NR 547 PMHNP FINAL ACTUA EXAM REVIEW 2025”2026 150
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES COVERING
THE RECENT MOST TESTED QUESTIONS GUARANTEE OVER 80%
PASSMARK
1. Which neurotransmitter is most closely associated with depression?
☑ A. Serotonin
☐ B. Dopamine
☐ C. Acetylcholine
☐ D. Glutamate
Rationale: Low levels of serotonin are linked to depressive symptoms, and many antidepressants target
serotonergic pathways.
2. Which of the following is a first-line pharmacologic treatment for generalized anxiety disorder
(GAD)?
☑ A. SSRIs (e.g., sertraline)
☐ B. Benzodiazepines (e.g., lorazepam)
☐ C. Antipsychotics
☐ D. Beta-blockers
Rationale: SSRIs are preferred for long-term management due to efficacy and lower risk of dependence
compared to benzodiazepines.
3. A patient with schizophrenia reports hearing voices commenting on their behavior. This is an
example of:
☑ A. Auditory hallucinations
☐ B. Delusions
☐ C. Thought broadcasting
☐ D. Echolalia
Rationale: Auditory hallucinations involve hearing sounds or voices that are not present.
4. Which of the following symptoms is considered a positive symptom of schizophrenia?
☑ A. Hallucinations
☐ B. Flat affect
☐ C. Anhedonia
☐ D. Social withdrawal
,Rationale: Positive symptoms are added experiences such as hallucinations and delusions, whereas
negative symptoms involve deficits in normal function.
5. Which class of medication is most commonly used to treat bipolar disorder during acute mania?
☑ A. Mood stabilizers (e.g., lithium, valproate)
☐ B. SSRIs
☐ C. Benzodiazepines
☐ D. Stimulants
Rationale: Lithium and valproate reduce manic symptoms and stabilize mood swings in bipolar disorder.
6. A patient presents with persistent sadness, insomnia, and feelings of worthlessness for more than 2
weeks. The most likely diagnosis is:
☑ A. Major depressive disorder (MDD)
☐ B. Adjustment disorder
☐ C. Bipolar II disorder
☐ D. Dysthymia
Rationale: MDD is characterized by a minimum of two weeks of depressed mood or loss of interest
along with functional impairment.
7. Which screening tool is commonly used to assess suicidal risk in psychiatric patients?
☑ A. Columbia-Suicide Severity Rating Scale (C-SSRS)
☐ B. PHQ-9
☐ C. GAD-7
☐ D. MMSE
Rationale: The C-SSRS is designed specifically to evaluate suicidal ideation and behavior.
8. Which of the following is a common side effect of SSRIs?
☑ A. Sexual dysfunction
☐ B. Weight loss
☐ C. Bradycardia
☐ D. Hypoglycemia
Rationale: SSRIs frequently cause sexual side effects such as decreased libido or delayed orgasm.
9. Which personality disorder is characterized by a pattern of instability in relationships, self-image,
and affect, with impulsivity?
,☑ A. Borderline personality disorder
☐ B. Antisocial personality disorder
☐ C. Obsessive-compulsive personality disorder
☐ D. Schizoid personality disorder
Rationale: Borderline personality disorder involves emotional dysregulation, unstable interpersonal
relationships, and impulsive behavior.
10. In cognitive-behavioral therapy (CBT), a primary goal is to:
☑ A. Identify and modify distorted thoughts and maladaptive behaviors
☐ B. Explore unconscious conflicts
☐ C. Provide medication education only
☐ D. Enhance family communication exclusively
Rationale: CBT focuses on recognizing and changing negative thought patterns to improve mood and
behavior.
11. A patient with PTSD experiences flashbacks and hypervigilance after a traumatic event. Which
symptom cluster does this represent?
☑ A. Re-experiencing and hyperarousal
☐ B. Avoidance only
☐ C. Negative mood only
☐ D. Dissociation only
Rationale: PTSD includes re-experiencing, avoidance, negative cognition, and hyperarousal clusters.
