NR 668 FINAL EXAM 2025 COMPREHENSIVE REVIEW TEST
BANK WITH 480 REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS/ NR 668 PSYCHIATRIC-MENTAL
HEALTH CAPSTONE PRACTICUM FINAL EXAM PREP
CHAMBERLAIN (NEW!)
Which mental illness accounts for the highest rate of mental illness?
Major depressive disorder
Which of the following expressed suicidal ideations has the highest lethality?
"I am planning to take all of my medications at once, I just want this pain to stop."
Mabel is a 85 year old female with moderate-advanced stage of Alzheimer's
dementia. She has been wandering inside of the locked ward within the nursing
home in which she resides. The PMHNP is consulted to address the wandering
behavior of Mabel. What is the most appropriate treatment option for wandering in
the case scenario?
Supervise Mabel and allow her to wander (The greatest concern of wandering in
patients with cognitive impairment is elopement. Mabel is safe considering she
resides in a locked ward. Person centered care may help meet the needs of
residents who wander. Wandering itself can be thought of as a desire to fulfill a
need.)
A 24-year-old man has been stable on lithium 1,800 mg daily for 2 years. His most
recent serum lithium level is 2.0. The patient has no signs or symptoms of toxicity.
Which of the following is the best action by the PMHNP?
Repeat the lithium level and ensure it is a trough
Which of the following would meet the diagnostic criterion A for the diagnosis of
Acute Stress disorder?
Being in the close vicinity of a drive by shooting while walking to work (The
Criterion A for Acute Stress Disorder include traumatic events that are experienced
directly such as exposure to war, threatened or actual violent assault, natural or
manmade disasters and severe accidents.)
pg. 1
,A 6-year-old boy is referred by the child study team for speech difficulty. On
examination the boy is friendly and cooperative, his speech is clear, and he uses
simple sentences with a limited vocabulary. Most notably he confuses verb tenses
consistently. The parents report he met most of his developmental milestones
except speech, which was delayed. His clinical presentation is most consistent with
which of the following?
Expressive language disorder
Which of the following substances would be most likely to cause withdrawal
symptoms?
Alprazolam
A patient who has been drinking a six-pack of beer each night to relax after work
has been having trouble staying asleep through the night. When she wakes up at 2
a.m. she takes diphenhydramine 25 mg to help her fall back asleep, but this makes
her sleep through the alarm clock and late for work. She also reports having a
headache through midmorning until she gets her second cup of coffee. She thinks
this is related to her alcohol use and has unsuccessfully tried to cut down several
times in the past year. Which of the following disorders best describes this patient's
condition?
Alcohol use disorder
A patient is complaining of chronic back pain and requests a refill of his
oxycodone prescription because the pain is so bad he becomes suicidal. As a result,
his primary care provider referred him to the PMHNP. The patient states he can tell
if he is late taking his next dose by even 1 hour as he becomes very anxious,
restless, irritable, and begins sweating. He states that he is so worried about having
pain attacks that much of his day is spent waiting to take the next dose. When he
runs out of his medication between visits he buys some from his friend. Which of
the following best describes the patient's condition?
Addiction
A 32-year-old man presents on referral from his primary care provider. He reports
a 6-month history of recurrent bouts of anxiety associated with chest pain,
tachycardia, tremors, nausea, diaphoresis, and an impending sense of doom. The
episodes last approximately 20 minutes and he is unable to identify a precipitating
event. The patient has become increasingly isolated for fear of not wanting to have
pg. 2
,this sort of episode in public. The primary care provider started him on a selective
serotonin reuptake inhibitor (SSRI) 6 months ago but he continues to have the
symptoms. Which adjunctive psychotherapy would be most appropriate for this
patient?
Cognitive behavioral therapy
Delirium and dementia may at times have overlapping characteristics. However,
which of the following are readily associated with delirium?
sudden onset (Delirium is associated with a sudden onset, fluctuating course over a
24-hour period, with reduced consciousness, slow or rapid incoherent speech and
decreased attention span.)
Jeanne received a Christmas card from a family that she has not connected with for
several years. Jeanne felt she only received this card "because they want a card
returned from her, to see if she gained weight". Jeanne has often worried that her
husband of 18 years is cheating on her despite any evidence to support infidelity.
Jeanne is quick to counterattack with anger with any perceived insults. Jeanne does
not like to confide in others because she fears the information will be used against
her in the future. Jeanne does not have a psychotic disorder or medical condition to
better explain her personality disorder. Which of the following disorders would
best explain Jeanne's behavior?
