NU 673 MIDTERM EXAM
QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026/2027 Q&A
| INSTANT DOWNLOAD PDF
Core Domains
• Neurobiology and Neuroanatomy of Psychiatric Disorders
• Psychopharmacology: Pharmacokinetics, Pharmacodynamics, and
Psychotropic Medications
• Psychiatric Assessment and Mental Status Examination (MSE)
• DSM-5-TR Diagnostic Criteria and Differential Diagnosis
• Major Depressive Disorder and Bipolar Spectrum Disorders
• Anxiety Disorders, OCD, and Trauma-Related Disorders
• Schizophrenia Spectrum and Other Psychotic Disorders
• Substance Use Disorders and Addiction Medicine
• Therapeutic Communication and the Nurse-Client Relationship
• Ethical and Legal Issues in Psychiatric Mental Health Nursing
Introduction
,This comprehensive assessment is designed to prepare graduate nursing
students for the NU 673 Psychiatric Mental Health Nurse Practitioner
(PMHNP) Midterm Examination. It evaluates advanced knowledge in
psychiatric assessment, neurobiology, psychopharmacology, DSM-5-TR
diagnostic criteria, and evidence-based treatment planning across the lifespan.
The exam employs multiple-choice, clinical scenario-based questions that test
critical thinking, differential diagnosis, and clinical decision-making. Emphasis
is placed on the integration of neurobiological principles with
psychopharmacological interventions, therapeutic communication, and
ethical-legal considerations to ensure students are prepared for both academic
success and advanced clinical practice in psychiatric mental health care.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient is started on fluoxetine (Prozac) for major depressive disorder. The
PMHNP understands that the therapeutic effect of SSRIs is primarily due to
which mechanism?
A. Blocking dopamine D2 receptors
B. Inhibiting the reuptake of serotonin at the presynaptic neuron
C. Blocking acetylcholinesterase
D. Enhancing GABA activity
B
RATIONALE: SSRIs work by selectively inhibiting the reuptake of
serotonin at the presynaptic neuron, increasing serotonin availability in the
synaptic cleft. Option A describes antipsychotics; Option C describes
cholinesterase inhibitors used in Alzheimer's disease; Option D describes
benzodiazepines and other GABAergic drugs.
,Question 2
A patient taking risperidone develops involuntary, repetitive movements of
the face and tongue, including lip-smacking and tongue protrusion. The
PMHNP recognizes this as:
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
C
RATIONALE: Tardive dyskinesia is characterized by involuntary,
repetitive movements, particularly of the orofacial region, and is associated
with long-term antipsychotic use. Option A (acute dystonia) involves
sustained muscle contractions. Option B (akathisia) is subjective restlessness.
Option D (NMS) includes rigidity, fever, and autonomic instability.
Question 3
A patient with bipolar I disorder is started on lithium. Which instruction
should the PMHNP include in patient education?
A. "Take lithium on an empty stomach for best absorption."
B. "Maintain consistent fluid and salt intake to prevent toxicity."
C. "If you miss a dose, double the next dose to maintain therapeutic levels."
D. "You can stop taking lithium once your mood stabilizes."
B
RATIONALE: Lithium levels are affected by hydration and sodium
balance. Dehydration or sodium depletion can increase lithium levels, leading
to toxicity. Option A is incorrect—lithium can cause GI upset and is often
taken with food. Option C is incorrect—doubling doses risks toxicity. Option
D is incorrect—bipolar disorder requires maintenance treatment.
, Question 4
A patient taking valproic acid (Depakote) for bipolar disorder requires routine
monitoring. Which laboratory test is MOST important to monitor?
A. Liver function tests
B. Renal function tests
C. Thyroid function tests
D. Complete blood count
A
RATIONALE: Valproic acid can cause hepatotoxicity, so liver function
tests must be monitored. Option B (renal) is more relevant for lithium.
Option C (thyroid) is relevant for lithium. Option D (CBC) may be affected
but liver function is the priority.
Question 5
A patient with generalized anxiety disorder has not responded to SSRIs.
Which medication has a different mechanism of action and is FDA-approved
for GAD?
A. Buspirone
B. Diphenhydramine
C. Propranolol
D. Trazodone
A
RATIONALE: Buspirone is a 5-HT1A partial agonist FDA-approved for
GAD with a different mechanism than SSRIs. Option B is an antihistamine
used for sleep. Option C is for performance anxiety, not GAD. Option D is
used for depression or sleep.
QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026/2027 Q&A
| INSTANT DOWNLOAD PDF
Core Domains
• Neurobiology and Neuroanatomy of Psychiatric Disorders
• Psychopharmacology: Pharmacokinetics, Pharmacodynamics, and
Psychotropic Medications
• Psychiatric Assessment and Mental Status Examination (MSE)
• DSM-5-TR Diagnostic Criteria and Differential Diagnosis
• Major Depressive Disorder and Bipolar Spectrum Disorders
• Anxiety Disorders, OCD, and Trauma-Related Disorders
• Schizophrenia Spectrum and Other Psychotic Disorders
• Substance Use Disorders and Addiction Medicine
• Therapeutic Communication and the Nurse-Client Relationship
• Ethical and Legal Issues in Psychiatric Mental Health Nursing
Introduction
,This comprehensive assessment is designed to prepare graduate nursing
students for the NU 673 Psychiatric Mental Health Nurse Practitioner
(PMHNP) Midterm Examination. It evaluates advanced knowledge in
psychiatric assessment, neurobiology, psychopharmacology, DSM-5-TR
diagnostic criteria, and evidence-based treatment planning across the lifespan.
The exam employs multiple-choice, clinical scenario-based questions that test
critical thinking, differential diagnosis, and clinical decision-making. Emphasis
is placed on the integration of neurobiological principles with
psychopharmacological interventions, therapeutic communication, and
ethical-legal considerations to ensure students are prepared for both academic
success and advanced clinical practice in psychiatric mental health care.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient is started on fluoxetine (Prozac) for major depressive disorder. The
PMHNP understands that the therapeutic effect of SSRIs is primarily due to
which mechanism?
A. Blocking dopamine D2 receptors
B. Inhibiting the reuptake of serotonin at the presynaptic neuron
C. Blocking acetylcholinesterase
D. Enhancing GABA activity
B
RATIONALE: SSRIs work by selectively inhibiting the reuptake of
serotonin at the presynaptic neuron, increasing serotonin availability in the
synaptic cleft. Option A describes antipsychotics; Option C describes
cholinesterase inhibitors used in Alzheimer's disease; Option D describes
benzodiazepines and other GABAergic drugs.
,Question 2
A patient taking risperidone develops involuntary, repetitive movements of
the face and tongue, including lip-smacking and tongue protrusion. The
PMHNP recognizes this as:
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
C
RATIONALE: Tardive dyskinesia is characterized by involuntary,
repetitive movements, particularly of the orofacial region, and is associated
with long-term antipsychotic use. Option A (acute dystonia) involves
sustained muscle contractions. Option B (akathisia) is subjective restlessness.
Option D (NMS) includes rigidity, fever, and autonomic instability.
Question 3
A patient with bipolar I disorder is started on lithium. Which instruction
should the PMHNP include in patient education?
A. "Take lithium on an empty stomach for best absorption."
B. "Maintain consistent fluid and salt intake to prevent toxicity."
C. "If you miss a dose, double the next dose to maintain therapeutic levels."
D. "You can stop taking lithium once your mood stabilizes."
B
RATIONALE: Lithium levels are affected by hydration and sodium
balance. Dehydration or sodium depletion can increase lithium levels, leading
to toxicity. Option A is incorrect—lithium can cause GI upset and is often
taken with food. Option C is incorrect—doubling doses risks toxicity. Option
D is incorrect—bipolar disorder requires maintenance treatment.
, Question 4
A patient taking valproic acid (Depakote) for bipolar disorder requires routine
monitoring. Which laboratory test is MOST important to monitor?
A. Liver function tests
B. Renal function tests
C. Thyroid function tests
D. Complete blood count
A
RATIONALE: Valproic acid can cause hepatotoxicity, so liver function
tests must be monitored. Option B (renal) is more relevant for lithium.
Option C (thyroid) is relevant for lithium. Option D (CBC) may be affected
but liver function is the priority.
Question 5
A patient with generalized anxiety disorder has not responded to SSRIs.
Which medication has a different mechanism of action and is FDA-approved
for GAD?
A. Buspirone
B. Diphenhydramine
C. Propranolol
D. Trazodone
A
RATIONALE: Buspirone is a 5-HT1A partial agonist FDA-approved for
GAD with a different mechanism than SSRIs. Option B is an antihistamine
used for sleep. Option C is for performance anxiety, not GAD. Option D is
used for depression or sleep.
