WALDEN UNIVERSITY NRNP 6665 FINAL EXAM 3
LATEST VERSIONS A, B & C 2025 — STUDY GUIDE |
LATEST UPDATE 2026/2027 | ACTUAL EXAM |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS
VERSION A
1.
A 45-year-old patient reports feeling depressed for the past month after
losing a job. Which of the following additional symptoms is required to
meet DSM-5 criteria for major depressive disorder?
A) Weight gain and hypersomnia
B) Depressed mood or anhedonia
C) Fatigue and feelings of worthlessness
D) Suicidal ideation
Correct Answer: B
The core diagnostic criteria for MDD require either depressed mood or
anhedonia nearly every day for at least 2 weeks. Weight changes,
fatigue, worthlessness, and suicidal ideation are additional symptoms
but not required core features.
2.
A patient prescribed fluoxetine 20 mg daily for depression reports
improved mood but new onset of sexual dysfunction. What is the most
appropriate initial management?
,A) Discontinue fluoxetine immediately
B) Add bupropion or reduce the dose
C) Switch to a tricyclic antidepressant
D) Increase fluoxetine to 40 mg
Correct Answer: B
SSRI-induced sexual dysfunction can be managed by adding bupropion,
reducing the dose, or switching to a non-serotonergic agent. Abrupt
discontinuation is unsafe; increasing dose worsens side effects; tricyclics
have more side effects.
3.
Which of the following is a first-line psychotherapy for posttraumatic
stress disorder?
A) Psychoanalysis
B) Trauma-focused cognitive behavioral therapy
C) Gestalt therapy
D) Family systems therapy only
Correct Answer: B
Trauma-focused CBT, including prolonged exposure and cognitive
processing therapy, is first-line for PTSD per clinical guidelines.
Psychoanalysis and Gestalt are not first-line; family therapy may be
adjunctive.
4.
A patient with bipolar I disorder is started on lithium. Which laboratory
value must be monitored regularly?
A) Serum creatinine and thyroid-stimulating hormone
B) Liver enzymes and platelet count
,C) Serum potassium and magnesium
D) Fasting glucose and hemoglobin A1c
Correct Answer: A
Lithium requires monitoring of renal function (creatinine) and thyroid
function (TSH) due to risk of nephrotoxicity and hypothyroidism.
Potassium, magnesium, glucose, and A1c are not primary monitoring
parameters for lithium.
5.
A 7-year-old child presents with inattention, hyperactivity, and
impulsivity at school and home for 9 months. Which disorder is most
consistent?
A) Oppositional defiant disorder
B) Attention-deficit/hyperactivity disorder
C) Autism spectrum disorder
D) Conduct disorder
Correct Answer: B
ADHD requires symptoms of inattention, hyperactivity, and impulsivity in
multiple settings for at least 6 months with functional impairment. ODD
involves defiance; ASD involves social communication deficits; conduct
disorder involves rule violation.
6.
Which of the following medications is FDA-approved for ADHD in
children and is a non-stimulant option?
A) Methylphenidate
B) Atomoxetine
, C) Dextroamphetamine
D) Lisdexamfetamine
Correct Answer: B
Atomoxetine is a non-stimulant selective norepinephrine reuptake
inhibitor approved for ADHD. Methylphenidate, dextroamphetamine,
and lisdexamfetamine are stimulants.
7.
A patient with schizophrenia has been stable on risperidone for 6
months but now presents with involuntary lip smacking and tongue
movements. What is the most likely diagnosis?
A) Dystonia
B) Tardive dyskinesia
C) Akathisia
D) Parkinsonism
Correct Answer: B
Tardive dyskinesia is a late-onset, potentially irreversible movement
disorder caused by long-term antipsychotic use, characterized by
choreoathetoid movements of the face, lips, and tongue. Dystonia,
akathisia, and Parkinsonism are other extrapyramidal symptoms with
different presentations.
8.
What is the recommended first-line pharmacological treatment for
generalized anxiety disorder?
