Chamberlain Pre-diagnostic NR607CEA
advanced Nursing Practice Questions with
Answers
Question 1
Skylar is a 33-year-old who presents to the clinic for a routine follow-up visit.
Past psychiatric history: Skylar was diagnosed with schizophrenia at age 19. At that
time, they had symptoms of visual hallucinations, disorganized thinking, and
anhedonia. They were prescribed risperidone and take 6 mg daily; the medication has
been well-tolerated since then and they have experienced no relapses in symptoms.
Skylar has no new complaints during today's visit. They state they have been taking
their medications as prescribed. Skylar's positive and negative syndrome scale
(PANSS) score is comparable to their last visit. Their abnormal involuntary movement
scale (AIMS) scoreLinks to an external site. is 2.
What is the most likely diagnosis for Skylar at this time?
-schizophrenia; multiple episodes, currently in partial remission
-schizophrenia; first episode, currently in partial remission
-schizophrenia; continuous
-s
Correct Answer
schizophrenia; first episode, currently in full remission
Rationale: The most likely diagnosis for Skylar is schizophrenia; first episode,
currently in full remission. Skylar has not had a relapse of symptoms since their
diagnosis, which meets the specifiers for first episode in full remission.
Page 1 of 152
,Question 2
Which of the following is the most appropriate pharmacologic management strategy
for Talitha?
-continue olanzapine 10 mg daily
-increase olanzapine to 15 mg daily
-switch to clozapine 12.5 mg daily
-switch to olanzapine/samidorphan 15mg/10mg
Correct Answer
switch to olanzapine/samidorphan 15mg/10mg
Rationale: The most appropriate pharmacologic management strategy for Talitha is
to switch to olanzapine/samidorphan 15mg/10mg. Olanzapine may be continued
with an increase in dosage; the medication has been well-tolerated and the client
has had trials of other antipsychotic medications. Since Talitha has experienced
weight gain with olanzapine, it may be appropriate to trial olanzapine/samidorphan
to mitigate additional weight gain. Talitha does not have a history of opioid use
disorder and may safely begin olanzapine/samidorphan without concerns of opioid
overdose, a potentially life-threatening interaction. If Talitha does not experience full
remission with an increased dose of olanzapine, the provider should consider
clozapine for this client.
Page 2 of 152
,Question 3
The PMHNP is sharing sexually explicit memes with a client that she saw earlier today
in a group session.
How the PMHNP applied ethical principles:
-Respect for the Individual
-Commitment to the Healthcare Consumer
-Advocacy for the Healthcare Consumer
-Responsibility and Accountability for Practice
-Duties to Self and Others
-Contributions to Healthcare Environments
-Advancement of the Nursing Profession
-Collaboration to Meet Health Needs
-Promotion of the Nursing Profession
Correct Answer
Advocacy for the Healthcare Consumer
Rationale: This is an unethical scenario. The PMHNP recognizes the power
differential in the therapeutic relationship and understands that any sort of sexual
activity or intimacies with current clients, their close family members, guardians, or
significant others is unethical.
Page 3 of 152
, Question 4
Bettina is a 24-year-old who presents to the mental health clinic after a referral from
her primary care provider. She endorses symptoms of depression that began "when I
was still in college," including excessive sleepiness, withdrawal from social activities,
the guilt associated with "leaving my friends hanging," and anhedonia. Bettina states
that she saw a counselor through the college health service, which helped her
symptoms somewhat, but she was unable to continue with counseling after
graduation two years ago. She made an appointment with her primary care provider
to discuss medications for depressive symptoms and was prescribed citalopram 20
mg daily. After six weeks on the medication, she did not experience relief of
symptoms and returned to the provider at which time her dose was increased to 40
mg daily. She had a follow-up appointment with the provider six months later, at
which time she was prescr
Correct Answer
continue current medications and add aripiprazole 2 mg daily
Rationale: The most appropriate treatment for Bettina is to continue her current
medications and add aripiprazole 2 mg daily. According to the STAR*D guidelines,
the client may choose to remain on the current medications and add an atypical
antipsychotic medication such as aripiprazole. Alternatively, the client may choose
to discontinue current medications and start a tricyclic or tetracyclic antidepressant.
The client may also choose to begin therapy. Inpatient admission is not indicated
for this client.
Question 5
Schizophrenia
Correct Answer
-complex chronic disorder
-affecting approximately 3.5 million people in the United States
-healthcare costs exceeding $155 billion
-Symptoms typically emerge between late teens & early 30s
-Many experience exacerbations of psychotic symptoms interspersed with periods
of remission or recovery
-response rates to antipsychotic good, tx adherence remains problematic
-Common comorbid conditions: dementia, liver disease, AIDS, heart failure, type 2
diabetes
Page 4 of 152
advanced Nursing Practice Questions with
Answers
Question 1
Skylar is a 33-year-old who presents to the clinic for a routine follow-up visit.
