NRNP 6566 MIDTERM EXAM LATEST QUESTIONS AND
ANSWERS 2025/2026 WEEK 1-5 |A+ GRADE WALDEN
UNIVERSITY
Question 1
A 28-year-old client presents with a history of recurrent episodes of intense
fear, palpitations, sweating, trembling, shortness of breath, and a fear of
"going crazy" or dying. These episodes peak within minutes. The client often
avoids places where these attacks have occurred. What is the most likely
diagnosis?
A) Generalized Anxiety Disorder
B) Social Anxiety Disorder
C) Panic Disorder
D) Agoraphobia
E) Obsessive-Compulsive Disorder
Correct Answer: C) Panic Disorder
Rationale: Panic Disorder is characterized by recurrent unexpected
panic attacks and at least one month of persistent concern about
additional panic attacks, worry about their implications, or a
significant maladaptive change in behavior related to the attacks.
Question 2
When prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) like
sertraline (Zoloft) for depression, the psychiatric mental health nurse
practitioner (PMHNP) should inform the client that the full therapeutic effects
may take approximately how long to manifest?
A) Within 24 hours
B) 1-3 days
C) 1 week
D) 4-6 weeks
E) 6-8 months
Correct Answer: D) 4-6 weeks
Rationale: SSRIs typically take 4-6 weeks to reach full therapeutic
efficacy for depression, although some clients may start to
experience benefits earlier. It's important to set realistic
expectations with clients to promote adherence.
Question 3
A client is diagnosed with Bipolar I Disorder and is prescribed lithium. Which
of the following is an essential baseline laboratory test to obtain before
initiating lithium therapy?
A) Liver function tests
,B) Complete blood count (CBC)
C) Thyroid stimulating hormone (TSH) and renal function tests
D) Serum glucose
E) Electrocardiogram (ECG)
Correct Answer: C) Thyroid stimulating hormone (TSH) and renal
function tests
Rationale: Lithium is primarily excreted by the kidneys, so renal
function (BUN, creatinine, GFR) must be assessed. It also affects
thyroid function, making TSH monitoring crucial. These tests should
be done at baseline and regularly throughout treatment.
Question 4
Which of the following defense mechanisms involves attributing one's own
unacceptable thoughts or feelings to another person?
A) Rationalization
B) Sublimation
C) Displacement
D) Projection
E) Repression
Correct Answer: D) Projection
Rationale: Projection is an ego defense mechanism in which an
individual unconsciously attributes their own unacceptable
thoughts, feelings, or impulses to another person.
Question 5
A 19-year-old client presents with a 2-month history of inflated self-esteem,
decreased need for sleep (sleeping 3 hours and feeling rested), pressured
speech, and reckless spending. These symptoms have significantly impacted
their academic performance. What is the most likely diagnosis?
A) Major Depressive Disorder
B) Cyclothymic Disorder
C) Schizoaffective Disorder
D) Bipolar I Disorder, manic episode
E) Attention-Deficit/Hyperactivity Disorder
Correct Answer: D) Bipolar I Disorder, manic episode
Rationale: Bipolar I Disorder is characterized by at least one manic
episode. The client's symptoms (inflated self-esteem, decreased
sleep, pressured speech, reckless behavior) are classic for a manic
episode of significant duration (2 months).
, Question 6
When conducting a mental status examination (MSE), which component
assesses the client's awareness of person, place, time, and situation?
A) Affect
B) Thought process
C) Memory
D) Orientation
E) Perception
Correct Answer: D) Orientation
Rationale: Orientation refers to the client's awareness and
understanding of their current circumstances, typically assessed by
asking about person (who they are), place (where they are), time
(date, day of week), and situation (why they are there).
Question 7
A client prescribed a first-generation antipsychotic (FGA) like haloperidol
(Haldol) develops sudden muscle spasms of the neck, jaw, and eyes. What is
this extrapyramidal symptom (EPS) called?
A) Akathisia
B) Parkinsonism
C) Tardive Dyskinesia
D) Acute Dystonia
E) Neuroleptic Malignant Syndrome
Correct Answer: D) Acute Dystonia
Rationale: Acute dystonia is a rapid-onset, often painful, involuntary
muscle spasm (e.g., torticollis, oculogyric crisis) that can occur
shortly after starting or increasing the dose of FGAs. It requires
urgent treatment, often with anticholinergics like benztropine.
Question 8
Which ethical principle emphasizes the client's right to make autonomous
decisions regarding their treatment, free from coercion?
A) Beneficence
B) Nonmaleficence
C) Justice
D) Autonomy
E) Fidelity
Correct Answer: D) Autonomy
Rationale: Autonomy is the ethical principle that respects the
client's right to self-determination and independent decision-
making, particularly concerning their healthcare choices.