Paranoid Personality Disorder
An 8-year-old boy diagnosed with leukemia is referred to child psychiatry because
he is consistently displaying a flat affect, irritability, angry acting out, and
occasional physical aggression toward his 6-year-old brother. What approach
should the PMHNP take when interviewing this child?
Provide toys and allow the child to play
Which eating disorder is considered ego syntonic?
Anorexia Nervosa (Anorexia Nervosa is challenging to treat because it is ego
syntonic. In other words, one's behaviors, feelings and values are in line with the
needs of the ego and reliable to one's self image.)
A 30-year-old G1P0,1 has become increasingly oddly related, neglecting self-care,
sleeping much of the day, eating minimally, crying easily, and despite reassurance
that her pregnancy is progressing normally, worries that she will lose the
pg. 3
, pregnancy. Which of the following medications is considered least harmful in
pregnancy?
Sertraline
A 10-year-old boy who had been prescribed fluoxetine for major depressive
disorder presents to the psychiatric emergency department for running into the
street in front of a car on the way home from school. In the emergency department,
he has been selectively mute, but the nurse practitioner student was able to elicit
his desire to be dead. He has been medically cleared pending a psychiatric
evaluation. What is the most common sign of major depressive disorder in
children?
Psychomotor agitation
A 6-year-old boy is referred by the child study team for speech difficulty. On
examination the boy is friendly and cooperative, his speech is clear, and he uses
simple sentences with a limited vocabulary. Most notably he confuses verb tenses
consistently. The parents report he met most of his developmental milestones
except speech, which was delayed. His clinical presentation is most consistent with
which of the following?
Expressive language disorder
The school psychologist refers a 7-year-old girl with difficulty reading,
distractibility, and writing avoidance behaviors. The child has no diagnosed
conditions, takes no medications, and met all of her developmental milestones. She
loves arts and crafts and physical education. Prior to diagnosing a learning
disorder, which of the following screening tests must be performed?
Vision and hearing
Which disorder is associated with higher rates of ADHD, enlarges testes, a long
narrow face, hypotonia and short stature?
Fragile X (Fragile X is associated with a higher rate of ADHD, impaired
intellectual ability, learning d/o's, autism spectrum d/o. Physical attributes include
hypotonia, flat feet, enlarges testes, long narrow face, flexible fingers and short
stature.)
A 10-year-old girl is referred for evaluation of behavioral difficulties. Her teachers
report that she is easily distracted and fails to complete any class work, and often
pg. 4
BANK WITH 480 REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS/ NR 668 PSYCHIATRIC-MENTAL
HEALTH CAPSTONE PRACTICUM FINAL EXAM PREP
CHAMBERLAIN (NEW!)
Which mental illness accounts for the highest rate of mental illness?
Major depressive disorder
Which of the following expressed suicidal ideations has the highest lethality?
"I am planning to take all of my medications at once, I just want this pain to stop."
Mabel is a 85 year old female with moderate-advanced stage of Alzheimer's
dementia. She has been wandering inside of the locked ward within the nursing
home in which she resides. The PMHNP is consulted to address the wandering
behavior of Mabel. What is the most appropriate treatment option for wandering in
the case scenario?
Supervise Mabel and allow her to wander (The greatest concern of wandering in
patients with cognitive impairment is elopement. Mabel is safe considering she
resides in a locked ward. Person centered care may help meet the needs of
residents who wander. Wandering itself can be thought of as a desire to fulfill a
need.)
A 24-year-old man has been stable on lithium 1,800 mg daily for 2 years. His most
recent serum lithium level is 2.0. The patient has no signs or symptoms of toxicity.
Which of the following is the best action by the PMHNP?
Repeat the lithium level and ensure it is a trough
Which of the following would meet the diagnostic criterion A for the diagnosis of
Acute Stress disorder?
Being in the close vicinity of a drive by shooting while walking to work (The
Criterion A for Acute Stress Disorder include traumatic events that are experienced
directly such as exposure to war, threatened or actual violent assault, natural or
manmade disasters and severe accidents.)
pg. 1
,A 6-year-old boy is referred by the child study team for speech difficulty. On
examination the boy is friendly and cooperative, his speech is clear, and he uses
simple sentences with a limited vocabulary. Most notably he confuses verb tenses
consistently. The parents report he met most of his developmental milestones
except speech, which was delayed. His clinical presentation is most consistent with
which of the following?
Expressive language disorder
Which of the following substances would be most likely to cause withdrawal
symptoms?
Alprazolam
A patient who has been drinking a six-pack of beer each night to relax after work
has been having trouble staying asleep through the night. When she wakes up at 2
a.m. she takes diphenhydramine 25 mg to help her fall back asleep, but this makes
her sleep through the alarm clock and late for work. She also reports having a
headache through midmorning until she gets her second cup of coffee. She thinks
this is related to her alcohol use and has unsuccessfully tried to cut down several
times in the past year. Which of the following disorders best describes this patient's
condition?
