PSYCHIATRIC ADVANCED PRACTICE
NURSING: A BIOPSYCHOSOCIAL
FOUNDATION QUESTIONS AND
ANSWERS
1. Which neurotransmitter is primarily implicated in the ‘reward’ circuit of the brain,
specifically within the mesolimbic pathway, and is a major target in substance use disorder
treatments?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. GABA
Answer: C
Conceptual Explanation: Dopamine is the key neurotransmitter in the reward system,
particularly moving from the ventral tegmental area (VTA) to the nucleus accumbens.
,2. In the context of the HPA axis, which hormone is released by the hypothalamus to
stimulate the pituitary gland during a stress response?
A. Cortisol
B. Corticotropin-releasing hormone (CRH)
C. Adrenocorticotropic hormone (ACTH)
D. Vasopressin
Answer: B
Conceptual Explanation: The hypothalamus releases CRH, which then stimulates the
anterior pituitary to release ACTH, eventually leading to cortisol release from the adrenal
cortex.
3. A PMHNP is treating a patient with Clozapine. Which Absolute Neutrophil Count (ANC)
result requires immediate cessation of the medication and consultation with hematology?
A. ANC < 2000/mm³
B. ANC < 500/mm³
C. ANC < 1000/mm³
D. ANC < 1500/mm³
Answer: B
, Conceptual Explanation: According to the Clozapine REMS program, an ANC of less than
500/mm³ is classified as severe neutropenia and requires immediate discontinuation of
the drug.
4. According to Hildegard Peplau’s Theory of Interpersonal Relations, during which phase
does the patient begin to take full advantage of the services offered to them?
A. Exploitation
B. Identification
C. Orientation
D. Resolution
Answer: A
Conceptual Explanation: In the exploitation phase, the patient uses the resources
available through the relationship to resolve problems and move toward health.
5. A patient presents with rapid speech, decreased need for sleep, and grandiosity for 5 days.
These symptoms do not cause marked impairment in social functioning and do not require
hospitalization. The most likely diagnosis is:
A. Hypomanic Episode
B. Manic Episode
C. Cyclothymic Disorder
D. Mixed Episode
NURSING: A BIOPSYCHOSOCIAL
FOUNDATION QUESTIONS AND
ANSWERS
1. Which neurotransmitter is primarily implicated in the ‘reward’ circuit of the brain,
specifically within the mesolimbic pathway, and is a major target in substance use disorder
treatments?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. GABA
Answer: C
Conceptual Explanation: Dopamine is the key neurotransmitter in the reward system,
particularly moving from the ventral tegmental area (VTA) to the nucleus accumbens.
,2. In the context of the HPA axis, which hormone is released by the hypothalamus to
stimulate the pituitary gland during a stress response?
A. Cortisol
B. Corticotropin-releasing hormone (CRH)
C. Adrenocorticotropic hormone (ACTH)
D. Vasopressin
Answer: B
Conceptual Explanation: The hypothalamus releases CRH, which then stimulates the
anterior pituitary to release ACTH, eventually leading to cortisol release from the adrenal
cortex.
3. A PMHNP is treating a patient with Clozapine. Which Absolute Neutrophil Count (ANC)
result requires immediate cessation of the medication and consultation with hematology?
A. ANC < 2000/mm³
B. ANC < 500/mm³
C. ANC < 1000/mm³
D. ANC < 1500/mm³
Answer: B
, Conceptual Explanation: According to the Clozapine REMS program, an ANC of less than
500/mm³ is classified as severe neutropenia and requires immediate discontinuation of
the drug.
4. According to Hildegard Peplau’s Theory of Interpersonal Relations, during which phase
does the patient begin to take full advantage of the services offered to them?
A. Exploitation
B. Identification
C. Orientation
D. Resolution
Answer: A
Conceptual Explanation: In the exploitation phase, the patient uses the resources
available through the relationship to resolve problems and move toward health.
5. A patient presents with rapid speech, decreased need for sleep, and grandiosity for 5 days.
These symptoms do not cause marked impairment in social functioning and do not require
hospitalization. The most likely diagnosis is:
A. Hypomanic Episode
B. Manic Episode
C. Cyclothymic Disorder
D. Mixed Episode
