NR 547 PMHNP 2025 LATEST TEST BANK
FOR MIDTERM AND FINAL EXAM REVIEW/
NR547/ NR 547 MIDTERM & FINAL EXAM
PREP CHAMBERLAIN (BRAND NEW!)
John is a 22-year-old RN who has started his first job in the cardiothoracic ICU.
After his orientation, he began his full-time position working three 12-hour night
shifts per week. On his days off, he reports excessive fatigue during the day with
periods of falling asleep while driving. He also reports difficulty staying awake at
work during his first night back to work. Which of the following is the most likely
diagnosis?
Narcolepsy
Circadian rhythm sleep disorder
Hypersomnia
Night terrors
Circadian rhythm sleep disorder
Which statement indicates that a client understands education regarding the
treatment Lithium?
“I should take all my medications as prescribed and get lab work drawn as
ordered.”
A client presents to the emergency department following a nonfatal suicide
attempt. She states that her boyfriend just broke up with her due to her bad temper
and constant moodiness, and she can't be alone. Her forearms and thighs show thin
cuts and scars at various stages of healing. What is the client's most likely
diagnosis?
Borderline personality disorder
A 50-year-old client presents with fatigue and poor motivation to the point that she
is avoiding work. She reports that for the past several weeks she has a poor
appetite and sleeps over 14 hours per day. She notes that last month, she felt "much
better" had lots of energy, and didn't need much sleep. She went on several
pg. 1
,shopping sprees that caused her checking account to be overdrawn. Which
diagnosis is most consistent with the client's symptoms?
Bipolar I disorder
A 25-year-old client presents with irritability, insomnia, and excessive energy. She
states she has felt this way for about a week. Last month, she reports that she felt
"really down" and slept most of the time. She endorses a pattern of "ups and
downs" in her mood at least half the time over the past few years. Which diagnosis
is the most consistent with the client's symptoms?
Cyclothymia
A client with substance use disorder is experiencing cravings and withdrawal
symptoms. The client is currently receiving inpatient therapy. Which is the most
appropriate diagnosis?
Substance use disorder in a controlled environment
A client presents with difficulties following her divorce from an abusive spouse.
She states that she is afraid of being on her own because she is worried that she
won't be able to take care of herself. She is currently living with her sister because
she can't decide whether to get an apartment or buy a house. Though she's only
been divorced for a few weeks, she's been on several dates through a dating
website in the hopes of finding another partner soon. The client's symptoms are
consistent with which diagnosis?
Dependent personality disorder
Which of the following best describes substance use disorder?
Prolonged use and abuse of a substance
The PMHNP is conducting a follow up exam with a 24 year old male patient
diagnosed with major depressive disorder who is on sertraline 50mg daily. Which
of the following sleep patterns may the patient report while on this medication?
No change in sleep pattern
Difficulty falling asleep
Difficulty waking up
Increased sleepiness earlier in the evening
pg. 2
,Difficulty falling asleep
Advise patients to take sertraline in the AM
A client wishing to use medication-assisted treatment for opioid use disorder
expresses concerns that her roommates may try to steal her medication to get high.
Which medication is the most appropriate options for the client?
Buprenorphine/Naloxone
Which of the following is the best predictor for antisocial personality disorder?
A diagnosis of conduct disorder at age 13
Which of the following is a tool that may be used to screen for any type of
substance use disorder?
SBIRT
Which of the following would be included in the treatment plan for a client with
antisocial personality disorder?
Reward-Based therapy
Which description best describes cluster A personality disorders?
Characterized by odd, eccentric thinking or behavior
Which characteristic is most indicative of narcissistic personality disorder?
Ongoing need for admiration
Select an appropriate initial medication choice for a 75-year-old with a new
diagnosis of major depressive disorder.
Escitalopram 10 mg daily
An inpatient client has a CIWA-Ar score of 12. What is the most appropriate
action by the nurse practitioner?
Prescribe STAT dose of oral Lorazepam and reassess CIWA-Ar every hour
Which of the following are characteristics of borderline personality disorder?
Tumultuous interpersonal relationships and short-lived psychotic episodes
pg. 3
, When conducting a cognitive assessment, what does the question "what did you
have for dinner last night" assess?
Recent memory
A client is concerned that he won't pass a urine drug screen at his new job because
he used marijuana three days ago. What is the most appropriate response by the
psychiatric mental health nurse practitioner?
Marijuana can be detected in the urine for up to 7 days
Which symptoms are associated with the anxious distress DSM specifier for major
depressive disorder?
Feeling restless, excessive worry
A client is interested in therapies to augment his medication treatment for mild
major depressive disorder. What are appropriate recommendations?
Cognitive Behavioral Therapy and exercise three times a week
A client presents with ataxia, short-term memory loss, and nystagmus. The client
has a history of prolonged, heavy alcohol use. What is the most likely diagnosis?
Wernicke Encephalopathy
_______ diagnosed with major neurocognitive disorder due to Alzheimer's disease.
What pharmacologic therapy would be anticipated?
Memantine
_____presents for treatment following a breakup with her girlfriend. She is dressed
in a short skirt and low-cut blouse. She is very friendly __________dramatically
providing intimate details about several past relationships. The client's presentation
is consistent with which personality disorder?
Histrionic personality disorder
An inpatient client has a CIWA-Ar score of 7. What is the most appropriate action
by the nurse practitioner?
Reassess CIWA-Ar every 4 hours; do not prescribe medication at this time
Which client is most likely to experience delirium?
