PMHNP recognizes that Christine is at high risk for which of the following
conditions?
A) Dissociative disorders
B) Post-traumatic stress disorder
C) Impulse-control disorder
D) Attachment disorder
Answer: D) Attachment disorder
,Detailed Rationale: Children with histories of multiple placements, disrupted
caregiving, and loss of parents are at high risk for attachment disorders. The
repeated disruption of caregiving relationships interferes with the development of
secure attachments, leading to difficulties forming healthy emotional bonds with
caregivers.
Question 2: Caylee is a 5-year-old girl who is referred for evaluation by child
protective services. She was recently removed from her biological family and
placed in foster care, as her home environment was reportedly unsafe due to
conditions of extreme neglect. Her foster mother reports that Caylee is very quiet
and withdrawn and always appears sad and disinterested in her surroundings;
however, she becomes very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it appeared that Caylee
was hallucinating. The PMHNP considers that:
A) Caylee is at high risk for suicide and precautions should be taken
B) The hallucinations are consistent with brief psychotic disorder or schizophrenia
C) The history and reported symptoms are typical of depressive disorder in young
children
D) This is a common situation when prepubertal children are removed from the
biological parents regardless of how dysfunctional they are
Answer: C) The history and reported symptoms are typical of depressive disorder
in young children
Detailed Rationale: In young children, depressive disorders can present with
irritability, withdrawal, and sadness rather than classic depressed mood.
Hallucinations may also occur in young children with severe depression as a
manifestation of significant distress or trauma.
Question 3: In which demographic is depression twice as prevalent in girls as
compared to boys?
A) Preschoolers
B) School-aged children
C) Adolescents
D) All children
Answer: C) Adolescents
,Detailed Rationale: During adolescence, depression becomes twice as prevalent in
females compared to males. This discrepancy is not present in prepubertal children,
where depression rates are more equal between sexes.
Question 4: A 15-year-old girl is currently being treated for depression. Her
parents have been proactive and involved in her care, and she achieved remission 2
months after beginning treatment with pharmacotherapy and cognitive behavioral
therapy. While counseling her parents about important issues in management, the
PMHNP advises that:
A) There is a > 50% likelihood that her younger sibling will develop depressive
symptoms
B) The mean length of major depressive episode in adolescents is 4 months
C) 20 to 40% of adolescents who have major depressive disorder will develop
bipolar I within 5 years
D) Adolescent-onset depression typically needs long-term pharmacologic
management to prevent relapses
Answer: D) Adolescent-onset depression typically needs long-term pharmacologic
management to prevent relapses
Detailed Rationale: Adolescent depression has a high rate of recurrence, and
continuation of pharmacotherapy for at least 6-12 months after remission is
recommended to prevent relapse. Long-term management is often necessary.
Question 5: Which of the following is NOT true with respect to confidentiality of
the child or adolescent client?
A) The PMHNP should not be concerned with consent for disclosure when child
abuse or maltreatment has occurred.
B) In 1979, the American Psychiatric Association (APA) stated that children 12
years of age or older can give consent for disclosure.
C) The American Academy of Child and Adolescent Psychiatry (AACAP) Code of
Ethics states that consent is not required for disclosure.
D) Regardless of code or position statement by any organization, the best approach
is when the child and PMHNP agree on disclosure.
Answer: A) The PMHNP should not be concerned with consent for disclosure
when child abuse or maltreatment has occurred.
Detailed Rationale: Even when child abuse or maltreatment has occurred, the
PMHNP must still be concerned with appropriate consent for disclosure.
, Mandatory reporting requirements override confidentiality, but the PMHNP must
still follow proper legal and ethical procedures for disclosure.
Question 6: What is the Confusion Assessment Method (CAM) instrument a
standardized assessment tool for?
A) Depression
B) Anxiety
C) Delirium
D) Schizophrenia
Answer: C) Delirium
Detailed Rationale: The Confusion Assessment Method (CAM) is a widely
recognized tool used to identify delirium in patients. Delirium is an acute
neuropsychiatric syndrome characterized by sudden changes in attention,
awareness, and cognition. CAM assesses key features such as acute onset and
fluctuating course, inattention, disorganized thinking, and altered level of
consciousness.
Question 7: Which of the following is a common sensory deficit of conversion
disorder?
A) Blindness
B) Deafness
C) Loss of limb
D) Paralysis
Answer: A) Blindness and B) Deafness (Select all that apply)
Detailed Rationale: Conversion disorder, now known as Functional Neurological
Symptom Disorder in the DSM-5, involves neurological symptoms that are not
explained by medical evaluation. Common sensory deficits include blindness and
deafness, which occur without any organic cause.
Question 8: During a physical exam on a patient with a paralyzed hand of
unknown etiology, the PMHNP raises and drops the patient's hand onto the
patient's face. Which patient response supports a finding of conversion disorder?
A) The patient's hand drops onto the patient's face
B) The patient's hand falls next to the patient's face
C) The patient's hand stays in the air when dropped
D) The patient moves their hand out of the way
