• NR607 CEA Exam 09/09/2026
NR607 CEA Exam 2 Prep COMPLETE 200
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
The PMHNP receives a consult to see a client admitted to the medical unit for atrial fibrillation with active suicidal
thoughts. The client is not medically stable. Which is the most appropriate recommendation for the client?
A. immediate transfer to the psychiatric inpatient unit
B. transfer to a private isolation room on the medical unit
C. every 15-minute checks
D. 24-hour supervision on the medical unit –
P 1
, • NR607 CEA Exam 09/09/2026
Correct Answer :D. 24-hour supervision on the medical unit
Rationale: A medically unstable suicidal client should remain on the medical unit until the medical condition is
stabilized. Continuous 24-hour observation provides suicide precautions while allowing necessary cardiac care;
transfer to a psychiatric unit should occur only when the client is medically appropriate for that setting.
A client has experienced sudden onset paralysis of bilateral lower extremities with no obvious physical cause
despite extensive neurologic testing. Due to the symptoms, the client has been excused from work and has
been receiving around-the-clock care from their spouse. Which psychological symptom associated with
conversion disorder is the client experiencing?
A. identification
B. secondary gain
C. primary gain
D. la belle indifference - Correct Answer :B. secondary gain
Rationale: Secondary gain refers to external benefits that result from symptoms, such as relief from work
responsibilities, financial benefits, attention, or increased caregiving. Being excused from work and receiving
around-the-clock care from a spouse are external consequences, so they represent secondary gain rather than
primary gain.
A 35-year-old client with schizophrenia refuses to continue his olanzapine; he believes the medication is causing
erectile dysfunction and plans to "take a break." Which is the most appropriate next step for the PMHNP?
A. switch to long acting olanzapine
B. document the client's refusal
C. ask the client to further explain the reasons for refusal
D. initiate treatment without informed consent - Correct Answer :C. ask the client to further explain the reasons
for refusal
Rationale: Before changing treatment or simply documenting refusal, the PMHNP should explore why the client
wants to stop the medication. Understanding the client's concern about erectile dysfunction supports informed
decision-making, validates the adverse effect, and creates an opportunity to discuss dose adjustment, switching
medications, or other acceptable alternatives.
P 2
, • NR607 CEA Exam 09/09/2026
A client presents with symptoms of major depressive disorder. He is unwilling to engage in the interview and
states he does not care to hear about treatment options, but he will do whatever the PMHNP recommends.
Which is the most appropriate next step for the PMHNP?
A. initiate treatment without informed consent
B. obtain consent from the client's wife
C. document the client's refusal to engage in the interview
D. ask the client to further explain his symptoms - Correct Answer :D. ask the client to further explain his
symptoms
Rationale: Valid informed consent requires meaningful participation, understanding, and an opportunity to
discuss symptoms, risks, benefits, and alternatives. A statement that the client will simply do whatever the
PMHNP says is not a substitute for assessment and shared decision-making, so the PMHNP should continue the
interview and invite the client to describe his symptoms.
A client presents to the emergency room with symptoms of paranoia, visual hallucinations, and irritability. He is
unwilling to respond to questions related to his medical history, but he has prescription bottles in his pocket that
indicate he takes levodopa and entacapone daily. Which is the most likely cause of the client's symptoms?
A. Parkinson disease dementia
B. schizophrenia
C. dissociative amnesia
D. Alzheimer's disease - Correct Answer :A. Parkinson disease dementia
Review note: Exam-bank answer retained; medication-induced Parkinson psychosis would also be a clinical
consideration.
Rationale: Visual hallucinations and paranoia are common neuropsychiatric manifestations in Parkinson disease
dementia and Parkinson disease psychosis, and dopaminergic medications such as levodopa can worsen
hallucinations in susceptible patients. The exam bank therefore selects Parkinson disease dementia, although
medication-induced or medication-exacerbated psychosis should also be assessed clinically.
P 3
, • NR607 CEA Exam 09/09/2026
Which of the following clients is most likely experiencing dissociative identity disorder?
A. A client who has frequent nightmares after a sexual assault
B. A client who feels like she is watching her life as if it was a movie
C. A client who feels like there are several people in her head telling her what to say
D. A client who cannot remember how she got home from dinner last night - Correct Answer :C. A client who
feels like there are several people in her head telling her what to say
Rationale: Experiencing several distinct people or identity states internally that influence speech or behavior is
most consistent with dissociative identity disorder. Watching life like a movie suggests
depersonalization/derealization, nightmares after assault suggest PTSD, and an isolated memory gap suggests
dissociative amnesia or another cause rather than DID by itself.
A client with major depressive disorder has been taking citalopram 40 mg for six weeks. The medication has
been well tolerated, but the client continues to have mild depressive symptoms. Which is the most appropriate
recommendation for the client?
A. recommend L-methylfolate
B. switch the client to nortriptyline
C. recommend L-theanine
D. schedule transcranial magnetic stimulation - Correct Answer :A. recommend L-methylfolate
Rationale: L-methylfolate may be used as an augmentation strategy when a client has a partial response to an
antidepressant and continues to have residual depressive symptoms. For mild symptoms after an otherwise
tolerated SSRI trial, augmentation is less disruptive than immediately switching to a tricyclic antidepressant or
moving to TMS.
A 17-year-old inpatient client refuses to take prescribed antipsychotic medication. The staff nurse has provided
extensive education on the need for continued medication. Which is the most appropriate next step for the
PMHNP?
