NU 673 MIDTERM EXAM ACTUAL EXAM 2026/2027 – COMPLETE EXAM-STYLE QUESTIONS AND ANSWERS
ALREADY GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains:
Neurobiology and Psychopharmacology
Psychiatric Assessment, Diagnosis, and Formulation
Ethics, Legal Issues, and Professional Standards
Mood Disorders and Anxiety Disorders
Psychotic Disorders and Schizophrenia
Trauma, Stressor-Related, and Dissociative Disorders
Substance Use Disorders and Co-Occurring Conditions
Child, Adolescent, and Geriatric Psychiatry
Suicide Risk Assessment and Crisis Intervention
Evidence-Based Practice and Clinical Decision-Making
Introduction:
This comprehensive midterm examination is designed to evaluate advanced practice nursing knowledge and
clinical reasoning in psychiatric-mental health care for the NU 673 course. It assesses foundational and applied
competencies across neurobiology, psychopharmacology, diagnostic assessment, psychotherapy, and ethical-legal
frameworks. The exam employs multiple-choice and scenario-based questions that challenge students to
synthesize complex patient data, prioritize interventions, and apply evidence-based guidelines. Emphasis is placed
,on real-world clinical decision-making, risk assessment, and the integration of biopsychosocial principles necessary
for safe, effective, and culturally responsive psychiatric-mental health nurse practitioner practice.
Section One: Questions 1–100
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
🟢 B. Inhibiting the reuptake of serotonin at the presynaptic neuron
🔴 RATIONALE: SSRIs work by selectively inhibiting the reuptake of serotonin at the presynaptic neuron,
increasing serotonin availability in the synaptic cleft. Option A describes antipsychotics. Option C describes
Alzheimer's medications. Option D describes benzodiazepines and other GABAergic drugs.
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
🟢 C. Tardive dyskinesia
🔴 RATIONALE: Tardive dyskinesia is characterized by involuntary, repetitive movements, particularly of the
orofacial region, and is associated with long-term antipsychotic use. Option A (acute dystonia) involves
sustained muscle contractions. Option B (akathisia) is subjective restlessness. Option D (NMS) includes rigidity,
fever, and autonomic instability.
3. A patient with bipolar I disorder is started on lithium. Which of the following instructions 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."
🟢 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. Option A is incorrect—lithium can cause GI upset and is often
, taken with food. Option C is incorrect—doubling doses risks toxicity. Option D is incorrect—bipolar disorder
requires maintenance treatment.
4. A patient taking valproic acid (Depakote) for bipolar disorder requires routine monitoring. Which of the
following laboratory tests is MOST important to monitor?
A. Liver function tests
B. Renal function tests
C. Thyroid function tests
D. Complete blood count
🟢 A. Liver function tests
🔴 RATIONALE: Valproic acid can cause hepatotoxicity, so liver function tests must be monitored. Option B
(renal) is for lithium. Option C (thyroid) is for lithium. Option D (CBC) may be affected but liver function is the
priority.
5. A patient with generalized anxiety disorder has not responded to SSRIs. Which of the following
medications has a different mechanism of action and is FDA-approved for GAD?
A. Buspirone
B. Diphenhydramine
ALREADY GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains:
Neurobiology and Psychopharmacology
Psychiatric Assessment, Diagnosis, and Formulation
Ethics, Legal Issues, and Professional Standards
Mood Disorders and Anxiety Disorders
Psychotic Disorders and Schizophrenia
Trauma, Stressor-Related, and Dissociative Disorders
Substance Use Disorders and Co-Occurring Conditions
Child, Adolescent, and Geriatric Psychiatry
Suicide Risk Assessment and Crisis Intervention
Evidence-Based Practice and Clinical Decision-Making
Introduction:
This comprehensive midterm examination is designed to evaluate advanced practice nursing knowledge and
clinical reasoning in psychiatric-mental health care for the NU 673 course. It assesses foundational and applied
competencies across neurobiology, psychopharmacology, diagnostic assessment, psychotherapy, and ethical-legal
frameworks. The exam employs multiple-choice and scenario-based questions that challenge students to
synthesize complex patient data, prioritize interventions, and apply evidence-based guidelines. Emphasis is placed
,on real-world clinical decision-making, risk assessment, and the integration of biopsychosocial principles necessary
for safe, effective, and culturally responsive psychiatric-mental health nurse practitioner practice.
Section One: Questions 1–100
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
🟢 B. Inhibiting the reuptake of serotonin at the presynaptic neuron
🔴 RATIONALE: SSRIs work by selectively inhibiting the reuptake of serotonin at the presynaptic neuron,
increasing serotonin availability in the synaptic cleft. Option A describes antipsychotics. Option C describes
Alzheimer's medications. Option D describes benzodiazepines and other GABAergic drugs.
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
🟢 C. Tardive dyskinesia
🔴 RATIONALE: Tardive dyskinesia is characterized by involuntary, repetitive movements, particularly of the
orofacial region, and is associated with long-term antipsychotic use. Option A (acute dystonia) involves
sustained muscle contractions. Option B (akathisia) is subjective restlessness. Option D (NMS) includes rigidity,
fever, and autonomic instability.
3. A patient with bipolar I disorder is started on lithium. Which of the following instructions 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."
🟢 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. Option A is incorrect—lithium can cause GI upset and is often
, taken with food. Option C is incorrect—doubling doses risks toxicity. Option D is incorrect—bipolar disorder
requires maintenance treatment.
4. A patient taking valproic acid (Depakote) for bipolar disorder requires routine monitoring. Which of the
following laboratory tests is MOST important to monitor?
A. Liver function tests
B. Renal function tests
C. Thyroid function tests
D. Complete blood count
🟢 A. Liver function tests
🔴 RATIONALE: Valproic acid can cause hepatotoxicity, so liver function tests must be monitored. Option B
(renal) is for lithium. Option C (thyroid) is for lithium. Option D (CBC) may be affected but liver function is the
priority.
5. A patient with generalized anxiety disorder has not responded to SSRIs. Which of the following
medications has a different mechanism of action and is FDA-approved for GAD?
A. Buspirone
B. Diphenhydramine
