NURS 6675 FINAL EXAM /ACTUAL NURS 6675 WEEK 11 FINAL EXAM
PMHNP CARE ACROSS THE LIFESPAN II EXAM TEST BANK 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE ACCURATE EXAM
1. A 72-year-old patient with major depressive disorder is being started on an
SSRI. The patient has reduced renal function, takes several medications, and
reports a history of medication sensitivity. Which prescribing approach is
most appropriate when initiating pharmacotherapy for this older adult?
A. Start at a low dose and increase gradually while monitoring response and
adverse effects
B. Begin at the usual adult dose because older adults generally require
higher doses
C. Use several medications simultaneously to reduce the need for dose
titration
D. Avoid antidepressants because psychotropic medications are
contraindicated in older adults
Answer: A
2. A 15-year-old adolescent presents for evaluation after several weeks of
social withdrawal, declining grades, irritability, insomnia, and statements
such as “nothing matters anymore.” Which assessment should the PMHNP
prioritize before completing a routine diagnostic evaluation?
A. Academic achievement testing
B. Detailed dietary assessment
C. Direct assessment of suicidal thoughts, intent, plan, means, and
protective factors
D. Evaluation of the adolescent’s preferred recreational activities
Answer: C
3. A postpartum patient reports persistent sadness, excessive guilt,
hopelessness, impaired bonding with the infant, and loss of interest in
previously enjoyable activities several weeks after delivery. Which clinical
condition should the PMHNP consider most strongly?
A. Postpartum blues
pg. 1
, B. Postpartum depression
C. Normal adjustment to parenthood
D. Premenstrual dysphoric disorder
Answer: B
4. An older adult develops new-onset confusion, fluctuating attention, visual
hallucinations, and disorganized thinking over 24 hours following
hospitalization for pneumonia. Which condition should the PMHNP
recognize as the most likely explanation?
A. Schizophrenia
B. Major neurocognitive disorder
C. Delirium
D. Persistent depressive disorder
Answer: C
5. A patient with alcohol use disorder has completed detoxification and states
that maintaining abstinence is the primary goal. Which medication may be
considered to help reduce the likelihood of returning to alcohol use in an
appropriate patient?
A. Naltrexone
B. Lorazepam
C. Methadone
D. Disulfiram only when actively intoxicated
Answer: A
6. A patient repeatedly demonstrates grandiosity, a need for admiration,
sensitivity to criticism, and limited empathy for others while maintaining an
exaggerated sense of personal importance. Which personality disorder
pattern is most consistent with these findings?
A. Avoidant personality disorder
B. Dependent personality disorder
C. Narcissistic personality disorder
D. Schizoid personality disorder
Answer: C
pg. 2
, 7. A 68-year-old patient receiving an antipsychotic develops repetitive
involuntary movements of the tongue, lips, and jaw after prolonged
treatment. Which adverse effect should the PMHNP recognize?
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Answer: C
8. A patient with bipolar disorder treated with lithium reports worsening
diarrhea, coarse tremor, increasing lethargy, and difficulty walking. What
should the PMHNP do first?
A. Increase the lithium dose
B. Continue lithium and reassess at the next scheduled appointment
C. Add an SSRI
D. Suspect lithium toxicity and arrange prompt evaluation of the lithium
level and clinical status
Answer: D
9. A patient reports that a partner has repeatedly threatened, intimidated,
and physically assaulted them. The patient appears frightened and states,
“If I leave, things will get worse.” Which response by the PMHNP is most
appropriate?
A. “You need to leave the relationship immediately.”
B. “What has the partner done to make you feel unsafe, and what safety
resources are available to you?”
C. “Why have you stayed in the relationship?”
D. “You should confront your partner about the behavior.”
Answer: B
10. During an evaluation of a patient who reports hearing voices, the PMHNP
asks whether the voices command the patient to harm anyone. What is the
primary purpose of this question?
A. To determine the patient's intelligence
pg. 3
, B. To establish the patient's educational level
C. To evaluate potential risk associated with command hallucinations
D. To determine whether the patient has a personality disorder
Answer: C
11. An older adult taking several medications becomes increasingly unsteady
and reports dizziness when standing. Which factor should the PMHNP
recognize as particularly important when evaluating medication-related
problems in older adults?
A. Increased total body water
B. Polypharmacy and age-related changes in pharmacokinetics
C. Consistently increased hepatic metabolism
D. Increased renal clearance
Answer: B
12. A patient with severe depression reports that life is meaningless but denies
having a specific plan for suicide. Which additional assessment is most
important for determining immediate suicide risk?
A. Favorite television programs
B. Current employment history only
C. Access to lethal means and previous suicide attempts
D. Childhood vaccination history
Answer: C
13. A PMHNP is evaluating a patient whose symptoms include intrusive
thoughts and repetitive behaviors performed to reduce anxiety. Which
diagnosis should be considered?
