NURS 6630 Final Exam Version1 & 2 Newest Exam Preparation Newest With Complete Questions And Correct Detailed Answers| Brand New Version

NURS 6630 Final Exam Version1 & 2 Newest Exam
Preparation Newest With Complete Questions And
Correct Detailed Answers| Brand New Version




NURS 6630 Final Exam Version 1 & 2
Complete Question Bank with Answers and Rationales
2025/2026 Updated Edition


VERSION 1


Question 1
What is the most strongly established and significant risk factor for the development of bipolar
disorder?
A) History of substance abuse
B) Female gender
C) Low socioeconomic status
D) Family history
E) Previous diagnosis of major depression
Correct Answer: D) Family history
Rationale: While other factors can be associated with bipolar disorder, genetic predisposition is
the strongest and most well-established risk factor. Individuals with a first-degree relative
(parent, sibling, child) with bipolar disorder have a significantly higher risk of developing the
illness compared to the general population. This genetic link is more powerful than any other
environmental or individual risk factor .

,Question 2
A patient is diagnosed with schizophrenia and has a history of poor medication adherence. The
PMHNP understands that non-adherence in this patient population significantly increases the
risk for which of the following?
A) Development of a personality disorder
B) Spontaneous remission of symptoms
C) Increased risk of substance use, violence, and victimization
D) Improved overall quality of life due to fewer side effects
E) Decreased need for future hospitalizations
Correct Answer: C) Increased risk of substance use, violence, and victimization
Rationale: Non-adherence to antipsychotic medication in patients with schizophrenia is a major
clinical challenge. It directly correlates with a higher rate of relapse, which in turn increases the
patient's vulnerability to substance use as a form of self-medication, episodes of violence (often
related to psychotic symptoms), and becoming a victim of crime. It also leads to a worse overall
quality of life and more frequent hospitalizations .


Question 3
A 72-year-old male with a history of atrial fibrillation and COPD is newly diagnosed with major
depressive disorder. Given his comorbidities, which antidepressant class should the PMHNP
generally AVOID as a first-line treatment?
A) Selective Serotonin Reuptake Inhibitors (SSRIs)
B) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
C) Tricyclic Antidepressants (TCAs)
D) Atypical antidepressants like bupropion
E) Mirtazapine
Correct Answer: C) Tricyclic Antidepressants (TCAs)
Rationale: Tricyclic antidepressants (e.g., nortriptyline, amitriptyline) have significant
cardiotoxic potential. They can affect cardiac conduction, leading to arrhythmias, which is
particularly dangerous in a patient with a pre-existing condition like atrial fibrillation. Their
anticholinergic properties and risk of orthostatic hypotension also make them a poor choice for
older adults. SSRIs or SNRIs are generally safer first-line options in this population .


Question 4

,A PMHNP is managing a patient with treatment-resistant depression who has not responded to
an adequate trial of a first-line SSRI. Which of the following is an appropriate next-step
strategy?
A) Discontinue the SSRI and begin a monoamine oxidase inhibitor (MAOI)
B) Augment the SSRI with a second-generation antipsychotic like aripiprazole
C) Increase the SSRI dose to four times the maximum recommended level
D) Switch to a benzodiazepine for long-term monotherapy
E) Recommend discontinuing all medications and focusing only on therapy
Correct Answer: B) Augment the SSRI with a second-generation antipsychotic like aripiprazole
Rationale: Augmentation with a second-generation (atypical) antipsychotic is a widely
accepted, evidence-based strategy for treatment-resistant depression. Agents like aripiprazole,
quetiapine, and olanzapine (in combination with fluoxetine) have FDA approval for this
indication. They work through different mechanisms (e.g., dopamine and serotonin
modulation) to enhance the effect of the primary antidepressant .


Question 5
When considering long-term maintenance treatment for a patient with bipolar disorder, which
medication class is generally best to avoid as monotherapy due to the risk of inducing mood
switching or increasing mood episode frequency?
A) Mood stabilizers (e.g., lithium)
B) Anticonvulsants (e.g., lamotrigine)
C) Second-generation antipsychotics (e.g., quetiapine)
D) Antidepressants (e.g., fluoxetine)
E) Calcium channel blockers
Correct Answer: D) Antidepressants (e.g., fluoxetine)
Rationale: While sometimes used cautiously for bipolar depression, antidepressant
monotherapy is generally avoided in the maintenance phase of bipolar disorder. There is a
significant risk that these agents can precipitate a switch into mania or hypomania, or lead to
cycle acceleration (an increase in the frequency of mood episodes) over time .


Question 6
An 8-year-old child presents with symptoms of severe hyperactivity, inattention, and
impulsivity consistent with ADHD. After a thorough evaluation, the PMHNP decides to initiate a
first-line pharmacological treatment. Which medication is most likely to be prescribed?

, A) Clonidine
B) Atomoxetine
C) Methylphenidate
D) Guanfacine
E) Trazodone
Correct Answer: C) Methylphenidate
Rationale: Stimulant medications, including methylphenidate (Ritalin, Concerta) and
amphetamines, are the first-line and most effective pharmacological treatments for ADHD in
children and adolescents. They have a rapid onset of action and high efficacy in reducing core
ADHD symptoms .


Question 7
The parents of an adolescent diagnosed with kleptomania are seeking pharmacological options.
The PMHNP explains that while no medication is FDA-approved for this condition, some have
shown potential benefit in case studies. Which medication might be an appropriate option to
discuss?
A) Diazepam
B) Methylphenidate
C) Haloperidol
D) Naltrexone
E) Lithium
Correct Answer: D) Naltrexone
Rationale: Kleptomania is an impulse control disorder. The neurobiology is thought to involve
the brain's opioid system, which mediates reward and reinforcement. Naltrexone, an opioid
antagonist, may reduce the rewarding effects and urges associated with stealing, making it a
rational off-label treatment option to consider .


Question 8
Which of the following substances carries the highest probability of inducing physical and
psychological dependence after just a single use?
A) Alcohol
B) Cannabis
C) Caffeine