Past psychiatric history: Skylar was diagnosed with schizophrenia at age 19. At that
time, they had symptoms of visual hallucinations, disorganized thinking, and
anhedonia. They were prescribed risperidone and take 6 mg daily; the medication has
been well-tolerated since then and they have experienced no relapses in symptoms.
Skylar has no new complaints during today's visit. They state they have been taking
their medications as prescribed. Skylar's positive and negative syndrome scale
(PANSS) score is comparable to their last visit. Their abnormal involuntary movement
scale (AIMS) scoreLinks to an external site. is 2.
What is the most likely diagnosis for Skylar at this time?
-schizophrenia; multiple episodes, currently in partial remission
-schizophrenia; first episode, currently in partial remission
-schizophrenia; continuous
-s
Correct Answer
schizophrenia; first episode, currently in full remission
Rationale: The most likely diagnosis for Skylar is schizophrenia; first episode,
currently in full remission. Skylar has not had a relapse of symptoms since their
diagnosis, which meets the specifiers for first episode in full remission.
Page 1 of 152
,Question 2
Which of the following is the most appropriate pharmacologic management strategy
for Talitha?
-continue olanzapine 10 mg daily
-increase olanzapine to 15 mg daily
-switch to clozapine 12.5 mg daily
-switch to olanzapine/samidorphan 15mg/10mg
Correct Answer
switch to olanzapine/samidorphan 15mg/10mg
Rationale: The most appropriate pharmacologic management strategy for Talitha is
to switch to olanzapine/samidorphan 15mg/10mg. Olanzapine may be continued
with an increase in dosage; the medication has been well-tolerated and the client
has had trials of other antipsychotic medications. Since Talitha has experienced
weight gain with olanzapine, it may be appropriate to trial olanzapine/samidorphan
to mitigate additional weight gain. Talitha does not have a history of opioid use
disorder and may safely begin olanzapine/samidorphan without concerns of opioid
overdose, a potentially life-threatening interaction. If Talitha does not experience full
remission with an increased dose of olanzapine, the provider should consider
clozapine for this client.
Page 2 of 152
,Question 3
The PMHNP is sharing sexually explicit memes with a client that she saw earlier today
in a group session.
How the PMHNP applied ethical principles:
-Respect for the Individual
-Commitment to the Healthcare Consumer
-Advocacy for the Healthcare Consumer
-Responsibility and Accountability for Practice
-Duties to Self and Others
-Contributions to Healthcare Environments
-Advancement of the Nursing Profession
-Collaboration to Meet Health Needs
-Promotion of the Nursing Profession
Correct Answer
Advocacy for the Healthcare Consumer
Rationale: This is an unethical scenario. The PMHNP recognizes the power
differential in the therapeutic relationship and understands that any sort of sexual
activity or intimacies with current clients, their close family members, guardians, or
significant others is unethical.
Page 3 of 152
, Question 4
Bettina is a 24-year-old who presents to the mental health clinic after a referral from
her primary care provider. She endorses symptoms of depression that began "when I
was still in college," including excessive sleepiness, withdrawal from social activities,
the guilt associated with "leaving my friends hanging," and anhedonia. Bettina states
that she saw a counselor through the college health service, which helped her
symptoms somewhat, but she was unable to continue with counseling after
graduation two years ago. She made an appointment with her primary care provider
to discuss medications for depressive symptoms and was prescribed citalopram 20
mg daily. After six weeks on the medication, she did not experience relief of
symptoms and returned to the provider at which time her dose was increased to 40
mg daily. She had a follow-up appointment with the provider six months later, at
which time she was prescr
Correct Answer
continue current medications and add aripiprazole 2 mg daily
Rationale: The most appropriate treatment for Bettina is to continue her current
medications and add aripiprazole 2 mg daily. According to the STAR*D guidelines,
the client may choose to remain on the current medications and add an atypical
antipsychotic medication such as aripiprazole. Alternatively, the client may choose
to discontinue current medications and start a tricyclic or tetracyclic antidepressant.
The client may also choose to begin therapy. Inpatient admission is not indicated
for this client.
Question 5
Schizophrenia
Correct Answer
-complex chronic disorder
-affecting approximately 3.5 million people in the United States
-healthcare costs exceeding $155 billion
-Symptoms typically emerge between late teens & early 30s
-Many experience exacerbations of psychotic symptoms interspersed with periods
of remission or recovery
-response rates to antipsychotic good, tx adherence remains problematic
-Common comorbid conditions: dementia, liver disease, AIDS, heart failure, type 2
diabetes
Page 4 of 152
