PMHNP BOARD
PASS.
CHAMBERLAIN UNIVERSITY · COLLEGE OF NURSING
NR 668 CEA Final — Part 2
Practice Question Bank
Psychopharmacology, Neuroscience & Psychiatric Disorders
COMPREHENSIVE REVIEW:
Medication Management, Neuroanatomy & Psychotherapy
— DSM-5 Diagnoses & Clinical Decision-Making
CEA Final Part 2 — Edition 1 · July 2026
EXAM FOCUSED DETAILED 90+ QUESTIONS BUILD CONFIDENCE
RATIONALES
Aligned with NR 668 CEA Complete psychopharm & Pass your NR 668 CEA Final
objectives Clear explanations for mastery neuro coverage
P r e pa r e · P r a c t i c e · Pa s s
Excellence in PMHNP Certification
,NR 668 CEA FINAL — PART 2 QUESTIONS 1–30
Section 1: Substance Use, Psychotherapy & Mental Status Exam
1 A 26-year-old female with 6-year opioid use disorder on buprenorphine
for 4 months is in early remission. She questions continuing
buprenorphine. What is the best course of action?
A Educate the patient on the benefit of continuing buprenorphine for 1-2
more years
B Discontinue buprenorphine and follow serial urine drug screens
C Explore changing from buprenorphine to methadone
D Taper buprenorphine over 2 months as the patient requests
CORRECT ANSWER: A
RATIONALE: Early remission does not mean cure — buprenorphine
maintenance for 1-2 more years reduces relapse risk and supports sustained
recovery. Premature discontinuation significantly increases relapse
potential. The patient's functional improvement is evidence the medication
is working, not that it is no longer needed.
,2 A 30-year-old man with schizoaffective disorder received court-ordered
Zyprexa Relprevv. He states he knows smoking can "make him need more
medication." Which stage of change is he in?
A Contemplation — aware of the problem and considering change
B Action — actively making changes
C Preparation — planning to take action soon
D Maintenance — sustaining changes over time
CORRECT ANSWER: A
RATIONALE: Contemplation involves recognizing a problem and
considering the possibility of change without yet committing to action. The
patient acknowledges smoking affects his medication needs but has not yet
taken steps to quit — this is classic contemplation.
3 A 16-year-old client Jamie states "I might be transgender" and prefers
pronouns "They." The PMHNP recognizes Jamie:
A Identifies as non-binary — not identifying exclusively with male or female
gender
B Identifies as cisgender
C Identifies as gender binary
D Identifies as none of these
CORRECT ANSWER: A
RATIONALE: Non-binary individuals do not identify exclusively as male or
female. They/them pronouns are commonly used by non-binary persons.
Cisgender means identifying with the sex assigned at birth. Gender binary
refers to the traditional male/female dichotomy.
, 4 Which immediate determinant related to relapse prevention is the
biggest predictor of relapse?
A Negative emotional state
B Ineffective coping skills
C Previous history of lapse
D Outcome expectancy
CORRECT ANSWER: A
RATIONALE: Negative emotional states (stress, anger, depression, anxiety)
are the strongest immediate predictors of relapse across substance use
disorders. While ineffective coping and previous lapses contribute, the
acute experience of negative affect most directly triggers return to use.
5 The mental status exam includes all of the following EXCEPT:
A Cranial nerves and reflexes — these are part of the neurological exam, not
the MSE
B Mood and affect
C Appearance and behavior
D Insight and judgment
CORRECT ANSWER: A
RATIONALE: The MSE assesses current mental functioning: appearance,
behavior, mood, affect, speech, thought process, thought content,
perception, cognition, insight, and judgment. Cranial nerves and reflexes
belong to the neurological examination, which is a separate assessment.
PASS.
CHAMBERLAIN UNIVERSITY · COLLEGE OF NURSING
NR 668 CEA Final — Part 2
Practice Question Bank
Psychopharmacology, Neuroscience & Psychiatric Disorders
COMPREHENSIVE REVIEW:
Medication Management, Neuroanatomy & Psychotherapy
— DSM-5 Diagnoses & Clinical Decision-Making
CEA Final Part 2 — Edition 1 · July 2026
EXAM FOCUSED DETAILED 90+ QUESTIONS BUILD CONFIDENCE
RATIONALES
Aligned with NR 668 CEA Complete psychopharm & Pass your NR 668 CEA Final
objectives Clear explanations for mastery neuro coverage
P r e pa r e · P r a c t i c e · Pa s s
Excellence in PMHNP Certification
,NR 668 CEA FINAL — PART 2 QUESTIONS 1–30
Section 1: Substance Use, Psychotherapy & Mental Status Exam
1 A 26-year-old female with 6-year opioid use disorder on buprenorphine
for 4 months is in early remission. She questions continuing
buprenorphine. What is the best course of action?
A Educate the patient on the benefit of continuing buprenorphine for 1-2
more years
B Discontinue buprenorphine and follow serial urine drug screens
C Explore changing from buprenorphine to methadone
D Taper buprenorphine over 2 months as the patient requests
CORRECT ANSWER: A
RATIONALE: Early remission does not mean cure — buprenorphine
maintenance for 1-2 more years reduces relapse risk and supports sustained
recovery. Premature discontinuation significantly increases relapse
potential. The patient's functional improvement is evidence the medication
is working, not that it is no longer needed.
,2 A 30-year-old man with schizoaffective disorder received court-ordered
Zyprexa Relprevv. He states he knows smoking can "make him need more
medication." Which stage of change is he in?
A Contemplation — aware of the problem and considering change
B Action — actively making changes
C Preparation — planning to take action soon
D Maintenance — sustaining changes over time
CORRECT ANSWER: A
RATIONALE: Contemplation involves recognizing a problem and
considering the possibility of change without yet committing to action. The
patient acknowledges smoking affects his medication needs but has not yet
taken steps to quit — this is classic contemplation.
3 A 16-year-old client Jamie states "I might be transgender" and prefers
pronouns "They." The PMHNP recognizes Jamie:
A Identifies as non-binary — not identifying exclusively with male or female
gender
B Identifies as cisgender
C Identifies as gender binary
D Identifies as none of these
CORRECT ANSWER: A
RATIONALE: Non-binary individuals do not identify exclusively as male or
female. They/them pronouns are commonly used by non-binary persons.
Cisgender means identifying with the sex assigned at birth. Gender binary
refers to the traditional male/female dichotomy.
, 4 Which immediate determinant related to relapse prevention is the
biggest predictor of relapse?
A Negative emotional state
B Ineffective coping skills
C Previous history of lapse
D Outcome expectancy
CORRECT ANSWER: A
RATIONALE: Negative emotional states (stress, anger, depression, anxiety)
are the strongest immediate predictors of relapse across substance use
disorders. While ineffective coping and previous lapses contribute, the
acute experience of negative affect most directly triggers return to use.
5 The mental status exam includes all of the following EXCEPT:
A Cranial nerves and reflexes — these are part of the neurological exam, not
the MSE
B Mood and affect
C Appearance and behavior
D Insight and judgment
CORRECT ANSWER: A
RATIONALE: The MSE assesses current mental functioning: appearance,
behavior, mood, affect, speech, thought process, thought content,
perception, cognition, insight, and judgment. Cranial nerves and reflexes
belong to the neurological examination, which is a separate assessment.
