NRNP 6665 FINAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST
EXAM UPDATE 2026/2027.
Section One: Questions 1–100
A patient presents with symptoms of major depressive disorder. Which neurotransmitter deficiency is most strongly associated with
the vegetative symptoms of depression?
A. Dopamine
🟢 B. Serotonin
C. Glutamate
D. GABA
🔴 RATIONALE: Serotonin deficiency is closely linked to the sleep, appetite, and energy disturbances known as vegetative
symptoms in depression.
Which ethical principle is violated if a nurse practitioner discloses a patient’s diagnosis to an employer without consent?
A. Beneficence
B. Justice
C. Non-maleficence
🟢 D. Autonomy
🔴 RATIONALE: Autonomy includes the right to privacy and control over one’s own health information.
A 45-year-old patient with bipolar I disorder is being transitioned from lithium to lamotrigine. What is the primary reason for slow
titration of lamotrigine?
A. To avoid serotonin syndrome
B. To prevent weight gain
🟢 C. To minimize the risk of Stevens-Johnson syndrome
D. To reduce the risk of hepatotoxicity
🔴 RATIONALE: Slow titration is required to reduce the risk of severe dermatological reactions, including Stevens-Johnson
syndrome.
When evaluating a patient for ADHD, which diagnostic criterion must be met regarding the onset of symptoms?
A. Symptoms must be present before age 18
🟢 B. Symptoms must be present before age 12
C. Symptoms must be present before age 7
D. Symptoms must be present before age 15
🔴 RATIONALE: The DSM-5-TR specifies that several inattentive or hyperactive-impulsive symptoms must have been present prior
to age 12.
,Which laboratory test is essential before initiating clozapine therapy?
A. Thyroid function panel
B. Liver function tests
🟢 C. Absolute neutrophil count
D. Serum creatinine
🔴 RATIONALE: Clozapine carries a black box warning for agranulocytosis, requiring baseline and ongoing monitoring of the
absolute neutrophil count.
A patient describes hearing voices that command them to harm others. What is the priority nursing action?
🟢 A. Assess for the presence of a specific plan and intent
B. Administer an intramuscular antipsychotic
C. Document the hallucination in the chart
D. Discharge the patient with a referral
🔴 RATIONALE: Assessment of command hallucinations must prioritize immediate safety by determining if the patient has a plan or
intent to act on the voices.
Which class of medication is considered first-line for treating obsessive-compulsive disorder?
A. Tricyclic antidepressants
🟢 B. Selective serotonin reuptake inhibitors
C. Benzodiazepines
D. Mood stabilizers
🔴 RATIONALE: SSRIs are the evidence-based first-line pharmacological treatment for OCD.
In a therapeutic relationship, which concept describes the clinician projecting their own past feelings onto the patient?
A. Transference
🟢 B. Countertransference
C. Empathy
D. Sympathy
🔴 RATIONALE: Countertransference occurs when the clinician projects their own unconscious feelings or experiences onto the
patient.
A patient with schizophrenia exhibits repetitive, involuntary movements of the tongue and jaw. Which condition is this?
A. Parkinsonism
B. Dystonia
🟢 C. Tardive dyskinesia
D. Akathisia
, 🔴 RATIONALE: Tardive dyskinesia is characterized by involuntary, repetitive movements, often involving the orofacial region, due to
long-term antipsychotic use.
Which defense mechanism involves attributing one's own unacceptable impulses to others?
A. Displacement
B. Reaction formation
🟢 C. Projection
D. Sublimation
🔴 RATIONALE: Projection is the defense mechanism where an individual shifts their own internal, unwanted thoughts or feelings
onto another person.
What is the mechanism of action of buspirone?
A. GABA-A receptor agonist
B. Norepinephrine reuptake inhibitor
🟢 C. 5-HT1A receptor partial agonist
D. Dopamine receptor antagonist
🔴 RATIONALE: Buspirone acts as a partial agonist at 5-HT1A receptors, which contributes to its anxiolytic effects.
A patient with generalized anxiety disorder reports continued worry despite adequate trials of SSRIs. Which medication is a non-
benzodiazepine alternative for maintenance?
A. Alprazolam
B. Lorazepam
🟢 C. Buspirone
D. Diazepam
🔴 RATIONALE: Buspirone is an effective, non-addictive, second-line or adjunctive treatment for GAD.
Which personality disorder is characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy?
A. Borderline personality disorder
🟢 B. Narcissistic personality disorder
C. Antisocial personality disorder
D. Histrionic personality disorder
🔴 RATIONALE: These are the core diagnostic features of narcissistic personality disorder as defined in the DSM-5.
During an intake interview, a patient exhibits "flight of ideas." How is this best described?
