NRNP 6675 Final Exam — 200 Practice Questions with Verified Answers & Rationales (2026
Q&A)
Table of Contents
| Topic | Questions |
|-------|-----------|
| Topic 1: Psychopharmacology & Pharmacokinetics | 1–35 |
| Topic 2: Neurobiology & Neurotransmission | 36–45 |
| Topic 3: Psychiatric Disorders & Differential Diagnosis | 46–75 |
| Topic 4: Psychotherapy & Therapeutic Modalities | 76–90 |
| Topic 5: Ethical & Legal Issues in PMHNP Practice | 91–115 |
| Topic 6: Suicide Risk Assessment & Crisis Intervention | 116–130 |
| Topic 7: Child & Adolescent Psychiatry | 131–145 |
| Topic 8: Geriatric Psychiatry | 146–160 |
| Topic 9: Substance Use Disorders & Treatment | 161–175 |
| Topic 10: Domestic Violence & Trauma | 176–185 |
| Topic 11: Health Policy, Advocacy & NP Competencies | 186–195 |
| Topic 12: Special Populations & Miscellaneous | 196–200 |
Topic 1: Psychopharmacology & Pharmacokinetics (Questions 1–35)
1. The half-life of lithium is approximately:
,A) 12 hours
B) 24 hours
C) 36 hours
D) 48 hours
Answer: B
Rationale: The half-life of lithium is approximately 24 hours. Lithium is a mood stabilizer used
primarily for bipolar disorder and requires careful monitoring of serum levels due to its narrow
therapeutic index.
2. Fluoxetine is the SSRI with the ______ withdrawal/discontinuation risk.
A) Highest
B) Moderate
C) Lowest
D) Variable
Answer: C
Rationale: Fluoxetine has the lowest discontinuation/withdrawal risk among SSRIs due to its
long half-life (approximately 4–6 days for fluoxetine itself and up to 16 days for its active
metabolite, norfluoxetine). This long half-life allows for a gradual self-taper when the
medication is stopped.
,3. Which antipsychotics are good for patients who miss doses of their medications?
A) Short-acting antipsychotics with half-lives under 12 hours
B) Antipsychotics with long half-lives
C) First-generation antipsychotics only
D) None—all antipsychotics require daily dosing
Answer: B
Rationale: Antipsychotics with long half-lives are beneficial for patients who may miss doses.
Examples include:
- Cariprazine (Vraylar): half-life 2–4 days, active metabolites up to 3 weeks
- Aripiprazole (Abilify): half-life approximately 3 days
- Brexpiprazole (Rexulti): half-life approximately 4 days
- Pimozide: half-life 4–5 days
4. Disulfiram's alcohol interactions persist for up to how long after the medication is stopped?
A) 24 hours
B) 3–5 days
C) 1–2 weeks
D) 1 month
Answer: C
, Rationale: Disulfiram has a long half-life of 2–3 days, and its alcohol interaction effects can
persist for up to 2 weeks (approximately 14 days) after the medication is discontinued. This is
why patients must be counseled to avoid alcohol-containing products for at least 14 days after
stopping disulfiram.
5. Which is the only tricyclic antidepressant with a long half-life?
A) Amitriptyline
B) Imipramine
C) Protriptyline (Vivactil)
D) Nortriptyline
Answer: C
Rationale: Protriptyline (Vivactil) is the only TCA with a long half-life. Most TCAs have half-lives
ranging from 8–30 hours, but protriptyline has a significantly longer half-life of approximately
54–92 hours.
6. A patient on chlorpromazine states his orgasm is dry and afterward he commonly has milky
urine. The APRN recognizes this as:
A) A serious adverse effect requiring immediate discontinuation
B) A harmless response to chlorpromazine
C) A sign of prostate cancer
D) An allergic reaction
Q&A)
Table of Contents
| Topic | Questions |
|-------|-----------|
| Topic 1: Psychopharmacology & Pharmacokinetics | 1–35 |
| Topic 2: Neurobiology & Neurotransmission | 36–45 |
| Topic 3: Psychiatric Disorders & Differential Diagnosis | 46–75 |
| Topic 4: Psychotherapy & Therapeutic Modalities | 76–90 |
| Topic 5: Ethical & Legal Issues in PMHNP Practice | 91–115 |
| Topic 6: Suicide Risk Assessment & Crisis Intervention | 116–130 |
| Topic 7: Child & Adolescent Psychiatry | 131–145 |
| Topic 8: Geriatric Psychiatry | 146–160 |
| Topic 9: Substance Use Disorders & Treatment | 161–175 |
| Topic 10: Domestic Violence & Trauma | 176–185 |
| Topic 11: Health Policy, Advocacy & NP Competencies | 186–195 |
| Topic 12: Special Populations & Miscellaneous | 196–200 |
Topic 1: Psychopharmacology & Pharmacokinetics (Questions 1–35)
1. The half-life of lithium is approximately:
,A) 12 hours
B) 24 hours
C) 36 hours
D) 48 hours
Answer: B
Rationale: The half-life of lithium is approximately 24 hours. Lithium is a mood stabilizer used
primarily for bipolar disorder and requires careful monitoring of serum levels due to its narrow
therapeutic index.
2. Fluoxetine is the SSRI with the ______ withdrawal/discontinuation risk.
A) Highest
B) Moderate
C) Lowest
D) Variable
Answer: C
Rationale: Fluoxetine has the lowest discontinuation/withdrawal risk among SSRIs due to its
long half-life (approximately 4–6 days for fluoxetine itself and up to 16 days for its active
metabolite, norfluoxetine). This long half-life allows for a gradual self-taper when the
medication is stopped.
,3. Which antipsychotics are good for patients who miss doses of their medications?
A) Short-acting antipsychotics with half-lives under 12 hours
B) Antipsychotics with long half-lives
C) First-generation antipsychotics only
D) None—all antipsychotics require daily dosing
Answer: B
Rationale: Antipsychotics with long half-lives are beneficial for patients who may miss doses.
Examples include:
- Cariprazine (Vraylar): half-life 2–4 days, active metabolites up to 3 weeks
- Aripiprazole (Abilify): half-life approximately 3 days
- Brexpiprazole (Rexulti): half-life approximately 4 days
- Pimozide: half-life 4–5 days
4. Disulfiram's alcohol interactions persist for up to how long after the medication is stopped?
A) 24 hours
B) 3–5 days
C) 1–2 weeks
D) 1 month
Answer: C
, Rationale: Disulfiram has a long half-life of 2–3 days, and its alcohol interaction effects can
persist for up to 2 weeks (approximately 14 days) after the medication is discontinued. This is
why patients must be counseled to avoid alcohol-containing products for at least 14 days after
stopping disulfiram.
5. Which is the only tricyclic antidepressant with a long half-life?
A) Amitriptyline
B) Imipramine
C) Protriptyline (Vivactil)
D) Nortriptyline
Answer: C
Rationale: Protriptyline (Vivactil) is the only TCA with a long half-life. Most TCAs have half-lives
ranging from 8–30 hours, but protriptyline has a significantly longer half-life of approximately
54–92 hours.
6. A patient on chlorpromazine states his orgasm is dry and afterward he commonly has milky
urine. The APRN recognizes this as:
A) A serious adverse effect requiring immediate discontinuation
B) A harmless response to chlorpromazine
C) A sign of prostate cancer
D) An allergic reaction
