NSG 526 EXAM 2 - ADVANCED
PRACTICE PSYCHIATRIC NURSING
COMPREHENSIVE QUESTIONS WITH
VERIFIED ANSWERS 2026/2027
1. Which neuroanatomical structure is primarily responsible for the ‘fear circuitry’ and the
processing of emotional responses in Anxiety Disorders?
A. Amygdala
B. Hippocampus
C. Basal Ganglia
D. Thalamus
Answer: A
Conceptual Explanation: The amygdala is the core structure for processing fear and
anxiety; the hippocampus is more involved in memory, and the basal ganglia in motor
control and reward.
2. A patient taking Clozapine presents with a fever, sore throat, and malaise. Which
laboratory value is the most critical for the PMHNP to assess immediately?
A. Serum Potassium
B. Hemoglobin A1c
,C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are clinical signs of infection that necessitate checking the ANC to rule
out life-threatening neutropenia.
3. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose a patient with Cyclothymic Disorder in adults?
A. 6 months
B. 1 year
C. 5 years
D. 2 years
Answer: D
Conceptual Explanation: Cyclothymic disorder requires at least a 2-year period (1 year in
children/adolescents) of numerous periods with hypomanic symptoms and depressive
symptoms that do not meet full criteria for a major episode.
4. Which dopamine pathway is associated with the negative symptoms of schizophrenia and
cognitive impairment when dopamine levels are low?
A. Mesocortical pathway
, B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesocortical pathway is linked to negative and cognitive
symptoms. The mesolimbic pathway is associated with positive symptoms
(hallucinations/delusions) when dopamine is excessive.
5. A PMHNP is treating a patient with Lithium for Bipolar I Disorder. The patient mentions
they have started a new ‘low salt’ diet and a diuretic for hypertension. The PMHNP knows
this will likely:
A. Decrease serum Lithium levels
B. Have no effect on Lithium levels
C. Increase serum Lithium levels
D. Increase the metabolism of Lithium via the liver
Answer: C
Conceptual Explanation: Lithium is a salt handled by the kidneys like sodium. A low-
sodium diet or diuretics cause the kidneys to reabsorb more sodium and Lithium, leading
to potentially toxic serum Lithium levels.
PRACTICE PSYCHIATRIC NURSING
COMPREHENSIVE QUESTIONS WITH
VERIFIED ANSWERS 2026/2027
1. Which neuroanatomical structure is primarily responsible for the ‘fear circuitry’ and the
processing of emotional responses in Anxiety Disorders?
A. Amygdala
B. Hippocampus
C. Basal Ganglia
D. Thalamus
Answer: A
Conceptual Explanation: The amygdala is the core structure for processing fear and
anxiety; the hippocampus is more involved in memory, and the basal ganglia in motor
control and reward.
2. A patient taking Clozapine presents with a fever, sore throat, and malaise. Which
laboratory value is the most critical for the PMHNP to assess immediately?
A. Serum Potassium
B. Hemoglobin A1c
,C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are clinical signs of infection that necessitate checking the ANC to rule
out life-threatening neutropenia.
3. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose a patient with Cyclothymic Disorder in adults?
A. 6 months
B. 1 year
C. 5 years
D. 2 years
Answer: D
Conceptual Explanation: Cyclothymic disorder requires at least a 2-year period (1 year in
children/adolescents) of numerous periods with hypomanic symptoms and depressive
symptoms that do not meet full criteria for a major episode.
4. Which dopamine pathway is associated with the negative symptoms of schizophrenia and
cognitive impairment when dopamine levels are low?
A. Mesocortical pathway
, B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesocortical pathway is linked to negative and cognitive
symptoms. The mesolimbic pathway is associated with positive symptoms
(hallucinations/delusions) when dopamine is excessive.
5. A PMHNP is treating a patient with Lithium for Bipolar I Disorder. The patient mentions
they have started a new ‘low salt’ diet and a diuretic for hypertension. The PMHNP knows
this will likely:
A. Decrease serum Lithium levels
B. Have no effect on Lithium levels
C. Increase serum Lithium levels
D. Increase the metabolism of Lithium via the liver
Answer: C
Conceptual Explanation: Lithium is a salt handled by the kidneys like sodium. A low-
sodium diet or diuretics cause the kidneys to reabsorb more sodium and Lithium, leading
to potentially toxic serum Lithium levels.
