NU 674
Psychiatric Mental Healthcare I
Midterm Exam Review
(With Solutions)
2026
1
,Multiple Choice
A 32-year-old patient with schizophrenia has been non-adherent to
oral antipsychotics and shows frequent relapse. Which long-acting
injectable antipsychotic is most appropriate to improve adherence?
A) Haloperidol oral
B) Risperidone microsphere injection
C) Clozapine oral
D) Fluoxetine oral Answer: B) Risperidone microsphere injection
Rationale: Long-acting injectables like risperidone microspheres
reduce relapse by improving adherence. Haloperidol oral offers no
adherence benefit; clozapine has serious side effects and adherence
challenges; fluoxetine is an SSRI, not antipsychotic.
True or False: Electroconvulsive therapy (ECT) is contraindicated in
patients with a history of recent myocardial infarction.
Answer: True
Rationale: ECT can cause transient cardiovascular stress and is risky
post-MI. ECG and clearance from cardiology are necessary.
In a patient presenting with acute mania, which mood stabilizer
requires regular blood monitoring due to its narrow therapeutic
index?
A) Valproate
B) Lithium
C) Carbamazepine
D) Lamotrigine Answer: B) Lithium Rationale: Lithium levels need
monitoring to avoid toxicity; valproate and carbamazepine also
require labs but lithium is the classic example; lamotrigine more for
bipolar depression.
Match the symptom cluster to the correct diagnosis:
a) Auditory hallucinations, delusions, disorganized speech
b) Persistent depressed mood, anhedonia, sleep disturbances
2
, c) Excessive worry, muscle tension, restlessness
Major depressive disorder
Generalized anxiety disorder
Schizophrenia
Answer: a-3, b-1, c-2
Rationale: Classic symptom clusters help differentiate diagnoses.
Fill in the blank: The primary neurotransmitter involved in the
pathophysiology of Parkinsonian side effects caused by
antipsychotics is _____.
Answer: Dopamine
Rationale: Dopamine blockade in nigrostriatal pathways causes
extrapyramidal symptoms (EPS).
True/False
Clozapine is the first-line treatment for treatment-resistant
schizophrenia.
Answer: True
Rationale: Clozapine is reserved for resistant cases but shows
superior efficacy.
Nurses should always avoid discussing suicidal ideation directly with
the patient to prevent increasing risk.
Answer: False
Rationale: Asking directly reduces stigma and allows risk
assessment.
A patient with borderline personality disorder commonly exhibits
splitting behavior (viewing others as all good or all bad).
Answer: True
Rationale: This defense mechanism can affect therapeutic
relationships.
3
Psychiatric Mental Healthcare I
Midterm Exam Review
(With Solutions)
2026
1
,Multiple Choice
A 32-year-old patient with schizophrenia has been non-adherent to
oral antipsychotics and shows frequent relapse. Which long-acting
injectable antipsychotic is most appropriate to improve adherence?
A) Haloperidol oral
B) Risperidone microsphere injection
C) Clozapine oral
D) Fluoxetine oral Answer: B) Risperidone microsphere injection
Rationale: Long-acting injectables like risperidone microspheres
reduce relapse by improving adherence. Haloperidol oral offers no
adherence benefit; clozapine has serious side effects and adherence
challenges; fluoxetine is an SSRI, not antipsychotic.
True or False: Electroconvulsive therapy (ECT) is contraindicated in
patients with a history of recent myocardial infarction.
Answer: True
Rationale: ECT can cause transient cardiovascular stress and is risky
post-MI. ECG and clearance from cardiology are necessary.
In a patient presenting with acute mania, which mood stabilizer
requires regular blood monitoring due to its narrow therapeutic
index?
A) Valproate
B) Lithium
C) Carbamazepine
D) Lamotrigine Answer: B) Lithium Rationale: Lithium levels need
monitoring to avoid toxicity; valproate and carbamazepine also
require labs but lithium is the classic example; lamotrigine more for
bipolar depression.
Match the symptom cluster to the correct diagnosis:
a) Auditory hallucinations, delusions, disorganized speech
b) Persistent depressed mood, anhedonia, sleep disturbances
2
, c) Excessive worry, muscle tension, restlessness
Major depressive disorder
Generalized anxiety disorder
Schizophrenia
Answer: a-3, b-1, c-2
Rationale: Classic symptom clusters help differentiate diagnoses.
Fill in the blank: The primary neurotransmitter involved in the
pathophysiology of Parkinsonian side effects caused by
antipsychotics is _____.
Answer: Dopamine
Rationale: Dopamine blockade in nigrostriatal pathways causes
extrapyramidal symptoms (EPS).
True/False
Clozapine is the first-line treatment for treatment-resistant
schizophrenia.
Answer: True
Rationale: Clozapine is reserved for resistant cases but shows
superior efficacy.
Nurses should always avoid discussing suicidal ideation directly with
the patient to prevent increasing risk.
Answer: False
Rationale: Asking directly reduces stigma and allows risk
assessment.
A patient with borderline personality disorder commonly exhibits
splitting behavior (viewing others as all good or all bad).
Answer: True
Rationale: This defense mechanism can affect therapeutic
relationships.
3
