NR607 FINAL EXAM: 200+ QUESTIONS AND 100% VERIFIED
ANSWERS 2025
________ in treatment-resistant cases.
- answer-clozapine
-Patients should be offered a clozapine trial if they have a partial or non-response to two
antipsychotic trials, assuming those antipsychotic trials are an adequate dose and
duration (four to eight weeks)
___________ is FDA approved for tx of tardive dyskinesia
- answer-Valbenazine (Ingrezza)
_____________________ for care and treatment is a fundamental ethical and legal
principle
- answer-Informed consent
A global pandemic limits face-to-face mental health visits, the PMHNP determines that
the patient requires ongoing mental health treatment. The PMHNP arranges to meet
with the client via weekly interactive video sessions.
PMHNP role:
Acute PMHNP Care
Telehealth
Case Management
Primary Care
Pharmacologic Intervention
Crisis Intervention
Partial Hospitalization/Intensive Outpatient Tx
Community-Based Care
Self-Employment
Psychotherapy
- answer-Telehealth
Rationale: Telehealth services utilize telecommunication technology to deliver treatment
to clients.
A PMHNP discovers her colleague is diverting scheduled medications to self-medicate
anxiety. The PMHNP reports the concerns to the colleagues supervisor.
How the PMHNP applied ethical principles:
,-Respect for the Individual
-Commitment to the Healthcare Consumer
-Advocacy for the Healthcare Consumer
-Responsibility and Accountability for Practice
-Duties to Self and Others
-Contributions to Healthcare Environments
-Advancement of the Nursing Profession
-Collaboration to Meet Health Needs
-Promotion of the Nursing Profession
- answer-Contributions to Healthcare Environments
Rationale: The PMHNP recognizes signs/symptoms of psychiatric disorders in the
workplace reporting peer observations to leadership. The PMHNP helps address
problems faced by colleagues that impact client safety or violate public trust, including
substance abuse.
A PMHNP speaks at a school board meeting about the need develop policies to expand
mental health services for underserved students.
How the PMHNP applied ethical principles:
-Respect for the Individual
-Commitment to the Healthcare Consumer
-Advocacy for the Healthcare Consumer
-Responsibility and Accountability for Practice
-Duties to Self and Others
-Contributions to Healthcare Environments
-Advancement of the Nursing Profession
-Collaboration to Meet Health Needs
-Promotion of the Nursing Profession
- answer-Promotion of the Nursing Profession
Rationale: The PMHNP participates in policy development and implementation that
recognizes PMH disorders as treatable and ensures that nursing care is delivered with
respect to human needs and values without prejudice.
Acute inpatient care
- answer-short-term treatment to provide care for acutely ill clients who are unable to
meet basic needs due to a mental health condition or are at risk of harming themselves
or others
-focus is crisis stabilization
-may be voluntary or involuntary
Agnieszka has experienced persistent racial discrimination since immigrating to the
United States, which has led to chronic stress, anxiety, depression, and post-traumatic
stress disorder (PTSD), exacerbating her chronic depression
,What racism's effect is the patient experiencing?
Limited access to resources
Intersections with other social determinants
Cultural mistrust and mental healthcare disparities
Discrimination and racial trauma
- answer-Discrimination and racial trauma
Agranulocytosis
- answer--Clozapine-induced agranulocytosis (CLIA)
• potentially life-threatening
• occurs in less than 1% of clients prescribed clozapine
• cause unknown; may be genetic
-Onset of symptoms any time following initiation of clozapine, most common after 4-5
weeks of drug therapy
-symptoms of CLIA:
• fever and chills
• increased heart rate
• sudden hypotension
• muscle weakness and fatigue
• mouth ulcers
• sore throat
-Diagnosis: absolute neutrophil counts (ANC) less than 100/mcL.
Agranulocytosis Tx
- answer--immediate discontinuation of clozapine
-supportive care for infection
-consultation with hematology
AIMS
- answer-Abnormal Involuntary Movement Scale
-12 questions
-5 point rating scale
• range from none to severe
Akathisia
- answer--The subjective feeling of restlessness with a compelling urge to move
-May include repetitive movements:
• finger tapping, rocking, crossing/uncrossing legs
-Onset is usually within four weeks of starting or increasing medication
-Management may include:
• discontinuing or reducing the antipsychotic dose
• switching to alternative antipsychotics
• beta-blockers
• benzodiazepines
, • anticholinergics
• Mirtazapine may be used at a low dose
All clients experiencing psychiatric symptoms must be
- answer--evaluated and screened with a validated suicide assessment tool
-Stabilization must be attempted
• using the least restrictive interventions.
