NRNP 6675 MIDTERM EXAM PRACTICE | ADVANCED
PSYCHIATRIC-MENTAL HEALTH NURSING STUDY
GUIDE | COMPREHENSIVE TESTBANK WITH
PRACTICE QUESTIONS & ANSWERS | EXAM
PREPARATION | LATEST UPDATE 2026/2027
Walden university
NRNP 6675 advanced practice psychiatric-mental health nursing
higher education level student
100+ Q&As with rationales
10 domains
academic year 2026/2027
TABLE OF CONTENTS
1. Psychiatric Assessment and Diagnostic Formulation
2. Psychopathology and Differential Diagnosis
3. Mood Disorders and Suicide Risk
4. Anxiety, Trauma, and Stressor-Related Disorders
5. Psychotic Disorders and Thought Disorders
6. Substance Use and Co-Occurring Disorders
7. Psychopharmacology and Medication Management
8. Psychotherapy and Therapeutic Interventions
9. Risk Assessment, Safety, and Crisis Management
10. Clinical Ethics, Documentation, and Advanced Practice Decision-
Making
NRNP 6675 MIDTERM EXAM PRACTICE, NRNP 6675 STUDY GUIDE,
NRNP 6675 TESTBANK, NRNP 6675 PRACTICE QUESTIONS &
ANSWERS, NRNP 6675 EXAM PREPARATION, ADVANCED
PSYCHIATRIC-MENTAL HEALTH NURSING, LATEST UPDATE
2026/2027, COMPREHENSIVE PRACTICE EXAM, 100% CORRECT
ANSWERS
,1 NRNP 6675 advanced practice psychiatric-mental health nursing
QUESTION 1.
A 32-year-old patient presents with a 4-month history of depressed mood, anhedonia,
insomnia, diminished appetite, impaired concentration, psychomotor slowing, and recurrent
thoughts that life is not worth living. The patient denies hallucinations, delusions, or periods
of elevated mood. During the interview, the patient states, “I have thought about taking all the
pills in my medicine cabinet, but I have not decided when.” Which action should the
psychiatric mental health nurse practitioner prioritize?
A. Schedule the patient for routine psychotherapy within one week
B. Complete an immediate suicide risk assessment, including intent, plan, access to means,
and protective factors
C. Initiate an antidepressant and reassess suicidal ideation at the next appointment
D. Ask the patient's family to monitor the patient without further assessment
Correct Answer: B. Complete an immediate suicide risk assessment, including intent,
plan, access to means, and protective factors
Explanation: The disclosure of a potential method and suicidal thinking requires immediate,
structured assessment of intent, planning, access to lethal means, previous attempts,
protective factors, and the patient's ability to maintain safety. Treatment planning should
follow determination of acute risk and the appropriate level of care. Initiating medication or
arranging routine follow-up without first determining imminent risk could inadequately
address a potentially life-threatening situation. Family involvement may be appropriate with
appropriate consideration of confidentiality and safety, but it does not replace the clinician's
risk assessment.
QUESTION 2.
A 41-year-old patient reports episodic periods lasting approximately 5 days during which the
patient sleeps 3 hours nightly without fatigue, speaks rapidly, develops numerous business
ideas, becomes unusually sociable, and spends substantially more money than usual. The
patient denies psychotic symptoms and has never required hospitalization. Between episodes,
mood and functioning return to baseline. Which diagnosis is most consistent with this
presentation?
A. Bipolar II disorder
B. Cyclothymic disorder
C. Bipolar I disorder
D. Major depressive disorder with mixed features
Correct Answer: A. Bipolar II disorder
Explanation: Bipolar II disorder is characterized by hypomanic episodes and major
depressive episodes without a history of full mania. The described episode involves a distinct
period of elevated or expansive functioning with decreased need for sleep and increased
goal-directed behavior but no evidence of marked impairment, hospitalization, or psychosis
required for mania. Bipolar I requires at least one manic episode. Cyclothymic disorder
involves numerous fluctuating hypomanic and depressive symptoms that do not meet full
episode criteria.
WALDEN UNIVERSITY 1
,2 NRNP 6675 advanced practice psychiatric-mental health nursing
QUESTION 3.
A patient with generalized anxiety disorder has been taking a therapeutic dose of an SSRI for
10 weeks with partial improvement. The patient reports persistent excessive worry, muscle
tension, and difficulty concentrating but denies suicidal ideation, mania, psychosis, or
substance misuse. The patient asks whether medication should immediately be discontinued
because symptoms remain. What is the most appropriate clinical reasoning?
