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NR605 FINAL EXAM (CHAMBERLAIN) 2026 COMPLETE
(100) CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
NR605
Prepare with confidence using this NR605 Final Exam (Chamberlain), designed
to assess comprehensive graduate-level nursing knowledge. It focuses on
evidence-based practice, advanced clinical decision-making, healthcare
policy, and complex patient management. The exam strengthens critical
thinking and application of nursing theory in advanced practice settings.
Suitable for graduate nursing students at Chamberlain University preparing for
final examinations.
MULTIPLE CHOICE.
Subsection 1: Advanced Psychopharmacology (Questions 1–20)
1. A patient with treatment-resistant schizophrenia has failed
trials of two antipsychotics, including clozapine. The next
appropriate intervention is:
A. High-dose monotherapy with another typical antipsychotic
B. Electroconvulsive therapy (ECT) for treatment-resistant
schizophrenia
C. Add a benzodiazepine
D. Discontinue all antipsychotics
Answer: B. Electroconvulsive therapy (ECT) for treatment-resistant
schizophrenia
Explanation: ECT has evidence for treatment-resistant schizophrenia,
including clozapine-refractory cases. It is also effective for catatonia. Not
first-line but indicated after clozapine failure.
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2. A patient on valproate for bipolar disorder develops polycystic
ovary syndrome (PCOS)-like symptoms. Which medication might
be substituted?
A. Lithium (does not cause PCOS)
B. Carbamazepine
C. Lamotrigine
D. All of the above
Answer: D. All of the above
Explanation: Valproate is associated with weight gain,
hyperandrogenism, and PCOS. Alternative mood stabilizers include
lithium, lamotrigine, or carbamazepine. Lithium is often preferred.
3. A patient with major depressive disorder and comorbid
obsessive-compulsive disorder is started on fluoxetine. After 8
weeks at 40 mg daily, the patient has partial response. The PMHNP
should:
A. Continue same dose
B. Increase to 80 mg daily (high-dose SSRI for OCD)
C. Switch to bupropion
D. Add a benzodiazepine
Answer: B. Increase to 80 mg daily (high-dose SSRI for OCD)
Explanation: OCD often requires higher SSRI doses than depression
(e.g., fluoxetine 60–80 mg, sertraline 200–250 mg). Partial response →
dose escalation if tolerated.
4. A patient on clozapine develops constipation. Which
intervention is most urgently needed?
A. Reassurance
B. Aggressive bowel regimen (clozapine causes severe constipation, can
lead to paralytic ileus, obstruction, death)
C. Stop clozapine
D. Add loperamide
Answer: B. Aggressive bowel regimen (clozapine causes severe
constipation, can lead to paralytic ileus, obstruction, death)
Explanation: Clozapine-induced constipation is a black box warning
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due to fatal bowel obstruction. Aggressive prevention (stool softeners,
stimulants, hydration) is essential.
5. A patient with bipolar I disorder is stabilized on lithium. He
develops an acute kidney injury after a bout of gastroenteritis. The
PMHNP should:
A. Continue lithium at the same dose
B. Hold lithium, assess renal function, and rehydrate IV fluids; restart at
lower dose when stable
C. Double the dose
D. Switch to valproate immediately
Answer: B. Hold lithium, assess renal function, and rehydrate IV
fluids; restart at lower dose when stable
Explanation: Lithium toxicity risk increases with dehydration,
NSAIDs, ACE inhibitors, thiazides. Hold lithium, correct hydration,
monitor levels. Restart at reduced dose.
6. A patient with PTSD and nightmares has failed SSRIs. Which
medication has evidence for reducing trauma-related nightmares?
A. Prazosin (alpha-1 antagonist) at bedtime
B. Quetiapine
C. Trazodone
D. Hydroxyzine
Answer: A. Prazosin (alpha-1 antagonist) at bedtime
Explanation: Prazosin reduces nightmares and sleep disturbance in
PTSD. Initial dose 1 mg at bedtime, titrate to 5–15 mg. Evidence
strongest in male veterans.