A. Slowed speech
B. Inability to answer questions
EXAM UPDATE 2026/2027.
Section One: Questions 1–100
A patient presents with symptoms of major depressive disorder. Which neurotransmitter deficiency is most strongly associated with
the vegetative symptoms of depression?
A. Dopamine
🟢 B. Serotonin
C. Glutamate
D. GABA
🔴 RATIONALE: Serotonin deficiency is closely linked to the sleep, appetite, and energy disturbances known as vegetative
symptoms in depression.
Which ethical principle is violated if a nurse practitioner discloses a patient’s diagnosis to an employer without consent?
A. Beneficence
B. Justice
C. Non-maleficence
🟢 D. Autonomy
🔴 RATIONALE: Autonomy includes the right to privacy and control over one’s own health information.
A 45-year-old patient with bipolar I disorder is being transitioned from lithium to lamotrigine. What is the primary reason for slow
titration of lamotrigine?
A. To avoid serotonin syndrome
B. To prevent weight gain
🟢 C. To minimize the risk of Stevens-Johnson syndrome
D. To reduce the risk of hepatotoxicity
🔴 RATIONALE: Slow titration is required to reduce the risk of severe dermatological reactions, including Stevens-Johnson
syndrome.
When evaluating a patient for ADHD, which diagnostic criterion must be met regarding the onset of symptoms?
A. Symptoms must be present before age 18
🟢 B. Symptoms must be present before age 12
C. Symptoms must be present before age 7
D. Symptoms must be present before age 15
🔴 RATIONALE: The DSM-5-TR specifies that several inattentive or hyperactive-impulsive symptoms must have been present prior
to age 12.
,Which laboratory test is essential before initiating clozapine therapy?
A. Thyroid function panel
B. Liver function tests
🟢 C. Absolute neutrophil count
D. Serum creatinine
🔴 RATIONALE: Clozapine carries a black box warning for agranulocytosis, requiring baseline and ongoing monitoring of the
absolute neutrophil count.
A patient describes hearing voices that command them to harm others. What is the priority nursing action?
🟢 A. Assess for the presence of a specific plan and intent
B. Administer an intramuscular antipsychotic
C. Document the hallucination in the chart
D. Discharge the patient with a referral
🔴 RATIONALE: Assessment of command hallucinations must prioritize immediate safety by determining if the patient has a plan or
intent to act on the voices.
Which class of medication is considered first-line for treating obsessive-compulsive disorder?
A. Tricyclic antidepressants
🟢 B. Selective serotonin reuptake inhibitors
C. Benzodiazepines
D. Mood stabilizers
🔴 RATIONALE: SSRIs are the evidence-based first-line pharmacological treatment for OCD.
In a therapeutic relationship, which concept describes the clinician projecting their own past feelings onto the patient?
A. Transference
🟢 B. Countertransference
C. Empathy
D. Sympathy
🔴 RATIONALE: Countertransference occurs when the clinician projects their own unconscious feelings or experiences onto the
patient.
A patient with schizophrenia exhibits repetitive, involuntary movements of the tongue and jaw. Which condition is this?
A. Parkinsonism
B. Dystonia
🟢 C. Tardive dyskinesia
D. Akathisia
, 🔴 RATIONALE: Tardive dyskinesia is characterized by involuntary, repetitive movements, often involving the orofacial region, due to
long-term antipsychotic use.
Which defense mechanism involves attributing one's own unacceptable impulses to others?
A. Displacement
B. Reaction formation
🟢 C. Projection
D. Sublimation
🔴 RATIONALE: Projection is the defense mechanism where an individual shifts their own internal, unwanted thoughts or feelings
onto another person.
What is the mechanism of action of buspirone?
A. GABA-A receptor agonist
B. Norepinephrine reuptake inhibitor
🟢 C. 5-HT1A receptor partial agonist
D. Dopamine receptor antagonist
🔴 RATIONALE: Buspirone acts as a partial agonist at 5-HT1A receptors, which contributes to its anxiolytic effects.
A patient with generalized anxiety disorder reports continued worry despite adequate trials of SSRIs. Which medication is a non-
benzodiazepine alternative for maintenance?
A. Alprazolam
B. Lorazepam
🟢 C. Buspirone
D. Diazepam
🔴 RATIONALE: Buspirone is an effective, non-addictive, second-line or adjunctive treatment for GAD.
Which personality disorder is characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy?
A. Borderline personality disorder
🟢 B. Narcissistic personality disorder
C. Antisocial personality disorder
D. Histrionic personality disorder
🔴 RATIONALE: These are the core diagnostic features of narcissistic personality disorder as defined in the DSM-5.
During an intake interview, a patient exhibits "flight of ideas." How is this best described?
A. Slowed speech
B. Inability to answer questions
