NR 607 FINAL EXAM 2025/2026 QUESTIONS AND CORRECT
ANSWERS GRADED A+ SUMMER- FALL CHAMBERLAIN
UNIVERSITY
Yolanda is a 20-year-old client who was referred to the PMHNP by her college health clinic for
symptoms consistent with bipolar II disorder. She initiates the interview by stating that she is not
willing to take any medications but is willing to engage in counseling or other therapies.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
provide additional education
Rationale: The client should receive education about the risks, benefits, and appropriateness of
pharmacological treatment. If, after receiving education, the client still refuses medication
therapy, it is important to document the education provided and the client's refusal of treatment.
Kevin is a 48-year-old with a 20-year history of schizophrenia. He has decided to stop
pharmacological treatment due to the intolerable adverse effects of his medications. Kevin and
the provider have discussed the benefits and drawbacks of ceasing treatment, and he has agreed
to weekly telephone check-ins to ensure his well-being.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
,initiate treatment without informed consent
document refusal of treatment
Rationale: The client has the capacity to consent, and the situation is not emergent. The ethic of
autonomy provides for the client to refuse treatment.
Ashlei is a 19-year-old who presents to the clinic with severe anxiety symptoms. As the PMHNP
begins reviewing treatment options, Ashlei interrupts and states, "Hearing about these
medications increases my anxiety. Please prescribe what you think is best for me, and I will take
it."
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
initiate treatment without informed consent
Rationale: Clients may choose to waive their right to informed consent. The PMHNP should
clearly document the client's waiver.
AD
Geoff is a 32-year-old who presents to the clinic with anhedonia, fatigue, feelings of
worthlessness, and a lack of focus. He admits to thinking about death but denies suicidal
,ideations or a plan. He has been taking sertraline 50 mg daily and wishes to stop taking the
medication as it does not seem to be helping.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
provide additional education
Rationale: The client has the capacity to provide consent and the situation is not emergent;
however, the client should receive education about the risks, benefits, and appropriateness of
pharmacological treatment. At this time, the dose should be increased to achieve efficacy. If,
after receiving education, the client still refuses medication therapy, the PMHNP should
document the education provided and the client's refusal of treatment.
Fritz is a 25-year-old who has been brought to the emergency department by the police after
threatening a server at a restaurant. The PMHNP on call has treated Fritz for schizophrenia in the
past. He has a history of poor treatment adherence. While in the emergency department, he
admits to auditory hallucinations. He becomes agitated and begins throwing items around the
examination room.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
initiate treatment without informed consent
, Rationale: The client does not have the capacity to provide consent at this time due to active
hallucinations and agitation. For the safety of the client and staff, treatment should be initiated
without obtaining informed consent.
Acute inpatient care
short-term treatment to provide care for acutely ill clients who are unable to meet basic needs
due to a mental health condition or are at risk of harming themselves or others
-focus is crisis stabilization
-may be voluntary or involuntary
Voluntary Admission
-when a client & provider agree that client's symptoms meet criteria for inpatient hospitalization
& the client may benefit from admission
-client will sign consent form agreeing to a hospital stay in a locked unit
-not require a psychiatric hold
• if client requests discharge & provider determines the client is not yet safe, the provider may
initiate an emergency involuntary hold
Involuntary Admission
-when a client does not agree to hospitalization
-an evaluation by a mental health professional indicates that the client may be at high risk of
harming themselves or others
-Other terms denoting an involuntary admission include involuntary commitment, psychiatric
hold, or civil admission
-most states, clients can be held for up to 72 hours involuntary if deemed an imminent threat
ANSWERS GRADED A+ SUMMER- FALL CHAMBERLAIN
UNIVERSITY
Yolanda is a 20-year-old client who was referred to the PMHNP by her college health clinic for
symptoms consistent with bipolar II disorder. She initiates the interview by stating that she is not
willing to take any medications but is willing to engage in counseling or other therapies.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
provide additional education
Rationale: The client should receive education about the risks, benefits, and appropriateness of
pharmacological treatment. If, after receiving education, the client still refuses medication
therapy, it is important to document the education provided and the client's refusal of treatment.
Kevin is a 48-year-old with a 20-year history of schizophrenia. He has decided to stop
pharmacological treatment due to the intolerable adverse effects of his medications. Kevin and
the provider have discussed the benefits and drawbacks of ceasing treatment, and he has agreed
to weekly telephone check-ins to ensure his well-being.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
,initiate treatment without informed consent
document refusal of treatment
Rationale: The client has the capacity to consent, and the situation is not emergent. The ethic of
autonomy provides for the client to refuse treatment.
Ashlei is a 19-year-old who presents to the clinic with severe anxiety symptoms. As the PMHNP
begins reviewing treatment options, Ashlei interrupts and states, "Hearing about these
medications increases my anxiety. Please prescribe what you think is best for me, and I will take
it."
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
initiate treatment without informed consent
Rationale: Clients may choose to waive their right to informed consent. The PMHNP should
clearly document the client's waiver.
AD
Geoff is a 32-year-old who presents to the clinic with anhedonia, fatigue, feelings of
worthlessness, and a lack of focus. He admits to thinking about death but denies suicidal
,ideations or a plan. He has been taking sertraline 50 mg daily and wishes to stop taking the
medication as it does not seem to be helping.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
provide additional education
Rationale: The client has the capacity to provide consent and the situation is not emergent;
however, the client should receive education about the risks, benefits, and appropriateness of
pharmacological treatment. At this time, the dose should be increased to achieve efficacy. If,
after receiving education, the client still refuses medication therapy, the PMHNP should
document the education provided and the client's refusal of treatment.
Fritz is a 25-year-old who has been brought to the emergency department by the police after
threatening a server at a restaurant. The PMHNP on call has treated Fritz for schizophrenia in the
past. He has a history of poor treatment adherence. While in the emergency department, he
admits to auditory hallucinations. He becomes agitated and begins throwing items around the
examination room.
Which of the following is the most appropriate action?
provide additional education
document refusal of treatment
initiate treatment without informed consent
initiate treatment without informed consent
, Rationale: The client does not have the capacity to provide consent at this time due to active
hallucinations and agitation. For the safety of the client and staff, treatment should be initiated
without obtaining informed consent.
Acute inpatient care
short-term treatment to provide care for acutely ill clients who are unable to meet basic needs
due to a mental health condition or are at risk of harming themselves or others
-focus is crisis stabilization
-may be voluntary or involuntary
Voluntary Admission
-when a client & provider agree that client's symptoms meet criteria for inpatient hospitalization
& the client may benefit from admission
-client will sign consent form agreeing to a hospital stay in a locked unit
-not require a psychiatric hold
• if client requests discharge & provider determines the client is not yet safe, the provider may
initiate an emergency involuntary hold
Involuntary Admission
-when a client does not agree to hospitalization
-an evaluation by a mental health professional indicates that the client may be at high risk of
harming themselves or others
-Other terms denoting an involuntary admission include involuntary commitment, psychiatric
hold, or civil admission
-most states, clients can be held for up to 72 hours involuntary if deemed an imminent threat