7. A patient on phenelzine (MAOI) requires surgery. Anesthesia
with meperidine (Demerol) is contraindicated because it can
cause:
A. Hypertensive crisis
B. Serotonin syndrome (MAOIs + meperidine = life-threatening
serotonin toxicity)
C. Neuroleptic malignant syndrome
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D. Dystonia
Answer: B. Serotonin syndrome (MAOIs + meperidine = life-
threatening serotonin toxicity)
Explanation: MAOIs interact with meperidine (serotonergic), SSRIs,
SNRIs, and many others to cause serotonin syndrome. Avoid for at least
2 weeks after MAOI discontinuation.
8. A patient with bipolar II depression is started on lamotrigine.
The titration schedule is slow. After 4 weeks at 50 mg daily, the
patient develops a rash without mucosal lesions or fever. The
PMHNP should:
A. Continue lamotrigine, monitor
B. Stop lamotrigine immediately and do not restart (any rash requires
discontinuation unless clearly benign)
C. Double the dose
D. Add an antihistamine
Answer: B. Stop lamotrigine immediately and do not restart (any
rash requires discontinuation unless clearly benign)
Explanation: Lamotrigine rash requires discontinuation unless clearly
non-drug-related (e.g., heat rash). Benign rashes cannot be
distinguished early from SJS. Rechallenge is riskier.
9. A patient with generalized anxiety disorder is started on
buspirone. Which statement about buspirone is correct?
A. Onset is immediate (within hours)
B. It has abuse potential
C. Onset is delayed (2–4 weeks), no dependence, and effective for
generalized anxiety
D. It is a benzodiazepine
Answer: C. Onset is delayed (2–4 weeks), no dependence, and
effective for generalized anxiety
Explanation: Buspirone is a 5-HT1A partial agonist. Delayed onset, no
sedation, no abuse potential. Not effective for panic disorder. Not a
benzodiazepine.
NR605 FINAL EXAM (CHAMBERLAIN) 2026 COMPLETE
(100) CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
NR605
Prepare with confidence using this NR605 Final Exam (Chamberlain), designed
to assess comprehensive graduate-level nursing knowledge. It focuses on
evidence-based practice, advanced clinical decision-making, healthcare
policy, and complex patient management. The exam strengthens critical
thinking and application of nursing theory in advanced practice settings.
Suitable for graduate nursing students at Chamberlain University preparing for
final examinations.
MULTIPLE CHOICE.
Subsection 1: Advanced Psychopharmacology (Questions 1–20)
1. A patient with treatment-resistant schizophrenia has failed
trials of two antipsychotics, including clozapine. The next
appropriate intervention is:
A. High-dose monotherapy with another typical antipsychotic
B. Electroconvulsive therapy (ECT) for treatment-resistant
schizophrenia
C. Add a benzodiazepine
D. Discontinue all antipsychotics
Answer: B. Electroconvulsive therapy (ECT) for treatment-resistant
schizophrenia
Explanation: ECT has evidence for treatment-resistant schizophrenia,
including clozapine-refractory cases. It is also effective for catatonia. Not
first-line but indicated after clozapine failure.
, Page 2 of 40
2. A patient on valproate for bipolar disorder develops polycystic
ovary syndrome (PCOS)-like symptoms. Which medication might
be substituted?
A. Lithium (does not cause PCOS)
B. Carbamazepine
C. Lamotrigine
D. All of the above
Answer: D. All of the above
Explanation: Valproate is associated with weight gain,
hyperandrogenism, and PCOS. Alternative mood stabilizers include
lithium, lamotrigine, or carbamazepine. Lithium is often preferred.