A. Discontinue the SSRI because persistent symptoms establish treatment failure
B. Replace the SSRI immediately with a benzodiazepine
C. Reassess adherence, dose adequacy, adverse effects, comorbidities, and psychotherapy
participation before modifying treatment
D. Increase the SSRI to the maximum dose regardless of tolerability
Correct Answer: C. Reassess adherence, dose adequacy, adverse effects, comorbidities,
and psychotherapy participation before modifying treatment
Explanation: Partial response should prompt systematic reassessment rather than an
automatic medication switch or discontinuation. The clinician should determine whether the
medication has been taken consistently at an adequate therapeutic dose and duration and
assess comorbid depression, substance use, medical contributors, and engagement in
evidence-based psychotherapy. A dose adjustment or medication change may ultimately be
appropriate, but it should be based on this assessment. Benzodiazepines are not
automatically preferred for persistent generalized anxiety symptoms.
QUESTION 4.
A 27-year-old patient presents with auditory hallucinations and paranoid beliefs that
coworkers are transmitting threatening messages through office computers. The patient has
been experiencing progressive social withdrawal, diminished occupational functioning, and
disorganized speech for approximately 8 months. Which finding would most strongly support
schizophrenia rather than schizophreniform disorder?
A. Presence of auditory hallucinations
B. Presence of persecutory delusions
C. Social withdrawal before psychotic symptoms
D. Continuous disturbance lasting at least 6 months with functional deterioration
Correct Answer: D. Continuous disturbance lasting at least 6 months with functional
deterioration
Explanation: Duration and functional decline are critical in differentiating schizophrenia
from schizophreniform disorder. Schizophrenia requires a continuous disturbance for at least
6 months, including at least 1 month of active-phase symptoms, with associated functional
impairment. Hallucinations, delusions, and disorganized speech can occur in both disorders
and therefore do not establish the distinction by themselves. The patient's prolonged course
and deterioration strongly support schizophrenia.
QUESTION 5.
A patient with recurrent major depressive episodes reports periods of markedly increased
energy, decreased need for sleep, impulsive spending, and unusually rapid speech. During the
current evaluation, the patient is euthymic and denies any history of hospitalization or
WALDEN UNIVERSITY 2
, 3 NRNP 6675 advanced practice psychiatric-mental health nursing
psychosis. Which additional historical question is most important before initiating
antidepressant monotherapy?
A. “Have you ever experienced a sustained period of elevated or unusually irritable mood
accompanied by increased goal-directed activity?”
B. “Do you prefer individual or group therapy?”
C. “Have you ever experienced a mild headache after taking medication?”
D. “Do depressive symptoms occur more frequently during winter?”
Correct Answer: A. “Have you ever experienced a sustained period of elevated or
unusually irritable mood accompanied by increased goal-directed activity?”
Explanation: A history suggestive of hypomania or mania can substantially change the
diagnostic formulation and treatment strategy. Antidepressant monotherapy in an individual
with bipolar-spectrum illness may worsen mood instability or precipitate mania or
hypomania. The clinician should obtain a detailed longitudinal mood history, including
duration, functional changes, impulsivity, decreased need for sleep, psychosis, and
consequences. The other questions may contribute to assessment but are less immediately
important to determining whether bipolarity is present.
QUESTION 6.
A 19-year-old college student presents after several weeks of worsening social withdrawal,
declining academic performance, suspiciousness, and hearing a voice commenting on
behavior. The patient's parents report that the patient has also begun neglecting hygiene. The
patient has no known medical illness and denies substance use. Which assessment is most
important before concluding that the symptoms represent a primary psychotic disorder?
A. Determine whether the patient has ever received psychotherapy
B. Establish the patient's preferred learning style
C. Evaluate for substance-induced, medical, neurologic, and medication-related causes of
psychosis
D. Determine whether the patient has experienced childhood separation anxiety
Correct Answer: C. Evaluate for substance-induced, medical, neurologic, and
medication-related causes of psychosis
Explanation: New-onset psychosis requires consideration of secondary causes before
assigning a primary psychotic diagnosis. Substances, medications, endocrine abnormalities,
neurologic disorders, infections, metabolic disturbances, and other medical conditions can
produce psychotic symptoms. The clinician should obtain a detailed history, physical
assessment, medication and substance review, and appropriate diagnostic testing based on
the presentation. Psychosocial history remains important but does not replace evaluation for
potentially reversible causes.
QUESTION 7.
A patient with panic disorder reports sudden episodes of intense fear accompanied by
palpitations, dyspnea, trembling, chest discomfort, and fear of dying. Cardiac evaluation has
been unrevealing. The patient now avoids exercise and crowded places because of concern
about having another attack. Which treatment approach most directly targets the behavioral
mechanism maintaining the patient's symptoms?
