NR 605 Psychiatric Mental Health Midterm Exam Latest
2026 2027 QUESTIONS AND DETAILED ANSWERS
**1.** A patient with major depressive disorder reports anhedonia, fatigue, and difficulty
concentrating. Which neurotransmitter system is most commonly associated with these symptoms?
A. Dopaminergic
B. Serotonergic
C. GABAergic
D. Glutamatergic
**Answer: B. Serotonergic**
**Rationale:** Serotonin dysfunction is strongly associated with depression, including mood
disturbance and loss of interest.
---
**2.** Which finding is most characteristic of a manic episode?
A. Increased need for sleep
B. Psychomotor retardation
C. Decreased need for sleep
D. Social withdrawal
**Answer: C. Decreased need for sleep**
**Rationale:** Mania commonly involves decreased need for sleep, increased energy, pressured
speech, grandiosity, and impulsive behavior.
,---
**3.** A patient taking lithium reports severe diarrhea, vomiting, coarse tremors, and confusion.
What should the psychiatric mental health nurse practitioner suspect?
A. Serotonin syndrome
B. Lithium toxicity
C. Neuroleptic malignant syndrome
D. Anticholinergic toxicity
**Answer: B. Lithium toxicity**
**Rationale:** GI symptoms, coarse tremor, confusion, and neurologic changes are concerning for
lithium toxicity.
---
**4.** Which psychotherapy is considered a first-line treatment for many patients with generalized
anxiety disorder?
A. Cognitive behavioral therapy
B. Psychoanalysis only
C. Electroconvulsive therapy
D. Aversion therapy
**Answer: A. Cognitive behavioral therapy**
**Rationale:** CBT helps patients identify maladaptive thoughts and behaviors and develop
healthier coping strategies.
---
,**5.** A patient says, “The voices are telling me that I am worthless.” Which response is most
therapeutic?
A. “Those voices aren't real, so ignore them.”
B. “Why do you think you're hearing voices?”
C. “I understand that you hear the voices, but I don't hear them.”
D. “You should do what the voices tell you.”
**Answer: C. “I understand that you hear the voices, but I don't hear them.”**
**Rationale:** The response acknowledges the patient's experience without reinforcing the
hallucination.
---
**6.** Which medication is a second-generation antipsychotic?
A. Haloperidol
B. Chlorpromazine
C. Risperidone
D. Fluphenazine
**Answer: C. Risperidone**
**Rationale:** Risperidone is an atypical/second-generation antipsychotic.
---
**7.** A patient taking an antipsychotic develops high fever, severe muscle rigidity, altered mental
, status, and autonomic instability. Which condition is most likely?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. Acute dystonia
**Answer: B. Neuroleptic malignant syndrome**
**Rationale:** NMS is characterized by hyperthermia, severe rigidity, altered consciousness, and
autonomic instability.
---
**8.** Which symptom is most associated with post-traumatic stress disorder (PTSD)?
A. Recurrent intrusive memories
B. Elevated mood
C. Increased need for sleep
D. Persistent pressured speech
**Answer: A. Recurrent intrusive memories**
**Rationale:** PTSD may involve intrusive memories, nightmares, avoidance, negative
mood/cognition changes, and hyperarousal.
---
**9.** Which assessment is most important when evaluating a patient with depression?
A. Favorite foods
2026 2027 QUESTIONS AND DETAILED ANSWERS
**1.** A patient with major depressive disorder reports anhedonia, fatigue, and difficulty
concentrating. Which neurotransmitter system is most commonly associated with these symptoms?
A. Dopaminergic
B. Serotonergic
C. GABAergic
D. Glutamatergic
**Answer: B. Serotonergic**
**Rationale:** Serotonin dysfunction is strongly associated with depression, including mood
disturbance and loss of interest.
---
**2.** Which finding is most characteristic of a manic episode?
A. Increased need for sleep
B. Psychomotor retardation
C. Decreased need for sleep
D. Social withdrawal
**Answer: C. Decreased need for sleep**
**Rationale:** Mania commonly involves decreased need for sleep, increased energy, pressured
speech, grandiosity, and impulsive behavior.
,---
**3.** A patient taking lithium reports severe diarrhea, vomiting, coarse tremors, and confusion.
What should the psychiatric mental health nurse practitioner suspect?
A. Serotonin syndrome
B. Lithium toxicity
C. Neuroleptic malignant syndrome
D. Anticholinergic toxicity
**Answer: B. Lithium toxicity**
**Rationale:** GI symptoms, coarse tremor, confusion, and neurologic changes are concerning for
lithium toxicity.
---
**4.** Which psychotherapy is considered a first-line treatment for many patients with generalized
anxiety disorder?
A. Cognitive behavioral therapy
B. Psychoanalysis only
C. Electroconvulsive therapy
D. Aversion therapy
**Answer: A. Cognitive behavioral therapy**
**Rationale:** CBT helps patients identify maladaptive thoughts and behaviors and develop
healthier coping strategies.
---
,**5.** A patient says, “The voices are telling me that I am worthless.” Which response is most
therapeutic?
A. “Those voices aren't real, so ignore them.”
B. “Why do you think you're hearing voices?”
C. “I understand that you hear the voices, but I don't hear them.”
D. “You should do what the voices tell you.”
**Answer: C. “I understand that you hear the voices, but I don't hear them.”**
**Rationale:** The response acknowledges the patient's experience without reinforcing the
hallucination.
---
**6.** Which medication is a second-generation antipsychotic?
A. Haloperidol
B. Chlorpromazine
C. Risperidone
D. Fluphenazine
**Answer: C. Risperidone**
**Rationale:** Risperidone is an atypical/second-generation antipsychotic.
---
**7.** A patient taking an antipsychotic develops high fever, severe muscle rigidity, altered mental
, status, and autonomic instability. Which condition is most likely?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. Acute dystonia
**Answer: B. Neuroleptic malignant syndrome**
**Rationale:** NMS is characterized by hyperthermia, severe rigidity, altered consciousness, and
autonomic instability.
---
**8.** Which symptom is most associated with post-traumatic stress disorder (PTSD)?
A. Recurrent intrusive memories
B. Elevated mood
C. Increased need for sleep
D. Persistent pressured speech
**Answer: A. Recurrent intrusive memories**
**Rationale:** PTSD may involve intrusive memories, nightmares, avoidance, negative
mood/cognition changes, and hyperarousal.
---
**9.** Which assessment is most important when evaluating a patient with depression?
A. Favorite foods
