NR NP 6665 WEEK 11 FINAL EXAM
WA L D E N P M HN P · L AT E S T 2 0 2 0 2 7
NRNP 6665 Final
Most Comprehensive
100% Verified
175-Question Capstone PMHNP Assessment — Updated
Edition
A 175-question final examination aligned with the Walden University NRNP
6665 Week 11 capstone blueprint. Coverage spans PMHNP scope and ethics,
psychiatric assessment and DSM-5-TR diagnosis, psychopharmacology,
depressive and bipolar disorders, anxiety/OCD/PTSD, schizophrenia
spectrum, substance use and personality disorders,
child/adolescent/geriatric/perinatal mental health, psychotherapy and crisis
intervention, and professional documentation — with 100% verified answers
reflecting 2026–2027 FDA approvals, black box warnings, and current
100% VE RI FI E D UPDATE D 175 Q UE STI O N S 10 SE CTI O N S
PMHNP certification standards.
F O R M AT CO GN ITIV E MIX STY LE
MCQ · A–D 25/55/20 75% Scenario
Z .A I · A D VA N C E D P R A C T I C E N U R S I N G E D U C AT I O N 100% V ER IFIED
,NRNP 6665 Week 11 Final Exam · 100% Verified (UPDATED) Walden PMHNP · Latest
NRNP 6665 Week 11 Final Exam
Most Comprehensive to Pass the Exam · 100% Verified (UPDATED) · Latest
Total Questions 175
Total Sections 10
Format Multiple Choice (A–D), one correct answer per question
Cognitive Mix ~25% recall, ~55% application, ~20% analysis
Question Style ~75% scenario-based, ~25% direct recall
Coverage PMHNP scope/ethics; assessment/DSM-5-TR; psychopharmacology; depression/bipolar;
anxiety/OCD/PTSD; schizophrenia; SUD/personality/somatic; child/adolescent/geriatric/perinatal;
psychotherapy/crisis; documentation/capstone
Answer Format Correct answer marked with [CORRECT]; rationale with PMHNP reasoning and clinical application
100% Verified Updated answers reflecting 2026–2027 FDA approvals, black box warnings, and PMHNP certification
standards
Section 1: Foundations of PMHNP Practice
Role, Scope, Ethics, Legal, & Therapeutic Relationships (Q1–Q16)
Q1: A PMHNP in independent practice receives a subpoena requesting the complete medical record of a
patient who is involved in civil litigation. The patient has not consented to release of records. Which
response by the PMHNP is MOST appropriate?
A. Notify the patient of the subpoena, refuse to release records without the patient's written authorization
or a court order, and consult malpractice counsel; release only what is specifically ordered by a court
[CORRECT]
B. Release the entire medical record because a subpoena is equivalent to a court order
C. Release only the medication list but withhold psychotherapy notes
D. Ignore the subpoena because medical records are privileged under HIPAA
Correct Answer: A
Rationale: A subpoena alone is NOT sufficient to compel release of psychotherapy records in most states. 100% verified: the
PMHNP must (1) notify the patient of the subpoena so the patient can file a motion to quash, (2) refuse to release records
without the patient's written authorization or a court order, and (3) consult malpractice counsel. Releasing records on a
subpoena alone can expose the PMHNP to HIPAA sanctions and malpractice liability. Psychotherapy notes receive extra
protection under HIPAA (42 CFR Part 2 for SUD records). Only a court order (not subpoena) compels release.
Q2: A patient reveals during a therapy session that he intends to kill his estranged wife when she returns
from a business trip in two days. The PMHNP's duty under Tarasoff v. Regents of University of California
requires:
A. The PMHNP to protect the identifiable victim by warning the victim, notifying law enforcement,
hospitalizing the patient involuntarily if criteria are met, and documenting all actions taken [CORRECT]
B. Maintaining strict patient confidentiality because no weapon has been acquired yet
C. Waiting until the patient actually attempts the act before intervening
Z.ai · Advanced Practice Nursing Education Page 1
,NRNP 6665 Week 11 Final Exam · 100% Verified (UPDATED) Walden PMHNP · Latest
D. Notifying only the patient's family, not the intended victim
Correct Answer: A
Rationale: Tarasoff v. Regents of University of California (1976) established the duty to protect an identifiable, foreseeable
victim of serious harm. 100% verified: the PMHNP must take reasonable steps to protect the victim, which may include
warning the victim, notifying law enforcement, initiating involuntary commitment if criteria are met, and/or adjusting
treatment. Confidentiality is breached only to the extent necessary to protect the victim. The duty arises when there is a serious
threat of physical violence against a reasonably identifiable victim. Documentation of the threat, clinical reasoning, and
protective actions is essential.
