NR668 WEEK 5 FINAL PAPER 2026 QUESTIONS
WITH FULL SOLUTION
◉ A mother of a teenage boy is unable to acknowledge that her son's
mental illness is perpetuated by his poly substance use disorder and
is insisting that his father's genes are to blame. Which defense
mechanism is employed?
a. Reaction formation
b. Regression
c. Denial
d. Dissociation. Answer: c. Denial
◉ A 21-year-old man had his first drink at his birthday party with
friends last night. He presented the following morning to the
emergency department with psychomotor agitation, cognitive
impairment, depressed mood, flat affect, and anhedonia. His heart
rate is 110, his blood pressure is 90/60, and he complains of
abdominal pain. He received 2 L of normal saline IV and is referred
to psychiatry for evaluation of mood disorder. Which of the following
tests should the consulting PMHNP order given these symptoms?
a. Urinary porphobilinogen
b. Acetaminophen level
c. Urinalysis
d. Blood alcohol level. Answer: a. Urinary porphobilinogen
,◉ In patients with active Lupus, the erythrocyte sedimentation rate
is likely?
a. 0.5 - 1.1
b. Between 11 and 20
c. Elevated
d. Markedly low. Answer: c. Elevated
The ESR or red blood cell sedimentation rate is elevated in
conditions with inflammation. This is because of higher amounts of
fibrinogen and antibodies found in conditions like Lupus, Temporal
arteritis, etc.
◉ A patient presents with atypical symptoms of psychosis that
include inconsistent auditory hallucinations without
disorganization. What is the best definition of an EEG and its utility?
a. Radiologic test utilizing magnets and radio waves to provide a
detailed image of the structures of the brain
b. Electrophysiologic test that depicts electrical activity on the
surface of the brain
c. A neuropsychological test to distinguish psychosis from a
psychosomatic illness
d. A serum test to indicate nutritional deficiencies that inhibit the
formation of neurotransmitters. Answer: b. Electrophysiologic test
that depicts electrical activity on the surface of the brain
,◉ A 48-year-old obese woman experiences excessive daytime
sleepiness, fatigue, anhedonia, and apathy. Her husband reports that
she snores loudly when sleeping, and often will wake up drenched in
sweat. The patient has no prior psychiatric history and denies
substance abuse. Which of the following is the most likely cause of
her symptoms?
a. Airway obstruction
b. Narcolepsy
c. Perimenopause
d. Major depression. Answer: a. Airway obstruction
◉ A middle-school girl who is timid to take any risks, prefers
solitary activities, and does not ask questions of her teachers for fear
that she is bothering them likely did not master which
developmental stage?
a. Initiative versus Guilt
b. Trust versus mistrust
c. Industry versus inferiority
d. Autonomy versus shame and doubt. Answer: a. Initiative versus
Guilt
◉ A woman who discovers her husband has committed suicide in
the middle of the night decides to tell her 4- and 6-year-old children
the next morning that the reason daddy is not here today is that he
, went to work. Based on their developmental stage, what might they
assume when mommy says she is going to work?
a. Mommy will come home, as has been the case in the past
b. When someone cannot be seen, then they cease to exist
c. Going to work means you are not coming home
d. Daddy will come home when mommy goes to work. Answer: c.
Going to work means you are not coming home
◉ A 26-year-old female is diagnosed with psychosis not otherwise
specified (NOS) and substance use disorder. Which of the following
lab tests should be ordered prior to starting antipsychotic
medications?
a. Amylase, lipase, liver function test
b. Urinalysis , urine pregnancy test
c. Cardiac enzymes, brain naturetic peptide
d. Hemoglobin A1C, lipid profile, EKG. Answer: d. Hemoglobin A1C,
lipid profile, EKG
◉ When evaluating a 78-year-old man, the PMHNP notices the
patient frequently leans in with the right side of his head and
frequently asks for things to be repeated. His daughter is very
worried that he has dementia or depression because he has also
become increasingly isolated, as well as increasingly irritable as he
believes people are yelling at him out of frustration of not being
WITH FULL SOLUTION
◉ A mother of a teenage boy is unable to acknowledge that her son's
mental illness is perpetuated by his poly substance use disorder and
is insisting that his father's genes are to blame. Which defense
mechanism is employed?
