Psychiatric Mental Health Nurse
Practitioner Exam Prep – Complete
150-Q Bank
Answers And Rationale Included.
(2025/2026)
1. A patient with major depressive disorder reports early-morning
awakening and loss of appetite. Which symptom cluster is the patient
displaying?
A. Atypical depression
B. Melancholic features
C. Mixed features
D. Catatonic features
Melancholic depression includes anhedonia, early-morning
awakening, psychomotor changes, and decreased appetite.
2. Which neurotransmitter is most associated with the positive
symptoms of schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Dopamine hyperactivity in the mesolimbic pathway is linked to
hallucinations and delusions.
,3. A patient taking lithium presents with tremor, diarrhea, and
confusion. What is the priority action?
A. Increase hydration
B. Hold the next dose
C. Obtain serum lithium level immediately
D. Start propranolol
These signs indicate possible lithium toxicity, requiring urgent serum
level evaluation.
4. Which SSRI has the highest risk of QT prolongation?
A. Sertraline
B. Fluoxetine
C. Citalopram
D. Paroxetine
Citalopram carries dose-dependent QT prolongation risk above 20 mg
in older adults.
5. Which medication is first-line for PTSD with prominent nightmares?
A. Fluoxetine
B. Prazosin
C. Quetiapine
D. Venlafaxine
Prazosin reduces trauma-related nightmares by blocking central
alpha-1 receptors.
,6. A patient on MAOIs wants to eat aged cheese. This should be
avoided due to the risk of:
A. Respiratory depression
B. Hypertensive crisis
C. Stevens-Johnson syndrome
D. Agranulocytosis
Tyramine-containing foods can trigger a hypertensive crisis with
MAOIs.
7. Which antipsychotic has the highest risk for agranulocytosis?
A. Risperidone
B. Olanzapine
C. Clozapine
D. Ziprasidone
Clozapine requires REMS monitoring due to severe neutropenia risk.
8. Which screening tool is used for diagnosing adult ADHD?
A. GAD-7
B. ASRS-v1.1
C. PHQ-9
D. MDQ
The Adult ADHD Self-Report Scale (ASRS) screens for ADHD symptoms
in adults.
9. A patient presents with acute dystonia shortly after starting
haloperidol. What is the best treatment?
, A. Benzodiazepine
B. Benztropine
C. Metoprolol
D. Diphenhydramine IV then propranolol
Anticholinergics such as benztropine rapidly reverse dystonia.
10. Which medication is FDA-approved for bipolar depression?
A. Risperidone
B. Lurasidone
C. Haloperidol
D. Ziprasidone
Lurasidone is approved for bipolar depression as monotherapy and
adjunct to lithium or valproate.
11. Which lab must be monitored before starting carbamazepine?
A. TSH
B. Creatinine
C. CBC with differential
D. Lipid panel
Carbamazepine may cause agranulocytosis; a baseline CBC is needed.
12. What is the recommended treatment for borderline personality
disorder?
A. SSRIs
B. Antipsychotics
C. Dialectical behavior therapy
D. EMDR
Practitioner Exam Prep – Complete
150-Q Bank
Answers And Rationale Included.
(2025/2026)
1. A patient with major depressive disorder reports early-morning
awakening and loss of appetite. Which symptom cluster is the patient
displaying?
A. Atypical depression
B. Melancholic features
C. Mixed features
D. Catatonic features
Melancholic depression includes anhedonia, early-morning
awakening, psychomotor changes, and decreased appetite.
2. Which neurotransmitter is most associated with the positive
symptoms of schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Dopamine hyperactivity in the mesolimbic pathway is linked to
hallucinations and delusions.
,3. A patient taking lithium presents with tremor, diarrhea, and
confusion. What is the priority action?
A. Increase hydration
B. Hold the next dose
C. Obtain serum lithium level immediately
D. Start propranolol
These signs indicate possible lithium toxicity, requiring urgent serum
level evaluation.
4. Which SSRI has the highest risk of QT prolongation?
A. Sertraline
B. Fluoxetine
C. Citalopram
D. Paroxetine
Citalopram carries dose-dependent QT prolongation risk above 20 mg
in older adults.
5. Which medication is first-line for PTSD with prominent nightmares?
A. Fluoxetine
B. Prazosin
C. Quetiapine
D. Venlafaxine
Prazosin reduces trauma-related nightmares by blocking central
alpha-1 receptors.
,6. A patient on MAOIs wants to eat aged cheese. This should be
avoided due to the risk of:
A. Respiratory depression
B. Hypertensive crisis
C. Stevens-Johnson syndrome
D. Agranulocytosis
Tyramine-containing foods can trigger a hypertensive crisis with
MAOIs.
7. Which antipsychotic has the highest risk for agranulocytosis?
A. Risperidone
B. Olanzapine
C. Clozapine
D. Ziprasidone
Clozapine requires REMS monitoring due to severe neutropenia risk.
8. Which screening tool is used for diagnosing adult ADHD?
A. GAD-7
B. ASRS-v1.1
C. PHQ-9
D. MDQ
The Adult ADHD Self-Report Scale (ASRS) screens for ADHD symptoms
in adults.
9. A patient presents with acute dystonia shortly after starting
haloperidol. What is the best treatment?
, A. Benzodiazepine
B. Benztropine
C. Metoprolol
D. Diphenhydramine IV then propranolol
Anticholinergics such as benztropine rapidly reverse dystonia.
10. Which medication is FDA-approved for bipolar depression?
A. Risperidone
B. Lurasidone
C. Haloperidol
D. Ziprasidone
Lurasidone is approved for bipolar depression as monotherapy and
adjunct to lithium or valproate.
11. Which lab must be monitored before starting carbamazepine?
A. TSH
B. Creatinine
C. CBC with differential
D. Lipid panel
Carbamazepine may cause agranulocytosis; a baseline CBC is needed.
12. What is the recommended treatment for borderline personality
disorder?
A. SSRIs
B. Antipsychotics
C. Dialectical behavior therapy
D. EMDR