A. administer the medication mixed into food
B. ask the client to explain the reasons for refusal
P 4
NR607 CEA Exam 2 Prep COMPLETE 200
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
The PMHNP receives a consult to see a client admitted to the medical unit for atrial fibrillation with active suicidal
thoughts. The client is not medically stable. Which is the most appropriate recommendation for the client?
A. immediate transfer to the psychiatric inpatient unit
B. transfer to a private isolation room on the medical unit
C. every 15-minute checks
D. 24-hour supervision on the medical unit –
P 1
, • NR607 CEA Exam 09/09/2026
Correct Answer :D. 24-hour supervision on the medical unit
Rationale: A medically unstable suicidal client should remain on the medical unit until the medical condition is
stabilized. Continuous 24-hour observation provides suicide precautions while allowing necessary cardiac care;
transfer to a psychiatric unit should occur only when the client is medically appropriate for that setting.
A client has experienced sudden onset paralysis of bilateral lower extremities with no obvious physical cause
despite extensive neurologic testing. Due to the symptoms, the client has been excused from work and has
been receiving around-the-clock care from their spouse. Which psychological symptom associated with
conversion disorder is the client experiencing?
A. identification
B. secondary gain
C. primary gain
D. la belle indifference - Correct Answer :B. secondary gain
Rationale: Secondary gain refers to external benefits that result from symptoms, such as relief from work
responsibilities, financial benefits, attention, or increased caregiving. Being excused from work and receiving
around-the-clock care from a spouse are external consequences, so they represent secondary gain rather than
primary gain.
A 35-year-old client with schizophrenia refuses to continue his olanzapine; he believes the medication is causing
erectile dysfunction and plans to "take a break." Which is the most appropriate next step for the PMHNP?
A. switch to long acting olanzapine
B. document the client's refusal
C. ask the client to further explain the reasons for refusal
D. initiate treatment without informed consent - Correct Answer :C. ask the client to further explain the reasons
for refusal
Rationale: Before changing treatment or simply documenting refusal, the PMHNP should explore why the client
wants to stop the medication. Understanding the client's concern about erectile dysfunction supports informed
decision-making, validates the adverse effect, and creates an opportunity to discuss dose adjustment, switching
medications, or other acceptable alternatives.
P 2
, • NR607 CEA Exam 09/09/2026
A client presents with symptoms of major depressive disorder. He is unwilling to engage in the interview and
states he does not care to hear about treatment options, but he will do whatever the PMHNP recommends.
Which is the most appropriate next step for the PMHNP?
A. initiate treatment without informed consent
B. obtain consent from the client's wife
C. document the client's refusal to engage in the interview
D. ask the client to further explain his symptoms - Correct Answer :D. ask the client to further explain his
symptoms
Rationale: Valid informed consent requires meaningful participation, understanding, and an opportunity to
discuss symptoms, risks, benefits, and alternatives. A statement that the client will simply do whatever the
PMHNP says is not a substitute for assessment and shared decision-making, so the PMHNP should continue the
interview and invite the client to describe his symptoms.
A client presents to the emergency room with symptoms of paranoia, visual hallucinations, and irritability. He is
unwilling to respond to questions related to his medical history, but he has prescription bottles in his pocket that
indicate he takes levodopa and entacapone daily. Which is the most likely cause of the client's symptoms?
A. Parkinson disease dementia
B. schizophrenia
C. dissociative amnesia
D. Alzheimer's disease - Correct Answer :A. Parkinson disease dementia
Review note: Exam-bank answer retained; medication-induced Parkinson psychosis would also be a clinical
consideration.
Rationale: Visual hallucinations and paranoia are common neuropsychiatric manifestations in Parkinson disease
dementia and Parkinson disease psychosis, and dopaminergic medications such as levodopa can worsen
hallucinations in susceptible patients. The exam bank therefore selects Parkinson disease dementia, although
medication-induced or medication-exacerbated psychosis should also be assessed clinically.
P 3
, • NR607 CEA Exam 09/09/2026
Which of the following clients is most likely experiencing dissociative identity disorder?
A. A client who has frequent nightmares after a sexual assault
B. A client who feels like she is watching her life as if it was a movie
C. A client who feels like there are several people in her head telling her what to say
D. A client who cannot remember how she got home from dinner last night - Correct Answer :C. A client who
feels like there are several people in her head telling her what to say
Rationale: Experiencing several distinct people or identity states internally that influence speech or behavior is
most consistent with dissociative identity disorder. Watching life like a movie suggests
depersonalization/derealization, nightmares after assault suggest PTSD, and an isolated memory gap suggests
dissociative amnesia or another cause rather than DID by itself.
A client with major depressive disorder has been taking citalopram 40 mg for six weeks. The medication has
been well tolerated, but the client continues to have mild depressive symptoms. Which is the most appropriate
recommendation for the client?
A. recommend L-methylfolate
B. switch the client to nortriptyline
C. recommend L-theanine
D. schedule transcranial magnetic stimulation - Correct Answer :A. recommend L-methylfolate
Rationale: L-methylfolate may be used as an augmentation strategy when a client has a partial response to an
antidepressant and continues to have residual depressive symptoms. For mild symptoms after an otherwise
tolerated SSRI trial, augmentation is less disruptive than immediately switching to a tricyclic antidepressant or
moving to TMS.
A 17-year-old inpatient client refuses to take prescribed antipsychotic medication. The staff nurse has provided
extensive education on the need for continued medication. Which is the most appropriate next step for the
PMHNP?
A. administer the medication mixed into food
B. ask the client to explain the reasons for refusal
P 4
