NSG 5544 Advanced Practice
Psychiatric-Mental Health Exam 3 Study Guide
South College Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
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## SECTION 1: SCHIZOPHRENIA SPECTRUM & PSYCHOTIC DISORDERS (Questions 1-18)
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Q1: A 22-year-old male patient is diagnosed with schizophrenia. He reports hearing voices
commenting on his actions and believes the FBI is monitoring him through his television. Which
symptom category best describes these findings?
A. Negative symptoms
B. Cognitive symptoms
C. Positive symptoms [CORRECT]
D. Affective symptoms
Correct Answer: C
Rationale: Correct because hallucinations and delusions are classified as positive symptoms of
schizophrenia, representing an excess or distortion of normal functions. This matches NSG 5544
Exam 3 content on the dopamine hypothesis, which suggests positive symptoms are due to
excessive dopamine activity in the mesolimbic pathway.
Q2: A patient with schizophrenia presents with flat affect, poverty of speech, and lack of motivation
to engage in daily activities. These symptoms are best classified as:
A. Positive symptoms
B. Negative symptoms [CORRECT]
C. Psychotic symptoms
D. Affective symptoms
Correct Answer: B
Rationale: Correct because affective flattening, alogia (poverty of speech), and avolition (lack of
motivation) are core negative symptoms of schizophrenia, representing a diminution or loss of
normal functions. The dopamine hypothesis suggests negative symptoms are associated with
dopamine deficiency in the prefrontal cortex.
Q3: A patient receiving haloperidol develops severe muscle rigidity, hyperthermia (104°F), autonomic
instability, and altered mental status. Laboratory studies reveal elevated creatine kinase (CK). The
nurse practitioner recognizes this as:
,A. Acute dystonia
B. Akathisia
C. Neuroleptic malignant syndrome [CORRECT]
D. Tardive dyskinesia
Correct Answer: C
Rationale: Correct because neuroleptic malignant syndrome (NMS) is a life-threatening emergency
characterized by severe muscle rigidity, hyperthermia, autonomic instability, and altered mental
status with elevated CK. Treatment includes immediate discontinuation of the offending agent,
supportive care, and administration of dantrolene or bromocriptine.
Q4: A patient on risperidone presents with restlessness and an inability to sit still, pacing constantly.
The nurse practitioner recognizes this as:
A. Acute dystonia
B. Akathisia [CORRECT]
C. Parkinsonism
D. Tardive dyskinesia
Correct Answer: B
Rationale: Correct because akathisia is characterized by subjective feelings of restlessness and
objective signs of inability to sit still, often presenting as pacing. It is an extrapyramidal symptom
caused by dopamine blockade in the nigrostriatal pathway and is treated with benzodiazepines or
propranolol.
Q5: A patient on chlorpromazine develops an acute torticollis with neck twisting and oculogyric
crisis. The most appropriate immediate treatment is:
A. Propranolol
B. Benztropine [CORRECT]
C. Dantrolene
D. Bromocriptine
Correct Answer: B
Rationale: Correct because acute dystonia, including torticollis and oculogyric crisis, is an
extrapyramidal symptom caused by dopamine blockade in the nigrostriatal pathway.
Anticholinergics such as benztropine or diphenhydramine are the first-line treatment for acute
dystonia and parkinsonism.
Q6: A 35-year-old patient with treatment-resistant schizophrenia is started on clozapine. Which
monitoring requirement is mandatory?
A. Weekly liver function tests for six months
B. Weekly absolute neutrophil count (ANC) for the first six months [CORRECT]
C. Monthly ECG monitoring
D. Weekly serum creatinine levels
Correct Answer: B
Rationale: Correct because clozapine carries a black box warning for agranulocytosis, requiring
mandatory monitoring of absolute neutrophil count (ANC) weekly for the first six months, then
biweekly for the next six months, and monthly thereafter if counts remain stable.
, Q7: A patient with schizophrenia is prescribed olanzapine. The nurse practitioner should counsel the
patient about which significant adverse effect?
A. Acute dystonia
B. Metabolic syndrome [CORRECT]
C. Agranulocytosis
D. Severe hypotension
Correct Answer: B
Rationale: Correct because second-generation antipsychotics, particularly olanzapine and clozapine,
carry a significant risk of metabolic syndrome including weight gain, hyperglycemia, hyperlipidemia,
and diabetes. Olanzapine is associated with the highest metabolic risk among atypical
antipsychotics.
Q8: A patient with schizophrenia exhibits tangentiality and loose associations during the interview.
These symptoms are classified as:
A. Negative symptoms
B. Disorganized speech [CORRECT]
C. Cognitive symptoms
D. Catatonic behavior
Correct Answer: B
Rationale: Correct because tangentiality (going off on tangents) and loose associations (lack of
logical connection between ideas) are forms of disorganized speech, which is a positive symptom of
schizophrenia representing a disturbance in the form of thought.
Q9: A patient with schizophrenia has enlarged ventricles and reduced hippocampal volume on MRI.
These findings are consistent with:
A. Acute psychotic episode
B. Neuroanatomical changes associated with schizophrenia [CORRECT]
C. Normal age-related changes
D. Medication-induced structural changes
Correct Answer: B
Rationale: Correct because neuroanatomical findings in schizophrenia include enlarged ventricles,
reduced cortical volume, and reduced hippocampal volume. These structural abnormalities are
associated with the pathophysiology of schizophrenia and may contribute to cognitive and negative
symptoms.
