WGU Psychiatric Mental Health Nurse
Practitioner Assessment ACTUAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+
,WGU PMHNP Assessment Practice Exam (100 Questions)
1. A 28-year-old client presents with a 6-month history of depressed mood, anhedonia, insomnia, and
feelings of worthlessness. Which neurotransmitter system is most classically implicated in the
pathophysiology of major depressive disorder?
A. Dopaminergic
B. Serotonergic
C. GABAergic
D. Glutamatergic
Answer: B
Rationale: The monoamine hypothesis of depression, which is the basis for most antidepressant
treatments, primarily implicates deficiencies in serotonin (5-HT), norepinephrine (NE), and dopamine
(DA). The serotonergic system is the most classically and commonly targeted system in the treatment of
major depressive disorder.
,2. Which of the following is a first-line medication for the treatment of obsessive-compulsive disorder
(OCD)?
A. Alprazolam
B. Sertraline
C. Quetiapine
D. Lithium
Answer: B
Rationale: SSRIs, such as sertraline, fluoxetine, and fluvoxamine, are considered first-line
pharmacological treatments for OCD. They often require higher doses than those used for depression.
Clomipramine, a TCA, is also FDA-approved but is typically used as a second-line agent due to its side
effect profile.
3. A client is diagnosed with schizophrenia and is experiencing prominent negative symptoms. Which of
the following is a negative symptom?
A. Auditory hallucinations
B. Delusions of persecution
C. Avolition
, D. Disorganized speech
Answer: C
Rationale: Negative symptoms represent a loss or decrease in normal functions. Avolition (lack of
motivation), anhedonia (inability to feel pleasure), alogia (poverty of speech), and affective flattening are
all negative symptoms. Hallucinations, delusions, and disorganized speech are positive symptoms
(additions to normal experience).
4. Which lab value must be monitored closely in a client taking lithium carbonate?
A. Potassium level
B. Serum creatinine and thyroid-stimulating hormone (TSH)
C. Hemoglobin A1c
D. Liver function tests (AST/ALT)
Answer: B
Rationale: Lithium has a narrow therapeutic index and is excreted by the kidneys. It can cause
nephrogenic diabetes insipidus and chronic kidney disease, necessitating monitoring of renal function
(BUN/Creatinine). It can also cause hypothyroidism, so TSH levels must be monitored regularly.
Practitioner Assessment ACTUAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+
,WGU PMHNP Assessment Practice Exam (100 Questions)
1. A 28-year-old client presents with a 6-month history of depressed mood, anhedonia, insomnia, and
feelings of worthlessness. Which neurotransmitter system is most classically implicated in the
pathophysiology of major depressive disorder?
A. Dopaminergic
B. Serotonergic
C. GABAergic
D. Glutamatergic
Answer: B
Rationale: The monoamine hypothesis of depression, which is the basis for most antidepressant
treatments, primarily implicates deficiencies in serotonin (5-HT), norepinephrine (NE), and dopamine
(DA). The serotonergic system is the most classically and commonly targeted system in the treatment of
major depressive disorder.
,2. Which of the following is a first-line medication for the treatment of obsessive-compulsive disorder
(OCD)?
A. Alprazolam
B. Sertraline
C. Quetiapine
D. Lithium
Answer: B
Rationale: SSRIs, such as sertraline, fluoxetine, and fluvoxamine, are considered first-line
pharmacological treatments for OCD. They often require higher doses than those used for depression.
Clomipramine, a TCA, is also FDA-approved but is typically used as a second-line agent due to its side
effect profile.
3. A client is diagnosed with schizophrenia and is experiencing prominent negative symptoms. Which of
the following is a negative symptom?
A. Auditory hallucinations
B. Delusions of persecution
C. Avolition
, D. Disorganized speech
Answer: C
Rationale: Negative symptoms represent a loss or decrease in normal functions. Avolition (lack of
motivation), anhedonia (inability to feel pleasure), alogia (poverty of speech), and affective flattening are
all negative symptoms. Hallucinations, delusions, and disorganized speech are positive symptoms
(additions to normal experience).
4. Which lab value must be monitored closely in a client taking lithium carbonate?
A. Potassium level
B. Serum creatinine and thyroid-stimulating hormone (TSH)
C. Hemoglobin A1c
D. Liver function tests (AST/ALT)
Answer: B
Rationale: Lithium has a narrow therapeutic index and is excreted by the kidneys. It can cause
nephrogenic diabetes insipidus and chronic kidney disease, necessitating monitoring of renal function
(BUN/Creatinine). It can also cause hypothyroidism, so TSH levels must be monitored regularly.
