NRNP 6635 PMHNP PRACTICE EXAM
2026-2027 QUESTIONS AND ANSWERS
1. A 24-year-old patient diagnosed with Schizophrenia is experiencing severe muscle rigidity,
a temperature of 104°F, and autonomic instability. Which of the following is the most likely
diagnosis?
A. Serotonin Syndrome
B. Akathisia
C. Acute Dystonia
D. Neuroleptic Malignant Syndrome (NMS)
Answer: D
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by lead-pipe rigidity, hyperthermia, and autonomic instability, whereas
Serotonin Syndrome usually involves hyperreflexia and myoclonus.
2. In the treatment of Bipolar I Disorder, which medication is most associated with a potential
risk for Stevens-Johnson Syndrome (SJS)?
A. Lamotrigine
,B. Valproic Acid
C. Lithium
D. Quetiapine
Answer: A
Conceptual Explanation: Lamotrigine requires a slow titration schedule specifically to
mitigate the risk of severe dermatological reactions like SJS.
3. Which brain region is primarily responsible for the ‘executive functions’ such as planning,
decision-making, and impulse control?
A. Prefrontal Cortex
B. Hippocampus
C. Amygdala
D. Thalamus
Answer: A
Conceptual Explanation: The prefrontal cortex is the center for higher-order cognitive
processes and executive function.
4. A patient on Clozapine therapy presents for a follow-up. According to the REMS program,
what is the Absolute Neutrophil Count (ANC) threshold to continue treatment normally?
A. ANC ≥ 1500/µL
B. ANC ≥ 1000/µL
, C. ANC ≥ 500/µL
D. ANC ≥ 2000/µL
Answer: A
Conceptual Explanation: For the general population, treatment with Clozapine can be
initiated and maintained if the ANC is ≥ 1500/µL.
5. The ‘Tarasoff’ rule pertains to which ethical and legal obligation of the PMHNP?
A. Duty to Warn
B. Informed Consent
C. Right to Refuse Treatment
D. Patient Confidentiality
Answer: A
Conceptual Explanation: The Tarasoff case established the legal duty of mental health
professionals to warn third parties who are at risk of harm from a patient.
6. Which neurotransmitter is primarily implicated in the reward system and is significantly
increased by addictive substances?
A. Serotonin
B. GABA
C. Glutamate
2026-2027 QUESTIONS AND ANSWERS
1. A 24-year-old patient diagnosed with Schizophrenia is experiencing severe muscle rigidity,
a temperature of 104°F, and autonomic instability. Which of the following is the most likely
diagnosis?
A. Serotonin Syndrome
B. Akathisia
C. Acute Dystonia
D. Neuroleptic Malignant Syndrome (NMS)
Answer: D
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by lead-pipe rigidity, hyperthermia, and autonomic instability, whereas
Serotonin Syndrome usually involves hyperreflexia and myoclonus.
2. In the treatment of Bipolar I Disorder, which medication is most associated with a potential
risk for Stevens-Johnson Syndrome (SJS)?
A. Lamotrigine
,B. Valproic Acid
C. Lithium
D. Quetiapine
Answer: A
Conceptual Explanation: Lamotrigine requires a slow titration schedule specifically to
mitigate the risk of severe dermatological reactions like SJS.
3. Which brain region is primarily responsible for the ‘executive functions’ such as planning,
decision-making, and impulse control?
A. Prefrontal Cortex
B. Hippocampus
C. Amygdala
D. Thalamus
Answer: A
Conceptual Explanation: The prefrontal cortex is the center for higher-order cognitive
processes and executive function.
4. A patient on Clozapine therapy presents for a follow-up. According to the REMS program,
what is the Absolute Neutrophil Count (ANC) threshold to continue treatment normally?
A. ANC ≥ 1500/µL
B. ANC ≥ 1000/µL
, C. ANC ≥ 500/µL
D. ANC ≥ 2000/µL
Answer: A
Conceptual Explanation: For the general population, treatment with Clozapine can be
initiated and maintained if the ANC is ≥ 1500/µL.
5. The ‘Tarasoff’ rule pertains to which ethical and legal obligation of the PMHNP?
A. Duty to Warn
B. Informed Consent
C. Right to Refuse Treatment
D. Patient Confidentiality
Answer: A
Conceptual Explanation: The Tarasoff case established the legal duty of mental health
professionals to warn third parties who are at risk of harm from a patient.
6. Which neurotransmitter is primarily implicated in the reward system and is significantly
increased by addictive substances?
A. Serotonin
B. GABA
C. Glutamate
