Chamberlain University | NR606 | PMHNP II Final Practice
CHAMBERLAIN UNIVERSITY NR606 FINAL EXAM (pdf) |
2026/2027 |
DIAGNOSIS & MANAGEMENT IN PSYCHIATRIC-MENTAL
HEALTH II Q&A | PMHNP
Original practice resource | 2026/2027
, Chamberlain University | NR606 | PMHNP II Final Practice
Practice Final Examination
Question 1
A 10-year-old has persistent inattention and hyperactivity at school and home for 8 months with academic impairment. Which
feature most supports ADHD?
A. The child has no functional impairment
B. Symptoms began yesterday
C. Symptoms occur only during math class
D. Symptoms occur in more than one setting and impair functioning
Correct Answer: D. Symptoms occur in more than one setting and impair functioning
Rationale: ADHD requires a persistent developmentally inappropriate pattern with impairment in multiple settings.
Why the Other Options Are Incorrect:
A. Incorrect - Clinically significant impairment is part of the diagnosis.
B. Incorrect - The pattern must be persistent rather than acute.
C. Incorrect - ADHD requires symptoms across settings, not a single class.
Question 2
For a 5-year-old with newly diagnosed ADHD, which initial intervention is most consistent with current pediatric guidance?
A. Long-term benzodiazepine therapy
B. Immediate high-dose amphetamine monotherapy
C. Parent training in behavior management
D. No treatment until age 12
Correct Answer: C. Parent training in behavior management
Rationale: For ages 4-6, parent training in behavior management and/or behavioral classroom intervention is first-line.
Why the Other Options Are Incorrect:
A. Incorrect - Benzodiazepines do not treat core ADHD symptoms and create safety risks.
B. Incorrect - Medication is not the preferred first step for most preschool-age children.
D. Incorrect - Early evidence-based intervention is appropriate when impairment is present.
Question 3
Which finding should be monitored routinely after starting a stimulant for ADHD?
A. Weekly liver biopsy
Original practice resource | 2026/2027
, Chamberlain University | NR606 | PMHNP II Final Practice
B. Blood pressure, pulse, appetite, weight, sleep, and symptom response
C. Serum lithium concentration
D. INR at every visit
Correct Answer: B. Blood pressure, pulse, appetite, weight, sleep, and symptom response
Rationale: Stimulants can affect appetite, growth, sleep, heart rate, and blood pressure; benefit and adverse effects should be
tracked.
Why the Other Options Are Incorrect:
A. Incorrect - This is not part of routine stimulant monitoring.
C. Incorrect - Lithium monitoring is unrelated to stimulant treatment.
D. Incorrect - Stimulants do not require anticoagulation monitoring.
Question 4
An adolescent with ADHD has a history of diverting stimulant medication. Which treatment feature is especially relevant when
selecting therapy?
A. Consider a nonstimulant or formulation with lower diversion potential
B. Stop all ADHD treatment permanently
C. Ignore the diversion history
D. Prescribe extra immediate-release doses without monitoring
Correct Answer: A. Consider a nonstimulant or formulation with lower diversion potential
Rationale: Diversion risk should shape shared treatment decisions and monitoring.
Why the Other Options Are Incorrect:
B. Incorrect - ADHD can still be treated using safer individualized options.
C. Incorrect - Misuse and diversion are important safety considerations.
D. Incorrect - This can increase diversion risk.
Question 5
Which medication is a selective norepinephrine reuptake inhibitor used for ADHD and has no stimulant abuse liability?
A. Dextroamphetamine
B. Lisdexamfetamine
C. Methylphenidate
D. Atomoxetine
Correct Answer: D. Atomoxetine
Original practice resource | 2026/2027
, Chamberlain University | NR606 | PMHNP II Final Practice
Rationale: Atomoxetine is a nonstimulant norepinephrine reuptake inhibitor used for ADHD.
Why the Other Options Are Incorrect:
A. Incorrect - This is an amphetamine stimulant.
B. Incorrect - This is a stimulant prodrug.
C. Incorrect - This is a stimulant.
Question 6
A patient taking atomoxetine reports new suicidal thoughts. What is the priority response?
A. Tell the patient this cannot be medication related
B. Wait until the next routine visit
C. Perform an immediate suicide risk assessment and address safety
D. Double the dose
Correct Answer: C. Perform an immediate suicide risk assessment and address safety
Rationale: Safety assessment takes priority when suicidal thoughts emerge during treatment.
Why the Other Options Are Incorrect:
A. Incorrect - Potential treatment-emergent psychiatric symptoms require evaluation.
B. Incorrect - New suicidal thinking requires prompt assessment.
D. Incorrect - Dose escalation is unsafe before evaluating the adverse change.
Question 7
Which adverse effect is commonly associated with stimulant treatment?
A. Profound weight gain
B. Persistent sedation
C. Severe bradycardia as the expected effect
D. Decreased appetite and insomnia
Correct Answer: D. Decreased appetite and insomnia
Rationale: Appetite reduction and sleep difficulty are common stimulant adverse effects.
