NRNP 6665 FINAL EXAM QUESTIONS & ANSWERS ( UPDATE) | WALDEN UNIVERSITY | 100% VERIFIED SOLUTIONS, ALREADY GRADED A+

1|Page




NRNP 6665 FINAL EXAM QUESTIONS & ANSWERS (2026-2027 UPDATE) |
WALDEN UNIVERSITY | 100% VERIFIED SOLUTIONS, ALREADY GRADED A+



Question 1
A psychiatric-mental health nurse practitioner is assessing a client with
generalized anxiety disorder (GAD). Which medication is considered first-line
pharmacologic treatment?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Beta-blockers
Correct Answer: B. SSRIs
Rationale:
SSRIs are the first-line pharmacologic agents for GAD because of their safety,
efficacy, and favorable long-term use profile. Benzodiazepines may provide rapid
relief but carry risks of dependence and tolerance, so they are not first-line.
Antipsychotics are not recommended for GAD unless comorbid psychosis exists.
Beta-blockers may help with performance anxiety but not generalized anxiety.

Question 2
A client with schizophrenia presents with flat affect, social withdrawal, and lack of
motivation. These symptoms are classified as:
A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Mood symptoms
Correct Answer: B. Negative symptoms
Rationale:
Schizophrenia is divided into positive symptoms (e.g., hallucinations, delusions),
negative symptoms (e.g., flat affect, alogia, anhedonia, avolition), and cognitive
impairments (e.g., attention and memory deficits). Negative symptoms often
persist even when positive symptoms improve, making treatment more
challenging. Recognizing them is critical for appropriate management.

,2|Page




Question 3
Which antipsychotic has the highest risk for agranulocytosis?
A. Risperidone
B. Clozapine
C. Olanzapine
D. Quetiapine
Correct Answer: B. Clozapine
Rationale:
Clozapine is highly effective for treatment-resistant schizophrenia but carries a
serious risk of agranulocytosis, requiring frequent CBC monitoring. Risperidone,
olanzapine, and quetiapine are associated with metabolic and extrapyramidal side
effects but not agranulocytosis at the same level of concern.

Question 4
A client is prescribed lithium for bipolar disorder. Which laboratory value must be
monitored closely?
A. Potassium
B. Creatinine
C. Sodium
D. Hemoglobin
Correct Answer: C. Sodium
Rationale:
Lithium levels are affected by sodium balance in the body. Hyponatremia can
increase lithium reabsorption in the kidneys, raising serum lithium levels and risk
of toxicity. Regular monitoring of sodium, renal function, and lithium blood levels
is essential for safe therapy.

Question 5
Which therapeutic approach is most effective for PTSD?
A. Cognitive Behavioral Therapy (CBT)
B. Psychoanalysis
C. Supportive counseling
D. Group therapy only
Correct Answer: A. Cognitive Behavioral Therapy (CBT)
Rationale:
Trauma-focused CBT, particularly prolonged exposure and cognitive processing
therapy, is evidence-based and most effective for PTSD. While supportive

,3|Page




counseling and group therapy can provide additional benefits, they are not
sufficient as standalone treatments. Psychoanalysis is less evidence-based in
PTSD.

Question 6
A nurse practitioner observes tremors, rigidity, and shuffling gait in a patient
taking haloperidol. These symptoms indicate:
A. Neuroleptic malignant syndrome
B. Extrapyramidal symptoms
C. Tardive dyskinesia
D. Serotonin syndrome
Correct Answer: B. Extrapyramidal symptoms
Rationale:
Extrapyramidal symptoms (EPS) are movement disorders caused by dopamine
blockade, especially in first-generation antipsychotics like haloperidol. Symptoms
include acute dystonia, akathisia, parkinsonism, and tardive dyskinesia. NMS
presents with hyperthermia and autonomic instability, while serotonin syndrome
presents with hyperreflexia and clonus.

Question 7
In children with ADHD, the first-line medication class is:
A. SSRIs
B. Stimulants
C. Benzodiazepines
D. Antipsychotics
Correct Answer: B. Stimulants
Rationale:
Stimulants such as methylphenidate and amphetamines are first-line therapy for
ADHD due to proven efficacy in improving attention and reducing
hyperactivity/impulsivity. SSRIs may be used for comorbid anxiety/depression,
antipsychotics for severe aggression, and benzodiazepines are not appropriate for
ADHD.

Question 8
Which of the following is a major side effect of SSRIs?
A. Hypertension
B. Sexual dysfunction
C. Constipation

, 4|Page




D. Hypoglycemia
Correct Answer: B. Sexual dysfunction
Rationale:
SSRIs are associated with sexual dysfunction, including decreased libido, delayed
orgasm, and anorgasmia. This is a common reason for discontinuation. They can
also cause GI upset, insomnia, or serotonin syndrome if combined with other
serotonergic drugs, but sexual dysfunction is the hallmark long-term adverse
effect.

Question 9
A patient on MAOIs should avoid which type of food?
A. High-carbohydrate
B. High-protein
C. Tyramine-rich
D. Low-fat
Correct Answer: C. Tyramine-rich
Rationale:
Tyramine-rich foods (aged cheeses, cured meats, red wine) can trigger a
hypertensive crisis when combined with MAOIs. This is due to tyramine’s ability to
release norepinephrine, leading to dangerous BP spikes. Patient education is
essential to prevent life-threatening interactions.

Question 10
A 70-year-old client is started on benzodiazepines for insomnia. What is the major
safety concern?
A. Increased liver enzymes
B. Increased fall risk
C. Hypertension
D. Weight gain
Correct Answer: B. Increased fall risk
Rationale:
Benzodiazepines cause sedation, dizziness, and impaired coordination, which
significantly increase fall risk in older adults. This population is also at higher risk
for delirium and dependence. Safer alternatives such as CBT for insomnia should
be considered first.

Question 11
A client taking fluoxetine develops agitation, confusion, sweating, tremors, and