NR547 ADVANCED PSYCHIATRIC-
MENTAL HEALTH NURSE
PRACTITIONER EXAM PREP
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A 24-year-old male presents with auditory hallucinations and paranoia. In the neurobiology
of schizophrenia, which dopaminergic pathway is primarily associated with the positive
symptoms of psychosis?
A. Nigrostriatal pathway
B. Tuberoinfundibular pathway
C. Mesocortical pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway is associated with reward and
pleasure; hyperactivity in this pathway is theorized to cause the positive symptoms of
schizophrenia, such as hallucinations and delusions.
2. A patient is started on Clozapine for treatment-resistant schizophrenia. Which laboratory
parameter must be monitored strictly due to the risk of agranulocytosis?
A. Absolute Neutrophil Count (ANC)
,B. Liver Function Tests (LFTs)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Clozapine carries a Risk Evaluation and Mitigation Strategy
(REMS) requirement for monitoring ANC due to the risk of life-threatening agranulocytosis.
3. A patient exhibits high fever, muscle rigidity (lead-pipe), altered mental status, and
autonomic instability after receiving Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Anticholinergic Toxicity
D. Acute Dystonia
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to dopamine antagonists
characterized by lead-pipe rigidity, hyperthermia, and autonomic instability.
4. Which neurotransmitter is primarily targeted by Benzodiazepines to produce anxiolytic and
sedative effects?
A. Glutamate
B. Serotonin
, C. Norepinephrine
D. GABA
Answer: D
Conceptual Explanation: Benzodiazepines act as positive allosteric modulators at the
GABA-A receptor, enhancing the inhibitory effects of Gamma-aminobutyric acid (GABA).
5. A 32-year-old female patient on Lamotrigine for Bipolar Disorder reports a new, blistering
rash on her torso. What is the priority action for the PMHNP?
A. Discontinue Lamotrigine immediately and refer to the emergency department
B. Decrease the dose of Lamotrigine by half
C. Advise the patient to take Diphenhydramine
D. Wait 24 hours to see if the rash resolves
Answer: A
Conceptual Explanation: A new rash in a patient taking Lamotrigine may indicate
Stevens-Johnson Syndrome (SJS), a life-threatening dermatological emergency requiring
immediate discontinuation.
6. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose a Major Depressive Episode?
A. 1 week
B. 2 weeks
MENTAL HEALTH NURSE
PRACTITIONER EXAM PREP
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A 24-year-old male presents with auditory hallucinations and paranoia. In the neurobiology
of schizophrenia, which dopaminergic pathway is primarily associated with the positive
symptoms of psychosis?
A. Nigrostriatal pathway
B. Tuberoinfundibular pathway
C. Mesocortical pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway is associated with reward and
pleasure; hyperactivity in this pathway is theorized to cause the positive symptoms of
schizophrenia, such as hallucinations and delusions.
2. A patient is started on Clozapine for treatment-resistant schizophrenia. Which laboratory
parameter must be monitored strictly due to the risk of agranulocytosis?
A. Absolute Neutrophil Count (ANC)
,B. Liver Function Tests (LFTs)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Clozapine carries a Risk Evaluation and Mitigation Strategy
(REMS) requirement for monitoring ANC due to the risk of life-threatening agranulocytosis.
3. A patient exhibits high fever, muscle rigidity (lead-pipe), altered mental status, and
autonomic instability after receiving Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Anticholinergic Toxicity
D. Acute Dystonia
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to dopamine antagonists
characterized by lead-pipe rigidity, hyperthermia, and autonomic instability.
4. Which neurotransmitter is primarily targeted by Benzodiazepines to produce anxiolytic and
sedative effects?
A. Glutamate
B. Serotonin
, C. Norepinephrine
D. GABA
Answer: D
Conceptual Explanation: Benzodiazepines act as positive allosteric modulators at the
GABA-A receptor, enhancing the inhibitory effects of Gamma-aminobutyric acid (GABA).
5. A 32-year-old female patient on Lamotrigine for Bipolar Disorder reports a new, blistering
rash on her torso. What is the priority action for the PMHNP?
A. Discontinue Lamotrigine immediately and refer to the emergency department
B. Decrease the dose of Lamotrigine by half
C. Advise the patient to take Diphenhydramine
D. Wait 24 hours to see if the rash resolves
Answer: A
Conceptual Explanation: A new rash in a patient taking Lamotrigine may indicate
Stevens-Johnson Syndrome (SJS), a life-threatening dermatological emergency requiring
immediate discontinuation.
6. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose a Major Depressive Episode?
A. 1 week
B. 2 weeks
