NU673 Midterm PMHNP – 200 Most
Tested Questions & 100% Correct
Answers | Latest Update 2026/2027 |
Nursing Exam Prep
1. A patient is started on fluoxetine (Prozac) for major depressive disorder.
The PMHNP understands that the therapeutic effect of SSRIs is primarily due
to:
A) Blocking dopamine D2 receptors
B) Inhibiting the reuptake of serotonin at the presynaptic neuron
C) Blocking acetylcholinesterase
D) Enhancing GABA activity
Answer B: Inhibiting the reuptake of serotonin at the presynaptic neuron
Rationale: SSRIs block serotonin reuptake, increasing synaptic serotonin.
Dopamine blockade describes antipsychotics; acetylcholinesterase inhibition
describes Alzheimer's medications.
2. A patient taking risperidone develops involuntary, repetitive movements
of the face and tongue, including lip-smacking and tongue protrusion. The
PMHNP recognizes this as:
A) Acute dystonia
,B) Akathisia
C) Tardive dyskinesia
D) Neuroleptic malignant syndrome
Answer C: Tardive dyskinesia
Rationale: Tardive dyskinesia is characterized by involuntary orofacial movements
associated with long-term antipsychotic use. Acute dystonia involves sustained
muscle contractions; akathisia is subjective restlessness; NMS includes rigidity and
fever .
3. A patient with bipolar I disorder is started on lithium. Which instruction
should the PMHNP include in patient education?
A) "Take lithium on an empty stomach for best absorption."
B) "Maintain consistent fluid and salt intake to prevent toxicity."
C) "If you miss a dose, double the next dose to maintain therapeutic levels."
D) "You can stop taking lithium once your mood stabilizes."
Answer B: "Maintain consistent fluid and salt intake to prevent toxicity."
Rationale: Lithium levels are affected by hydration and sodium balance;
dehydration or sodium depletion can increase lithium levels, leading to toxicity .
4. A patient taking valproic acid (Depakote) for bipolar disorder requires
routine monitoring. Which laboratory test is MOST important to monitor?
A) Liver function tests
B) Renal function tests
,C) Thyroid function tests
D) Complete blood count
Answer A: Liver function tests
Rationale: Valproic acid can cause hepatotoxicity, so liver function tests must be
monitored. Renal function is monitored with lithium; thyroid with lithium .
5. A patient with generalized anxiety disorder has not responded to SSRIs.
Which medication has a different mechanism of action and is FDA-approved
for GAD?
A) Buspirone
B) Diphenhydramine
C) Propranolol
D) Trazodone
Answer A: Buspirone
Rationale: Buspirone is a 5-HT1A partial agonist FDA-approved for GAD with a
different mechanism than SSRIs. Propranolol is for performance anxiety; trazodone
is for depression or sleep .
6. A patient is prescribed phenelzine (Nardil), an MAOI. The PMHNP instructs
the patient to avoid foods high in tyramine to prevent which emergency?
A) Serotonin syndrome
B) Hypertensive crisis
C) Neuroleptic malignant syndrome
, D) Agranulocytosis
Answer B: Hypertensive crisis
Rationale: MAOIs inhibit tyramine breakdown; ingestion of tyramine-rich foods
can cause excessive catecholamine release, leading to hypertensive crisis .
7. A DSM-5 diagnosis of schizophrenia requires the presence of two or more
active-phase symptoms during a one-month period, with at least one
symptom being:
A) Delusions or hallucinations
B) Negative symptoms only
C) Disorganized behavior only
D) Any combination of symptoms
Answer A: Delusions or hallucinations
Rationale: At least one symptom must be delusions, hallucinations, or
disorganized speech, plus continuous signs of disturbance for at least six months .
8. Which of the following would be considered positive symptoms of
schizophrenia?
