F I N A L E X A M P R AC T I C E · 2 0 2 6\2027 E D I T I O N
NR 607
Final Exam Prep
Diagnosis and Management in Psychiatric-Mental Health
Practicum I I I . A complete practice examination of 150
single-best-answer questions with correct answers and
detailed rationales, covering psychopharmacology, DSM-
5-TR diagnosis, and clinical management across the
lifespan.
Psychiatric-Mental Health Nurse Practitioner Program
150 Questions · Detailed Answer Rationales · Balanced Full-Scope
Review
,NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III Final Exam Prep - 150 Questions with Rationales
NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III
Final Exam Prep - Practice Question Bank
2026 Edition
Directions: Select the single best answer for each of the 150 questions. The correct
answer and a detailed rationale follow immediately beneath each item.
Suggested pacing is approximately one minute per question.
1. A 34-year-old woman presents with a 2-month history of depressed mood,
anhedonia, insomnia, and fatigue. She has never taken a psychiatric medication and
has no medical comorbidities. Which medication is the most appropriate first-line
treatment?
A. Lithium carbonate
B. Olanzapine
C. Phenelzine
D. Fluoxetine
Correct Answer: D
Rationale. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine are first-line for moderate major
depressive disorder because of established efficacy, safety in overdose, and tolerability. Phenelzine is a monoamine
oxidase inhibitor (MAOI) reserved for treatment-resistant or clearly atypical depression because of dietary tyramine
restrictions and dangerous drug interactions. Lithium carbonate is a mood stabilizer used in bipolar disorder or as
augmentation, not first-line monotherapy for unipolar depression. Olanzapine is an antipsychotic with no indication for
MDD without psychotic features.
2. Which laboratory monitoring is most essential for a patient maintained on long-term
lithium therapy?
A. Liver enzymes only
B. Monthly complete blood count only
C. Weekly electrocardiograms
D. Serum creatinine and thyroid-stimulating hormone
2026 Edition - Practice Question Bank 1
,NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III Final Exam Prep - 150 Questions with Rationales
Correct Answer: D
Rationale. Lithium is excreted almost entirely by the kidneys, so declining renal function raises levels and toxicity
risk; serum creatinine or eGFR should be checked at baseline and every 3 to 6 months. Lithium also inhibits thyroid
hormone synthesis and release, making TSH monitoring essential. Liver enzymes and CBC are not the primary
monitoring targets, and weekly ECGs are unnecessary unless cardiac disease or overdose is suspected. Lithium serum
levels themselves are checked 5 to 7 days after any dose change.
2026 Edition - Practice Question Bank 2
, NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III Final Exam Prep - 150 Questions with Rationales
3.According to DSM-5-TR criteria, excessive anxiety and worry that is difficult to
control must persist for how long to diagnose generalized anxiety disorder?
A. At least 1 month
B. At least 3 months
C. At least 6 months
D. At least 12 months
Correct Answer: C
Rationale. Generalized anxiety disorder requires excessive anxiety and worry occurring more days than not for at least
6 months about a number of events, accompanied by difficulty controlling the worry and at least three associated
symptoms such as restlessness, fatigue, poor concentration, irritability, muscle tension, or sleep disturbance. One
month is too short, and 12 months exceeds the requirement. Three months is the minimum duration for persistent
depressive disorder, not GAD.
4.A patient with schizophrenia has been stable on clozapine for 13 months with
normal absolute neutrophil counts. How frequently should ANC monitoring now
occur under the REMS program?
A. Weekly
B. Every 2 weeks
C. Monthly
D. Every 3 months
Correct Answer: C
Rationale. Clozapine REMS requires weekly ANC monitoring for the first 6 months, every 2 weeks for the second 6
months, and then monthly for as long as the patient remains on the drug. After one full year of therapeutic counts, the
monthly schedule applies. Weekly and biweekly monitoring are more intensive than necessary at this stage, and
quarterly monitoring would miss emerging neutropenia. Monitoring is lifelong because agranulocytosis can occur at
any point in treatment.
5.A hospitalized patient with alcohol use disorder develops coarse tremor,
diaphoresis, and a CIWA-Ar score of 18 approximately 24 hours after his last drink.
What is the first-line pharmacologic treatment?
