, Comprehensive NR606 Midterm actual test questions
and answers graded a+updated on 2026
___________ and ___________ have been demonstrated to have the lowest serum concentrations
among infants exposed to medication during breastfeeding - CORRECT ANS ***Bupropion and Sertraline
_______________ women suffer from higher SUD rates compared to other racial and ethnic groups and
are disproportionately affected by criminalization laws at the federal, state, and tribal levels. - CORRECT
ANS ***Indigenous
__________________ is considered a psychiatric emergency and requires immediate hospitalization and
treatment - CORRECT ANS ***Perinatal psychosis
________, __________, and _____________ have shown benefits across the spectrum of perinatal
mental health disorders. - CORRECT ANS ***Yoga
massage
peer support
!!!!!!!!!!This SSRI has been associated with increased suicidal thinking & actions in children &
adolescents & should not typically be used to treat depression in this population!!!!!!!!!!!!!!!!!!!! -
CORRECT ANS ***Paroxetine
A program policy that prohibits individuals from using specific forms of prescribed medication for
addiction (MAT) treatment is an example of __________ stigma - CORRECT ANS ***structural
A stereotypic belief that individuals choose to use alcohol or other drugs and blame them for their
substance use disorder is an example of _________ stigma - CORRECT ANS ***public
Addressing Parental Concerns: Collaborative Treatment Plans - CORRECT ANS ***-tx plans for children
typically made in collaboration with parents or guardians
-Collaboration between the PMHNP, clients, and families when creating the treatment plan is key to
ensuring the plan meets the client's needs and is comfortable and manageable for the family
,After a few weeks, Elaine started to feel more tired. She started to experience episodes of guilt about
being more focused on her projects than her baby. She began to have difficulty making decisions and
withdrew from her friends and husband. At her 6-week follow-up with her provider, she explained that
she was feeling a little down and described her symptoms. The provider administered an EPDS. Elaine's
score was 15. Since Elaine was breastfeeding, the provider prescribed sertraline.
Is this t - CORRECT ANS ***no
Rationale: This is not the correct treatment decision for this client. Clients with bipolar disorder may
present during the depressive phase of the illness and may not report any symptoms of hypomanic or
manic episodes. The provider must obtain a careful history from the client and/or family members to
differentiate between bipolar disorder and depression. Bipolar disorder should be ruled out as a cause
of depression before prescribing medication as certain antidepressant medications can precipitate a
manic episode or induce rapid-cycling bipolar depression, which may contribute to the increased
incidence of death by suicide in children and adults younger than 25.
Alexandra has been taking lithium 1200 mg orally in two divided doses of 600 mg each for bipolar I
disorder. She has been in remission of symptoms for 14 months. She is 7 weeks pregnant.
Which of the following is the most appropriate recommendation for Alexandra?
obtain serum lithium levels before tapering the lithium dose
decrease dose to 600 mg daily
decrease dose to 900 mg daily
discontinue lithium and switch to lamotrigine - CORRECT ANS ***obtain serum lithium levels before
tapering the lithium dose
Rationale: Lithium exposure during the first trimester has a small but statistically significant risk of
cardiac malformations; the risk increases with higher dosages of the medication. Obtaining serum
lithium levels before tapering the dose is indicated since Alexandra has bipolar I disorder and is stable.
The development of the heart begins as early as the third week of gestation with the 4-chamber fetal
heart formed by gestational week 7. By the time Alexandra is weaned the risk has passed as the heart is
already formed. Although lamotrigine is considered safe during pregnancy, it may not be appropriate for
clients who have experienced mania in the past.
, Allie is a 26-year-old who has been receiving treatment for bipolar I disorder for 3 years. Her symptoms
have been in remission with lithium 500 mg twice daily. She also completed 12 weeks of interpersonal
and social rhythm therapy (IPSRT) upon diagnosis and used the life charting methodology to track her
symptoms. She calls her PMHNP and states "I just found out I'm pregnant. My partner and I were not
expecting this, but we are excited! I am worried about what lithium will do to my baby. Sh - CORRECT
ANS ***schedule an appointment for Allie and her husband to discuss a treatment plan as soon as
possible
ask Allie to continue taking lithium at the current dose for now
recommend that Allie begin tracking her mood, sleep schedule, and other symptoms
Rationale: Rationale: The PMHNP should schedule an appointment as soon as possible to discuss Allie's
treatment plan during her pregnancy. Discontinuation of medications for pregnancy is associated with a
relapse rate of 80-100% for clients who take mood stabilizers; therefore, the client should not abruptly
cease taking lithium (Ortega et al., 2023). Clients with a diagnosis of bipolar disorder may benefit from
tracking the symptoms of their illness, especially during stressful times.
Although reassurance is appropriate, the PMHNP should not minimize the potential risks of continuing
medication by telling the client that no harm will come to the baby.
Although SSRIs are typically well tolerated in this population, adverse effects can occur including
behavioral activation which can manifest as: - CORRECT ANS ***-irritability, agitation, and impulsivity.
• Generally, these symptoms are time-limited and can be managed with care and support.