a. Reaction formation
b. Regression
c. Denial
d. Dissociation. Answer: c. Denial
◉ A 21-year-old man had his first drink at his birthday party with
friends last night. He presented the following morning to the
emergency department with psychomotor agitation, cognitive
impairment, depressed mood, flat affect, and anhedonia. His heart
rate is 110, his blood pressure is 90/60, and he complains of
abdominal pain. He received 2 L of normal saline IV and is referred
to psychiatry for evaluation of mood disorder. Which of the following
tests should the consulting PMHNP order given these symptoms?
a. Urinary porphobilinogen
b. Acetaminophen level
c. Urinalysis
d. Blood alcohol level. Answer: a. Urinary porphobilinogen
,◉ In patients with active Lupus, the erythrocyte sedimentation rate
is likely?
a. 0.5 - 1.1
b. Between 11 and 20
c. Elevated
d. Markedly low. Answer: c. Elevated
The ESR or red blood cell sedimentation rate is elevated in
conditions with inflammation. This is because of higher amounts of
fibrinogen and antibodies found in conditions like Lupus, Temporal
arteritis, etc.
◉ A patient presents with atypical symptoms of psychosis that
include inconsistent auditory hallucinations without
disorganization. What is the best definition of an EEG and its utility?
a. Radiologic test utilizing magnets and radio waves to provide a
detailed image of the structures of the brain
b. Electrophysiologic test that depicts electrical activity on the
surface of the brain
c. A neuropsychological test to distinguish psychosis from a
psychosomatic illness
d. A serum test to indicate nutritional deficiencies that inhibit the
formation of neurotransmitters. Answer: b. Electrophysiologic test
that depicts electrical activity on the surface of the brain
,◉ A 48-year-old obese woman experiences excessive daytime
sleepiness, fatigue, anhedonia, and apathy. Her husband reports that
she snores loudly when sleeping, and often will wake up drenched in
sweat. The patient has no prior psychiatric history and denies
substance abuse. Which of the following is the most likely cause of
her symptoms?
a. Airway obstruction
b. Narcolepsy
c. Perimenopause
d. Major depression. Answer: a. Airway obstruction
◉ A middle-school girl who is timid to take any risks, prefers
solitary activities, and does not ask questions of her teachers for fear
that she is bothering them likely did not master which
developmental stage?
a. Initiative versus Guilt
b. Trust versus mistrust
c. Industry versus inferiority
d. Autonomy versus shame and doubt. Answer: a. Initiative versus
Guilt
◉ A woman who discovers her husband has committed suicide in
the middle of the night decides to tell her 4- and 6-year-old children
the next morning that the reason daddy is not here today is that he
, went to work. Based on their developmental stage, what might they
assume when mommy says she is going to work?
a. Mommy will come home, as has been the case in the past
b. When someone cannot be seen, then they cease to exist
c. Going to work means you are not coming home
d. Daddy will come home when mommy goes to work. Answer: c.
Going to work means you are not coming home
◉ A 26-year-old female is diagnosed with psychosis not otherwise
specified (NOS) and substance use disorder. Which of the following
lab tests should be ordered prior to starting antipsychotic
medications?
a. Amylase, lipase, liver function test
b. Urinalysis , urine pregnancy test
c. Cardiac enzymes, brain naturetic peptide
d. Hemoglobin A1C, lipid profile, EKG. Answer: d. Hemoglobin A1C,
lipid profile, EKG
◉ When evaluating a 78-year-old man, the PMHNP notices the
patient frequently leans in with the right side of his head and
frequently asks for things to be repeated. His daughter is very
worried that he has dementia or depression because he has also
become increasingly isolated, as well as increasingly irritable as he
believes people are yelling at him out of frustration of not being