A. Obsessive-compulsive disorder
B. Bipolar I disorder
C. Schizotypal personality disorder
D. Somatic symptom disorder
Answer: A
14. A patient with schizophrenia has been stable on antipsychotic therapy but
develops muscular rigidity, high fever, autonomic instability, and altered
pg. 4
PMHNP CARE ACROSS THE LIFESPAN II EXAM TEST BANK 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE ACCURATE EXAM
1. A 72-year-old patient with major depressive disorder is being started on an
SSRI. The patient has reduced renal function, takes several medications, and
reports a history of medication sensitivity. Which prescribing approach is
most appropriate when initiating pharmacotherapy for this older adult?
A. Start at a low dose and increase gradually while monitoring response and
adverse effects
B. Begin at the usual adult dose because older adults generally require
higher doses
C. Use several medications simultaneously to reduce the need for dose
titration
D. Avoid antidepressants because psychotropic medications are
contraindicated in older adults
Answer: A
2. A 15-year-old adolescent presents for evaluation after several weeks of
social withdrawal, declining grades, irritability, insomnia, and statements
such as “nothing matters anymore.” Which assessment should the PMHNP
prioritize before completing a routine diagnostic evaluation?
A. Academic achievement testing
B. Detailed dietary assessment
C. Direct assessment of suicidal thoughts, intent, plan, means, and
protective factors
D. Evaluation of the adolescent’s preferred recreational activities
Answer: C
3. A postpartum patient reports persistent sadness, excessive guilt,
hopelessness, impaired bonding with the infant, and loss of interest in
previously enjoyable activities several weeks after delivery. Which clinical
condition should the PMHNP consider most strongly?
A. Postpartum blues
pg. 1
, B. Postpartum depression
C. Normal adjustment to parenthood
D. Premenstrual dysphoric disorder
Answer: B
4. An older adult develops new-onset confusion, fluctuating attention, visual
hallucinations, and disorganized thinking over 24 hours following
hospitalization for pneumonia. Which condition should the PMHNP
recognize as the most likely explanation?
A. Schizophrenia
B. Major neurocognitive disorder
C. Delirium
D. Persistent depressive disorder
Answer: C
5. A patient with alcohol use disorder has completed detoxification and states
that maintaining abstinence is the primary goal. Which medication may be
considered to help reduce the likelihood of returning to alcohol use in an
appropriate patient?
A. Naltrexone
B. Lorazepam
C. Methadone
D. Disulfiram only when actively intoxicated
Answer: A
6. A patient repeatedly demonstrates grandiosity, a need for admiration,
sensitivity to criticism, and limited empathy for others while maintaining an
exaggerated sense of personal importance. Which personality disorder
pattern is most consistent with these findings?
A. Avoidant personality disorder
B. Dependent personality disorder
C. Narcissistic personality disorder
D. Schizoid personality disorder
Answer: C
pg. 2
, 7. A 68-year-old patient receiving an antipsychotic develops repetitive
involuntary movements of the tongue, lips, and jaw after prolonged
treatment. Which adverse effect should the PMHNP recognize?
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Answer: C
8. A patient with bipolar disorder treated with lithium reports worsening
diarrhea, coarse tremor, increasing lethargy, and difficulty walking. What
should the PMHNP do first?
A. Increase the lithium dose
B. Continue lithium and reassess at the next scheduled appointment
C. Add an SSRI
D. Suspect lithium toxicity and arrange prompt evaluation of the lithium
level and clinical status
Answer: D
9. A patient reports that a partner has repeatedly threatened, intimidated,
and physically assaulted them. The patient appears frightened and states,
“If I leave, things will get worse.” Which response by the PMHNP is most
appropriate?
A. “You need to leave the relationship immediately.”
B. “What has the partner done to make you feel unsafe, and what safety
resources are available to you?”
C. “Why have you stayed in the relationship?”
D. “You should confront your partner about the behavior.”
Answer: B
10. During an evaluation of a patient who reports hearing voices, the PMHNP
asks whether the voices command the patient to harm anyone. What is the
primary purpose of this question?
A. To determine the patient's intelligence
pg. 3
, B. To establish the patient's educational level
C. To evaluate potential risk associated with command hallucinations
D. To determine whether the patient has a personality disorder
Answer: C
11. An older adult taking several medications becomes increasingly unsteady
and reports dizziness when standing. Which factor should the PMHNP
recognize as particularly important when evaluating medication-related
problems in older adults?
A. Increased total body water
B. Polypharmacy and age-related changes in pharmacokinetics
C. Consistently increased hepatic metabolism
D. Increased renal clearance
Answer: B
12. A patient with severe depression reports that life is meaningless but denies
having a specific plan for suicide. Which additional assessment is most
important for determining immediate suicide risk?
A. Favorite television programs
B. Current employment history only
C. Access to lethal means and previous suicide attempts
D. Childhood vaccination history
Answer: C
13. A PMHNP is evaluating a patient whose symptoms include intrusive
thoughts and repetitive behaviors performed to reduce anxiety. Which
diagnosis should be considered?
A. Obsessive-compulsive disorder
B. Bipolar I disorder
C. Schizotypal personality disorder
D. Somatic symptom disorder
Answer: A
14. A patient with schizophrenia has been stable on antipsychotic therapy but
develops muscular rigidity, high fever, autonomic instability, and altered
pg. 4
