Question 1
A psychiatric nursing student notices that several answer choices on a practice exam look very
similar in wording and meaning. What should the student conclude about those similar answers?
A) One of them is definitely correct
B) They are usually wrong
C) They should be selected if unsure
D) They indicate a trick question
Answer: B) They are usually wrong
Rationale: When multiple answer choices are remarkably similar in wording and meaning, exam
designers typically use them as distractors, making the distinct or unique answer more likely
correct.
Question 2
During a multidisciplinary team meeting, the PMHNP actively seeks input from the social
worker, pharmacist, primary care provider, and patient's family. This approach best demonstrates:
A) Delegate tasks to unlicensed staff
B) Interprofessional collaboration
C) Independent decision-making
D) Hierarchical authority
Answer: B) Interprofessional collaboration
Rationale: Interprofessional collaboration involves active participation from multiple disciplines
to improve patient outcomes; delegation transfers specific tasks but is not synonymous with
collaborative decision-making.
,Question 3
A PMHNP is delegating a task to a licensed practical nurse. Based on standard exam principles,
which statement is most likely true?
A) Collaborate is usually wrong
B) Delegate is usually wrong
C) Delegate is always correct
D) Collaborate and delegate mean the same thing
Answer: B) Delegate is usually wrong
Rationale: In exam-taking strategy, "delegate" is often the incorrect answer because proper
interprofessional collaboration is preferred over simple task delegation in most clinical
scenarios.
Question 4
A PMHNP is organizing patient care using the ADPIER framework. After completing the
intervention phase, what is the immediate next step?
A) Refer out to specialist
B) Discharge planning
C) Evaluate outcomes
D) Re-assess the patient
Answer: C) Evaluate outcomes
Rationale: ADPIER stands for Assessment, Diagnosis, Plan, Intervention, Evaluation, Refer out
last; evaluation must occur before considering referral, which is the final step.
Question 5
A patient with bipolar disorder has a lithium level of 0.8 mEq/L. The PMHNP interprets this as:
A) Subtherapeutic
B) Normal
,C) Toxic
D) Critical
Answer: B) Normal
*Rationale: The normal therapeutic range for lithium is 0.6-1.2 mEq/L; 0.8 falls within this range
and is considered therapeutic for maintenance and acute mania.*
Question 6
A patient's lithium level is 1.4 mEq/L. According to standard ranges, this value is:
A) *Normal (0.6-1.2)*
B) Subtherapeutic
C) Toxic
D) Critical low
*Answer: A) Normal (0.6-1.2)*
*Rationale: The normal therapeutic range for lithium is 0.6-1.2 mEq/L; 1.4 is slightly above
normal and requires monitoring but is not yet in the toxic range.*
Question 7
At what serum level does lithium toxicity typically begin to occur?
A) > 0.8
B) > 1.2
C) > 1.5
D) > 2.0
Answer: C) > 1.5
*Rationale: Lithium toxicity typically occurs at levels greater than 1.5 mEq/L; levels between
1.5 and 2.5 indicate early to moderate toxicity, while levels above 2.5 indicate severe toxicity
requiring urgent intervention.*
, Question 8
A patient on lithium therapy presents with severe nausea, vomiting, diarrhea, confusion, and
drowsiness. The PMHNP recognizes these as:
A) Expected therapeutic effects
B) Signs of lithium toxicity
C) Normal age-related changes
D) Serotonin syndrome symptoms
Answer: B) Signs of lithium toxicity
Rationale: Signs of lithium toxicity include severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitations, coarse hand tremors, and unsteady gait; these
require immediate evaluation and possible discontinuation.
Question 9
A patient on lithium reports muscle weakness, heart palpitations, and an unsteady gait. The
PMHNP should suspect:
A) Therapeutic lithium level
B) Lithium toxicity
C) Hypothyroidism
D) Normal side effects
Answer: B) Lithium toxicity
Rationale: Muscle weakness, heart palpitations, and unsteady gait are classic signs of lithium
toxicity, along with coarse hand tremors, severe GI symptoms, and confusion; these findings
warrant immediate lithium level check.
Question 10
A patient with acute mania has failed trials of two atypical antipsychotics. Which medication is
considered the gold standard for treating manic episodes?
