NR607 PRE DIAGNOSTIC EXAM /NEWEST NR607 PRE DIAGNOSTIC TEST
2026/2027 TESTBANK AND STUDY GUIDE COMPLETE ACCURATE
EXAM APPROVED QUESTIONS AND CORRECT VERIFIED ANSWERS
WITH DETAILED RATIONALES (A NEW UPDATED VERSION 2026
EDITION) |GUARANTEED PASS A+ |FULL REVISED NR 607 PRE
DIAGNOSTIC |CHAMBERLAIN
1. A 52-year-old obese man with type 2 diabetes reports dozing off while driving,
watching TV, or reading, with increased apathy and fatigue. The PMHNP ordered
a sleep study, which revealed 10 episodes of apnea lasting 15 to 20 seconds each
per hour of sleep. Based on these findings, what should the PMHNP prescribe for
his condition?
A. Referral to otolaryngology for rhinoplasty
B. Antidepressant medications
C. Referral to otolaryngology for uvuloplasty
D. Continuous positive airway pressure
Correct Answer: D. Continuous positive airway pressure
Rationale: This patient's presentation is consistent with obstructive sleep apnea
(OSA), which is confirmed by the sleep study findings of 10 apneic episodes per
hour. The first-line treatment for moderate to severe OSA is Continuous Positive
Airway Pressure (CPAP), which provides pneumatic splinting of the airway to
prevent collapse during sleep. Surgical referrals are not the initial treatment of
choice .
2. Which of the following is an indication for monitoring of serum drug levels?
A. Smoking cessation
B. New diagnosis of hyperlipidemia
C. Resolution of symptoms
D. New diagnosis of diabetes
,Correct Answer: A. Smoking cessation
Rationale: Smoking cessation is a critical indication for monitoring serum drug
levels because tobacco smoke induces the CYP1A2 enzyme system. When a
patient stops smoking, the metabolism of certain drugs (e.g., clozapine, olanzapine)
decreases, leading to potentially toxic serum levels. Therefore, dose adjustments
and serum level monitoring are necessary .
3. Your client Jamie asks you about a mole on her forearm. As an APRN, you
recognize that cancerous moles can be detected on exam. Which of the following
would not be of concern?
A. A dark mole
B. A mole that is 5 mm in size
C. A mole that is not elevated
D. All of the above
Correct Answer: C. A mole that is not elevated
Rationale: The ABCDE mnemonic is used to assess moles for malignancy:
Asymmetry, Border irregularity, Color variation, Diameter >6mm, and Evolution.
A mole that is not elevated is a normal characteristic and is not a sign of
melanoma. Dark coloration and a 5mm diameter could be concerning .
4. A 42-year-old female recalls a brief episode of chest tightness with no radiation
or chest wall injury during her new taekwondo martial arts class. This pain
subsided during "the cool down period" of her class. Which of the following is
most likely given her presentation?
A. Pericarditis
B. Acute myocardial infarction
C. Hiatal hernia
D. Angina pectoris
Correct Answer: D. Angina pectoris
,Rationale: This patient's chest tightness occurs with exertion (taekwondo class) and
is relieved at rest (cool down period), which is classic for stable angina pectoris
due to myocardial ischemia. While an acute myocardial infarction can present with
chest pain, the pattern of pain with activity and relief at rest makes angina more
likely .
5. 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. Urinalysis
B. Acetaminophen level
C. Urinary porphobilinogen
D. Blood alcohol level
Correct Answer: C. Urinary porphobilinogen
Rationale: The patient's symptoms of neuropsychiatric disturbances (agitation,
cognitive impairment, mood changes), tachycardia, hypotension, and abdominal
pain following alcohol ingestion are classic signs of an acute porphyria attack,
specifically acute intermittent porphyria (AIP). Alcohol is a known precipitant.
The diagnostic test for AIP is a urinary porphobilinogen (PBG) level .
6. An 81-year-old female is found in acute respiratory distress after choking on a
hotdog during lunch. On exam, which of the following lung sounds are you most
likely to hear?
A. Bronchophony
B. Egophony
C. Crackles
, D. Stridor
Correct Answer: D. Stridor
Rationale: Stridor is a high-pitched, musical sound heard during inspiration that
indicates a partial upper airway obstruction. The acute onset of respiratory distress
following choking is highly suggestive of an aspirated foreign body, and the
resultant upper airway obstruction would produce stridor .
7. A PMHNP employed within a small telehealth practice routinely "curb side
consults" a collaborative psychiatrist within the same state through email. The
email includes the client's name in the subject line and the email body includes a
general question about Risperdal management. Is this considered a HIPAA
violation?
A. No, the collaborative psychiatrist is located in the same practicing state as the
PMHNP.
B. Yes, the email mentions Clozaril and medications cannot be discussed via
email.
C. Yes, this became a HIPAA violation when she put the client's name in the title
subject line.
D. No, the body of the email does not include protected psychotherapy notes.
Correct Answer: C. Yes, this became a HIPAA violation when she put the client's
name in the title subject line.
Rationale: The Health Insurance Portability and Accountability Act (HIPAA)
requires that protected health information (PHI) be kept confidential. Including the
client's name in the subject line of an unencrypted email creates a breach of
confidentiality, even if the body of the email only discusses treatment in general.
Email subject lines are often visible and not secure .
8. A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that
he had felt a lump on his left testicle. He is concerned he has not had a physical
exam in 10 years. What is the best action by the PMHNP?
