NU 665C / NU665C Psychiatric Mental Health Care
Family II Exam Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section 1: Mood & Affective Disorders in Families (12 Questions)
Q1: A 34-year-old client with major depressive disorder has been taking sertraline 50
mg daily for 4 weeks with minimal improvement. What is the most appropriate next
step?
A. Discontinue sertraline immediately and switch to a different SSRI
B. Increase the sertraline dose to 100 mg daily and reassess in 2 to 4 weeks
C. Add a benzodiazepine for immediate mood improvement
D. Switch to electroconvulsive therapy without further medication adjustment
Correct Answer: B
Rationale: Correct because SSRIs typically require 4 to 6 weeks at a therapeutic dose
for full effect; increasing to a standard therapeutic dose and reassessing is the
appropriate next step before changing agents.
Q2: A client with bipolar I disorder is in a manic episode and has been nonadherent
with lithium. Which medication is most appropriate for acute stabilization?
A. Fluoxetine
B. Lithium or valproate with an atypical antipsychotic
C. Alprazolam monotherapy
D. Bupropion
Correct Answer: B
Rationale: Correct because acute mania is best treated with a mood stabilizer such
as lithium or valproate combined with an atypical antipsychotic; antidepressants and
benzodiazepines are not appropriate monotherapy for mania.
Q3: A client with persistent depressive disorder (dysthymia) reports chronic low
mood, fatigue, and poor concentration for 3 years. Which medication is considered
first-line treatment?
,A. Methylphenidate
B. An SSRI such as fluoxetine or sertraline
C. Lithium carbonate
D. Haloperidol
Correct Answer: B
Rationale: Correct because SSRIs are the first-line pharmacological treatment for
persistent depressive disorder due to their efficacy and favorable side effect profile.
Q4: A mother with postpartum depression tells the PMHNP she is afraid to take
antidepressants because she is breastfeeding. Which response is most accurate?
A. "You must stop breastfeeding if you take any antidepressant."
B. "Sertraline and paroxetine have favorable safety profiles during breastfeeding with
minimal infant exposure."
C. "All antidepressants are equally safe for breastfeeding mothers."
D. "You should only use herbal supplements while breastfeeding."
Correct Answer: B
Rationale: Correct because sertraline and paroxetine have the lowest relative infant
dose and are preferred for breastfeeding mothers; the benefits of treating maternal
depression outweigh minimal risks.
Q5: A client with bipolar disorder asks why antidepressant monotherapy is avoided.
What is the PMHNP's best explanation?
A. "Antidepressants are ineffective for any mood disorder."
B. "Antidepressants can trigger manic episodes and rapid cycling in clients with
bipolar disorder."
C. "Antidepressants interact dangerously with all mood stabilizers."
D. "Antidepressants are too expensive for long-term use."
Correct Answer: B
Rationale: Correct because antidepressant monotherapy in bipolar disorder
increases the risk of mood switching to mania and rapid cycling; mood stabilizers
are the foundation of treatment.
Q6: A client with major depressive disorder is started on venlafaxine. Which adverse
effect should the PMHNP monitor most closely?
A. Hyperglycemia
B. Hypertension at higher doses due to norepinephrine reuptake inhibition
C. Bradycardia
D. Hyperkalemia
Correct Answer: B
, Rationale: Correct because venlafaxine is an SNRI that can cause dose-dependent
increases in blood pressure due to norepinephrine reuptake inhibition, requiring
regular monitoring.
Q7: A family member of a client with depression asks how they can best support
their loved one. Which recommendation is most evidence-based?
A. "Encourage your loved one to push through daily activities without rest."
B. "Provide emotional support, encourage treatment adherence, and watch for
warning signs of suicide."
C. "Avoid discussing the depression to prevent making your loved one feel worse."
D. "Take over all decision-making for your loved one to reduce stress."
Correct Answer: B
Rationale: Correct because family support that encourages treatment adherence,
provides emotional validation, and monitors for suicide risk is associated with
improved outcomes in depression.
Q8: A client with treatment-resistant depression has failed two adequate trials of
SSRIs. Which treatment option is most appropriate to consider next?
A. Increasing the SSRI to triple the standard dose
B. Augmentation with an atypical antipsychotic such as aripiprazole or switching to a
different class
C. Discontinuing all medications and recommending exercise only
D. Starting benzodiazepine monotherapy
Correct Answer: B
Rationale: Correct because augmentation with atypical antipsychotics or switching
to a different antidepressant class such as an SNRI or TCA is the evidence-based
approach for treatment-resistant depression.
Q9: A client with seasonal affective disorder presents in November with increased
sleep, carbohydrate craving, and weight gain. Which treatment is most appropriate?
A. Light therapy and an SSRI
B. Lithium monotherapy
C. Stimulant medication only
D. Antipsychotic monotherapy
Correct Answer: A
Rationale: Correct because seasonal affective disorder responds well to light
therapy, which helps regulate circadian rhythms, often combined with an SSRI for
moderate to severe symptoms.
