NR548 PSYCHIATRIC-MENTAL HEALTH
NURSE PRACTITIONER ASSESSMENT
FINAL EXAM PREP
1. A patient presents with symptoms of bradykinesia, rigidity, and a resting tremor. During
the assessment, which neurotransmitter pathway is most likely dysregulated in the basal
ganglia?
A. Mesolimbic pathway
B. Tuberoinfundibular pathway
C. Mesocortical pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway projects from the substantia nigra to
the striatum and is responsible for motor control; its dysfunction leads to extrapyramidal
symptoms and Parkinsonism.
,2. When assessing a 10-year-old for ADHD, the PMHNP uses the ‘Clock Drawing Test.’ This
specific tool primarily screens for deficits in which area?
A. Auditory processing
B. Limbic system arousal
C. Executive function and visuospatial skills
D. Long-term semantic memory
Answer: C
Conceptual Explanation: The Clock Drawing Test is a brief screening tool for cognitive
impairment, focusing on executive function and visuospatial abilities controlled by the
frontal and parietal lobes.
3. A patient on Lithium Carbonate reports polyuria and polydipsia. Which laboratory value is
the most critical to assess for potential nephrogenic diabetes insipidus?
A. Serum Sodium
B. Blood Urea Nitrogen (BUN)
C. Creatinine Clearance
D. Urine Specific Gravity
Answer: D
Conceptual Explanation: Nephrogenic diabetes insipidus caused by lithium results in the
inability to concentrate urine, leading to low urine specific gravity.
, 4. During the Mental Status Exam, the PMHNP asks the patient to interpret the proverb
‘Don’t cry over spilled milk.’ The patient responds, ‘It means once the milk is on the floor, you
can’t put it back in the bottle.’ This is an example of:
A. Abstract thinking
B. Circumstantiality
C. Tangentiality
D. Concrete thinking
Answer: D
Conceptual Explanation: Concrete thinking is characterized by literal interpretations of
proverbs and a lack of hypothetical or symbolic reasoning.
5. Which neuroanatomical structure is primarily responsible for the ‘alarm’ response and the
mediation of fear and anxiety?
A. Hippocampus
B. Nucleus Accumbens
C. Thalamus
D. Amygdala
Answer: D
Conceptual Explanation: The amygdala is the core of the brain’s fear circuit, processing
emotional stimuli and triggering the fight-or-flight response.
NURSE PRACTITIONER ASSESSMENT
FINAL EXAM PREP
1. A patient presents with symptoms of bradykinesia, rigidity, and a resting tremor. During
the assessment, which neurotransmitter pathway is most likely dysregulated in the basal
ganglia?
A. Mesolimbic pathway
B. Tuberoinfundibular pathway
C. Mesocortical pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway projects from the substantia nigra to
the striatum and is responsible for motor control; its dysfunction leads to extrapyramidal
symptoms and Parkinsonism.
,2. When assessing a 10-year-old for ADHD, the PMHNP uses the ‘Clock Drawing Test.’ This
specific tool primarily screens for deficits in which area?
A. Auditory processing
B. Limbic system arousal
C. Executive function and visuospatial skills
D. Long-term semantic memory
Answer: C
Conceptual Explanation: The Clock Drawing Test is a brief screening tool for cognitive
impairment, focusing on executive function and visuospatial abilities controlled by the
frontal and parietal lobes.
3. A patient on Lithium Carbonate reports polyuria and polydipsia. Which laboratory value is
the most critical to assess for potential nephrogenic diabetes insipidus?
A. Serum Sodium
B. Blood Urea Nitrogen (BUN)
C. Creatinine Clearance
D. Urine Specific Gravity
Answer: D
Conceptual Explanation: Nephrogenic diabetes insipidus caused by lithium results in the
inability to concentrate urine, leading to low urine specific gravity.
, 4. During the Mental Status Exam, the PMHNP asks the patient to interpret the proverb
‘Don’t cry over spilled milk.’ The patient responds, ‘It means once the milk is on the floor, you
can’t put it back in the bottle.’ This is an example of:
A. Abstract thinking
B. Circumstantiality
C. Tangentiality
D. Concrete thinking
Answer: D
Conceptual Explanation: Concrete thinking is characterized by literal interpretations of
proverbs and a lack of hypothetical or symbolic reasoning.
5. Which neuroanatomical structure is primarily responsible for the ‘alarm’ response and the
mediation of fear and anxiety?
A. Hippocampus
B. Nucleus Accumbens
C. Thalamus
D. Amygdala
Answer: D
Conceptual Explanation: The amygdala is the core of the brain’s fear circuit, processing
emotional stimuli and triggering the fight-or-flight response.
