PSYCHIATRIC ADVANCED PRACTICE
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway, projecting from the ventral tegmental
area to the nucleus accumbens, is associated with reward and pleasure. Overactivity in this
pathway is linked to positive psychotic symptoms.
,2. A patient is prescribed Clozapine (Clozaril). The Psychiatric Mental Health Nurse
Practitioner (PMHNP) must monitor which laboratory value most closely to screen for a life-
threatening side effect?
A. Absolute Neutrophil Count (ANC)
B. Serum creatinine
C. Liver function tests (LFTs)
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. Strict
monitoring of the Absolute Neutrophil Count (ANC) is required by the REMS program.
3. According to Hildegard Peplau’s theory, during which phase of the nurse-patient
relationship do the patient and nurse work together to solve problems and the patient begins
to feel like a participant in the plan of care?
A. Orientation phase
B. Exploitation phase
C. Identification phase
D. Resolution phase
Answer: B
, Conceptual Explanation: During the exploitation phase, the patient takes full advantage of
the services offered and actively works toward goals established during the earlier phases.
4. A 72-year-old patient presents with sudden onset of confusion, fluctuating levels of
consciousness, and visual hallucinations. Which diagnosis is most likely?
A. Major Depressive Disorder with Psychotic Features
B. Delirium
C. Vascular Dementia
D. Alzheimer’s Disease
Answer: B
Conceptual Explanation: Delirium is characterized by an acute onset, a fluctuating course,
and disturbances in consciousness and attention, often caused by an underlying medical
condition.
5. Which neurotransmitter is primarily targeted by benzodiazepines to produce anxiolytic and
sedative effects?
A. Glutamate
B. GABA
C. Serotonin
D. Norepinephrine
Answer: B
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway, projecting from the ventral tegmental
area to the nucleus accumbens, is associated with reward and pleasure. Overactivity in this
pathway is linked to positive psychotic symptoms.
,2. A patient is prescribed Clozapine (Clozaril). The Psychiatric Mental Health Nurse
Practitioner (PMHNP) must monitor which laboratory value most closely to screen for a life-
threatening side effect?
A. Absolute Neutrophil Count (ANC)
B. Serum creatinine
C. Liver function tests (LFTs)
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. Strict
monitoring of the Absolute Neutrophil Count (ANC) is required by the REMS program.
3. According to Hildegard Peplau’s theory, during which phase of the nurse-patient
relationship do the patient and nurse work together to solve problems and the patient begins
to feel like a participant in the plan of care?
A. Orientation phase
B. Exploitation phase
C. Identification phase
D. Resolution phase
Answer: B
, Conceptual Explanation: During the exploitation phase, the patient takes full advantage of
the services offered and actively works toward goals established during the earlier phases.
4. A 72-year-old patient presents with sudden onset of confusion, fluctuating levels of
consciousness, and visual hallucinations. Which diagnosis is most likely?
A. Major Depressive Disorder with Psychotic Features
B. Delirium
C. Vascular Dementia
D. Alzheimer’s Disease
Answer: B
Conceptual Explanation: Delirium is characterized by an acute onset, a fluctuating course,
and disturbances in consciousness and attention, often caused by an underlying medical
condition.
5. Which neurotransmitter is primarily targeted by benzodiazepines to produce anxiolytic and
sedative effects?
A. Glutamate
B. GABA
C. Serotonin
D. Norepinephrine
Answer: B