Why the Other Options Are Incorrect:
A. Incorrect - Appetite suppression and weight loss are more typical.
B. Incorrect - Stimulants generally increase alertness rather than cause persistent sedation.
C. Incorrect - Stimulants more often increase heart rate than cause expected bradycardia.
Original practice resource | 2026/2027
CHAMBERLAIN UNIVERSITY NR606 FINAL EXAM (pdf) |
2026/2027 |
DIAGNOSIS & MANAGEMENT IN PSYCHIATRIC-MENTAL
HEALTH II Q&A | PMHNP
Original practice resource | 2026/2027
, Chamberlain University | NR606 | PMHNP II Final Practice
Practice Final Examination
Question 1
A 10-year-old has persistent inattention and hyperactivity at school and home for 8 months with academic impairment. Which
feature most supports ADHD?
A. The child has no functional impairment
B. Symptoms began yesterday
C. Symptoms occur only during math class
D. Symptoms occur in more than one setting and impair functioning
Correct Answer: D. Symptoms occur in more than one setting and impair functioning
Rationale: ADHD requires a persistent developmentally inappropriate pattern with impairment in multiple settings.
Why the Other Options Are Incorrect:
A. Incorrect - Clinically significant impairment is part of the diagnosis.
B. Incorrect - The pattern must be persistent rather than acute.
C. Incorrect - ADHD requires symptoms across settings, not a single class.
Question 2
For a 5-year-old with newly diagnosed ADHD, which initial intervention is most consistent with current pediatric guidance?
A. Long-term benzodiazepine therapy
B. Immediate high-dose amphetamine monotherapy
C. Parent training in behavior management
D. No treatment until age 12
Correct Answer: C. Parent training in behavior management
Rationale: For ages 4-6, parent training in behavior management and/or behavioral classroom intervention is first-line.
Why the Other Options Are Incorrect:
A. Incorrect - Benzodiazepines do not treat core ADHD symptoms and create safety risks.
B. Incorrect - Medication is not the preferred first step for most preschool-age children.
D. Incorrect - Early evidence-based intervention is appropriate when impairment is present.
Question 3
Which finding should be monitored routinely after starting a stimulant for ADHD?
A. Weekly liver biopsy
Original practice resource | 2026/2027
, Chamberlain University | NR606 | PMHNP II Final Practice
B. Blood pressure, pulse, appetite, weight, sleep, and symptom response
C. Serum lithium concentration
D. INR at every visit
Correct Answer: B. Blood pressure, pulse, appetite, weight, sleep, and symptom response
Rationale: Stimulants can affect appetite, growth, sleep, heart rate, and blood pressure; benefit and adverse effects should be
tracked.
Why the Other Options Are Incorrect:
A. Incorrect - This is not part of routine stimulant monitoring.
C. Incorrect - Lithium monitoring is unrelated to stimulant treatment.
D. Incorrect - Stimulants do not require anticoagulation monitoring.
Question 4
An adolescent with ADHD has a history of diverting stimulant medication. Which treatment feature is especially relevant when
selecting therapy?
A. Consider a nonstimulant or formulation with lower diversion potential
B. Stop all ADHD treatment permanently
C. Ignore the diversion history
D. Prescribe extra immediate-release doses without monitoring
Correct Answer: A. Consider a nonstimulant or formulation with lower diversion potential
Rationale: Diversion risk should shape shared treatment decisions and monitoring.
Why the Other Options Are Incorrect:
B. Incorrect - ADHD can still be treated using safer individualized options.
C. Incorrect - Misuse and diversion are important safety considerations.
D. Incorrect - This can increase diversion risk.
Question 5
Which medication is a selective norepinephrine reuptake inhibitor used for ADHD and has no stimulant abuse liability?
A. Dextroamphetamine
B. Lisdexamfetamine
C. Methylphenidate
D. Atomoxetine
Correct Answer: D. Atomoxetine
Original practice resource | 2026/2027
, Chamberlain University | NR606 | PMHNP II Final Practice
Rationale: Atomoxetine is a nonstimulant norepinephrine reuptake inhibitor used for ADHD.
Why the Other Options Are Incorrect:
A. Incorrect - This is an amphetamine stimulant.
B. Incorrect - This is a stimulant prodrug.
C. Incorrect - This is a stimulant.
Question 6
A patient taking atomoxetine reports new suicidal thoughts. What is the priority response?
A. Tell the patient this cannot be medication related
B. Wait until the next routine visit
C. Perform an immediate suicide risk assessment and address safety
D. Double the dose
Correct Answer: C. Perform an immediate suicide risk assessment and address safety
Rationale: Safety assessment takes priority when suicidal thoughts emerge during treatment.
Why the Other Options Are Incorrect:
A. Incorrect - Potential treatment-emergent psychiatric symptoms require evaluation.
B. Incorrect - New suicidal thinking requires prompt assessment.
D. Incorrect - Dose escalation is unsafe before evaluating the adverse change.
Question 7
Which adverse effect is commonly associated with stimulant treatment?
A. Profound weight gain
B. Persistent sedation
C. Severe bradycardia as the expected effect
D. Decreased appetite and insomnia
Correct Answer: D. Decreased appetite and insomnia
Rationale: Appetite reduction and sleep difficulty are common stimulant adverse effects.
Why the Other Options Are Incorrect:
A. Incorrect - Appetite suppression and weight loss are more typical.
B. Incorrect - Stimulants generally increase alertness rather than cause persistent sedation.
C. Incorrect - Stimulants more often increase heart rate than cause expected bradycardia.
Original practice resource | 2026/2027