A) Delusions and hallucinations
B) Apathy and social withdrawal
C) Lack of motivation
D) Flat affect
Answer A: Delusions and hallucinations
Tested Questions & 100% Correct
Answers | Latest Update 2026/2027 |
Nursing Exam Prep
1. A patient is started on fluoxetine (Prozac) for major depressive disorder.
The PMHNP understands that the therapeutic effect of SSRIs is primarily due
to:
A) Blocking dopamine D2 receptors
B) Inhibiting the reuptake of serotonin at the presynaptic neuron
C) Blocking acetylcholinesterase
D) Enhancing GABA activity
Answer B: Inhibiting the reuptake of serotonin at the presynaptic neuron
Rationale: SSRIs block serotonin reuptake, increasing synaptic serotonin.
Dopamine blockade describes antipsychotics; acetylcholinesterase inhibition
describes Alzheimer's medications.
2. A patient taking risperidone develops involuntary, repetitive movements
of the face and tongue, including lip-smacking and tongue protrusion. The
PMHNP recognizes this as:
A) Acute dystonia
,B) Akathisia
C) Tardive dyskinesia
D) Neuroleptic malignant syndrome
Answer C: Tardive dyskinesia
Rationale: Tardive dyskinesia is characterized by involuntary orofacial movements
associated with long-term antipsychotic use. Acute dystonia involves sustained
muscle contractions; akathisia is subjective restlessness; NMS includes rigidity and
fever .
3. A patient with bipolar I disorder is started on lithium. Which instruction
should the PMHNP include in patient education?
A) "Take lithium on an empty stomach for best absorption."
B) "Maintain consistent fluid and salt intake to prevent toxicity."
C) "If you miss a dose, double the next dose to maintain therapeutic levels."
D) "You can stop taking lithium once your mood stabilizes."
Answer B: "Maintain consistent fluid and salt intake to prevent toxicity."
Rationale: Lithium levels are affected by hydration and sodium balance;
dehydration or sodium depletion can increase lithium levels, leading to toxicity .
4. A patient taking valproic acid (Depakote) for bipolar disorder requires
routine monitoring. Which laboratory test is MOST important to monitor?
A) Liver function tests
B) Renal function tests
,C) Thyroid function tests
D) Complete blood count
Answer A: Liver function tests
Rationale: Valproic acid can cause hepatotoxicity, so liver function tests must be
monitored. Renal function is monitored with lithium; thyroid with lithium .
5. A patient with generalized anxiety disorder has not responded to SSRIs.
Which medication has a different mechanism of action and is FDA-approved
for GAD?
A) Buspirone
B) Diphenhydramine
C) Propranolol
D) Trazodone
Answer A: Buspirone
Rationale: Buspirone is a 5-HT1A partial agonist FDA-approved for GAD with a
different mechanism than SSRIs. Propranolol is for performance anxiety; trazodone
is for depression or sleep .
6. A patient is prescribed phenelzine (Nardil), an MAOI. The PMHNP instructs
the patient to avoid foods high in tyramine to prevent which emergency?
A) Serotonin syndrome
B) Hypertensive crisis
C) Neuroleptic malignant syndrome
, D) Agranulocytosis
Answer B: Hypertensive crisis
Rationale: MAOIs inhibit tyramine breakdown; ingestion of tyramine-rich foods
can cause excessive catecholamine release, leading to hypertensive crisis .
7. A DSM-5 diagnosis of schizophrenia requires the presence of two or more
active-phase symptoms during a one-month period, with at least one
symptom being:
A) Delusions or hallucinations
B) Negative symptoms only
C) Disorganized behavior only
D) Any combination of symptoms
Answer A: Delusions or hallucinations
Rationale: At least one symptom must be delusions, hallucinations, or
disorganized speech, plus continuous signs of disturbance for at least six months .
8. Which of the following would be considered positive symptoms of
schizophrenia?
A) Delusions and hallucinations
B) Apathy and social withdrawal
C) Lack of motivation
D) Flat affect
Answer A: Delusions and hallucinations