3. A patient with major depressive disorder and comorbid
obsessive-compulsive disorder is started on fluoxetine. After 8
weeks at 40 mg daily, the patient has partial response. The PMHNP
should:
A. Continue same dose
B. Increase to 80 mg daily (high-dose SSRI for OCD)
C. Switch to bupropion
D. Add a benzodiazepine
Answer: B. Increase to 80 mg daily (high-dose SSRI for OCD)
Explanation: OCD often requires higher SSRI doses than depression
(e.g., fluoxetine 60–80 mg, sertraline 200–250 mg). Partial response →
dose escalation if tolerated.
4. A patient on clozapine develops constipation. Which
intervention is most urgently needed?
A. Reassurance
B. Aggressive bowel regimen (clozapine causes severe constipation, can
lead to paralytic ileus, obstruction, death)
C. Stop clozapine
D. Add loperamide
Answer: B. Aggressive bowel regimen (clozapine causes severe
constipation, can lead to paralytic ileus, obstruction, death)
Explanation: Clozapine-induced constipation is a black box warning
, Page 3 of 40
due to fatal bowel obstruction. Aggressive prevention (stool softeners,
stimulants, hydration) is essential.
5. A patient with bipolar I disorder is stabilized on lithium. He
develops an acute kidney injury after a bout of gastroenteritis. The
PMHNP should:
A. Continue lithium at the same dose
B. Hold lithium, assess renal function, and rehydrate IV fluids; restart at
lower dose when stable
C. Double the dose
D. Switch to valproate immediately
Answer: B. Hold lithium, assess renal function, and rehydrate IV
fluids; restart at lower dose when stable
Explanation: Lithium toxicity risk increases with dehydration,
NSAIDs, ACE inhibitors, thiazides. Hold lithium, correct hydration,
monitor levels. Restart at reduced dose.
6. A patient with PTSD and nightmares has failed SSRIs. Which
medication has evidence for reducing trauma-related nightmares?
A. Prazosin (alpha-1 antagonist) at bedtime
B. Quetiapine
C. Trazodone
D. Hydroxyzine
Answer: A. Prazosin (alpha-1 antagonist) at bedtime
Explanation: Prazosin reduces nightmares and sleep disturbance in
PTSD. Initial dose 1 mg at bedtime, titrate to 5–15 mg. Evidence
strongest in male veterans.
7. A patient on phenelzine (MAOI) requires surgery. Anesthesia
with meperidine (Demerol) is contraindicated because it can
cause:
A. Hypertensive crisis
B. Serotonin syndrome (MAOIs + meperidine = life-threatening
serotonin toxicity)
C. Neuroleptic malignant syndrome
, Page 4 of 40
D. Dystonia
Answer: B. Serotonin syndrome (MAOIs + meperidine = life-
threatening serotonin toxicity)
Explanation: MAOIs interact with meperidine (serotonergic), SSRIs,
SNRIs, and many others to cause serotonin syndrome. Avoid for at least
2 weeks after MAOI discontinuation.
8. A patient with bipolar II depression is started on lamotrigine.
The titration schedule is slow. After 4 weeks at 50 mg daily, the
patient develops a rash without mucosal lesions or fever. The
PMHNP should:
A. Continue lamotrigine, monitor
B. Stop lamotrigine immediately and do not restart (any rash requires
discontinuation unless clearly benign)
C. Double the dose
D. Add an antihistamine
Answer: B. Stop lamotrigine immediately and do not restart (any
rash requires discontinuation unless clearly benign)
Explanation: Lamotrigine rash requires discontinuation unless clearly
non-drug-related (e.g., heat rash). Benign rashes cannot be
distinguished early from SJS. Rechallenge is riskier.
9. A patient with generalized anxiety disorder is started on
buspirone. Which statement about buspirone is correct?
A. Onset is immediate (within hours)
B. It has abuse potential
C. Onset is delayed (2–4 weeks), no dependence, and effective for
generalized anxiety
D. It is a benzodiazepine
Answer: C. Onset is delayed (2–4 weeks), no dependence, and
effective for generalized anxiety
Explanation: Buspirone is a 5-HT1A partial agonist. Delayed onset, no
sedation, no abuse potential. Not effective for panic disorder. Not a
benzodiazepine.