Amir is a 28-year-old who was brought to the ED by law enforcement after his mother
called 911 due to his bizarre behaviors. When the police arrived, Amir was agitated and
wandering the street naked. He refused to follow directions and became combative with
officers when approached. He was handcuffed and transported by a squad car. Before
transfer, his mother told police that Amir had a history of schizophrenia with treatment
nonadherence and marijuana use.
During the ride to the ED, Amir was calm and cooperative. He was transferred to a
gurney in the triage area without incident, but after transfer to an exam room, Amir
began screaming and threatening the PMHNP and staff member. Amir tried to punch
and spit at them when they approached the bedside.
Which of the following are the most appropriate management strategies for Amir?
Select all that apply.
-begin the involuntary admission process
-use de-escalation techni
- answer--use de-escalation techniques
-request additional staff support
-medicate with intramuscular lorazepam 0.5 mg
-remove objects from the room, such as monitors, tray tables, or other equipment, that
the client may use to injure himself or others
Rationale: Amir presents a risk of harm to self and others due to his combative
behavior; therefore, the most appropriate management strategies for Amir include the
use of de-escalation techniques, request for additional staff support, intramuscular
lorazepam 0.5 mg, and the removal of objects from the room, such as monitors, tray
tables, or other equipment, that he may use to injure himself or others. Chemical
restraint may be necessary. Additional staff should be requested to provide support, and
de-escalation techniques should be attempted. Items the client may be used to injure
himself or others should be secured or removed. Physical restraints may be necessary
and should be applied by the emergency department team, not law enforcement.
Antidepressants
- answer-SSRIs
-inhibit 5-HT reuptake
SNRIs
-inhibit 5-HT reuptake
-inhibit NE reuptake (↑ energy, focus)
ANSWERS 2025
________ in treatment-resistant cases.
- answer-clozapine
-Patients should be offered a clozapine trial if they have a partial or non-response to two
antipsychotic trials, assuming those antipsychotic trials are an adequate dose and
duration (four to eight weeks)
___________ is FDA approved for tx of tardive dyskinesia
- answer-Valbenazine (Ingrezza)
_____________________ for care and treatment is a fundamental ethical and legal
principle
- answer-Informed consent
A global pandemic limits face-to-face mental health visits, the PMHNP determines that
the patient requires ongoing mental health treatment. The PMHNP arranges to meet
with the client via weekly interactive video sessions.
PMHNP role:
Acute PMHNP Care
Telehealth
Case Management
Primary Care
Pharmacologic Intervention
Crisis Intervention
Partial Hospitalization/Intensive Outpatient Tx
Community-Based Care
Self-Employment
Psychotherapy
- answer-Telehealth
Rationale: Telehealth services utilize telecommunication technology to deliver treatment
to clients.
A PMHNP discovers her colleague is diverting scheduled medications to self-medicate
anxiety. The PMHNP reports the concerns to the colleagues supervisor.
How the PMHNP applied ethical principles:
,-Respect for the Individual
-Commitment to the Healthcare Consumer
-Advocacy for the Healthcare Consumer
-Responsibility and Accountability for Practice
-Duties to Self and Others
-Contributions to Healthcare Environments
-Advancement of the Nursing Profession
-Collaboration to Meet Health Needs
-Promotion of the Nursing Profession
- answer-Contributions to Healthcare Environments
Rationale: The PMHNP recognizes signs/symptoms of psychiatric disorders in the
workplace reporting peer observations to leadership. The PMHNP helps address
problems faced by colleagues that impact client safety or violate public trust, including
substance abuse.
A PMHNP speaks at a school board meeting about the need develop policies to expand
mental health services for underserved students.
