NRNP 6635 - MIDTERM EXAM
(WALDEN UNIVERSITY)
QUESTIONS AND VERIFIED
LATEST MOCK PRACTICE SET
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NRNP 6635 - MIDTERM EXAM (WALDEN UNIVERSITY) QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES JUST RELEASED .PDF. It contains 190 carefully selected questions that reflect the most current
exam content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale
that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NRNP 6635 Walden University AND WITH Rationales JUST Released PDF
Psychiatric Mental Health Nurse Practitioner Pmhnp Differential Diagnosis & Clinical Reasoning Graduate
All answers with rationales
,Table of Contents
Section A - Disorder Section B - Appropriate
Questions 1 to 48 Questions 49 to 96
Section C - Medication Section D - Schizophrenia
Questions 97 to 144 Questions 145 to 190
,Section A - Disorder
Q1.
A patient with a history of bipolar I disorder presents with acute mania. They are currently
taking valproic acid and lamotrigine. The patient has abnormal liver enzymes and a BMI of
31. Which medication adjustment is most appropriate?
A. Increase lamotrigine to target acute B. Add aripiprazole while tapering valproic
mania acid
C. Switch valproic acid to carbamazepine D. Add lithium carbonate
Correct: B - Add aripiprazole while tapering valproic acid
Rationale:Aripiprazole is approved for acute mania and has a lower metabolic/liver burden
than valproic acid, which is hepatotoxic and associated with weight gain. Lamotrigine is
ineffective for acute mania. Carbamazepine also carries hepatic and metabolic risks. Lithium
is renally cleared but can be used if renal function is normal; however, switching to an
antipsychotic is preferred given the existing metabolic issues.
Q2.
Which electroencephalographic (EEG) finding is most consistent with delirium rather than
dementia?
A. Generalized slowing with triphasic waves B. Focal epileptiform discharges
C. Normal alpha rhythm D. Frontal intermittent rhythmic delta activity
(FIRDA)
Correct: A - Generalized slowing with triphasic waves
Rationale:Delirium typically shows diffuse slowing, often with triphasic waves, reflecting a
global encephalopathy. Dementia usually has normal or mildly slowed background without
triphasic waves. Focal discharges suggest seizure disorders; FIRDA is nonspecific but seen
in toxic-metabolic states, not pathognomonic. A normal alpha rhythm is typical of normal
aging or mild dementia, not delirium.
Q3.
A patient with schizophrenia has persistent negative symptoms despite adequate trials of
two antipsychotics. Which approach aligns with current evidence-based practice?
A. Add a second-generation antipsychotic to B. Switch to clozapine after confirming
the current regimen treatment resistance
C. Prescribe a monoamine oxidase inhibitor D. Augment with a benzodiazepine
(MAOI)
Page 3
, Section A - Disorder
Correct: B - Switch to clozapine after confirming treatment resistance
Rationale:Clozapine is the gold standard for treatment-resistant schizophrenia, including
persistent negative symptoms, after two adequate trials. Combining antipsychotics lacks
robust evidence. MAOIs are not indicated for schizophrenia. Benzodiazepines are not
effective for negative symptoms and have abuse potential.
Q4.
Which laboratory finding is most consistent with serotonin syndrome rather than
neuroleptic malignant syndrome (NMS)?
A. Leukocytosis B. Elevated creatine kinase
C. Metabolic acidosis D. Low serum iron
Correct: C - Metabolic acidosis
Rationale:Serotonin syndrome often presents with metabolic acidosis due to hyperthermia
and muscle activity, while NMS typically shows elevated CK, leukocytosis, and low iron.
Metabolic acidosis is more specific to serotonin syndrome, though both can have similar
features. Elevated CK and leukocytosis are more classic for NMS.
Q5.
Which assessment tool is most appropriate for evaluating a patient's capacity to make a
specific medical decision?
A. MacArthur Competence Assessment Tool B. Montreal Cognitive Assessment (MoCA)
for Treatment (MacCAT-T)
C. Beck Depression Inventory (BDI) D. Brief Psychiatric Rating Scale (BPRS)
Correct: A - MacArthur Competence Assessment Tool for Treatment (MacCAT-T)
Rationale:MacCAT-T is specifically designed to assess decision-making capacity across four
domains: understanding, appreciation, reasoning, and expressing a choice. MoCA screens for
cognitive impairment but does not directly measure capacity. BDI and BPRS assess mood
and psychopathology, not capacity.
Q6.
A patient with major depressive disorder has failed two adequate SSRI trials. According to
the STAR*D trial, which strategy is most appropriate next?