Q10: A patient on a first-generation antipsychotic develops pill-rolling tremor, bradykinesia, and
rigidity. The nurse practitioner recognizes this as:
A. Akathisia
B. Parkinsonism [CORRECT]
C. Acute dystonia
D. Tardive dyskinesia
Correct Answer: B
Psychiatric-Mental Health Exam 3 Study Guide
South College Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
---
## SECTION 1: SCHIZOPHRENIA SPECTRUM & PSYCHOTIC DISORDERS (Questions 1-18)
---
Q1: A 22-year-old male patient is diagnosed with schizophrenia. He reports hearing voices
commenting on his actions and believes the FBI is monitoring him through his television. Which
symptom category best describes these findings?
A. Negative symptoms
B. Cognitive symptoms
C. Positive symptoms [CORRECT]
D. Affective symptoms
Correct Answer: C
Rationale: Correct because hallucinations and delusions are classified as positive symptoms of
schizophrenia, representing an excess or distortion of normal functions. This matches NSG 5544
Exam 3 content on the dopamine hypothesis, which suggests positive symptoms are due to
excessive dopamine activity in the mesolimbic pathway.
Q2: A patient with schizophrenia presents with flat affect, poverty of speech, and lack of motivation
to engage in daily activities. These symptoms are best classified as:
A. Positive symptoms
B. Negative symptoms [CORRECT]
C. Psychotic symptoms
D. Affective symptoms
Correct Answer: B
Rationale: Correct because affective flattening, alogia (poverty of speech), and avolition (lack of
motivation) are core negative symptoms of schizophrenia, representing a diminution or loss of
normal functions. The dopamine hypothesis suggests negative symptoms are associated with
dopamine deficiency in the prefrontal cortex.
Q3: A patient receiving haloperidol develops severe muscle rigidity, hyperthermia (104°F), autonomic
instability, and altered mental status. Laboratory studies reveal elevated creatine kinase (CK). The
nurse practitioner recognizes this as:
,A. Acute dystonia
B. Akathisia
C. Neuroleptic malignant syndrome [CORRECT]
D. Tardive dyskinesia
Correct Answer: C
Rationale: Correct because neuroleptic malignant syndrome (NMS) is a life-threatening emergency
characterized by severe muscle rigidity, hyperthermia, autonomic instability, and altered mental
status with elevated CK. Treatment includes immediate discontinuation of the offending agent,
supportive care, and administration of dantrolene or bromocriptine.
Q4: A patient on risperidone presents with restlessness and an inability to sit still, pacing constantly.
The nurse practitioner recognizes this as:
A. Acute dystonia
B. Akathisia [CORRECT]
C. Parkinsonism
D. Tardive dyskinesia
Correct Answer: B
Rationale: Correct because akathisia is characterized by subjective feelings of restlessness and
objective signs of inability to sit still, often presenting as pacing. It is an extrapyramidal symptom
caused by dopamine blockade in the nigrostriatal pathway and is treated with benzodiazepines or
propranolol.
Q5: A patient on chlorpromazine develops an acute torticollis with neck twisting and oculogyric
crisis. The most appropriate immediate treatment is:
A. Propranolol
B. Benztropine [CORRECT]
C. Dantrolene
D. Bromocriptine
Correct Answer: B
Rationale: Correct because acute dystonia, including torticollis and oculogyric crisis, is an
extrapyramidal symptom caused by dopamine blockade in the nigrostriatal pathway.
Anticholinergics such as benztropine or diphenhydramine are the first-line treatment for acute
dystonia and parkinsonism.
Q6: A 35-year-old patient with treatment-resistant schizophrenia is started on clozapine. Which
monitoring requirement is mandatory?
A. Weekly liver function tests for six months
B. Weekly absolute neutrophil count (ANC) for the first six months [CORRECT]
C. Monthly ECG monitoring
D. Weekly serum creatinine levels
Correct Answer: B
Rationale: Correct because clozapine carries a black box warning for agranulocytosis, requiring
mandatory monitoring of absolute neutrophil count (ANC) weekly for the first six months, then
biweekly for the next six months, and monthly thereafter if counts remain stable.
, Q7: A patient with schizophrenia is prescribed olanzapine. The nurse practitioner should counsel the
patient about which significant adverse effect?
A. Acute dystonia
B. Metabolic syndrome [CORRECT]
C. Agranulocytosis
D. Severe hypotension
Correct Answer: B
Rationale: Correct because second-generation antipsychotics, particularly olanzapine and clozapine,
carry a significant risk of metabolic syndrome including weight gain, hyperglycemia, hyperlipidemia,
and diabetes. Olanzapine is associated with the highest metabolic risk among atypical
antipsychotics.
Q8: A patient with schizophrenia exhibits tangentiality and loose associations during the interview.
These symptoms are classified as:
A. Negative symptoms
B. Disorganized speech [CORRECT]
C. Cognitive symptoms
D. Catatonic behavior
Correct Answer: B
Rationale: Correct because tangentiality (going off on tangents) and loose associations (lack of
logical connection between ideas) are forms of disorganized speech, which is a positive symptom of
schizophrenia representing a disturbance in the form of thought.
Q9: A patient with schizophrenia has enlarged ventricles and reduced hippocampal volume on MRI.
These findings are consistent with:
A. Acute psychotic episode
B. Neuroanatomical changes associated with schizophrenia [CORRECT]
C. Normal age-related changes
D. Medication-induced structural changes
Correct Answer: B
Rationale: Correct because neuroanatomical findings in schizophrenia include enlarged ventricles,
reduced cortical volume, and reduced hippocampal volume. These structural abnormalities are
associated with the pathophysiology of schizophrenia and may contribute to cognitive and negative
symptoms.
Q10: A patient on a first-generation antipsychotic develops pill-rolling tremor, bradykinesia, and
rigidity. The nurse practitioner recognizes this as:
A. Akathisia
B. Parkinsonism [CORRECT]
C. Acute dystonia
D. Tardive dyskinesia
Correct Answer: B