WALDEN UNIVERSITY 3
PSYCHIATRIC-MENTAL HEALTH NURSING STUDY
GUIDE | COMPREHENSIVE TESTBANK WITH
PRACTICE QUESTIONS & ANSWERS | EXAM
PREPARATION | LATEST UPDATE 2026/2027
Walden university
NRNP 6675 advanced practice psychiatric-mental health nursing
higher education level student
100+ Q&As with rationales
10 domains
academic year 2026/2027
TABLE OF CONTENTS
1. Psychiatric Assessment and Diagnostic Formulation
2. Psychopathology and Differential Diagnosis
3. Mood Disorders and Suicide Risk
4. Anxiety, Trauma, and Stressor-Related Disorders
5. Psychotic Disorders and Thought Disorders
6. Substance Use and Co-Occurring Disorders
7. Psychopharmacology and Medication Management
8. Psychotherapy and Therapeutic Interventions
9. Risk Assessment, Safety, and Crisis Management
10. Clinical Ethics, Documentation, and Advanced Practice Decision-
Making
NRNP 6675 MIDTERM EXAM PRACTICE, NRNP 6675 STUDY GUIDE,
NRNP 6675 TESTBANK, NRNP 6675 PRACTICE QUESTIONS &
ANSWERS, NRNP 6675 EXAM PREPARATION, ADVANCED
PSYCHIATRIC-MENTAL HEALTH NURSING, LATEST UPDATE
2026/2027, COMPREHENSIVE PRACTICE EXAM, 100% CORRECT
ANSWERS
,1 NRNP 6675 advanced practice psychiatric-mental health nursing
QUESTION 1.
A 32-year-old patient presents with a 4-month history of depressed mood, anhedonia,
insomnia, diminished appetite, impaired concentration, psychomotor slowing, and recurrent
thoughts that life is not worth living. The patient denies hallucinations, delusions, or periods
of elevated mood. During the interview, the patient states, “I have thought about taking all the
pills in my medicine cabinet, but I have not decided when.” Which action should the
psychiatric mental health nurse practitioner prioritize?
A. Schedule the patient for routine psychotherapy within one week
B. Complete an immediate suicide risk assessment, including intent, plan, access to means,
and protective factors
C. Initiate an antidepressant and reassess suicidal ideation at the next appointment
D. Ask the patient's family to monitor the patient without further assessment
Correct Answer: B. Complete an immediate suicide risk assessment, including intent,
plan, access to means, and protective factors
Explanation: The disclosure of a potential method and suicidal thinking requires immediate,
structured assessment of intent, planning, access to lethal means, previous attempts,
protective factors, and the patient's ability to maintain safety. Treatment planning should
follow determination of acute risk and the appropriate level of care. Initiating medication or
arranging routine follow-up without first determining imminent risk could inadequately
address a potentially life-threatening situation. Family involvement may be appropriate with
appropriate consideration of confidentiality and safety, but it does not replace the clinician's
risk assessment.
QUESTION 2.
A 41-year-old patient reports episodic periods lasting approximately 5 days during which the
patient sleeps 3 hours nightly without fatigue, speaks rapidly, develops numerous business
ideas, becomes unusually sociable, and spends substantially more money than usual. The
patient denies psychotic symptoms and has never required hospitalization. Between episodes,
mood and functioning return to baseline. Which diagnosis is most consistent with this
presentation?
A. Bipolar II disorder
B. Cyclothymic disorder
C. Bipolar I disorder
D. Major depressive disorder with mixed features
Correct Answer: A. Bipolar II disorder
Explanation: Bipolar II disorder is characterized by hypomanic episodes and major
depressive episodes without a history of full mania. The described episode involves a distinct
period of elevated or expansive functioning with decreased need for sleep and increased
goal-directed behavior but no evidence of marked impairment, hospitalization, or psychosis
required for mania. Bipolar I requires at least one manic episode. Cyclothymic disorder
involves numerous fluctuating hypomanic and depressive symptoms that do not meet full
episode criteria.
WALDEN UNIVERSITY 1
,2 NRNP 6675 advanced practice psychiatric-mental health nursing
QUESTION 3.
A patient with generalized anxiety disorder has been taking a therapeutic dose of an SSRI for
10 weeks with partial improvement. The patient reports persistent excessive worry, muscle
tension, and difficulty concentrating but denies suicidal ideation, mania, psychosis, or
substance misuse. The patient asks whether medication should immediately be discontinued
because symptoms remain. What is the most appropriate clinical reasoning?