Q3: A PMHNP is providing care to a 16-year-old patient who discloses suicidal ideation but asks the
PMHNP not to tell her parents. Which statement BEST describes the PMHNP's legal and ethical
obligation?
A. Confidentiality for minors is generally protected for mental health and SUD treatment under state law,
BUT an exception exists for imminent risk of harm to self or others; the PMHNP must inform
parents/guardians of the suicide risk, document the clinical reasoning, and develop a safety plan with the
patient and parents [CORRECT]
B. Always maintain confidentiality for minors regardless of risk
C. Always inform parents of everything the adolescent discloses in treatment
D. Refer the patient to an adult provider because adolescents cannot be treated by PMHNPs
Correct Answer: A
Rationale: Minors' confidentiality for mental health and substance use treatment is protected under most state laws, with
exceptions for imminent risk of harm to self or others, abuse/neglect (mandated reporting), and court orders. 100% verified:
suicidal ideation constitutes a safety exception — the PMHNP must inform parents/guardians of the risk, document the clinical
reasoning, and develop a safety plan. Best practice is to involve the adolescent in the disclosure process (e.g., 'let's call your
parents together'). Other disclosures (e.g., substance use, sexual activity) may be confidential depending on state law. State law
varies on minor consent ages and conditions.
Q4: A PMHNP working in a rural clinic is asked by a long-time patient to write a prescription for a
controlled substance for the patient's spouse, who is not a patient of the clinic. Which is the appropriate
response?
A. Refuse; prescribing controlled substances requires an established provider-patient relationship with the
actual patient, including evaluation, history, and appropriate documentation; prescribing for someone who
is not a patient is unprofessional conduct and violates DEA regulations [CORRECT]
B. Write the prescription as a favor, since the spouse is married to the patient
C. Write the prescription only if the spouse calls the clinic to confirm identity
D. Write the prescription if the patient signs a release of liability
Correct Answer: A
Rationale: Prescribing controlled substances requires an established provider-patient relationship with the actual patient,
including evaluation, history, and appropriate documentation. 100% verified: prescribing for someone who is not an
established patient is unprofessional conduct, violates DEA regulations, and can result in license revocation and criminal
charges. This practice (often called 'phantom prescribing' or prescribing without a legitimate medical purpose) is a federal
offense under 21 USC 841. The PMHNP must refuse and offer to see the spouse as a new patient if appropriate. The 'favor'
or 'release of liability' exceptions do not exist.
Q5: During a therapy session, a patient begins to bring the PMHNP expensive gifts and asks the PMHNP
to attend a family wedding. The PMHNP should:
Z.ai · Advanced Practice Nursing Education Page 2
, NRNP 6665 Week 11 Final Exam · 100% Verified (UPDATED) Walden PMHNP · Latest
A. Decline the gifts and the wedding invitation, explore the meaning of the gifts and the invitation with the
patient (potential boundary issue or transference), document the discussion, and seek consultation if the
pattern continues [CORRECT]
B. Accept the gifts to avoid offending the patient
C. Attend the wedding to demonstrate caring
D. Terminate treatment because the patient is being inappropriate
Correct Answer: A
Rationale: Boundary issues in the therapeutic relationship require careful management. 100% verified: small, inexpensive
gifts (e.g., cookies at holidays) may be acceptable, but expensive gifts or invitations to personal events are boundary violations.
The PMHNP should decline, explore the meaning of the gift/invitation (potential transference, desire for a personal
relationship, or compensation for perceived poor care), document the discussion, and seek consultation if the pattern continues.
Termination is premature without first exploring the dynamics. Acceptance of expensive gifts or social invitations can constitute
a boundary violation and may trigger board disciplinary action.