Amy is a 14-year-old who frequently echoes what she just heard, saying that word or phrase over and
over.
match the clinical scenario with the appropriate tic:
Simple motor tics
Complex vocal tics: Coprolalia
Complex motor tics
Simple vocal tics
and answers graded a+updated on 2026
___________ and ___________ have been demonstrated to have the lowest serum concentrations
among infants exposed to medication during breastfeeding - CORRECT ANS ***Bupropion and Sertraline
_______________ women suffer from higher SUD rates compared to other racial and ethnic groups and
are disproportionately affected by criminalization laws at the federal, state, and tribal levels. - CORRECT
ANS ***Indigenous
__________________ is considered a psychiatric emergency and requires immediate hospitalization and
treatment - CORRECT ANS ***Perinatal psychosis
________, __________, and _____________ have shown benefits across the spectrum of perinatal
mental health disorders. - CORRECT ANS ***Yoga
massage
peer support
!!!!!!!!!!This SSRI has been associated with increased suicidal thinking & actions in children &
adolescents & should not typically be used to treat depression in this population!!!!!!!!!!!!!!!!!!!! -
CORRECT ANS ***Paroxetine
A program policy that prohibits individuals from using specific forms of prescribed medication for
addiction (MAT) treatment is an example of __________ stigma - CORRECT ANS ***structural
A stereotypic belief that individuals choose to use alcohol or other drugs and blame them for their
substance use disorder is an example of _________ stigma - CORRECT ANS ***public
Addressing Parental Concerns: Collaborative Treatment Plans - CORRECT ANS ***-tx plans for children
typically made in collaboration with parents or guardians
-Collaboration between the PMHNP, clients, and families when creating the treatment plan is key to
ensuring the plan meets the client's needs and is comfortable and manageable for the family
,After a few weeks, Elaine started to feel more tired. She started to experience episodes of guilt about
being more focused on her projects than her baby. She began to have difficulty making decisions and
withdrew from her friends and husband. At her 6-week follow-up with her provider, she explained that
she was feeling a little down and described her symptoms. The provider administered an EPDS. Elaine's
score was 15. Since Elaine was breastfeeding, the provider prescribed sertraline.
Is this t - CORRECT ANS ***no
Rationale: This is not the correct treatment decision for this client. Clients with bipolar disorder may
present during the depressive phase of the illness and may not report any symptoms of hypomanic or
manic episodes. The provider must obtain a careful history from the client and/or family members to
differentiate between bipolar disorder and depression. Bipolar disorder should be ruled out as a cause
of depression before prescribing medication as certain antidepressant medications can precipitate a
manic episode or induce rapid-cycling bipolar depression, which may contribute to the increased
incidence of death by suicide in children and adults younger than 25.
Alexandra has been taking lithium 1200 mg orally in two divided doses of 600 mg each for bipolar I
disorder. She has been in remission of symptoms for 14 months. She is 7 weeks pregnant.
Which of the following is the most appropriate recommendation for Alexandra?
obtain serum lithium levels before tapering the lithium dose
decrease dose to 600 mg daily
decrease dose to 900 mg daily
discontinue lithium and switch to lamotrigine - CORRECT ANS ***obtain serum lithium levels before
tapering the lithium dose
Rationale: Lithium exposure during the first trimester has a small but statistically significant risk of
cardiac malformations; the risk increases with higher dosages of the medication. Obtaining serum
lithium levels before tapering the dose is indicated since Alexandra has bipolar I disorder and is stable.
The development of the heart begins as early as the third week of gestation with the 4-chamber fetal
heart formed by gestational week 7. By the time Alexandra is weaned the risk has passed as the heart is
already formed. Although lamotrigine is considered safe during pregnancy, it may not be appropriate for
clients who have experienced mania in the past.
, Allie is a 26-year-old who has been receiving treatment for bipolar I disorder for 3 years. Her symptoms
have been in remission with lithium 500 mg twice daily. She also completed 12 weeks of interpersonal
and social rhythm therapy (IPSRT) upon diagnosis and used the life charting methodology to track her
symptoms. She calls her PMHNP and states "I just found out I'm pregnant. My partner and I were not
expecting this, but we are excited! I am worried about what lithium will do to my baby. Sh - CORRECT
ANS ***schedule an appointment for Allie and her husband to discuss a treatment plan as soon as
possible
ask Allie to continue taking lithium at the current dose for now
recommend that Allie begin tracking her mood, sleep schedule, and other symptoms
Rationale: Rationale: The PMHNP should schedule an appointment as soon as possible to discuss Allie's
treatment plan during her pregnancy. Discontinuation of medications for pregnancy is associated with a
relapse rate of 80-100% for clients who take mood stabilizers; therefore, the client should not abruptly
cease taking lithium (Ortega et al., 2023). Clients with a diagnosis of bipolar disorder may benefit from
tracking the symptoms of their illness, especially during stressful times.
Although reassurance is appropriate, the PMHNP should not minimize the potential risks of continuing
medication by telling the client that no harm will come to the baby.
Although SSRIs are typically well tolerated in this population, adverse effects can occur including
behavioral activation which can manifest as: - CORRECT ANS ***-irritability, agitation, and impulsivity.
• Generally, these symptoms are time-limited and can be managed with care and support.
Amy is a 14-year-old who frequently echoes what she just heard, saying that word or phrase over and
over.
match the clinical scenario with the appropriate tic:
Simple motor tics
Complex vocal tics: Coprolalia
Complex motor tics
Simple vocal tics