A. Switch to a different class such as B. Augment with lithium
venlafaxine or mirtazapine
C. Augment with thyroid hormone (T3) D. Refer for electroconvulsive therapy (ECT)
Page 4
(WALDEN UNIVERSITY)
QUESTIONS AND VERIFIED
LATEST MOCK PRACTICE SET
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NRNP 6635 - MIDTERM EXAM (WALDEN UNIVERSITY) QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES JUST RELEASED .PDF. It contains 190 carefully selected questions that reflect the most current
exam content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale
that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NRNP 6635 Walden University AND WITH Rationales JUST Released PDF
Psychiatric Mental Health Nurse Practitioner Pmhnp Differential Diagnosis & Clinical Reasoning Graduate
All answers with rationales
,Table of Contents
Section A - Disorder Section B - Appropriate
Questions 1 to 48 Questions 49 to 96
Section C - Medication Section D - Schizophrenia
Questions 97 to 144 Questions 145 to 190
,Section A - Disorder
Q1.
A patient with a history of bipolar I disorder presents with acute mania. They are currently
taking valproic acid and lamotrigine. The patient has abnormal liver enzymes and a BMI of
31. Which medication adjustment is most appropriate?
A. Increase lamotrigine to target acute B. Add aripiprazole while tapering valproic
mania acid
C. Switch valproic acid to carbamazepine D. Add lithium carbonate
Correct: B - Add aripiprazole while tapering valproic acid
Rationale:Aripiprazole is approved for acute mania and has a lower metabolic/liver burden
than valproic acid, which is hepatotoxic and associated with weight gain. Lamotrigine is
ineffective for acute mania. Carbamazepine also carries hepatic and metabolic risks. Lithium
is renally cleared but can be used if renal function is normal; however, switching to an
antipsychotic is preferred given the existing metabolic issues.
Q2.
Which electroencephalographic (EEG) finding is most consistent with delirium rather than
dementia?
A. Generalized slowing with triphasic waves B. Focal epileptiform discharges
C. Normal alpha rhythm D. Frontal intermittent rhythmic delta activity
(FIRDA)
Correct: A - Generalized slowing with triphasic waves
Rationale:Delirium typically shows diffuse slowing, often with triphasic waves, reflecting a
global encephalopathy. Dementia usually has normal or mildly slowed background without
triphasic waves. Focal discharges suggest seizure disorders; FIRDA is nonspecific but seen
in toxic-metabolic states, not pathognomonic. A normal alpha rhythm is typical of normal
aging or mild dementia, not delirium.
Q3.
A patient with schizophrenia has persistent negative symptoms despite adequate trials of
two antipsychotics. Which approach aligns with current evidence-based practice?
A. Add a second-generation antipsychotic to B. Switch to clozapine after confirming
the current regimen treatment resistance
C. Prescribe a monoamine oxidase inhibitor D. Augment with a benzodiazepine
(MAOI)
Page 3
, Section A - Disorder
Correct: B - Switch to clozapine after confirming treatment resistance
Rationale:Clozapine is the gold standard for treatment-resistant schizophrenia, including
persistent negative symptoms, after two adequate trials. Combining antipsychotics lacks
robust evidence. MAOIs are not indicated for schizophrenia. Benzodiazepines are not
effective for negative symptoms and have abuse potential.
Q4.
Which laboratory finding is most consistent with serotonin syndrome rather than
neuroleptic malignant syndrome (NMS)?
A. Leukocytosis B. Elevated creatine kinase
C. Metabolic acidosis D. Low serum iron
Correct: C - Metabolic acidosis
Rationale:Serotonin syndrome often presents with metabolic acidosis due to hyperthermia
and muscle activity, while NMS typically shows elevated CK, leukocytosis, and low iron.
Metabolic acidosis is more specific to serotonin syndrome, though both can have similar
features. Elevated CK and leukocytosis are more classic for NMS.
Q5.
Which assessment tool is most appropriate for evaluating a patient's capacity to make a
specific medical decision?
A. MacArthur Competence Assessment Tool B. Montreal Cognitive Assessment (MoCA)
for Treatment (MacCAT-T)
C. Beck Depression Inventory (BDI) D. Brief Psychiatric Rating Scale (BPRS)
Correct: A - MacArthur Competence Assessment Tool for Treatment (MacCAT-T)
Rationale:MacCAT-T is specifically designed to assess decision-making capacity across four
domains: understanding, appreciation, reasoning, and expressing a choice. MoCA screens for
cognitive impairment but does not directly measure capacity. BDI and BPRS assess mood
and psychopathology, not capacity.
Q6.
A patient with major depressive disorder has failed two adequate SSRI trials. According to
the STAR*D trial, which strategy is most appropriate next?
A. Switch to a different class such as B. Augment with lithium
venlafaxine or mirtazapine
C. Augment with thyroid hormone (T3) D. Refer for electroconvulsive therapy (ECT)
Page 4
