Walden University NRNP 6665 Midterm Exam (pdf) | 2026/2027 |
PMHNP Q&A | Psychiatric Mental Health
**1. Biofeedback, deep breathing, mindfulness, and progressive muscle
relaxation are strategies typically used in which of the following therapies?**
A) Relaxation therapy
B) Social skills training
C) Motivational interviewing
D) Applied behavioral analysis
**Correct Answer: A**
**Rationale:** Relaxation therapy encompasses a range of techniques
including biofeedback, deep breathing, mindfulness, and progressive muscle
relaxation to reduce physiological arousal and promote calm. Social skills
training focuses on interpersonal interactions, motivational interviewing
addresses ambivalence about change, and applied behavioral analysis uses
reinforcement principles to modify behavior.
---
**2. According to the APA, which of the following are required to support a
child's DSM-5 diagnosis? (Select all that apply)**
A) The child's clinical presentation fulfills the specific symptom-based
diagnostic criteria
B) The child's symptoms are not caused by other diagnoses or stressors
C) The child's symptoms are impairing the child's functioning in at least two
settings
D) A and B only
,**Correct Answer: D**
**Rationale:** DSM-5 requires that the clinical presentation fulfills specific
diagnostic criteria and that symptoms are not better explained by other
diagnoses or stressors. While impairment in functioning is often present, the
DSM-5 does not universally require impairment in at least two settings for all
diagnoses.
---
**3. Which of the following is NOT consistent with good sleep hygiene?**
A) Allow child to keep a cell phone at bedside
B) Establish bedtime routines and maintain consistently
C) Limit use of electronics in the evening
D) Set and maintain a bedtime that allows for adequate sleep
**Correct Answer: A**
**Rationale:** Allowing a child to keep a cell phone at bedside is contrary to
good sleep hygiene, as screen exposure before bedtime can disrupt sleep
quality. Establishing consistent routines, limiting electronics in the evening,
and maintaining regular bedtimes are all recommended sleep hygiene
practices.
---
**4. Which of the following antipsychotic medications has the greatest
tendency to increase appetite and body weight?**
,A) Aripiprazole (Abilify)
B) Ziprasidone (Geodon)
C) Haloperidol (Haldol)
D) Risperidone (Risperdal)
**Correct Answer: D**
**Rationale:** Risperidone is associated with significant weight gain and
increased appetite. Olanzapine and clozapine have even greater metabolic
effects. Aripiprazole and ziprasidone have lower metabolic side effect
profiles, and haloperidol is a first-generation antipsychotic with less weight
gain.
---
**5. When assessing a child with disruptive or aggressive behavior, the
clinician asks "Have you been thinking about or planning to hurt anyone?" to
screen for which diagnostic category?**
A) Safety
B) Bullying
C) Conduct disorder
D) Oppositional defiant disorder
**Correct Answer: C**
**Rationale:** This question screens for safety concerns and aggressive
behavior consistent with conduct disorder. While safety is a broader concern,
, the specific focus on planning to hurt others is a key feature of conduct
disorder, which involves a persistent pattern of violating the rights of others
and societal norms.
---
**6. The clinician assessing substance abuse in an adolescent asks, "Did you
develop more mood or anxiety problems after you started using?" to screen
for which diagnostic possibility?**
A) Substance use disorder
B) Substance withdrawal
C) Substance tolerance
D) Substance-induced mental disorder
**Correct Answer: D**
**Rationale:** This question screens for substance-induced mental disorders,
where mood or anxiety symptoms are caused by substance use. Substance-
induced disorders are distinct from primary mental health conditions and
require different treatment approaches, often including abstinence from the
substance.
---
**7. When the patient lacks capacity to make a decision, the nurse has the
ethical responsibility to do which of the following?**
A) Become a surrogate decision maker for the patient
B) Consult a formally-designated surrogate for patient choices
PMHNP Q&A | Psychiatric Mental Health
**1. Biofeedback, deep breathing, mindfulness, and progressive muscle
relaxation are strategies typically used in which of the following therapies?**
A) Relaxation therapy
B) Social skills training
C) Motivational interviewing
D) Applied behavioral analysis
**Correct Answer: A**
**Rationale:** Relaxation therapy encompasses a range of techniques
including biofeedback, deep breathing, mindfulness, and progressive muscle
relaxation to reduce physiological arousal and promote calm. Social skills
training focuses on interpersonal interactions, motivational interviewing
addresses ambivalence about change, and applied behavioral analysis uses
reinforcement principles to modify behavior.
---
**2. According to the APA, which of the following are required to support a
child's DSM-5 diagnosis? (Select all that apply)**
A) The child's clinical presentation fulfills the specific symptom-based
diagnostic criteria
B) The child's symptoms are not caused by other diagnoses or stressors
C) The child's symptoms are impairing the child's functioning in at least two
settings
D) A and B only
,**Correct Answer: D**
**Rationale:** DSM-5 requires that the clinical presentation fulfills specific
diagnostic criteria and that symptoms are not better explained by other
diagnoses or stressors. While impairment in functioning is often present, the
DSM-5 does not universally require impairment in at least two settings for all
diagnoses.
---
**3. Which of the following is NOT consistent with good sleep hygiene?**
A) Allow child to keep a cell phone at bedside
B) Establish bedtime routines and maintain consistently
C) Limit use of electronics in the evening
D) Set and maintain a bedtime that allows for adequate sleep
**Correct Answer: A**
**Rationale:** Allowing a child to keep a cell phone at bedside is contrary to
good sleep hygiene, as screen exposure before bedtime can disrupt sleep
quality. Establishing consistent routines, limiting electronics in the evening,
and maintaining regular bedtimes are all recommended sleep hygiene
practices.
---
**4. Which of the following antipsychotic medications has the greatest
tendency to increase appetite and body weight?**
,A) Aripiprazole (Abilify)
B) Ziprasidone (Geodon)
C) Haloperidol (Haldol)
D) Risperidone (Risperdal)
**Correct Answer: D**
**Rationale:** Risperidone is associated with significant weight gain and
increased appetite. Olanzapine and clozapine have even greater metabolic
effects. Aripiprazole and ziprasidone have lower metabolic side effect
profiles, and haloperidol is a first-generation antipsychotic with less weight
gain.
---
**5. When assessing a child with disruptive or aggressive behavior, the
clinician asks "Have you been thinking about or planning to hurt anyone?" to
screen for which diagnostic category?**
A) Safety
B) Bullying
C) Conduct disorder
D) Oppositional defiant disorder
**Correct Answer: C**
**Rationale:** This question screens for safety concerns and aggressive
behavior consistent with conduct disorder. While safety is a broader concern,
, the specific focus on planning to hurt others is a key feature of conduct
disorder, which involves a persistent pattern of violating the rights of others
and societal norms.
---
**6. The clinician assessing substance abuse in an adolescent asks, "Did you
develop more mood or anxiety problems after you started using?" to screen
for which diagnostic possibility?**
A) Substance use disorder
B) Substance withdrawal
C) Substance tolerance
D) Substance-induced mental disorder
**Correct Answer: D**
**Rationale:** This question screens for substance-induced mental disorders,
where mood or anxiety symptoms are caused by substance use. Substance-
induced disorders are distinct from primary mental health conditions and
require different treatment approaches, often including abstinence from the
substance.
---
**7. When the patient lacks capacity to make a decision, the nurse has the
ethical responsibility to do which of the following?**
A) Become a surrogate decision maker for the patient
B) Consult a formally-designated surrogate for patient choices