12. Which of the following is a hallmark feature of attention-deficit/hyperactivity disorder (ADHD) in
adults?
☑ A. Difficulty sustaining attention and impulsivity
☐ B. Hallucinations
☐ C. Depressed mood
☐ D. Social withdrawal
Rationale: ADHD in adults often presents with inattention, distractibility, impulsivity, and difficulty
organizing tasks.
13. Which atypical antipsychotic has the lowest risk of metabolic side effects?
☑ A. Ziprasidone
☐ B. Olanzapine
, ☐ C. Clozapine
☐ D. Quetiapine
Rationale: Ziprasidone is associated with less weight gain and metabolic disturbance compared to other
atypical antipsychotics.
14. A patient with alcohol use disorder presents with tremors, anxiety, and diaphoresis 12 hours after
their last drink. This is most consistent with:
☑ A. Alcohol withdrawal
☐ B. Intoxication
☐ C. Wernicke encephalopathy
☐ D. Delirium tremens
Rationale: Early alcohol withdrawal occurs 6–24 hours after cessation, presenting with autonomic
hyperactivity and tremors.
15. Which of the following medications is FDA-approved for treatment-resistant depression?
☑ A. Esketamine nasal spray
☐ B. Buspirone
☐ C. Bupropion
☐ D. Lorazepam
Rationale: Esketamine, combined with an oral antidepressant, is indicated for patients with inadequate
response to standard therapies.
16. Which symptom differentiates bipolar I disorder from major depressive disorder?
☑ A. Manic episodes
☐ B. Sadness
☐ C. Fatigue
☐ D. Insomnia
Rationale: The presence of at least one manic episode distinguishes bipolar I from MDD.
17. In older adults, which antidepressant is generally considered safer due to fewer anticholinergic
effects?
☑ A. Sertraline
☐ B. Amitriptyline
☐ C. Paroxetine
☐ D. Doxepin
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES COVERING
THE RECENT MOST TESTED QUESTIONS GUARANTEE OVER 80%
PASSMARK
1. Which neurotransmitter is most closely associated with depression?
☑ A. Serotonin
☐ B. Dopamine
☐ C. Acetylcholine
☐ D. Glutamate
Rationale: Low levels of serotonin are linked to depressive symptoms, and many antidepressants target
serotonergic pathways.
2. Which of the following is a first-line pharmacologic treatment for generalized anxiety disorder
(GAD)?
☑ A. SSRIs (e.g., sertraline)
☐ B. Benzodiazepines (e.g., lorazepam)
☐ C. Antipsychotics
☐ D. Beta-blockers
Rationale: SSRIs are preferred for long-term management due to efficacy and lower risk of dependence
compared to benzodiazepines.
3. A patient with schizophrenia reports hearing voices commenting on their behavior. This is an
example of:
☑ A. Auditory hallucinations
☐ B. Delusions
☐ C. Thought broadcasting
☐ D. Echolalia
Rationale: Auditory hallucinations involve hearing sounds or voices that are not present.
4. Which of the following symptoms is considered a positive symptom of schizophrenia?
☑ A. Hallucinations
☐ B. Flat affect
☐ C. Anhedonia
☐ D. Social withdrawal
,Rationale: Positive symptoms are added experiences such as hallucinations and delusions, whereas
negative symptoms involve deficits in normal function.
5. Which class of medication is most commonly used to treat bipolar disorder during acute mania?
☑ A. Mood stabilizers (e.g., lithium, valproate)
☐ B. SSRIs
☐ C. Benzodiazepines
☐ D. Stimulants
Rationale: Lithium and valproate reduce manic symptoms and stabilize mood swings in bipolar disorder.