A) Benzodiazepine alone
B) SSRI or SNRI
LATEST VERSIONS A, B & C 2025 — STUDY GUIDE |
LATEST UPDATE 2026/2027 | ACTUAL EXAM |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS
VERSION A
1.
A 45-year-old patient reports feeling depressed for the past month after
losing a job. Which of the following additional symptoms is required to
meet DSM-5 criteria for major depressive disorder?
A) Weight gain and hypersomnia
B) Depressed mood or anhedonia
C) Fatigue and feelings of worthlessness
D) Suicidal ideation
Correct Answer: B
The core diagnostic criteria for MDD require either depressed mood or
anhedonia nearly every day for at least 2 weeks. Weight changes,
fatigue, worthlessness, and suicidal ideation are additional symptoms
but not required core features.
2.
A patient prescribed fluoxetine 20 mg daily for depression reports
improved mood but new onset of sexual dysfunction. What is the most
appropriate initial management?
,A) Discontinue fluoxetine immediately
B) Add bupropion or reduce the dose
C) Switch to a tricyclic antidepressant
D) Increase fluoxetine to 40 mg
Correct Answer: B
SSRI-induced sexual dysfunction can be managed by adding bupropion,
reducing the dose, or switching to a non-serotonergic agent. Abrupt
discontinuation is unsafe; increasing dose worsens side effects; tricyclics
have more side effects.
3.
Which of the following is a first-line psychotherapy for posttraumatic
stress disorder?
A) Psychoanalysis
B) Trauma-focused cognitive behavioral therapy
C) Gestalt therapy
D) Family systems therapy only
Correct Answer: B
Trauma-focused CBT, including prolonged exposure and cognitive
processing therapy, is first-line for PTSD per clinical guidelines.
Psychoanalysis and Gestalt are not first-line; family therapy may be
adjunctive.
4.
A patient with bipolar I disorder is started on lithium. Which laboratory
value must be monitored regularly?
A) Serum creatinine and thyroid-stimulating hormone
B) Liver enzymes and platelet count
,C) Serum potassium and magnesium
D) Fasting glucose and hemoglobin A1c
Correct Answer: A
Lithium requires monitoring of renal function (creatinine) and thyroid
function (TSH) due to risk of nephrotoxicity and hypothyroidism.
Potassium, magnesium, glucose, and A1c are not primary monitoring
parameters for lithium.
5.
A 7-year-old child presents with inattention, hyperactivity, and
impulsivity at school and home for 9 months. Which disorder is most
consistent?
A) Oppositional defiant disorder
B) Attention-deficit/hyperactivity disorder
C) Autism spectrum disorder
D) Conduct disorder
Correct Answer: B
ADHD requires symptoms of inattention, hyperactivity, and impulsivity in
multiple settings for at least 6 months with functional impairment. ODD
involves defiance; ASD involves social communication deficits; conduct
disorder involves rule violation.
6.
Which of the following medications is FDA-approved for ADHD in
children and is a non-stimulant option?
A) Methylphenidate
B) Atomoxetine
, C) Dextroamphetamine
D) Lisdexamfetamine
Correct Answer: B
Atomoxetine is a non-stimulant selective norepinephrine reuptake
inhibitor approved for ADHD. Methylphenidate, dextroamphetamine,
and lisdexamfetamine are stimulants.
7.
A patient with schizophrenia has been stable on risperidone for 6
months but now presents with involuntary lip smacking and tongue
movements. What is the most likely diagnosis?
A) Dystonia
B) Tardive dyskinesia
C) Akathisia
D) Parkinsonism
Correct Answer: B
Tardive dyskinesia is a late-onset, potentially irreversible movement
disorder caused by long-term antipsychotic use, characterized by
choreoathetoid movements of the face, lips, and tongue. Dystonia,
akathisia, and Parkinsonism are other extrapyramidal symptoms with
different presentations.
8.
What is the recommended first-line pharmacological treatment for
generalized anxiety disorder?
A) Benzodiazepine alone
B) SSRI or SNRI