A. Disulfiram
B. Lorazepam
C. Haloperidol
2026 Edition - Practice Question Bank 3
NR 607
Final Exam Prep
Diagnosis and Management in Psychiatric-Mental Health
Practicum I I I . A complete practice examination of 150
single-best-answer questions with correct answers and
detailed rationales, covering psychopharmacology, DSM-
5-TR diagnosis, and clinical management across the
lifespan.
Psychiatric-Mental Health Nurse Practitioner Program
150 Questions · Detailed Answer Rationales · Balanced Full-Scope
Review
,NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III Final Exam Prep - 150 Questions with Rationales
NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III
Final Exam Prep - Practice Question Bank
2026 Edition
Directions: Select the single best answer for each of the 150 questions. The correct
answer and a detailed rationale follow immediately beneath each item.
Suggested pacing is approximately one minute per question.
1. A 34-year-old woman presents with a 2-month history of depressed mood,
anhedonia, insomnia, and fatigue. She has never taken a psychiatric medication and
has no medical comorbidities. Which medication is the most appropriate first-line
treatment?
A. Lithium carbonate
B. Olanzapine
C. Phenelzine
D. Fluoxetine
Correct Answer: D
Rationale. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine are first-line for moderate major
depressive disorder because of established efficacy, safety in overdose, and tolerability. Phenelzine is a monoamine
oxidase inhibitor (MAOI) reserved for treatment-resistant or clearly atypical depression because of dietary tyramine
restrictions and dangerous drug interactions. Lithium carbonate is a mood stabilizer used in bipolar disorder or as
augmentation, not first-line monotherapy for unipolar depression. Olanzapine is an antipsychotic with no indication for
MDD without psychotic features.
2. Which laboratory monitoring is most essential for a patient maintained on long-term
lithium therapy?
A. Liver enzymes only
B. Monthly complete blood count only
C. Weekly electrocardiograms
D. Serum creatinine and thyroid-stimulating hormone
2026 Edition - Practice Question Bank 1
,NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III Final Exam Prep - 150 Questions with Rationales
Correct Answer: D
Rationale. Lithium is excreted almost entirely by the kidneys, so declining renal function raises levels and toxicity
risk; serum creatinine or eGFR should be checked at baseline and every 3 to 6 months. Lithium also inhibits thyroid
hormone synthesis and release, making TSH monitoring essential. Liver enzymes and CBC are not the primary
monitoring targets, and weekly ECGs are unnecessary unless cardiac disease or overdose is suspected. Lithium serum
levels themselves are checked 5 to 7 days after any dose change.
2026 Edition - Practice Question Bank 2
, NR 607 - Diagnosis and Management in Psychiatric-Mental Health Practicum III Final Exam Prep - 150 Questions with Rationales
3.According to DSM-5-TR criteria, excessive anxiety and worry that is difficult to
control must persist for how long to diagnose generalized anxiety disorder?
A. At least 1 month
B. At least 3 months
C. At least 6 months
D. At least 12 months
Correct Answer: C
Rationale. Generalized anxiety disorder requires excessive anxiety and worry occurring more days than not for at least
6 months about a number of events, accompanied by difficulty controlling the worry and at least three associated
symptoms such as restlessness, fatigue, poor concentration, irritability, muscle tension, or sleep disturbance. One
month is too short, and 12 months exceeds the requirement. Three months is the minimum duration for persistent
depressive disorder, not GAD.
4.A patient with schizophrenia has been stable on clozapine for 13 months with
normal absolute neutrophil counts. How frequently should ANC monitoring now
occur under the REMS program?
A. Weekly
B. Every 2 weeks
C. Monthly
D. Every 3 months
Correct Answer: C
Rationale. Clozapine REMS requires weekly ANC monitoring for the first 6 months, every 2 weeks for the second 6
months, and then monthly for as long as the patient remains on the drug. After one full year of therapeutic counts, the
monthly schedule applies. Weekly and biweekly monitoring are more intensive than necessary at this stage, and
quarterly monitoring would miss emerging neutropenia. Monitoring is lifelong because agranulocytosis can occur at
any point in treatment.
5.A hospitalized patient with alcohol use disorder develops coarse tremor,
diaphoresis, and a CIWA-Ar score of 18 approximately 24 hours after his last drink.
What is the first-line pharmacologic treatment?
A. Disulfiram
B. Lorazepam
C. Haloperidol
2026 Edition - Practice Question Bank 3
