PSYCHIATRIC ADVANCED PRACTICE
NURSING: A BIOPSYCHOSOCIAL
FOUNDATION FOR PRACTICE TEST
BANK QUESTIONS AND ANSWERS
1. A 45-year-old patient presents with chronic depressive symptoms and executive
functioning deficits. The PMHNP identifies that the patient’s difficulty with planning and
working memory likely involves which brain region?
A. The Amygdala
B. The Dorsolateral Prefrontal Cortex
C. The Hippocampus
D. The Basal Ganglia
Answer: B
Conceptual Explanation: The dorsolateral prefrontal cortex (dlPFC) is primarily
responsible for executive functions, including planning, cognitive flexibility, and working
memory.
,2. When considering the pharmacokinetics of psychotropic medications in geriatric patients,
which physiological change most significantly increases the risk of drug toxicity?
A. Increased total body water
B. Decreased hepatic blood flow and glomerular filtration rate
C. Decreased body fat percentage
D. Increased gastric acidity
Answer: B
Conceptual Explanation: Aging reduces hepatic blood flow and renal clearance (GFR),
leading to slower metabolism and excretion of drugs, thereby increasing the risk of toxicity.
3. A patient taking Clozapine presents with a sore throat, fever, and malaise. What is the
priority intervention for the PMHNP?
A. Prescribe a course of broad-spectrum antibiotics
B. Order an immediate Absolute Neutrophil Count (ANC)
C. Increase the Clozapine dose to manage possible psychosis
D. Advise the patient to take over-the-counter antipyretics
Answer: B
Conceptual Explanation: Agranulocytosis is a life-threatening side effect of Clozapine. A
fever and sore throat are clinical signs that necessitate an immediate ANC check.
, 4. In the context of Peplau’s Theory of Interpersonal Relations, which phase is characterized
by the patient identifying those who can help them and starting to respond to persons who
offer help?
A. Orientation phase
B. Exploitation phase
C. Identification phase
D. Resolution phase
Answer: C
Conceptual Explanation: During the identification phase, the patient begins to respond to
those who can help and develops a sense of belonging with the nurse.
5. A PMHNP is treating a patient with Bipolar I Disorder. The patient expresses a desire to
become pregnant. Which mood stabilizer carries the highest risk for neural tube defects?
A. Lithium
B. Lamotrigine
C. Valproate
D. Oxcarbazepine
Answer: C
Conceptual Explanation: Valproate (Depakote) is highly teratogenic, specifically
associated with a high risk of neural tube defects like spina bifida.
NURSING: A BIOPSYCHOSOCIAL
FOUNDATION FOR PRACTICE TEST
BANK QUESTIONS AND ANSWERS
1. A 45-year-old patient presents with chronic depressive symptoms and executive
functioning deficits. The PMHNP identifies that the patient’s difficulty with planning and
working memory likely involves which brain region?
A. The Amygdala
B. The Dorsolateral Prefrontal Cortex
C. The Hippocampus
D. The Basal Ganglia
Answer: B
Conceptual Explanation: The dorsolateral prefrontal cortex (dlPFC) is primarily
responsible for executive functions, including planning, cognitive flexibility, and working
memory.
,2. When considering the pharmacokinetics of psychotropic medications in geriatric patients,
which physiological change most significantly increases the risk of drug toxicity?
A. Increased total body water
B. Decreased hepatic blood flow and glomerular filtration rate
C. Decreased body fat percentage
D. Increased gastric acidity
Answer: B
Conceptual Explanation: Aging reduces hepatic blood flow and renal clearance (GFR),
leading to slower metabolism and excretion of drugs, thereby increasing the risk of toxicity.
3. A patient taking Clozapine presents with a sore throat, fever, and malaise. What is the
priority intervention for the PMHNP?
A. Prescribe a course of broad-spectrum antibiotics
B. Order an immediate Absolute Neutrophil Count (ANC)
C. Increase the Clozapine dose to manage possible psychosis
D. Advise the patient to take over-the-counter antipyretics
Answer: B
Conceptual Explanation: Agranulocytosis is a life-threatening side effect of Clozapine. A
fever and sore throat are clinical signs that necessitate an immediate ANC check.
, 4. In the context of Peplau’s Theory of Interpersonal Relations, which phase is characterized
by the patient identifying those who can help them and starting to respond to persons who
offer help?
A. Orientation phase
B. Exploitation phase
C. Identification phase
D. Resolution phase
Answer: C
Conceptual Explanation: During the identification phase, the patient begins to respond to
those who can help and develops a sense of belonging with the nurse.
5. A PMHNP is treating a patient with Bipolar I Disorder. The patient expresses a desire to
become pregnant. Which mood stabilizer carries the highest risk for neural tube defects?
A. Lithium
B. Lamotrigine
C. Valproate
D. Oxcarbazepine
Answer: C
Conceptual Explanation: Valproate (Depakote) is highly teratogenic, specifically
associated with a high risk of neural tube defects like spina bifida.