ANSWERS 2025/2026 WEEK 1-5 |A+ GRADE WALDEN
UNIVERSITY
Question 1
A 28-year-old client presents with a history of recurrent episodes of intense
fear, palpitations, sweating, trembling, shortness of breath, and a fear of
"going crazy" or dying. These episodes peak within minutes. The client often
avoids places where these attacks have occurred. What is the most likely
diagnosis?
A) Generalized Anxiety Disorder
B) Social Anxiety Disorder
C) Panic Disorder
D) Agoraphobia
E) Obsessive-Compulsive Disorder
Correct Answer: C) Panic Disorder
Rationale: Panic Disorder is characterized by recurrent unexpected
panic attacks and at least one month of persistent concern about
additional panic attacks, worry about their implications, or a
significant maladaptive change in behavior related to the attacks.
Question 2
When prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) like
sertraline (Zoloft) for depression, the psychiatric mental health nurse
practitioner (PMHNP) should inform the client that the full therapeutic effects
may take approximately how long to manifest?
A) Within 24 hours
B) 1-3 days
C) 1 week
D) 4-6 weeks
E) 6-8 months
Correct Answer: D) 4-6 weeks
Rationale: SSRIs typically take 4-6 weeks to reach full therapeutic
efficacy for depression, although some clients may start to
experience benefits earlier. It's important to set realistic
expectations with clients to promote adherence.
Question 3
A client is diagnosed with Bipolar I Disorder and is prescribed lithium. Which
of the following is an essential baseline laboratory test to obtain before
initiating lithium therapy?
A) Liver function tests
,B) Complete blood count (CBC)
C) Thyroid stimulating hormone (TSH) and renal function tests
D) Serum glucose
E) Electrocardiogram (ECG)
Correct Answer: C) Thyroid stimulating hormone (TSH) and renal
function tests
Rationale: Lithium is primarily excreted by the kidneys, so renal
function (BUN, creatinine, GFR) must be assessed. It also affects
thyroid function, making TSH monitoring crucial. These tests should
be done at baseline and regularly throughout treatment.
Question 4
Which of the following defense mechanisms involves attributing one's own
unacceptable thoughts or feelings to another person?
A) Rationalization
B) Sublimation
C) Displacement
D) Projection
E) Repression
Correct Answer: D) Projection
Rationale: Projection is an ego defense mechanism in which an
individual unconsciously attributes their own unacceptable
thoughts, feelings, or impulses to another person.
Question 5
A 19-year-old client presents with a 2-month history of inflated self-esteem,
decreased need for sleep (sleeping 3 hours and feeling rested), pressured
speech, and reckless spending. These symptoms have significantly impacted
their academic performance. What is the most likely diagnosis?
A) Major Depressive Disorder
B) Cyclothymic Disorder
C) Schizoaffective Disorder
D) Bipolar I Disorder, manic episode
E) Attention-Deficit/Hyperactivity Disorder
Correct Answer: D) Bipolar I Disorder, manic episode
Rationale: Bipolar I Disorder is characterized by at least one manic
episode. The client's symptoms (inflated self-esteem, decreased
sleep, pressured speech, reckless behavior) are classic for a manic
episode of significant duration (2 months).
, Question 6
When conducting a mental status examination (MSE), which component
assesses the client's awareness of person, place, time, and situation?
A) Affect
B) Thought process
C) Memory
D) Orientation
E) Perception
Correct Answer: D) Orientation
Rationale: Orientation refers to the client's awareness and
understanding of their current circumstances, typically assessed by
asking about person (who they are), place (where they are), time
(date, day of week), and situation (why they are there).
Question 7
A client prescribed a first-generation antipsychotic (FGA) like haloperidol
(Haldol) develops sudden muscle spasms of the neck, jaw, and eyes. What is
this extrapyramidal symptom (EPS) called?
A) Akathisia
B) Parkinsonism
C) Tardive Dyskinesia
D) Acute Dystonia
E) Neuroleptic Malignant Syndrome
Correct Answer: D) Acute Dystonia
Rationale: Acute dystonia is a rapid-onset, often painful, involuntary
muscle spasm (e.g., torticollis, oculogyric crisis) that can occur
shortly after starting or increasing the dose of FGAs. It requires
urgent treatment, often with anticholinergics like benztropine.
Question 8
Which ethical principle emphasizes the client's right to make autonomous
decisions regarding their treatment, free from coercion?
A) Beneficence
B) Nonmaleficence
C) Justice
D) Autonomy
E) Fidelity
Correct Answer: D) Autonomy
Rationale: Autonomy is the ethical principle that respects the
client's right to self-determination and independent decision-
making, particularly concerning their healthcare choices.
