PSYCHIATRIC ADVANCED PRACTICE
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. Which brain region is primarily responsible for executive functions, including decision-
making and impulse control, and is often dysregulated in ADHD?
A. Amaygdala
B. Prefrontal Cortex
C. Hippocampus
D. Basal Ganglia
Answer: B
Conceptual Explanation: The prefrontal cortex manages executive functions like planning
and impulse control. Dysfunction here is a hallmark of ADHD and other impulsive
disorders.
2. A patient taking Clozapine presents with a fever, sore throat, and lethargy. Which
laboratory finding would require immediate discontinuation of the drug?
A. Absolute Neutrophil Count (ANC) of 450/mm3
,B. White Blood Cell (WBC) count of 4,000/mm3
C. Platelet count of 150,000/mm3
D. Hemoglobin of 11.0 g/dL
Answer: A
Conceptual Explanation: Agranulocytosis is a life-threatening side effect of Clozapine; an
ANC below 500/mm3 constitutes severe neutropenia requiring cessation of therapy.
3. According to Peplau’s theory of Interpersonal Relations, in which phase does the patient
work to derive full value from what they have learned during the relationship?
A. Orientation
B. Exploitation
C. Identification
D. Resolution
Answer: B
Conceptual Explanation: In the exploitation phase, the patient takes full advantage of the
services offered and the relationship to address their needs.
4. A PMHNP is treating a patient who reports seeing shadows and hearing voices when no
one is around. Which neurotransmitter pathway is most likely hyperactive?
A. Mesocortical dopamine pathway
B. Nigrostriatal dopamine pathway
, C. Mesolimbic dopamine pathway
D. Tuberoinfundibular dopamine pathway
Answer: C
Conceptual Explanation: Hyperactivity in the mesolimbic dopamine pathway is
associated with positive symptoms of schizophrenia, such as hallucinations and delusions.
5. Which ethical principle is demonstrated when a PMHNP respects a patient’s right to refuse
a specific medication despite the provider’s belief that it would be beneficial?
A. Beneficence
B. Justice
C. Non-maleficence
D. Autonomy
Answer: D
Conceptual Explanation: Autonomy refers to the patient’s right to self-determination and
to make decisions about their own medical care.
6. What is the black box warning associated with all SSRI and SNRI antidepressants when
prescribed to children, adolescents, and young adults?
A. Increased risk of suicidal ideation and behavior
B. Risk of hepatic failure
C. Risk of QTc prolongation
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. Which brain region is primarily responsible for executive functions, including decision-
making and impulse control, and is often dysregulated in ADHD?
A. Amaygdala
B. Prefrontal Cortex
C. Hippocampus
D. Basal Ganglia
Answer: B
Conceptual Explanation: The prefrontal cortex manages executive functions like planning
and impulse control. Dysfunction here is a hallmark of ADHD and other impulsive
disorders.
2. A patient taking Clozapine presents with a fever, sore throat, and lethargy. Which
laboratory finding would require immediate discontinuation of the drug?
A. Absolute Neutrophil Count (ANC) of 450/mm3
,B. White Blood Cell (WBC) count of 4,000/mm3
C. Platelet count of 150,000/mm3
D. Hemoglobin of 11.0 g/dL
Answer: A
Conceptual Explanation: Agranulocytosis is a life-threatening side effect of Clozapine; an
ANC below 500/mm3 constitutes severe neutropenia requiring cessation of therapy.
3. According to Peplau’s theory of Interpersonal Relations, in which phase does the patient
work to derive full value from what they have learned during the relationship?
A. Orientation
B. Exploitation
C. Identification
D. Resolution
Answer: B
Conceptual Explanation: In the exploitation phase, the patient takes full advantage of the
services offered and the relationship to address their needs.
4. A PMHNP is treating a patient who reports seeing shadows and hearing voices when no
one is around. Which neurotransmitter pathway is most likely hyperactive?
A. Mesocortical dopamine pathway
B. Nigrostriatal dopamine pathway
, C. Mesolimbic dopamine pathway
D. Tuberoinfundibular dopamine pathway
Answer: C
Conceptual Explanation: Hyperactivity in the mesolimbic dopamine pathway is
associated with positive symptoms of schizophrenia, such as hallucinations and delusions.
5. Which ethical principle is demonstrated when a PMHNP respects a patient’s right to refuse
a specific medication despite the provider’s belief that it would be beneficial?
A. Beneficence
B. Justice
C. Non-maleficence
D. Autonomy
Answer: D
Conceptual Explanation: Autonomy refers to the patient’s right to self-determination and
to make decisions about their own medical care.
6. What is the black box warning associated with all SSRI and SNRI antidepressants when
prescribed to children, adolescents, and young adults?
A. Increased risk of suicidal ideation and behavior
B. Risk of hepatic failure
C. Risk of QTc prolongation