Q6: A patient repeatedly arrives 20 minutes late to therapy sessions, then attempts to extend the session
beyond the scheduled time. The PMHNP recognizes this behavior as a potential:
A. Acting out / boundary-testing behavior that should be addressed therapeutically by exploring the
meaning of the lateness and reinforcing the frame (session boundaries, start/end times); document the
pattern [CORRECT]
B. Sign that the patient needs longer sessions and the schedule should be changed
C. Sign that the patient is dissatisfied and should be referred elsewhere
D. Patient rights violation if the PMHNP ends sessions on time
Correct Answer: A
Rationale: Repeated lateness and attempts to extend sessions are common boundary-testing behaviors that should be addressed
therapeutically. 100% verified: the PMHNP should (1) explore the meaning of the lateness (resistance, ambivalence about
treatment, need for control, transference), (2) reinforce the frame (session boundaries, start/end times), and (3) document the
pattern and discussion. Changing session length without exploration reinforces the behavior. Premature termination without
exploration is unprofessional. Ending sessions on time is appropriate boundary management, not a patient rights violation.
Q7: A PMHNP who works in a community mental health center becomes aware that a colleague is diverting
controlled substances from the clinic supply. The PMHNP's ethical obligation under the ANA Code of
Ethics and state nurse practice acts is to:
A. Report the colleague to the appropriate authority (state board of nursing, DEA, and clinic
administration) and document the report; failure to report known diversion is itself a violation of nursing
ethics and law [CORRECT]
B. Confront the colleague directly and ask them to stop
C. Ignore the situation because it is not the PMHNP's patient
D. Wait until there is more evidence before reporting
Correct Answer: A
Rationale: The ANA Code of Ethics for Nurses and state nurse practice acts require nurses to report impaired colleagues and
known diversion of controlled substances. 100% verified: the PMHNP must report the colleague to the state board of nursing,
DEA, and clinic administration, and document the report. Failure to report known diversion is itself a violation of nursing
ethics and law, and can result in disciplinary action against the PMHNP who failed to report. Direct confrontation may
destroy evidence or enable denial; waiting for more evidence is not appropriate when diversion is observed. The duty to report
supersedes collegial loyalty.
Z.ai · Advanced Practice Nursing Education Page 3
WA L D E N P M HN P · L AT E S T 2 0 2 0 2 7
NRNP 6665 Final
Most Comprehensive
100% Verified
175-Question Capstone PMHNP Assessment — Updated
Edition
A 175-question final examination aligned with the Walden University NRNP
6665 Week 11 capstone blueprint. Coverage spans PMHNP scope and ethics,
psychiatric assessment and DSM-5-TR diagnosis, psychopharmacology,
depressive and bipolar disorders, anxiety/OCD/PTSD, schizophrenia
spectrum, substance use and personality disorders,
child/adolescent/geriatric/perinatal mental health, psychotherapy and crisis
intervention, and professional documentation — with 100% verified answers
reflecting 2026–2027 FDA approvals, black box warnings, and current
100% VE RI FI E D UPDATE D 175 Q UE STI O N S 10 SE CTI O N S
PMHNP certification standards.
F O R M AT CO GN ITIV E MIX STY LE
MCQ · A–D 25/55/20 75% Scenario
Z .A I · A D VA N C E D P R A C T I C E N U R S I N G E D U C AT I O N 100% V ER IFIED
,NRNP 6665 Week 11 Final Exam · 100% Verified (UPDATED) Walden PMHNP · Latest
NRNP 6665 Week 11 Final Exam
Most Comprehensive to Pass the Exam · 100% Verified (UPDATED) · Latest
Total Questions 175
Total Sections 10
Format Multiple Choice (A–D), one correct answer per question
Cognitive Mix ~25% recall, ~55% application, ~20% analysis
Question Style ~75% scenario-based, ~25% direct recall
Coverage PMHNP scope/ethics; assessment/DSM-5-TR; psychopharmacology; depression/bipolar;
anxiety/OCD/PTSD; schizophrenia; SUD/personality/somatic; child/adolescent/geriatric/perinatal;
psychotherapy/crisis; documentation/capstone
Answer Format Correct answer marked with [CORRECT]; rationale with PMHNP reasoning and clinical application
100% Verified Updated answers reflecting 2026–2027 FDA approvals, black box warnings, and PMHNP certification
standards
Section 1: Foundations of PMHNP Practice
Role, Scope, Ethics, Legal, & Therapeutic Relationships (Q1–Q16)
Q1: A PMHNP in independent practice receives a subpoena requesting the complete medical record of a
patient who is involved in civil litigation. The patient has not consented to release of records. Which
response by the PMHNP is MOST appropriate?
