NR 607 Final Exam – Chamberlain
Psychiatric-Mental Health Practicum III
(2026) Complete Practice Exam: 100
Questions with Verified Answers and
Rationales
SECTION 1: PSYCHIATRIC ASSESSMENT &
DIAGNOSTIC REASONING (Questions 1-20)
Question 1
A 45-year-old patient presents with new-onset auditory hallucinations,
paranoia, and disorganized thinking. The patient has no prior psychiatric
history. Which of the following is the MOST critical initial step in the
diagnostic workup?
A) Start an antipsychotic medication immediately
B) Obtain a thorough medical and substance use history with appropriate
laboratory testing
C) Refer the patient for cognitive-behavioral therapy
D) Diagnose schizophrenia and begin treatment planning
Answer: B – Obtain a thorough medical and substance use history with
appropriate laboratory testing
Rationale: New-onset psychosis in a patient without prior psychiatric history
requires ruling out medical and substance-induced causes before
diagnosing a primary psychotic disorder. Conditions such as thyroid
disorders, vitamin B12 deficiency, infections, neurological conditions, and
substance use can present with psychotic symptoms.
,Question 2
A client being treated for schizophrenia presents with fever, 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
Answer: C – Order complete blood count
Rationale: Fever, hypotension, and mouth ulcers in a patient on
antipsychotic medication suggest neutropenia or agranulocytosis, which
can be caused by clozapine. A complete blood count should be ordered
immediately to assess white blood cell count and determine the severity of
neutropenia.
Question 3
Which of the following screening tools is most appropriate for assessing a
patient's risk of developing pressure ulcers?
A) PHQ-9
B) Braden Scale
C) GAD-7
D) CAGE Questionnaire
Answer: B – Braden Scale
Rationale: The Braden Scale is used to assess pressure ulcer risk. The
PHQ-9 screens for depression, GAD-7 for anxiety, and CAGE for alcohol
use disorder. The PMHNP should be familiar with various screening tools
across domains of patient care.
,Question 4
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 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.
Question 5
A 32-year-old client with a history of traumatic brain injury is being treated
for symptoms of depression and is prescribed bupropion. For which
adverse effect should the client carefully monitor?
A) Aggression
B) Memory loss
C) Sleep disturbances
D) Seizures
Answer: D – Seizures
Rationale: Bupropion lowers the seizure threshold, particularly at higher
doses or in patients with predisposing conditions such as a history of
traumatic brain injury, seizure disorder, or eating disorders. The patient
should be counseled to monitor for any new neurologic changes.
, Question 6
A client presents to the emergency department with her sister. She lives
alone and has been unable to perform basic care for herself for three
weeks due to active hallucinations. She has stopped eating, bathing, and is
drinking only a small amount of water each day. This presentation is best
described as:
A) Risk to self
B) Grave disability
C) Risk to others
D) Substance-induced psychosis
Answer: B – Grave disability
Rationale: Grave disability is defined as the inability to provide for one's
basic needs, including food, clothing, and shelter, due to a psychiatric
condition. This client's inability to perform basic self-care, including eating
and bathing, meets criteria for grave disability, which is a basis for
involuntary psychiatric admission.
Question 7
The PMHNP is assessing a patient who reports hearing voices that
comment on their actions. The voices are described as "outside my head"
and the patient acknowledges they are not real. This finding is best
described as:
A) Auditory hallucinations with insight
B) Auditory hallucinations without insight
C) Illusions
D) Delusions
Answer: A – Auditory hallucinations with insight
Psychiatric-Mental Health Practicum III
(2026) Complete Practice Exam: 100
Questions with Verified Answers and
Rationales
SECTION 1: PSYCHIATRIC ASSESSMENT &
DIAGNOSTIC REASONING (Questions 1-20)
Question 1
A 45-year-old patient presents with new-onset auditory hallucinations,
paranoia, and disorganized thinking. The patient has no prior psychiatric
history. Which of the following is the MOST critical initial step in the
diagnostic workup?
A) Start an antipsychotic medication immediately
B) Obtain a thorough medical and substance use history with appropriate
laboratory testing
C) Refer the patient for cognitive-behavioral therapy
D) Diagnose schizophrenia and begin treatment planning
Answer: B – Obtain a thorough medical and substance use history with
appropriate laboratory testing
Rationale: New-onset psychosis in a patient without prior psychiatric history
requires ruling out medical and substance-induced causes before
diagnosing a primary psychotic disorder. Conditions such as thyroid
disorders, vitamin B12 deficiency, infections, neurological conditions, and
substance use can present with psychotic symptoms.
,Question 2
A client being treated for schizophrenia presents with fever, 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
Answer: C – Order complete blood count
Rationale: Fever, hypotension, and mouth ulcers in a patient on
antipsychotic medication suggest neutropenia or agranulocytosis, which
can be caused by clozapine. A complete blood count should be ordered
immediately to assess white blood cell count and determine the severity of
neutropenia.
Question 3
Which of the following screening tools is most appropriate for assessing a
patient's risk of developing pressure ulcers?
A) PHQ-9
B) Braden Scale
C) GAD-7
D) CAGE Questionnaire
Answer: B – Braden Scale
Rationale: The Braden Scale is used to assess pressure ulcer risk. The
PHQ-9 screens for depression, GAD-7 for anxiety, and CAGE for alcohol
use disorder. The PMHNP should be familiar with various screening tools
across domains of patient care.
,Question 4
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 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.
Question 5
A 32-year-old client with a history of traumatic brain injury is being treated
for symptoms of depression and is prescribed bupropion. For which
adverse effect should the client carefully monitor?
A) Aggression
B) Memory loss
C) Sleep disturbances
D) Seizures
Answer: D – Seizures
Rationale: Bupropion lowers the seizure threshold, particularly at higher
doses or in patients with predisposing conditions such as a history of
traumatic brain injury, seizure disorder, or eating disorders. The patient
should be counseled to monitor for any new neurologic changes.
, Question 6
A client presents to the emergency department with her sister. She lives
alone and has been unable to perform basic care for herself for three
weeks due to active hallucinations. She has stopped eating, bathing, and is
drinking only a small amount of water each day. This presentation is best
described as:
A) Risk to self
B) Grave disability
C) Risk to others
D) Substance-induced psychosis
Answer: B – Grave disability
Rationale: Grave disability is defined as the inability to provide for one's
basic needs, including food, clothing, and shelter, due to a psychiatric
condition. This client's inability to perform basic self-care, including eating
and bathing, meets criteria for grave disability, which is a basis for
involuntary psychiatric admission.
Question 7
The PMHNP is assessing a patient who reports hearing voices that
comment on their actions. The voices are described as "outside my head"
and the patient acknowledges they are not real. This finding is best
described as:
A) Auditory hallucinations with insight
B) Auditory hallucinations without insight
C) Illusions
D) Delusions
Answer: A – Auditory hallucinations with insight
