NRS546 Week 4 Midterm Examination
Comprehensive PMHNP Study Guide — 75 Questions with Rationales
Question 1 of 75
The psychiatric mental health nurse practitioner (PMHNP) is performing a mental
status exam and the client has difficulty copying a drawing. This deficit is with which
part of the brain?
A. Temporal lobe
B. Occipital lobe
C. Hypothalamus
D. Corpus callosum
Correct Answer: B. Occipital lobe
Rationale: The occipital lobe is primarily responsible for visual processing and visuospatial construction.
Difficulty copying a drawing (constructional apraxia) on the mental status exam reflects impaired
visuospatial processing. While the parietal lobe also contributes to spatial construction, among the given
options, the occipital lobe is the primary center for visual processing required to interpret and reproduce
visual stimuli. The temporal lobe governs auditory processing and memory; the hypothalamus regulates
Page 1 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
,autonomic and endocrine functions; and the corpus callosum facilitates interhemispheric communication.
Page 2 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
,Question 2 of 75
Which of the following medications is FDA approved for post-traumatic stress
disorder?
A. Bupropion
B. Lithium
C. Paroxetine
D. Lorazepam
Correct Answer: C. Paroxetine
Rationale: The U.S. Food and Drug Administration (FDA) has approved only two selective serotonin
reuptake inhibitors (SSRIs) for the treatment of PTSD: paroxetine and sertraline. Paroxetine is an SSRI
that modulates serotonin neurotransmission to reduce intrusive thoughts, hyperarousal, and avoidance
symptoms characteristic of PTSD. Bupropion is an NDRI indicated for depression and smoking cessation;
lithium is a mood stabilizer for bipolar disorder; and lorazepam is a benzodiazepine anxiolytic that is not
FDA-approved for PTSD and may actually interfere with fear extinction.
Page 3 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
, Question 3 of 75
Breastfeeding people should avoid which of the following benzodiazepines?
A. Alprazolam
B. Clonazepam
C. Diazepam
D. Citalopram
Correct Answer: C. Diazepam
Rationale: Diazepam has a long half-life (approximately 43 hours) and active metabolites (e.g.,
nordiazepam) that accumulate in breastfed infants with repeated maternal dosing, posing risks of sedation,
poor feeding, and weight loss. Short-acting benzodiazepines such as lorazepam are preferred during
lactation. Alprazolam and clonazepam require caution but are not contraindicated to the same degree as
diazepam. Citalopram is not a benzodiazepine; it is an SSRI antidepressant and is generally considered
compatible with breastfeeding.
Page 4 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
Comprehensive PMHNP Study Guide — 75 Questions with Rationales
Question 1 of 75
The psychiatric mental health nurse practitioner (PMHNP) is performing a mental
status exam and the client has difficulty copying a drawing. This deficit is with which
part of the brain?
A. Temporal lobe
B. Occipital lobe
C. Hypothalamus
D. Corpus callosum
Correct Answer: B. Occipital lobe
Rationale: The occipital lobe is primarily responsible for visual processing and visuospatial construction.
Difficulty copying a drawing (constructional apraxia) on the mental status exam reflects impaired
visuospatial processing. While the parietal lobe also contributes to spatial construction, among the given
options, the occipital lobe is the primary center for visual processing required to interpret and reproduce
visual stimuli. The temporal lobe governs auditory processing and memory; the hypothalamus regulates
Page 1 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
,autonomic and endocrine functions; and the corpus callosum facilitates interhemispheric communication.
Page 2 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
,Question 2 of 75
Which of the following medications is FDA approved for post-traumatic stress
disorder?
A. Bupropion
B. Lithium
C. Paroxetine
D. Lorazepam
Correct Answer: C. Paroxetine
Rationale: The U.S. Food and Drug Administration (FDA) has approved only two selective serotonin
reuptake inhibitors (SSRIs) for the treatment of PTSD: paroxetine and sertraline. Paroxetine is an SSRI
that modulates serotonin neurotransmission to reduce intrusive thoughts, hyperarousal, and avoidance
symptoms characteristic of PTSD. Bupropion is an NDRI indicated for depression and smoking cessation;
lithium is a mood stabilizer for bipolar disorder; and lorazepam is a benzodiazepine anxiolytic that is not
FDA-approved for PTSD and may actually interfere with fear extinction.
Page 3 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
, Question 3 of 75
Breastfeeding people should avoid which of the following benzodiazepines?
A. Alprazolam
B. Clonazepam
C. Diazepam
D. Citalopram
Correct Answer: C. Diazepam
Rationale: Diazepam has a long half-life (approximately 43 hours) and active metabolites (e.g.,
nordiazepam) that accumulate in breastfed infants with repeated maternal dosing, posing risks of sedation,
poor feeding, and weight loss. Short-acting benzodiazepines such as lorazepam are preferred during
lactation. Alprazolam and clonazepam require caution but are not contraindicated to the same degree as
diazepam. Citalopram is not a benzodiazepine; it is an SSRI antidepressant and is generally considered
compatible with breastfeeding.
Page 4 of 75
NRS546 PMHNP Midterm Exam Study Guide | Confidential Study Material