A. Discontinue the SSRI because persistent symptoms establish treatment failure
B. Replace the SSRI immediately with a benzodiazepine
C. Reassess adherence, dose adequacy, adverse effects, comorbidities, and psychotherapy
participation before modifying treatment
D. Increase the SSRI to the maximum dose regardless of tolerability
Correct Answer: C. Reassess adherence, dose adequacy, adverse effects, comorbidities,
and psychotherapy participation before modifying treatment
Explanation: Partial response should prompt systematic reassessment rather than an
automatic medication switch or discontinuation. The clinician should determine whether the
medication has been taken consistently at an adequate therapeutic dose and duration and
assess comorbid depression, substance use, medical contributors, and engagement in
evidence-based psychotherapy. A dose adjustment or medication change may ultimately be
appropriate, but it should be based on this assessment. Benzodiazepines are not
automatically preferred for persistent generalized anxiety symptoms.
QUESTION 4.
A 27-year-old patient presents with auditory hallucinations and paranoid beliefs that
coworkers are transmitting threatening messages through office computers. The patient has
been experiencing progressive social withdrawal, diminished occupational functioning, and
disorganized speech for approximately 8 months. Which finding would most strongly support
schizophrenia rather than schizophreniform disorder?
A. Presence of auditory hallucinations
B. Presence of persecutory delusions
C. Social withdrawal before psychotic symptoms
D. Continuous disturbance lasting at least 6 months with functional deterioration
Correct Answer: D. Continuous disturbance lasting at least 6 months with functional
deterioration
Explanation: Duration and functional decline are critical in differentiating schizophrenia
from schizophreniform disorder. Schizophrenia requires a continuous disturbance for at least
6 months, including at least 1 month of active-phase symptoms, with associated functional
impairment. Hallucinations, delusions, and disorganized speech can occur in both disorders
and therefore do not establish the distinction by themselves. The patient's prolonged course
and deterioration strongly support schizophrenia.
QUESTION 5.
A patient with recurrent major depressive episodes reports periods of markedly increased
energy, decreased need for sleep, impulsive spending, and unusually rapid speech. During the
current evaluation, the patient is euthymic and denies any history of hospitalization or
WALDEN UNIVERSITY 2
, 3 NRNP 6675 advanced practice psychiatric-mental health nursing
psychosis. Which additional historical question is most important before initiating
antidepressant monotherapy?
A. “Have you ever experienced a sustained period of elevated or unusually irritable mood
accompanied by increased goal-directed activity?”
B. “Do you prefer individual or group therapy?”
C. “Have you ever experienced a mild headache after taking medication?”
D. “Do depressive symptoms occur more frequently during winter?”
Correct Answer: A. “Have you ever experienced a sustained period of elevated or
unusually irritable mood accompanied by increased goal-directed activity?”
Explanation: A history suggestive of hypomania or mania can substantially change the
diagnostic formulation and treatment strategy. Antidepressant monotherapy in an individual
with bipolar-spectrum illness may worsen mood instability or precipitate mania or
hypomania. The clinician should obtain a detailed longitudinal mood history, including
duration, functional changes, impulsivity, decreased need for sleep, psychosis, and
consequences. The other questions may contribute to assessment but are less immediately
important to determining whether bipolarity is present.
QUESTION 6.
A 19-year-old college student presents after several weeks of worsening social withdrawal,
declining academic performance, suspiciousness, and hearing a voice commenting on
behavior. The patient's parents report that the patient has also begun neglecting hygiene. The
patient has no known medical illness and denies substance use. Which assessment is most
important before concluding that the symptoms represent a primary psychotic disorder?
A. Determine whether the patient has ever received psychotherapy
B. Establish the patient's preferred learning style
C. Evaluate for substance-induced, medical, neurologic, and medication-related causes of
psychosis
D. Determine whether the patient has experienced childhood separation anxiety
Correct Answer: C. Evaluate for substance-induced, medical, neurologic, and
medication-related causes of psychosis
Explanation: New-onset psychosis requires consideration of secondary causes before
assigning a primary psychotic diagnosis. Substances, medications, endocrine abnormalities,
neurologic disorders, infections, metabolic disturbances, and other medical conditions can
produce psychotic symptoms. The clinician should obtain a detailed history, physical
assessment, medication and substance review, and appropriate diagnostic testing based on
the presentation. Psychosocial history remains important but does not replace evaluation for
potentially reversible causes.
QUESTION 7.
A patient with panic disorder reports sudden episodes of intense fear accompanied by
palpitations, dyspnea, trembling, chest discomfort, and fear of dying. Cardiac evaluation has
been unrevealing. The patient now avoids exercise and crowded places because of concern
about having another attack. Which treatment approach most directly targets the behavioral
mechanism maintaining the patient's symptoms?
WALDEN UNIVERSITY 3
