NR606 Week 1 Exam V3 | NR606 Diagnosis & Management in
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 1 Exam) | Chamberlain University
1. A 45-year-old male presents with symptoms of anhedonia, fatigue, and feelings of
worthlessness for the past three weeks. According to the DSM-5-TR, which of the following is
required for a diagnosis of Major Depressive Disorder (MDD)?
A. Symptoms must include either depressed mood or loss of interest/pleasure.
B. The patient must have at least three somatic symptoms.
C. Symptoms must be present for at least six consecutive months.
D. The patient must report a family history of depressive episodes.
Answer: A
Explanation: To meet the criteria for Major Depressive Disorder, at least five symptoms
must be present during the same 2-week period. One of these symptoms must be either
depressed mood or loss of interest or pleasure, which is clinically known as anhedonia.
This diagnostic standard ensures that the core features of the depressive syndrome are
recognized before a diagnosis is finalized.
2. A PMHNP is assessing a patient for Bipolar Disorder. The patient reports a period of
elevated mood lasting 4 days that did not require hospitalization. Which diagnosis is most
likely?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with psychotic features
Answer: B
Explanation: Bipolar II Disorder requires at least one hypomanic episode lasting at least 4
days and at least one major depressive episode. Unlike full mania seen in Bipolar I,
hypomania does not cause marked impairment in social or occupational functioning and
does not require hospitalization. The differentiation depends on the duration and severity
of the elevated mood period.
3. Which neurotransmitter is primarily associated with the ‘reward’ system of the brain and is
often implicated in substance use disorders?
A. Serotonin
B. Norepinephrine
,C. GABA
D. Dopamine
Answer: D
Explanation: Dopamine is the primary neurotransmitter involved in the brain’s reward
and pleasure circuitry, particularly within the mesolimbic pathway. Most addictive
substances trigger a significant release of dopamine, reinforcing the behavior and leading
to the cycle of addiction. Understanding this pathway is essential for PMHNPs when
treating patients with co-occurring disorders.
4. When conducting a suicide risk assessment, which of the following factors is considered the
strongest predictor of a completed suicide?
A. Current use of antidepressant medication
B. A family history of mental illness
C. A history of previous suicide attempts
D. Expression of vague suicidal ideation
Answer: C
Explanation: A history of previous suicide attempts is widely recognized as the strongest
single predictor of a future completed suicide. PMHNPs must prioritize a thorough
exploration of past self-harm behaviors during the intake process. This clinical insight
allows for more accurate risk stratification and the implementation of appropriate safety
planning.
5. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which laboratory
value must be monitored strictly to screen for agranulocytosis?
A. Liver function tests (LFTs)
B. Thyroid stimulating hormone (TSH)
C. Serum creatinine
D. Absolute Neutrophil Count (ANC)
Answer: D
Explanation: Clozapine therapy is associated with a risk of severe neutropenia, which can
lead to life-threatening infections. The Absolute Neutrophil Count (ANC) must be
monitored regularly according to the Clozapine REMS program guidelines. Clinicians must
follow strict protocols for reporting these values to ensure the patient’s safety throughout
the treatment process.
, 6. In the context of the PMHNP-patient relationship, what is the primary purpose of
‘therapeutic neutrality’?
A. To prevent the clinician from sharing personal opinions or values.
B. To ensure the patient likes the provider.
C. To minimize the cost of the treatment session.
D. To allow the provider to avoid making difficult diagnoses.
Answer: A
Explanation: Therapeutic neutrality involves the clinician maintaining a non-judgmental
stance and refraining from imposing their own values or opinions on the patient. This
approach fosters a safe environment where the patient feels free to explore their own
thoughts and feelings without fear of criticism. It is a fundamental component of effective
psychotherapeutic management in advanced nursing practice.
7. A 28-year-old female presents with intense fear of gaining weight and a body weight that is
significantly below the minimum normal for her age. She admits to restricting food intake.
What is the most likely diagnosis?
A. Anorexia Nervosa
B. Binge-Eating Disorder
C. Bulimia Nervosa
D. Avoidant/Restrictive Food Intake Disorder
Answer: A
Explanation: Anorexia Nervosa is characterized by a restriction of energy intake leading to
a significantly low body weight, an intense fear of gaining weight, and a disturbance in the
way one’s body weight is experienced. Unlike Bulimia, the core feature is the significantly
low body weight. Identifying these criteria is vital for early intervention and medical
stabilization.
8. Which legal principle established that mental health professionals have a ‘duty to warn’
third parties who are in imminent danger from a patient?
