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NR 547 MIDTERM EXAM 2025/2026 |COMPLETE
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES (100% VERIFIED) |ALREADY
GRADED A+.
Which of the following should be included when providing client education about
medication regimens?
a. Explain how the medication targets the symptoms, specific benefits, and expected time
course.
b. Identify potential side effects, duration of side effects, and adverse effects.
c. Explain the instructions, dosing, and special requirements.
d. Use teach-back methods to ensure client understanding.
e. All of the above
e. All of the above
A 52-year-old client presents to the emergency department following a car accident. The
emergency department (ED) physician is concerned that the client may have
intentionally crashed her car and requests a stat PMHNP consult. In speaking with the
PMHNP, the client describes persistent feelings of sadness and hopelessness. She states
that she often wonders if her husband would be happier if she wasn't around anymore
since she's never happy and sometimes thinks about what it would be like to just take a
handful of sleeping pills and go to sleep forever. The client reports a previous suicide
attempt when she was 16 but denies that she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a stat full safety and mental
health evaluation, the client requires a brief suicide safety assessment to determine whether a
full mental health evaluation in necessary. It is also important to notify the client's physician
or the clinician responsible for the client's care.
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Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L
Refer
Rationale: A TSH level >4.0 is indicative of hypothyroidism, which is associated with
fatigue. A referral for treatment of hypothyroidism is required. Client can be reevaluated for
fatigue if symptoms persist after hypothyroid treatment has been initiated, TSH levels are
within normal limits.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Leo is a 49-year-old who presents with fatigue. His hemoglobin is 15 g/dL and
hematocrit is 42%.
Begin Treatment
Rationale: The hemoglobin and hematocrit are within normal limits. This client’s complaint
of fatigue is not due to anemia. Begin treatment based on a complete evaluation.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Terri is a 79-year old who presents with confusion. She has positive urine leukocyte
esterase.
Refer
Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary tract
infection (UTI) , which may cause confusion. Refer this client for treatment of the UTI.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Julio is a 66-year-old who presents with depression. His vitamin D level 11 ng/mL.
Refer
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Rationale: Vitamin D deficiency is associated with depressive symptoms. The PMHNP may
refer or treat vitamin D deficiency depending on the level of comfort of the provider. Normal
20-50ng/mL a level less than 12 is indicative of Vit. D deficiency.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
Refer
Rationale: Clients with hyperthyroidism have elevated T3 levels. Hyperthyroidism is
associated with anxiety symptoms. Client can be reevaluated for anxiety once hyperthyroid
treatment has been initiated and T3 levels are within normal limits. Normal T3 100-200.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Fred is a 19-year-old who presents with psychosis. His vitamin B12 level is 900
picograms/mL.
Begin Treatment
Rationale: The B12 level is within normal limits. Treatment for symptoms of psychosis
should be initiated. Normal is 190-950 picograms/mL
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Ted is a 64-year-old who presents with confusion. His serum creatinine is 7.0 mg/dL and
BUN is 32.
Refer
Rationale: Elevated serum creatinine and BUN indicate a problem with kidney function,
which could contribute to confusion.Normal creatinine 06-1.2mg/dL Normal BUN 7-18
First Line Medication Treatment for Generalized Anxiety Disorder (GAD).
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1. SSRI
2. SNRI
3. Buspirone
4. Drug Therapy for at least 12 months
First Line Medication Therapy for Panic Disorder
1. Paroxetine
2. Sertraline
3. Fluoxetine
4. Drug Therapy 6-9 months
First-line medication therapy for Obsessive Compulsive Disorder (OCD)
1. Fluoxetine
2. Fluvoxamine
3. Sertraline
4. Paroxetine
5. Clomipramine (TCA)
6. Drug therapy for at least 1 year
First-line medication therapy for Social Anxiety Disorder.
1. Sertraline
2. Paroxetine
3. Drug therapy takes 4 weeks to see effects
First-line medication therapy for Post-traumatic stress disorder (PTSD)
1. Paroxetine
2. Sertraline
Harold is a 32-year-old who presents to the clinic with complaints of fatigue, difficulty
concentrating, and difficulty falling asleep at night. He states he worries about finances,
his performance at work, and his relationship, and his worries have been "almost
constant" for 8 months. He denies substance use and recently had a normal physical
exam. He feels that his relationship is suffering due to his constant worry.
Based on the DSM-5-TR, dose Harold meet diagnostic criterial for generalized anxiety
NR 547 MIDTERM EXAM 2025/2026 |COMPLETE
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES (100% VERIFIED) |ALREADY
GRADED A+.