Alcohol use disorder
A patient is complaining of chronic back pain and requests a refill of his
oxycodone prescription because the pain is so bad he becomes suicidal. As a result,
his primary care provider referred him to the PMHNP. The patient states he can tell
if he is late taking his next dose by even 1 hour as he becomes very anxious,
restless, irritable, and begins sweating. He states that he is so worried about having
pain attacks that much of his day is spent waiting to take the next dose. When he
runs out of his medication between visits he buys some from his friend. Which of
the following best describes the patient's condition?
Addiction
A 32-year-old man presents on referral from his primary care provider. He reports
a 6-month history of recurrent bouts of anxiety associated with chest pain,
tachycardia, tremors, nausea, diaphoresis, and an impending sense of doom. The
episodes last approximately 20 minutes and he is unable to identify a precipitating
event. The patient has become increasingly isolated for fear of not wanting to have
pg. 2
,this sort of episode in public. The primary care provider started him on a selective
serotonin reuptake inhibitor (SSRI) 6 months ago but he continues to have the
symptoms. Which adjunctive psychotherapy would be most appropriate for this
patient?
Cognitive behavioral therapy
Delirium and dementia may at times have overlapping characteristics. However,
which of the following are readily associated with delirium?
sudden onset (Delirium is associated with a sudden onset, fluctuating course over a
24-hour period, with reduced consciousness, slow or rapid incoherent speech and
decreased attention span.)
Jeanne received a Christmas card from a family that she has not connected with for
several years. Jeanne felt she only received this card "because they want a card
returned from her, to see if she gained weight". Jeanne has often worried that her
husband of 18 years is cheating on her despite any evidence to support infidelity.
Jeanne is quick to counterattack with anger with any perceived insults. Jeanne does
not like to confide in others because she fears the information will be used against
her in the future. Jeanne does not have a psychotic disorder or medical condition to
better explain her personality disorder. Which of the following disorders would
best explain Jeanne's behavior?
Paranoid Personality Disorder
An 8-year-old boy diagnosed with leukemia is referred to child psychiatry because
he is consistently displaying a flat affect, irritability, angry acting out, and
occasional physical aggression toward his 6-year-old brother. What approach
should the PMHNP take when interviewing this child?
Provide toys and allow the child to play
Which eating disorder is considered ego syntonic?
Anorexia Nervosa (Anorexia Nervosa is challenging to treat because it is ego
syntonic. In other words, one's behaviors, feelings and values are in line with the
needs of the ego and reliable to one's self image.)
A 30-year-old G1P0,1 has become increasingly oddly related, neglecting self-care,
sleeping much of the day, eating minimally, crying easily, and despite reassurance
that her pregnancy is progressing normally, worries that she will lose the
pg. 3
, pregnancy. Which of the following medications is considered least harmful in
pregnancy?
Sertraline
A 10-year-old boy who had been prescribed fluoxetine for major depressive
disorder presents to the psychiatric emergency department for running into the
street in front of a car on the way home from school. In the emergency department,
he has been selectively mute, but the nurse practitioner student was able to elicit
his desire to be dead. He has been medically cleared pending a psychiatric
evaluation. What is the most common sign of major depressive disorder in
children?
Psychomotor agitation
A 6-year-old boy is referred by the child study team for speech difficulty. On
examination the boy is friendly and cooperative, his speech is clear, and he uses
simple sentences with a limited vocabulary. Most notably he confuses verb tenses
consistently. The parents report he met most of his developmental milestones
except speech, which was delayed. His clinical presentation is most consistent with
which of the following?
Expressive language disorder
The school psychologist refers a 7-year-old girl with difficulty reading,
distractibility, and writing avoidance behaviors. The child has no diagnosed
conditions, takes no medications, and met all of her developmental milestones. She
loves arts and crafts and physical education. Prior to diagnosing a learning
disorder, which of the following screening tests must be performed?
Vision and hearing
Which disorder is associated with higher rates of ADHD, enlarges testes, a long
narrow face, hypotonia and short stature?
Fragile X (Fragile X is associated with a higher rate of ADHD, impaired
intellectual ability, learning d/o's, autism spectrum d/o. Physical attributes include
hypotonia, flat feet, enlarges testes, long narrow face, flexible fingers and short
stature.)
A 10-year-old girl is referred for evaluation of behavioral difficulties. Her teachers
report that she is easily distracted and fails to complete any class work, and often
pg. 4
