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NR 607 Final Exam Chamberlain PMHNP Newest
Exam Preparation With Complete Questions And
Correct Answers With Rationales Already Graded
A+Brand New Version!!
1. A client who is having active visual hallucinations currently has a
lighter and a pocketknife in his possession. Which AEIO risk assessment
category is correctly assigned for this client?
A) Objects—high risk
B) Environment—moderate risk
C) Intent—high risk
D) Agitation—moderate risk
Answer: A) Objects—high risk
Rationale: The AEIO (Agitation, Environment, Intent, Objects) risk
assessment framework evaluates immediate safety concerns. The
presence of a lighter and pocketknife during active hallucinations
represents an object-related high risk, as these items could be used to
harm self or others. Objects that can be used as weapons warrant the
highest risk classification.
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2. A client who experienced significant childhood trauma is seeking
alternative treatments to help ease symptoms associated with complex
trauma. Which approach might the PMHNP recommend?
A) Acupuncture
B) Structured walking programs
C) Passionflower extract
D) Reiki
Answer: A) Acupuncture
Rationale: Acupuncture is an evidence-based complementary and
alternative medicine (CAM) treatment for trauma-related symptoms. It
has shown benefit for anxiety, depression, and PTSD symptoms. Other
CAM treatments for complex PTSD include mindfulness, yoga, relaxation
techniques, and equine-assisted therapy.
3. A client being treated for schizophrenia presents with fever and
chills, hypotension, and mouth ulcers. After stabilization, which is the
most appropriate next step?
A) Discontinue medications that alter serotonin
B) Order stat serum medication level
C) Order complete blood count
D) Discontinue antipsychotic medications
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Answer: A) Discontinue medications that alter serotonin
Rationale: The presentation of fever, chills, hypotension, and mouth
ulcers in a patient on antipsychotic medication suggests a possible
neuroleptic malignant syndrome (NMS) or serotonin syndrome picture.
Discontinuing medications that alter serotonin is appropriate when
serotonin toxicity is suspected. Antipsychotics should also be considered
for discontinuation in the context of NMS.
4. A 10-year-old boy is referred by the school nurse because of a
persistent stomachache every morning at school. In evaluating the boy,
the PMHNP learns that he does not like to go to school and insists on
coming home immediately, and that he sleeps in his parents' bed at
night. His clinical description is most characteristic of which condition?
A) Social phobia
B) Posttraumatic stress disorder (PTSD)
C) Separation anxiety disorder
D) Reactive attachment disorder
Answer: C) Separation anxiety disorder
Rationale: Separation anxiety disorder is characterized by excessive fear
or anxiety concerning separation from attachment figures. The somatic
complaints (stomachache) that occur during school days, the insistence
on returning home, and the need to sleep in parents' bed are classic
manifestations of this disorder in children.
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5. A 38-year-old male presents for follow-up of chronic back pain and
spasm. He sustained a motorcycle accident four years earlier. He has
been taking morphine extended release 40 mg PO BID and
hydrocodone 10 mg IR QD PRN. Today he complains the medication is
no longer effective. He notes diarrhea and restlessness when he skips a
dose. He has been filling the prescription one day early each month and
visited urgent care twice this summer requesting additional pain
control. Which of the following do you recommend?
A) Evaluate for opioid use disorder; recommend a slow taper off full
opioid agonists and then start buprenorphine
B) Increase the standing morphine and re-evaluate in 2 weeks
C) Add a non-opioid adjunct and continue current regimen
D) Refer to pain management without changing medication
Answer: A) Evaluate for opioid use disorder; recommend a slow taper
off full opioid agonists and then start buprenorphine
Rationale: The patient demonstrates signs of opioid use disorder
including tolerance, withdrawal symptoms (diarrhea, restlessness), and
loss of control over use (filling early, seeking additional prescriptions).
Buprenorphine is appropriate for opioid use disorder after tapering off
full opioid agonists.
