CMN 574 EXAM 4: ADVANCED
PSYCHIATRIC-MENTAL HEALTH
NURSING PRACTICE QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
2026/2027 UPDATE. JUST RELEASED
1. A 45-year-old male with a history of Bipolar I Disorder presents with a Lithium level of 1.9
mEq/L. Which of the following clinical findings is most likely present?
A. Mild hand tremor
B. Ataxia and slurred speech
C. Seizures and cardiovascular collapse
D. Normal therapeutic response
Answer: B
Conceptual Explanation: Lithium levels between 1.5 and 2.0 mEq/L are considered
moderate toxicity, typically presenting with GI upset, coarse tremors, ataxia, and slurred
speech. Seizures occur at levels above 2.5.
2. Which neurotransmitter pathway is primarily associated with the development of the
positive symptoms of Schizophrenia?
A. Mesocortical pathway
,B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Hyperactivity in the mesolimbic pathway is associated with
positive symptoms (hallucinations/delusions), while the mesocortical pathway is linked to
negative and cognitive symptoms.
3. A patient is prescribed Lamotrigine for Bipolar II Disorder maintenance. What is the most
critical education point regarding this medication?
A. Importance of weekly blood draws for levels
B. Requirement for a high-sodium diet
C. Avoidance of tyramine-containing foods
D. Immediate reporting of any new rash
Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for Stevens-Johnson
Syndrome (SJS). Any new rash must be reported and assessed immediately to prevent life-
threatening complications.
, 4. Which of the following antidepressants is contraindicated in a patient with a history of
Bulimia Nervosa?
A. Sertraline
B. Fluoxetine
C. Bupropion
D. Venlafaxine
Answer: C
Conceptual Explanation: Bupropion is contraindicated in patients with seizure disorders
and eating disorders (Bulimia/Anorexia) due to a lowered seizure threshold in these
populations.
5. A patient experiencing a hypertensive crisis after consuming aged cheese while on an
MAOI should be treated with which medication?
A. Naloxone
B. Propranolol
C. Phentolamine
D. Lorazepam
Answer: C
PSYCHIATRIC-MENTAL HEALTH
NURSING PRACTICE QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
2026/2027 UPDATE. JUST RELEASED
1. A 45-year-old male with a history of Bipolar I Disorder presents with a Lithium level of 1.9
mEq/L. Which of the following clinical findings is most likely present?
A. Mild hand tremor
B. Ataxia and slurred speech
C. Seizures and cardiovascular collapse
D. Normal therapeutic response
Answer: B
Conceptual Explanation: Lithium levels between 1.5 and 2.0 mEq/L are considered
moderate toxicity, typically presenting with GI upset, coarse tremors, ataxia, and slurred
speech. Seizures occur at levels above 2.5.
2. Which neurotransmitter pathway is primarily associated with the development of the
positive symptoms of Schizophrenia?
A. Mesocortical pathway
,B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Hyperactivity in the mesolimbic pathway is associated with
positive symptoms (hallucinations/delusions), while the mesocortical pathway is linked to
negative and cognitive symptoms.
3. A patient is prescribed Lamotrigine for Bipolar II Disorder maintenance. What is the most
critical education point regarding this medication?
A. Importance of weekly blood draws for levels
B. Requirement for a high-sodium diet
C. Avoidance of tyramine-containing foods
D. Immediate reporting of any new rash
Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for Stevens-Johnson
Syndrome (SJS). Any new rash must be reported and assessed immediately to prevent life-
threatening complications.
, 4. Which of the following antidepressants is contraindicated in a patient with a history of
Bulimia Nervosa?
A. Sertraline
B. Fluoxetine
C. Bupropion
D. Venlafaxine
Answer: C
Conceptual Explanation: Bupropion is contraindicated in patients with seizure disorders
and eating disorders (Bulimia/Anorexia) due to a lowered seizure threshold in these
populations.
5. A patient experiencing a hypertensive crisis after consuming aged cheese while on an
MAOI should be treated with which medication?
A. Naloxone
B. Propranolol
C. Phentolamine
D. Lorazepam
Answer: C