A. Roe v. Wade
B. Tarasoff v. Regents of the University of California
C. Miranda v. Arizona
D. O’Connor v. Donaldson
Answer: B
Psychiatric-Mental Health II Practicum | Q&A with Rationale (NR606
Week 1 Exam) | Chamberlain University
1. A 45-year-old male presents with symptoms of anhedonia, fatigue, and feelings of
worthlessness for the past three weeks. According to the DSM-5-TR, which of the following is
required for a diagnosis of Major Depressive Disorder (MDD)?
A. Symptoms must include either depressed mood or loss of interest/pleasure.
B. The patient must have at least three somatic symptoms.
C. Symptoms must be present for at least six consecutive months.
D. The patient must report a family history of depressive episodes.
Answer: A
Explanation: To meet the criteria for Major Depressive Disorder, at least five symptoms
must be present during the same 2-week period. One of these symptoms must be either
depressed mood or loss of interest or pleasure, which is clinically known as anhedonia.
This diagnostic standard ensures that the core features of the depressive syndrome are
recognized before a diagnosis is finalized.
2. A PMHNP is assessing a patient for Bipolar Disorder. The patient reports a period of
elevated mood lasting 4 days that did not require hospitalization. Which diagnosis is most
likely?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with psychotic features
Answer: B
Explanation: Bipolar II Disorder requires at least one hypomanic episode lasting at least 4
days and at least one major depressive episode. Unlike full mania seen in Bipolar I,
hypomania does not cause marked impairment in social or occupational functioning and
does not require hospitalization. The differentiation depends on the duration and severity
of the elevated mood period.
3. Which neurotransmitter is primarily associated with the ‘reward’ system of the brain and is
often implicated in substance use disorders?
A. Serotonin
B. Norepinephrine
,C. GABA
D. Dopamine
Answer: D
Explanation: Dopamine is the primary neurotransmitter involved in the brain’s reward
and pleasure circuitry, particularly within the mesolimbic pathway. Most addictive
substances trigger a significant release of dopamine, reinforcing the behavior and leading
to the cycle of addiction. Understanding this pathway is essential for PMHNPs when
treating patients with co-occurring disorders.
4. When conducting a suicide risk assessment, which of the following factors is considered the
strongest predictor of a completed suicide?
A. Current use of antidepressant medication
B. A family history of mental illness
C. A history of previous suicide attempts
D. Expression of vague suicidal ideation
Answer: C
Explanation: A history of previous suicide attempts is widely recognized as the strongest
single predictor of a future completed suicide. PMHNPs must prioritize a thorough
exploration of past self-harm behaviors during the intake process. This clinical insight
allows for more accurate risk stratification and the implementation of appropriate safety
planning.
5. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which laboratory
value must be monitored strictly to screen for agranulocytosis?
A. Liver function tests (LFTs)
B. Thyroid stimulating hormone (TSH)
C. Serum creatinine
D. Absolute Neutrophil Count (ANC)
Answer: D
Explanation: Clozapine therapy is associated with a risk of severe neutropenia, which can
lead to life-threatening infections. The Absolute Neutrophil Count (ANC) must be
monitored regularly according to the Clozapine REMS program guidelines. Clinicians must
follow strict protocols for reporting these values to ensure the patient’s safety throughout
the treatment process.
, 6. In the context of the PMHNP-patient relationship, what is the primary purpose of
‘therapeutic neutrality’?
A. To prevent the clinician from sharing personal opinions or values.
B. To ensure the patient likes the provider.
C. To minimize the cost of the treatment session.
D. To allow the provider to avoid making difficult diagnoses.
Answer: A
Explanation: Therapeutic neutrality involves the clinician maintaining a non-judgmental
stance and refraining from imposing their own values or opinions on the patient. This
approach fosters a safe environment where the patient feels free to explore their own
thoughts and feelings without fear of criticism. It is a fundamental component of effective
psychotherapeutic management in advanced nursing practice.
7. A 28-year-old female presents with intense fear of gaining weight and a body weight that is
significantly below the minimum normal for her age. She admits to restricting food intake.
What is the most likely diagnosis?
A. Anorexia Nervosa
B. Binge-Eating Disorder
C. Bulimia Nervosa
D. Avoidant/Restrictive Food Intake Disorder
Answer: A
Explanation: Anorexia Nervosa is characterized by a restriction of energy intake leading to
a significantly low body weight, an intense fear of gaining weight, and a disturbance in the
way one’s body weight is experienced. Unlike Bulimia, the core feature is the significantly
low body weight. Identifying these criteria is vital for early intervention and medical
stabilization.
8. Which legal principle established that mental health professionals have a ‘duty to warn’
third parties who are in imminent danger from a patient?
A. Roe v. Wade
B. Tarasoff v. Regents of the University of California
C. Miranda v. Arizona
D. O’Connor v. Donaldson
Answer: B