A client admitted to the intensive care unit after his hip surgery
pg. 4
FOR MIDTERM AND FINAL EXAM REVIEW/
NR547/ NR 547 MIDTERM & FINAL EXAM
PREP CHAMBERLAIN (BRAND NEW!)
John is a 22-year-old RN who has started his first job in the cardiothoracic ICU.
After his orientation, he began his full-time position working three 12-hour night
shifts per week. On his days off, he reports excessive fatigue during the day with
periods of falling asleep while driving. He also reports difficulty staying awake at
work during his first night back to work. Which of the following is the most likely
diagnosis?
Narcolepsy
Circadian rhythm sleep disorder
Hypersomnia
Night terrors
Circadian rhythm sleep disorder
Which statement indicates that a client understands education regarding the
treatment Lithium?
“I should take all my medications as prescribed and get lab work drawn as
ordered.”
A client presents to the emergency department following a nonfatal suicide
attempt. She states that her boyfriend just broke up with her due to her bad temper
and constant moodiness, and she can't be alone. Her forearms and thighs show thin
cuts and scars at various stages of healing. What is the client's most likely
diagnosis?
Borderline personality disorder
A 50-year-old client presents with fatigue and poor motivation to the point that she
is avoiding work. She reports that for the past several weeks she has a poor
appetite and sleeps over 14 hours per day. She notes that last month, she felt "much
better" had lots of energy, and didn't need much sleep. She went on several
pg. 1
,shopping sprees that caused her checking account to be overdrawn. Which
diagnosis is most consistent with the client's symptoms?
Bipolar I disorder
A 25-year-old client presents with irritability, insomnia, and excessive energy. She
states she has felt this way for about a week. Last month, she reports that she felt
"really down" and slept most of the time. She endorses a pattern of "ups and
downs" in her mood at least half the time over the past few years. Which diagnosis
is the most consistent with the client's symptoms?
Cyclothymia
A client with substance use disorder is experiencing cravings and withdrawal
symptoms. The client is currently receiving inpatient therapy. Which is the most
appropriate diagnosis?
Substance use disorder in a controlled environment
A client presents with difficulties following her divorce from an abusive spouse.
She states that she is afraid of being on her own because she is worried that she
won't be able to take care of herself. She is currently living with her sister because
she can't decide whether to get an apartment or buy a house. Though she's only
been divorced for a few weeks, she's been on several dates through a dating
website in the hopes of finding another partner soon. The client's symptoms are
consistent with which diagnosis?
Dependent personality disorder
Which of the following best describes substance use disorder?
Prolonged use and abuse of a substance
The PMHNP is conducting a follow up exam with a 24 year old male patient
diagnosed with major depressive disorder who is on sertraline 50mg daily. Which
of the following sleep patterns may the patient report while on this medication?
No change in sleep pattern
Difficulty falling asleep
Difficulty waking up
Increased sleepiness earlier in the evening
pg. 2
,Difficulty falling asleep
Advise patients to take sertraline in the AM
A client wishing to use medication-assisted treatment for opioid use disorder
expresses concerns that her roommates may try to steal her medication to get high.
Which medication is the most appropriate options for the client?
Buprenorphine/Naloxone
Which of the following is the best predictor for antisocial personality disorder?
A diagnosis of conduct disorder at age 13
Which of the following is a tool that may be used to screen for any type of
substance use disorder?
SBIRT
Which of the following would be included in the treatment plan for a client with
antisocial personality disorder?
Reward-Based therapy
Which description best describes cluster A personality disorders?
Characterized by odd, eccentric thinking or behavior
Which characteristic is most indicative of narcissistic personality disorder?
Ongoing need for admiration
Select an appropriate initial medication choice for a 75-year-old with a new
diagnosis of major depressive disorder.
Escitalopram 10 mg daily
An inpatient client has a CIWA-Ar score of 12. What is the most appropriate
action by the nurse practitioner?
Prescribe STAT dose of oral Lorazepam and reassess CIWA-Ar every hour
Which of the following are characteristics of borderline personality disorder?
Tumultuous interpersonal relationships and short-lived psychotic episodes
pg. 3
, When conducting a cognitive assessment, what does the question "what did you
have for dinner last night" assess?
Recent memory
A client is concerned that he won't pass a urine drug screen at his new job because
he used marijuana three days ago. What is the most appropriate response by the
psychiatric mental health nurse practitioner?
Marijuana can be detected in the urine for up to 7 days
Which symptoms are associated with the anxious distress DSM specifier for major
depressive disorder?
Feeling restless, excessive worry
A client is interested in therapies to augment his medication treatment for mild
major depressive disorder. What are appropriate recommendations?
Cognitive Behavioral Therapy and exercise three times a week
A client presents with ataxia, short-term memory loss, and nystagmus. The client
has a history of prolonged, heavy alcohol use. What is the most likely diagnosis?
Wernicke Encephalopathy
_______ diagnosed with major neurocognitive disorder due to Alzheimer's disease.
What pharmacologic therapy would be anticipated?
Memantine
_____presents for treatment following a breakup with her girlfriend. She is dressed
in a short skirt and low-cut blouse. She is very friendly __________dramatically
providing intimate details about several past relationships. The client's presentation
is consistent with which personality disorder?
Histrionic personality disorder
An inpatient client has a CIWA-Ar score of 7. What is the most appropriate action
by the nurse practitioner?
Reassess CIWA-Ar every 4 hours; do not prescribe medication at this time
Which client is most likely to experience delirium?
A client admitted to the intensive care unit after his hip surgery
pg. 4