NR 607 Final Exam Chamberlain PMHNP Newest
Exam Preparation With Complete Questions And
Correct Answers With Rationales Already Graded
A+Brand New Version!!
1. A client who is having active visual hallucinations currently has a
lighter and a pocketknife in his possession. Which AEIO risk assessment
category is correctly assigned for this client?
A) Objects—high risk
B) Environment—moderate risk
C) Intent—high risk
D) Agitation—moderate risk
Answer: A) Objects—high risk
Rationale: The AEIO (Agitation, Environment, Intent, Objects) risk
assessment framework evaluates immediate safety concerns. The
presence of a lighter and pocketknife during active hallucinations
represents an object-related high risk, as these items could be used to
harm self or others. Objects that can be used as weapons warrant the
highest risk classification.
,2|Page
2. A client who experienced significant childhood trauma is seeking
alternative treatments to help ease symptoms associated with complex
trauma. Which approach might the PMHNP recommend?
A) Acupuncture
B) Structured walking programs
C) Passionflower extract
D) Reiki
Answer: A) Acupuncture
Rationale: Acupuncture is an evidence-based complementary and
alternative medicine (CAM) treatment for trauma-related symptoms. It
has shown benefit for anxiety, depression, and PTSD symptoms. Other
CAM treatments for complex PTSD include mindfulness, yoga, relaxation
techniques, and equine-assisted therapy.
3. A client being treated for schizophrenia presents with fever and
chills, hypotension, and mouth ulcers. After stabilization, which is the
most appropriate next step?
A) Discontinue medications that alter serotonin
B) Order stat serum medication level
C) Order complete blood count
D) Discontinue antipsychotic medications
,3|Page
Answer: A) Discontinue medications that alter serotonin
Rationale: The presentation of fever, chills, hypotension, and mouth
ulcers in a patient on antipsychotic medication suggests a possible
neuroleptic malignant syndrome (NMS) or serotonin syndrome picture.
Discontinuing medications that alter serotonin is appropriate when
serotonin toxicity is suspected. Antipsychotics should also be considered
for discontinuation in the context of NMS.
4. A 10-year-old boy is referred by the school nurse because of a
persistent stomachache every morning at school. In evaluating the boy,
the PMHNP learns that he does not like to go to school and insists on
coming home immediately, and that he sleeps in his parents' bed at
night. His clinical description is most characteristic of which condition?
A) Social phobia
B) Posttraumatic stress disorder (PTSD)
C) Separation anxiety disorder
D) Reactive attachment disorder
Answer: C) Separation anxiety disorder
Rationale: Separation anxiety disorder is characterized by excessive fear
or anxiety concerning separation from attachment figures. The somatic
complaints (stomachache) that occur during school days, the insistence
on returning home, and the need to sleep in parents' bed are classic
manifestations of this disorder in children.
, 4|Page
5. A 38-year-old male presents for follow-up of chronic back pain and
spasm. He sustained a motorcycle accident four years earlier. He has
been taking morphine extended release 40 mg PO BID and
hydrocodone 10 mg IR QD PRN. Today he complains the medication is
no longer effective. He notes diarrhea and restlessness when he skips a
dose. He has been filling the prescription one day early each month and
visited urgent care twice this summer requesting additional pain
control. Which of the following do you recommend?
A) Evaluate for opioid use disorder; recommend a slow taper off full
opioid agonists and then start buprenorphine
B) Increase the standing morphine and re-evaluate in 2 weeks
C) Add a non-opioid adjunct and continue current regimen
D) Refer to pain management without changing medication
Answer: A) Evaluate for opioid use disorder; recommend a slow taper
off full opioid agonists and then start buprenorphine
Rationale: The patient demonstrates signs of opioid use disorder
including tolerance, withdrawal symptoms (diarrhea, restlessness), and
loss of control over use (filling early, seeking additional prescriptions).
Buprenorphine is appropriate for opioid use disorder after tapering off
full opioid agonists.