How the PMHNP applied ethical principles:
-Respect for the Individual
-Commitment to the Healthcare Consumer
-Advocacy for the Healthcare Consumer
-Responsibility and Accountability for Practice
-Duties to Self and Others
-Contributions to Healthcare Environments
-Advancement of the Nursing Profession
-Collaboration to Meet Health Needs
-Promotion of the Nursing Profession
- answer-Promotion of the Nursing Profession
Rationale: The PMHNP participates in policy development and implementation that
recognizes PMH disorders as treatable and ensures that nursing care is delivered with
respect to human needs and values without prejudice.
Acute inpatient care
- answer-short-term treatment to provide care for acutely ill clients who are unable to
meet basic needs due to a mental health condition or are at risk of harming themselves
or others
-focus is crisis stabilization
-may be voluntary or involuntary
Agnieszka has experienced persistent racial discrimination since immigrating to the
United States, which has led to chronic stress, anxiety, depression, and post-traumatic
stress disorder (PTSD), exacerbating her chronic depression
,What racism's effect is the patient experiencing?
Limited access to resources
Intersections with other social determinants
Cultural mistrust and mental healthcare disparities
Discrimination and racial trauma
- answer-Discrimination and racial trauma
Agranulocytosis
- answer--Clozapine-induced agranulocytosis (CLIA)
• potentially life-threatening
• occurs in less than 1% of clients prescribed clozapine
• cause unknown; may be genetic
-Onset of symptoms any time following initiation of clozapine, most common after 4-5
weeks of drug therapy
-symptoms of CLIA:
• fever and chills
• increased heart rate
• sudden hypotension
• muscle weakness and fatigue
• mouth ulcers
• sore throat
-Diagnosis: absolute neutrophil counts (ANC) less than 100/mcL.
Agranulocytosis Tx
- answer--immediate discontinuation of clozapine
-supportive care for infection
-consultation with hematology
AIMS
- answer-Abnormal Involuntary Movement Scale
-12 questions
-5 point rating scale
• range from none to severe
Akathisia
- answer--The subjective feeling of restlessness with a compelling urge to move
-May include repetitive movements:
• finger tapping, rocking, crossing/uncrossing legs
-Onset is usually within four weeks of starting or increasing medication
-Management may include:
• discontinuing or reducing the antipsychotic dose
• switching to alternative antipsychotics
• beta-blockers
• benzodiazepines
, • anticholinergics
• Mirtazapine may be used at a low dose
All clients experiencing psychiatric symptoms must be
- answer--evaluated and screened with a validated suicide assessment tool
-Stabilization must be attempted
• using the least restrictive interventions.
Amir is a 28-year-old who was brought to the ED by law enforcement after his mother
called 911 due to his bizarre behaviors. When the police arrived, Amir was agitated and
wandering the street naked. He refused to follow directions and became combative with
officers when approached. He was handcuffed and transported by a squad car. Before
transfer, his mother told police that Amir had a history of schizophrenia with treatment
nonadherence and marijuana use.
During the ride to the ED, Amir was calm and cooperative. He was transferred to a
gurney in the triage area without incident, but after transfer to an exam room, Amir
began screaming and threatening the PMHNP and staff member. Amir tried to punch
and spit at them when they approached the bedside.
Which of the following are the most appropriate management strategies for Amir?
Select all that apply.
-begin the involuntary admission process
-use de-escalation techni
- answer--use de-escalation techniques
-request additional staff support
-medicate with intramuscular lorazepam 0.5 mg
-remove objects from the room, such as monitors, tray tables, or other equipment, that
the client may use to injure himself or others
Rationale: Amir presents a risk of harm to self and others due to his combative
behavior; therefore, the most appropriate management strategies for Amir include the
use of de-escalation techniques, request for additional staff support, intramuscular
lorazepam 0.5 mg, and the removal of objects from the room, such as monitors, tray
tables, or other equipment, that he may use to injure himself or others. Chemical
restraint may be necessary. Additional staff should be requested to provide support, and
de-escalation techniques should be attempted. Items the client may be used to injure
himself or others should be secured or removed. Physical restraints may be necessary
and should be applied by the emergency department team, not law enforcement.
Antidepressants
- answer-SSRIs
-inhibit 5-HT reuptake
SNRIs
-inhibit 5-HT reuptake
-inhibit NE reuptake (↑ energy, focus)