A. Notify the patient of the subpoena, refuse to release records without the patient's written authorization
or a court order, and consult malpractice counsel; release only what is specifically ordered by a court
[CORRECT]
B. Release the entire medical record because a subpoena is equivalent to a court order
C. Release only the medication list but withhold psychotherapy notes
D. Ignore the subpoena because medical records are privileged under HIPAA
Correct Answer: A
Rationale: A subpoena alone is NOT sufficient to compel release of psychotherapy records in most states. 100% verified: the
PMHNP must (1) notify the patient of the subpoena so the patient can file a motion to quash, (2) refuse to release records
without the patient's written authorization or a court order, and (3) consult malpractice counsel. Releasing records on a
subpoena alone can expose the PMHNP to HIPAA sanctions and malpractice liability. Psychotherapy notes receive extra
protection under HIPAA (42 CFR Part 2 for SUD records). Only a court order (not subpoena) compels release.
Q2: A patient reveals during a therapy session that he intends to kill his estranged wife when she returns
from a business trip in two days. The PMHNP's duty under Tarasoff v. Regents of University of California
requires:
A. The PMHNP to protect the identifiable victim by warning the victim, notifying law enforcement,
hospitalizing the patient involuntarily if criteria are met, and documenting all actions taken [CORRECT]
B. Maintaining strict patient confidentiality because no weapon has been acquired yet
C. Waiting until the patient actually attempts the act before intervening
Z.ai · Advanced Practice Nursing Education Page 1
,NRNP 6665 Week 11 Final Exam · 100% Verified (UPDATED) Walden PMHNP · Latest
D. Notifying only the patient's family, not the intended victim
Correct Answer: A
Rationale: Tarasoff v. Regents of University of California (1976) established the duty to protect an identifiable, foreseeable
victim of serious harm. 100% verified: the PMHNP must take reasonable steps to protect the victim, which may include
warning the victim, notifying law enforcement, initiating involuntary commitment if criteria are met, and/or adjusting
treatment. Confidentiality is breached only to the extent necessary to protect the victim. The duty arises when there is a serious
threat of physical violence against a reasonably identifiable victim. Documentation of the threat, clinical reasoning, and
protective actions is essential.
Q3: A PMHNP is providing care to a 16-year-old patient who discloses suicidal ideation but asks the
PMHNP not to tell her parents. Which statement BEST describes the PMHNP's legal and ethical
obligation?
A. Confidentiality for minors is generally protected for mental health and SUD treatment under state law,
BUT an exception exists for imminent risk of harm to self or others; the PMHNP must inform
parents/guardians of the suicide risk, document the clinical reasoning, and develop a safety plan with the
patient and parents [CORRECT]
B. Always maintain confidentiality for minors regardless of risk
C. Always inform parents of everything the adolescent discloses in treatment
D. Refer the patient to an adult provider because adolescents cannot be treated by PMHNPs
Correct Answer: A
Rationale: Minors' confidentiality for mental health and substance use treatment is protected under most state laws, with
exceptions for imminent risk of harm to self or others, abuse/neglect (mandated reporting), and court orders. 100% verified:
suicidal ideation constitutes a safety exception — the PMHNP must inform parents/guardians of the risk, document the clinical
reasoning, and develop a safety plan. Best practice is to involve the adolescent in the disclosure process (e.g., 'let's call your
parents together'). Other disclosures (e.g., substance use, sexual activity) may be confidential depending on state law. State law
varies on minor consent ages and conditions.
Q4: A PMHNP working in a rural clinic is asked by a long-time patient to write a prescription for a
controlled substance for the patient's spouse, who is not a patient of the clinic. Which is the appropriate
response?