Which of the following should be included when providing client education about
medication regimens?
a. Explain how the medication targets the symptoms, specific benefits, and expected time
course.
b. Identify potential side effects, duration of side effects, and adverse effects.
c. Explain the instructions, dosing, and special requirements.
d. Use teach-back methods to ensure client understanding.
e. All of the above
e. All of the above
A 52-year-old client presents to the emergency department following a car accident. The
emergency department (ED) physician is concerned that the client may have
intentionally crashed her car and requests a stat PMHNP consult. In speaking with the
PMHNP, the client describes persistent feelings of sadness and hopelessness. She states
that she often wonders if her husband would be happier if she wasn't around anymore
since she's never happy and sometimes thinks about what it would be like to just take a
handful of sleeping pills and go to sleep forever. The client reports a previous suicide
attempt when she was 16 but denies that she is considering killing herself right now.
Based on the client's ASQ score, what is the most appropriate response?
provide a brief suicide safety assessment.
Rationale: While the client's responses do not indicate a need for a stat full safety and mental
health evaluation, the client requires a brief suicide safety assessment to determine whether a
full mental health evaluation in necessary. It is also important to notify the client's physician
or the clinician responsible for the client's care.
, Page |2
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Toni is a 58-year-old who presents with fatigue. Her TSH is 6.3 mIU/L
Refer
Rationale: A TSH level >4.0 is indicative of hypothyroidism, which is associated with
fatigue. A referral for treatment of hypothyroidism is required. Client can be reevaluated for
fatigue if symptoms persist after hypothyroid treatment has been initiated, TSH levels are
within normal limits.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Leo is a 49-year-old who presents with fatigue. His hemoglobin is 15 g/dL and
hematocrit is 42%.
Begin Treatment
Rationale: The hemoglobin and hematocrit are within normal limits. This client’s complaint
of fatigue is not due to anemia. Begin treatment based on a complete evaluation.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Terri is a 79-year old who presents with confusion. She has positive urine leukocyte
esterase.
Refer
Rationale: A positive Urine Leukocyte Esterase indicates the presence of a urinary tract
infection (UTI) , which may cause confusion. Refer this client for treatment of the UTI.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Julio is a 66-year-old who presents with depression. His vitamin D level 11 ng/mL.
Refer
, Page |3
Rationale: Vitamin D deficiency is associated with depressive symptoms. The PMHNP may
refer or treat vitamin D deficiency depending on the level of comfort of the provider. Normal
20-50ng/mL a level less than 12 is indicative of Vit. D deficiency.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Beth is a 24-year-old who presents with anxiety. Her T3 is 260 ng/dL.
Refer
Rationale: Clients with hyperthyroidism have elevated T3 levels. Hyperthyroidism is
associated with anxiety symptoms. Client can be reevaluated for anxiety once hyperthyroid
treatment has been initiated and T3 levels are within normal limits. Normal T3 100-200.
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Fred is a 19-year-old who presents with psychosis. His vitamin B12 level is 900
picograms/mL.
Begin Treatment
Rationale: The B12 level is within normal limits. Treatment for symptoms of psychosis
should be initiated. Normal is 190-950 picograms/mL
Evaluate the laboratory value and presenting symptom in the activity below and select
whether to treat or refer.
Ted is a 64-year-old who presents with confusion. His serum creatinine is 7.0 mg/dL and
BUN is 32.
Refer
Rationale: Elevated serum creatinine and BUN indicate a problem with kidney function,
which could contribute to confusion.Normal creatinine 06-1.2mg/dL Normal BUN 7-18
First Line Medication Treatment for Generalized Anxiety Disorder (GAD).
, Page |4
1. SSRI
2. SNRI
3. Buspirone
4. Drug Therapy for at least 12 months
First Line Medication Therapy for Panic Disorder
1. Paroxetine
2. Sertraline
3. Fluoxetine
4. Drug Therapy 6-9 months
First-line medication therapy for Obsessive Compulsive Disorder (OCD)
1. Fluoxetine
2. Fluvoxamine
3. Sertraline
4. Paroxetine
5. Clomipramine (TCA)
6. Drug therapy for at least 1 year
First-line medication therapy for Social Anxiety Disorder.
1. Sertraline
2. Paroxetine
3. Drug therapy takes 4 weeks to see effects
First-line medication therapy for Post-traumatic stress disorder (PTSD)
1. Paroxetine
2. Sertraline
Harold is a 32-year-old who presents to the clinic with complaints of fatigue, difficulty
concentrating, and difficulty falling asleep at night. He states he worries about finances,
his performance at work, and his relationship, and his worries have been "almost
constant" for 8 months. He denies substance use and recently had a normal physical
exam. He feels that his relationship is suffering due to his constant worry.
Based on the DSM-5-TR, dose Harold meet diagnostic criterial for generalized anxiety