A) Valproate
A psychiatric nursing student notices that several answer choices on a practice exam look very
similar in wording and meaning. What should the student conclude about those similar answers?
A) One of them is definitely correct
B) They are usually wrong
C) They should be selected if unsure
D) They indicate a trick question
Answer: B) They are usually wrong
Rationale: When multiple answer choices are remarkably similar in wording and meaning, exam
designers typically use them as distractors, making the distinct or unique answer more likely
correct.
Question 2
During a multidisciplinary team meeting, the PMHNP actively seeks input from the social
worker, pharmacist, primary care provider, and patient's family. This approach best demonstrates:
A) Delegate tasks to unlicensed staff
B) Interprofessional collaboration
C) Independent decision-making
D) Hierarchical authority
Answer: B) Interprofessional collaboration
Rationale: Interprofessional collaboration involves active participation from multiple disciplines
to improve patient outcomes; delegation transfers specific tasks but is not synonymous with
collaborative decision-making.
,Question 3
A PMHNP is delegating a task to a licensed practical nurse. Based on standard exam principles,
which statement is most likely true?
A) Collaborate is usually wrong
B) Delegate is usually wrong
C) Delegate is always correct
D) Collaborate and delegate mean the same thing
Answer: B) Delegate is usually wrong
Rationale: In exam-taking strategy, "delegate" is often the incorrect answer because proper
interprofessional collaboration is preferred over simple task delegation in most clinical
scenarios.
Question 4
A PMHNP is organizing patient care using the ADPIER framework. After completing the
intervention phase, what is the immediate next step?
A) Refer out to specialist
B) Discharge planning
C) Evaluate outcomes
D) Re-assess the patient
Answer: C) Evaluate outcomes
Rationale: ADPIER stands for Assessment, Diagnosis, Plan, Intervention, Evaluation, Refer out
last; evaluation must occur before considering referral, which is the final step.
Question 5
A patient with bipolar disorder has a lithium level of 0.8 mEq/L. The PMHNP interprets this as:
A) Subtherapeutic
B) Normal
,C) Toxic
D) Critical
Answer: B) Normal
*Rationale: The normal therapeutic range for lithium is 0.6-1.2 mEq/L; 0.8 falls within this range
and is considered therapeutic for maintenance and acute mania.*
Question 6
A patient's lithium level is 1.4 mEq/L. According to standard ranges, this value is:
A) *Normal (0.6-1.2)*
B) Subtherapeutic
C) Toxic
D) Critical low
*Answer: A) Normal (0.6-1.2)*
*Rationale: The normal therapeutic range for lithium is 0.6-1.2 mEq/L; 1.4 is slightly above
normal and requires monitoring but is not yet in the toxic range.*
Question 7
At what serum level does lithium toxicity typically begin to occur?
A) > 0.8
B) > 1.2
C) > 1.5
D) > 2.0
Answer: C) > 1.5
*Rationale: Lithium toxicity typically occurs at levels greater than 1.5 mEq/L; levels between
1.5 and 2.5 indicate early to moderate toxicity, while levels above 2.5 indicate severe toxicity
requiring urgent intervention.*
, Question 8
A patient on lithium therapy presents with severe nausea, vomiting, diarrhea, confusion, and
drowsiness. The PMHNP recognizes these as:
A) Expected therapeutic effects
B) Signs of lithium toxicity
C) Normal age-related changes
D) Serotonin syndrome symptoms
Answer: B) Signs of lithium toxicity
Rationale: Signs of lithium toxicity include severe nausea, diarrhea, vomiting, confusion,
drowsiness, muscle weakness, heart palpitations, coarse hand tremors, and unsteady gait; these
require immediate evaluation and possible discontinuation.
Question 9
A patient on lithium reports muscle weakness, heart palpitations, and an unsteady gait. The
PMHNP should suspect:
A) Therapeutic lithium level
B) Lithium toxicity
C) Hypothyroidism
D) Normal side effects
Answer: B) Lithium toxicity
Rationale: Muscle weakness, heart palpitations, and unsteady gait are classic signs of lithium
toxicity, along with coarse hand tremors, severe GI symptoms, and confusion; these findings
warrant immediate lithium level check.
Question 10
A patient with acute mania has failed trials of two atypical antipsychotics. Which medication is
considered the gold standard for treating manic episodes?
A) Valproate