A. Refuse; prescribing controlled substances requires an established provider-patient relationship with the
actual patient, including evaluation, history, and appropriate documentation; prescribing for someone who
is not a patient is unprofessional conduct and violates DEA regulations [CORRECT]
B. Write the prescription as a favor, since the spouse is married to the patient
C. Write the prescription only if the spouse calls the clinic to confirm identity
D. Write the prescription if the patient signs a release of liability
Correct Answer: A
Rationale: Prescribing controlled substances requires an established provider-patient relationship with the actual patient,
including evaluation, history, and appropriate documentation. 100% verified: prescribing for someone who is not an
established patient is unprofessional conduct, violates DEA regulations, and can result in license revocation and criminal
charges. This practice (often called 'phantom prescribing' or prescribing without a legitimate medical purpose) is a federal
offense under 21 USC 841. The PMHNP must refuse and offer to see the spouse as a new patient if appropriate. The 'favor'
or 'release of liability' exceptions do not exist.
Q5: During a therapy session, a patient begins to bring the PMHNP expensive gifts and asks the PMHNP
to attend a family wedding. The PMHNP should:
Z.ai · Advanced Practice Nursing Education Page 2
, NRNP 6665 Week 11 Final Exam · 100% Verified (UPDATED) Walden PMHNP · Latest
A. Decline the gifts and the wedding invitation, explore the meaning of the gifts and the invitation with the
patient (potential boundary issue or transference), document the discussion, and seek consultation if the
pattern continues [CORRECT]
B. Accept the gifts to avoid offending the patient
C. Attend the wedding to demonstrate caring
D. Terminate treatment because the patient is being inappropriate
Correct Answer: A
Rationale: Boundary issues in the therapeutic relationship require careful management. 100% verified: small, inexpensive
gifts (e.g., cookies at holidays) may be acceptable, but expensive gifts or invitations to personal events are boundary violations.
The PMHNP should decline, explore the meaning of the gift/invitation (potential transference, desire for a personal
relationship, or compensation for perceived poor care), document the discussion, and seek consultation if the pattern continues.
Termination is premature without first exploring the dynamics. Acceptance of expensive gifts or social invitations can constitute
a boundary violation and may trigger board disciplinary action.
Q6: A patient repeatedly arrives 20 minutes late to therapy sessions, then attempts to extend the session
beyond the scheduled time. The PMHNP recognizes this behavior as a potential:
A. Acting out / boundary-testing behavior that should be addressed therapeutically by exploring the
meaning of the lateness and reinforcing the frame (session boundaries, start/end times); document the
pattern [CORRECT]
B. Sign that the patient needs longer sessions and the schedule should be changed
C. Sign that the patient is dissatisfied and should be referred elsewhere
D. Patient rights violation if the PMHNP ends sessions on time
Correct Answer: A
Rationale: Repeated lateness and attempts to extend sessions are common boundary-testing behaviors that should be addressed
therapeutically. 100% verified: the PMHNP should (1) explore the meaning of the lateness (resistance, ambivalence about
treatment, need for control, transference), (2) reinforce the frame (session boundaries, start/end times), and (3) document the
pattern and discussion. Changing session length without exploration reinforces the behavior. Premature termination without
exploration is unprofessional. Ending sessions on time is appropriate boundary management, not a patient rights violation.
Q7: A PMHNP who works in a community mental health center becomes aware that a colleague is diverting
controlled substances from the clinic supply. The PMHNP's ethical obligation under the ANA Code of
Ethics and state nurse practice acts is to:
A. Report the colleague to the appropriate authority (state board of nursing, DEA, and clinic
administration) and document the report; failure to report known diversion is itself a violation of nursing
ethics and law [CORRECT]
B. Confront the colleague directly and ask them to stop
C. Ignore the situation because it is not the PMHNP's patient
D. Wait until there is more evidence before reporting
Correct Answer: A
Rationale: The ANA Code of Ethics for Nurses and state nurse practice acts require nurses to report impaired colleagues and
known diversion of controlled substances. 100% verified: the PMHNP must report the colleague to the state board of nursing,
DEA, and clinic administration, and document the report. Failure to report known diversion is itself a violation of nursing
ethics and law, and can result in disciplinary action against the PMHNP who failed to report. Direct confrontation may
destroy evidence or enable denial; waiting for more evidence is not appropriate when diversion is observed. The duty to report
supersedes collegial loyalty.
Z.ai · Advanced Practice Nursing Education Page 3
