WILKES NSG 526 EXAM 2 FINAL QUESTIONS AND ANSWERS ALREADY GRADED A+| 100% VERIFIED
SOLUTIONS
Core Domains:
Psychopharmacology
Therapeutic Communication
Legal and Ethical Issues in Psychiatric Nursing
Assessment and Diagnosis
Crisis Intervention
Psychotherapy Modalities
Mood and Psychotic Disorders
Anxiety and Stress-Related Disorders
Substance Use Disorders
Neurocognitive Disorders
Introduction
This comprehensive examination is designed to assess the advanced practice nursing student's mastery of key
concepts in psychiatric-mental health nursing. It evaluates foundational and applied knowledge, critical thinking,
and clinical decision-making skills essential for safe and effective practice. The exam consists of 100 multiple-
choice questions, including scenario-based items that require the application of theoretical principles to real-world
clinical situations. This assessment emphasizes the integration of psychopharmacology, therapeutic
communication, legal and ethical standards, and evidence-based interventions to prepare the student for the
complexities of mental health care delivery.
,SECTION ONE: QUESTIONS 1-100
Question 1
A patient with schizophrenia has been non-adherent with their oral antipsychotic medication. Which of the
following is the most appropriate initial strategy to address this issue?
A. Discharge the patient from the clinic
B. Administer a long-acting injectable antipsychotic
C. Explore the patient's reasons for non-adherence
D. Increase the dose of the current oral medication
🟢 C. Explore the patient's reasons for non-adherence
🔴 RATIONALE: The initial step in managing non-adherence is to assess the patient's perspective, including
their beliefs about the medication, side effects, and practical barriers. This patient-centered approach is more
effective than coercion or immediate changes to the medication regimen and aligns with therapeutic alliance
principles.
Question 2
A patient diagnosed with major depressive disorder is started on fluoxetine. The nurse's education should
include which of the following as a critical warning?
,A. Risk of hypertensive crisis
B. Increased risk of suicidal ideation in young adults
C. Need for a low-tyramine diet
D. Potential for agranulocytosis
🟢 B. Increased risk of suicidal ideation in young adults
🔴 RATIONALE: Fluoxetine, an SSRI, carries a black box warning for an increased risk of suicidal thinking and
behavior in children, adolescents, and young adults. This is a critical point of patient and family education.
Hypertensive crisis is a risk with MAOIs, and a low-tyramine diet is associated with MAOIs.
Question 3
A psychiatric-mental health nurse practitioner (PMHNP) is providing therapy to a patient who has difficulty
expressing anger. The patient states, "I just don't get angry. I'm a very peaceful person." The PMHNP responds,
"You say you are peaceful, yet you have described several situations today that would make most people
angry." This therapeutic communication technique is an example of:
A. Confrontation
B. Reflection
C. Clarification
D. Interpretation
🟢 A. Confrontation
, 🔴 RATIONALE: The PMHNP is pointing out a discrepancy between the patient's stated self-perception ("I'm a
very peaceful person") and their reported experiences. This is a controlled and therapeutic use of confrontation
to promote self-awareness.
Question 4
A patient with bipolar disorder is prescribed lithium. Which of the following serum levels is considered within
the therapeutic range for acute mania?
A. 0.4 - 0.8 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.0 - 1.5 mEq/L
D. 1.5 - 2.0 mEq/L
🟢 C. 1.0 - 1.5 mEq/L
🔴 RATIONALE: For acute treatment of mania, the therapeutic serum lithium level is typically between 1.0 and
1.5 mEq/L. Maintenance levels are generally lower (0.6 - 1.2 mEq/L). Levels above 1.5 mEq/L increase the risk of
toxicity.
Question 5
SOLUTIONS
Core Domains:
Psychopharmacology
Therapeutic Communication
Legal and Ethical Issues in Psychiatric Nursing
Assessment and Diagnosis
Crisis Intervention
Psychotherapy Modalities
Mood and Psychotic Disorders
Anxiety and Stress-Related Disorders
Substance Use Disorders
Neurocognitive Disorders
Introduction
This comprehensive examination is designed to assess the advanced practice nursing student's mastery of key
concepts in psychiatric-mental health nursing. It evaluates foundational and applied knowledge, critical thinking,
and clinical decision-making skills essential for safe and effective practice. The exam consists of 100 multiple-
choice questions, including scenario-based items that require the application of theoretical principles to real-world
clinical situations. This assessment emphasizes the integration of psychopharmacology, therapeutic
communication, legal and ethical standards, and evidence-based interventions to prepare the student for the
complexities of mental health care delivery.
,SECTION ONE: QUESTIONS 1-100
Question 1
A patient with schizophrenia has been non-adherent with their oral antipsychotic medication. Which of the
following is the most appropriate initial strategy to address this issue?
A. Discharge the patient from the clinic
B. Administer a long-acting injectable antipsychotic
C. Explore the patient's reasons for non-adherence
D. Increase the dose of the current oral medication
🟢 C. Explore the patient's reasons for non-adherence
🔴 RATIONALE: The initial step in managing non-adherence is to assess the patient's perspective, including
their beliefs about the medication, side effects, and practical barriers. This patient-centered approach is more
effective than coercion or immediate changes to the medication regimen and aligns with therapeutic alliance
principles.
Question 2
A patient diagnosed with major depressive disorder is started on fluoxetine. The nurse's education should
include which of the following as a critical warning?
,A. Risk of hypertensive crisis
B. Increased risk of suicidal ideation in young adults
C. Need for a low-tyramine diet
D. Potential for agranulocytosis
🟢 B. Increased risk of suicidal ideation in young adults
🔴 RATIONALE: Fluoxetine, an SSRI, carries a black box warning for an increased risk of suicidal thinking and
behavior in children, adolescents, and young adults. This is a critical point of patient and family education.
Hypertensive crisis is a risk with MAOIs, and a low-tyramine diet is associated with MAOIs.
Question 3
A psychiatric-mental health nurse practitioner (PMHNP) is providing therapy to a patient who has difficulty
expressing anger. The patient states, "I just don't get angry. I'm a very peaceful person." The PMHNP responds,
"You say you are peaceful, yet you have described several situations today that would make most people
angry." This therapeutic communication technique is an example of:
A. Confrontation
B. Reflection
C. Clarification
D. Interpretation
🟢 A. Confrontation
, 🔴 RATIONALE: The PMHNP is pointing out a discrepancy between the patient's stated self-perception ("I'm a
very peaceful person") and their reported experiences. This is a controlled and therapeutic use of confrontation
to promote self-awareness.
Question 4
A patient with bipolar disorder is prescribed lithium. Which of the following serum levels is considered within
the therapeutic range for acute mania?
A. 0.4 - 0.8 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.0 - 1.5 mEq/L
D. 1.5 - 2.0 mEq/L
🟢 C. 1.0 - 1.5 mEq/L
🔴 RATIONALE: For acute treatment of mania, the therapeutic serum lithium level is typically between 1.0 and
1.5 mEq/L. Maintenance levels are generally lower (0.6 - 1.2 mEq/L). Levels above 1.5 mEq/L increase the risk of
toxicity.
Question 5