A. Perform a urogenital exam and order an ultrasound
2026/2027 TESTBANK AND STUDY GUIDE COMPLETE ACCURATE
EXAM APPROVED QUESTIONS AND CORRECT VERIFIED ANSWERS
WITH DETAILED RATIONALES (A NEW UPDATED VERSION 2026
EDITION) |GUARANTEED PASS A+ |FULL REVISED NR 607 PRE
DIAGNOSTIC |CHAMBERLAIN
1. A 52-year-old obese man with type 2 diabetes reports dozing off while driving,
watching TV, or reading, with increased apathy and fatigue. The PMHNP ordered
a sleep study, which revealed 10 episodes of apnea lasting 15 to 20 seconds each
per hour of sleep. Based on these findings, what should the PMHNP prescribe for
his condition?
A. Referral to otolaryngology for rhinoplasty
B. Antidepressant medications
C. Referral to otolaryngology for uvuloplasty
D. Continuous positive airway pressure
Correct Answer: D. Continuous positive airway pressure
Rationale: This patient's presentation is consistent with obstructive sleep apnea
(OSA), which is confirmed by the sleep study findings of 10 apneic episodes per
hour. The first-line treatment for moderate to severe OSA is Continuous Positive
Airway Pressure (CPAP), which provides pneumatic splinting of the airway to
prevent collapse during sleep. Surgical referrals are not the initial treatment of
choice .
2. Which of the following is an indication for monitoring of serum drug levels?
A. Smoking cessation
B. New diagnosis of hyperlipidemia
C. Resolution of symptoms
D. New diagnosis of diabetes
,Correct Answer: A. Smoking cessation
Rationale: Smoking cessation is a critical indication for monitoring serum drug
levels because tobacco smoke induces the CYP1A2 enzyme system. When a
patient stops smoking, the metabolism of certain drugs (e.g., clozapine, olanzapine)
decreases, leading to potentially toxic serum levels. Therefore, dose adjustments
and serum level monitoring are necessary .
3. Your client Jamie asks you about a mole on her forearm. As an APRN, you
recognize that cancerous moles can be detected on exam. Which of the following
would not be of concern?
A. A dark mole
B. A mole that is 5 mm in size
C. A mole that is not elevated
D. All of the above
Correct Answer: C. A mole that is not elevated
Rationale: The ABCDE mnemonic is used to assess moles for malignancy:
Asymmetry, Border irregularity, Color variation, Diameter >6mm, and Evolution.
A mole that is not elevated is a normal characteristic and is not a sign of
melanoma. Dark coloration and a 5mm diameter could be concerning .
4. A 42-year-old female recalls a brief episode of chest tightness with no radiation
or chest wall injury during her new taekwondo martial arts class. This pain
subsided during "the cool down period" of her class. Which of the following is
most likely given her presentation?
A. Pericarditis
B. Acute myocardial infarction
C. Hiatal hernia
D. Angina pectoris
Correct Answer: D. Angina pectoris
,Rationale: This patient's chest tightness occurs with exertion (taekwondo class) and
is relieved at rest (cool down period), which is classic for stable angina pectoris
due to myocardial ischemia. While an acute myocardial infarction can present with
chest pain, the pattern of pain with activity and relief at rest makes angina more
likely .
5. 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. Urinalysis
B. Acetaminophen level
C. Urinary porphobilinogen
D. Blood alcohol level
Correct Answer: C. Urinary porphobilinogen
Rationale: The patient's symptoms of neuropsychiatric disturbances (agitation,
cognitive impairment, mood changes), tachycardia, hypotension, and abdominal
pain following alcohol ingestion are classic signs of an acute porphyria attack,
specifically acute intermittent porphyria (AIP). Alcohol is a known precipitant.
The diagnostic test for AIP is a urinary porphobilinogen (PBG) level .
6. An 81-year-old female is found in acute respiratory distress after choking on a
hotdog during lunch. On exam, which of the following lung sounds are you most
likely to hear?
A. Bronchophony
B. Egophony
C. Crackles
, D. Stridor
Correct Answer: D. Stridor
Rationale: Stridor is a high-pitched, musical sound heard during inspiration that
indicates a partial upper airway obstruction. The acute onset of respiratory distress
following choking is highly suggestive of an aspirated foreign body, and the
resultant upper airway obstruction would produce stridor .
7. A PMHNP employed within a small telehealth practice routinely "curb side
consults" a collaborative psychiatrist within the same state through email. The
email includes the client's name in the subject line and the email body includes a
general question about Risperdal management. Is this considered a HIPAA
violation?
A. No, the collaborative psychiatrist is located in the same practicing state as the
PMHNP.
B. Yes, the email mentions Clozaril and medications cannot be discussed via
email.
C. Yes, this became a HIPAA violation when she put the client's name in the title
subject line.
D. No, the body of the email does not include protected psychotherapy notes.
Correct Answer: C. Yes, this became a HIPAA violation when she put the client's
name in the title subject line.
Rationale: The Health Insurance Portability and Accountability Act (HIPAA)
requires that protected health information (PHI) be kept confidential. Including the
client's name in the subject line of an unencrypted email creates a breach of
confidentiality, even if the body of the email only discusses treatment in general.
Email subject lines are often visible and not secure .
8. A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that
he had felt a lump on his left testicle. He is concerned he has not had a physical
exam in 10 years. What is the best action by the PMHNP?
A. Perform a urogenital exam and order an ultrasound