Family II Exam Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section 1: Mood & Affective Disorders in Families (12 Questions)
Q1: A 34-year-old client with major depressive disorder has been taking sertraline 50
mg daily for 4 weeks with minimal improvement. What is the most appropriate next
step?
A. Discontinue sertraline immediately and switch to a different SSRI
B. Increase the sertraline dose to 100 mg daily and reassess in 2 to 4 weeks
C. Add a benzodiazepine for immediate mood improvement
D. Switch to electroconvulsive therapy without further medication adjustment
Correct Answer: B
Rationale: Correct because SSRIs typically require 4 to 6 weeks at a therapeutic dose
for full effect; increasing to a standard therapeutic dose and reassessing is the
appropriate next step before changing agents.
Q2: A client with bipolar I disorder is in a manic episode and has been nonadherent
with lithium. Which medication is most appropriate for acute stabilization?
A. Fluoxetine
B. Lithium or valproate with an atypical antipsychotic
C. Alprazolam monotherapy
D. Bupropion
Correct Answer: B
Rationale: Correct because acute mania is best treated with a mood stabilizer such
as lithium or valproate combined with an atypical antipsychotic; antidepressants and
benzodiazepines are not appropriate monotherapy for mania.
Q3: A client with persistent depressive disorder (dysthymia) reports chronic low
mood, fatigue, and poor concentration for 3 years. Which medication is considered
first-line treatment?
,A. Methylphenidate
B. An SSRI such as fluoxetine or sertraline
C. Lithium carbonate
D. Haloperidol
Correct Answer: B
Rationale: Correct because SSRIs are the first-line pharmacological treatment for
persistent depressive disorder due to their efficacy and favorable side effect profile.
Q4: A mother with postpartum depression tells the PMHNP she is afraid to take
antidepressants because she is breastfeeding. Which response is most accurate?
A. "You must stop breastfeeding if you take any antidepressant."
B. "Sertraline and paroxetine have favorable safety profiles during breastfeeding with
minimal infant exposure."
C. "All antidepressants are equally safe for breastfeeding mothers."
D. "You should only use herbal supplements while breastfeeding."
Correct Answer: B
Rationale: Correct because sertraline and paroxetine have the lowest relative infant
dose and are preferred for breastfeeding mothers; the benefits of treating maternal
depression outweigh minimal risks.
Q5: A client with bipolar disorder asks why antidepressant monotherapy is avoided.
What is the PMHNP's best explanation?
A. "Antidepressants are ineffective for any mood disorder."
B. "Antidepressants can trigger manic episodes and rapid cycling in clients with
bipolar disorder."
C. "Antidepressants interact dangerously with all mood stabilizers."
D. "Antidepressants are too expensive for long-term use."
Correct Answer: B
Rationale: Correct because antidepressant monotherapy in bipolar disorder
increases the risk of mood switching to mania and rapid cycling; mood stabilizers
are the foundation of treatment.
Q6: A client with major depressive disorder is started on venlafaxine. Which adverse
effect should the PMHNP monitor most closely?
A. Hyperglycemia
B. Hypertension at higher doses due to norepinephrine reuptake inhibition
C. Bradycardia
D. Hyperkalemia
Correct Answer: B
, Rationale: Correct because venlafaxine is an SNRI that can cause dose-dependent
increases in blood pressure due to norepinephrine reuptake inhibition, requiring
regular monitoring.
Q7: A family member of a client with depression asks how they can best support
their loved one. Which recommendation is most evidence-based?
A. "Encourage your loved one to push through daily activities without rest."
B. "Provide emotional support, encourage treatment adherence, and watch for
warning signs of suicide."
C. "Avoid discussing the depression to prevent making your loved one feel worse."
D. "Take over all decision-making for your loved one to reduce stress."
Correct Answer: B
Rationale: Correct because family support that encourages treatment adherence,
provides emotional validation, and monitors for suicide risk is associated with
improved outcomes in depression.
Q8: A client with treatment-resistant depression has failed two adequate trials of
SSRIs. Which treatment option is most appropriate to consider next?
A. Increasing the SSRI to triple the standard dose
B. Augmentation with an atypical antipsychotic such as aripiprazole or switching to a
different class
C. Discontinuing all medications and recommending exercise only
D. Starting benzodiazepine monotherapy
Correct Answer: B
Rationale: Correct because augmentation with atypical antipsychotics or switching
to a different antidepressant class such as an SNRI or TCA is the evidence-based
approach for treatment-resistant depression.
Q9: A client with seasonal affective disorder presents in November with increased
sleep, carbohydrate craving, and weight gain. Which treatment is most appropriate?
A. Light therapy and an SSRI
B. Lithium monotherapy
C. Stimulant medication only
D. Antipsychotic monotherapy
Correct Answer: A
Rationale: Correct because seasonal affective disorder responds well to light
therapy, which helps regulate circadian rhythms, often combined with an SSRI for
moderate to severe symptoms.
