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NR607 FINAL EXAM STUDY GUIDE
QUESTIONS WITH SOLUTIONS &
RATIONALES 2026/2027
A 16-year-old boy is consistently on the honor roll at school. Neither his school
nor his community offers extracurricular activities, but he plans to apply to
prestigious colleges when he graduates from high school. His parents believe that
he should get a job immediately after graduation as they cannot help him
financially, and they believe college is a "waste of time." In which category does
the boy have the most protective factors against perpetrating violence?
A. society
B. individual
C. family
D. community - correct-answer - B. individual
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Rationale: The strongest protective factors described are individual factors: strong
academic achievement, future orientation, and a clear goal of attending college.
The family is not providing educational encouragement or financial support, and
the school/community lack extracurricular opportunities, so the boy's personal
strengths are the most prominent protective category.
A client presents with hand tremor and confusion. The client reports having a
"stomach bug" last week with vomiting and diarrhea. She states she takes a
"psych" medication but cannot remember what it is called. Which medication
should the PMHNP suspect as a cause of the client's symptoms?
A. lithium
B. clozapine
C. bupropion
D. aripiprazole - correct-answer - A. lithium
Rationale: Lithium is cleared by the kidneys, and dehydration or sodium loss from
vomiting and diarrhea can raise serum lithium concentrations. Tremor and
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confusion are classic neurologic signs of lithium toxicity, making lithium the
medication that should be suspected first.
Which is a common factor found in those who perpetrate child sexual abuse?
A. high IQ
B. high IQ
C. exposure to sexually explicit behavior at an early age
D. low economic status - correct-answer - C. exposure to sexually explicit behavior
at an early age
Rationale: Early exposure to sexualized behavior or sexual victimization is
recognized as one potential developmental risk factor among some people who
later perpetrate child sexual abuse. It is not deterministic, but it is more relevant
to the question than intelligence level or low economic status, neither of which is
a defining common factor.
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A client presents to the emergency department with sudden vision loss. The
attending physician finds no immediate medical cause. Which finding best
supports a diagnosis of functional neurological symptom disorder?
A. The client does not appear distressed by the vision changes
B. The client has a history of borderline personality disorder
C. The client is able to touch his fingers to his nose
D. The client has been drinking alcohol - correct-answer - A. The client does not
appear distressed by the vision changes.
Rationale: The answer reflects the classic exam concept of la belle indifference, in
which a person with a functional neurologic symptom may appear unexpectedly
unconcerned about a dramatic deficit. Clinically, lack of distress is neither
required nor diagnostic by itself; functional neurologic symptom disorder is
established by positive findings showing incompatibility with recognized
neurologic disease rather than simply by a normal workup.
NR607 FINAL EXAM STUDY GUIDE
QUESTIONS WITH SOLUTIONS &
RATIONALES 2026/2027
A 16-year-old boy is consistently on the honor roll at school. Neither his school
nor his community offers extracurricular activities, but he plans to apply to
prestigious colleges when he graduates from high school. His parents believe that
he should get a job immediately after graduation as they cannot help him
financially, and they believe college is a "waste of time." In which category does
the boy have the most protective factors against perpetrating violence?
A. society
B. individual
C. family
D. community - correct-answer - B. individual
, 2
Rationale: The strongest protective factors described are individual factors: strong
academic achievement, future orientation, and a clear goal of attending college.
The family is not providing educational encouragement or financial support, and
the school/community lack extracurricular opportunities, so the boy's personal
strengths are the most prominent protective category.
A client presents with hand tremor and confusion. The client reports having a
"stomach bug" last week with vomiting and diarrhea. She states she takes a
"psych" medication but cannot remember what it is called. Which medication
should the PMHNP suspect as a cause of the client's symptoms?
A. lithium
B. clozapine
C. bupropion
D. aripiprazole - correct-answer - A. lithium
Rationale: Lithium is cleared by the kidneys, and dehydration or sodium loss from
vomiting and diarrhea can raise serum lithium concentrations. Tremor and
, 3
confusion are classic neurologic signs of lithium toxicity, making lithium the
medication that should be suspected first.
Which is a common factor found in those who perpetrate child sexual abuse?
A. high IQ
B. high IQ
C. exposure to sexually explicit behavior at an early age
D. low economic status - correct-answer - C. exposure to sexually explicit behavior
at an early age
Rationale: Early exposure to sexualized behavior or sexual victimization is
recognized as one potential developmental risk factor among some people who
later perpetrate child sexual abuse. It is not deterministic, but it is more relevant
to the question than intelligence level or low economic status, neither of which is
a defining common factor.
, 4
A client presents to the emergency department with sudden vision loss. The
attending physician finds no immediate medical cause. Which finding best
supports a diagnosis of functional neurological symptom disorder?
A. The client does not appear distressed by the vision changes
B. The client has a history of borderline personality disorder
C. The client is able to touch his fingers to his nose
D. The client has been drinking alcohol - correct-answer - A. The client does not
appear distressed by the vision changes.
Rationale: The answer reflects the classic exam concept of la belle indifference, in
which a person with a functional neurologic symptom may appear unexpectedly
unconcerned about a dramatic deficit. Clinically, lack of distress is neither
required nor diagnostic by itself; functional neurologic symptom disorder is
established by positive findings showing incompatibility with recognized
neurologic disease rather than simply by a normal workup.