6. A patient presents with persistent sadness, insomnia, and feelings of worthlessness for more than 2
weeks. The most likely diagnosis is:
☑ A. Major depressive disorder (MDD)
☐ B. Adjustment disorder
☐ C. Bipolar II disorder
☐ D. Dysthymia
Rationale: MDD is characterized by a minimum of two weeks of depressed mood or loss of interest
along with functional impairment.
7. Which screening tool is commonly used to assess suicidal risk in psychiatric patients?
☑ A. Columbia-Suicide Severity Rating Scale (C-SSRS)
☐ B. PHQ-9
☐ C. GAD-7
☐ D. MMSE
Rationale: The C-SSRS is designed specifically to evaluate suicidal ideation and behavior.
8. Which of the following is a common side effect of SSRIs?
☑ A. Sexual dysfunction
☐ B. Weight loss
☐ C. Bradycardia
☐ D. Hypoglycemia
Rationale: SSRIs frequently cause sexual side effects such as decreased libido or delayed orgasm.
9. Which personality disorder is characterized by a pattern of instability in relationships, self-image,
and affect, with impulsivity?
,☑ A. Borderline personality disorder
☐ B. Antisocial personality disorder
☐ C. Obsessive-compulsive personality disorder
☐ D. Schizoid personality disorder
Rationale: Borderline personality disorder involves emotional dysregulation, unstable interpersonal
relationships, and impulsive behavior.
10. In cognitive-behavioral therapy (CBT), a primary goal is to:
☑ A. Identify and modify distorted thoughts and maladaptive behaviors
☐ B. Explore unconscious conflicts
☐ C. Provide medication education only
☐ D. Enhance family communication exclusively
Rationale: CBT focuses on recognizing and changing negative thought patterns to improve mood and
behavior.
11. A patient with PTSD experiences flashbacks and hypervigilance after a traumatic event. Which
symptom cluster does this represent?
☑ A. Re-experiencing and hyperarousal
☐ B. Avoidance only
☐ C. Negative mood only
☐ D. Dissociation only
Rationale: PTSD includes re-experiencing, avoidance, negative cognition, and hyperarousal clusters.
12. Which of the following is a hallmark feature of attention-deficit/hyperactivity disorder (ADHD) in
adults?
☑ A. Difficulty sustaining attention and impulsivity
☐ B. Hallucinations
☐ C. Depressed mood
☐ D. Social withdrawal
Rationale: ADHD in adults often presents with inattention, distractibility, impulsivity, and difficulty
organizing tasks.
13. Which atypical antipsychotic has the lowest risk of metabolic side effects?
☑ A. Ziprasidone
☐ B. Olanzapine
, ☐ C. Clozapine
☐ D. Quetiapine
Rationale: Ziprasidone is associated with less weight gain and metabolic disturbance compared to other
atypical antipsychotics.
14. A patient with alcohol use disorder presents with tremors, anxiety, and diaphoresis 12 hours after
their last drink. This is most consistent with:
☑ A. Alcohol withdrawal
☐ B. Intoxication
☐ C. Wernicke encephalopathy
☐ D. Delirium tremens
Rationale: Early alcohol withdrawal occurs 6–24 hours after cessation, presenting with autonomic
hyperactivity and tremors.
15. Which of the following medications is FDA-approved for treatment-resistant depression?
☑ A. Esketamine nasal spray
☐ B. Buspirone
☐ C. Bupropion
☐ D. Lorazepam
Rationale: Esketamine, combined with an oral antidepressant, is indicated for patients with inadequate
response to standard therapies.
16. Which symptom differentiates bipolar I disorder from major depressive disorder?
☑ A. Manic episodes
☐ B. Sadness
☐ C. Fatigue
☐ D. Insomnia
Rationale: The presence of at least one manic episode distinguishes bipolar I from MDD.
17. In older adults, which antidepressant is generally considered safer due to fewer anticholinergic
effects?
☑ A. Sertraline
☐ B. Amitriptyline
☐ C. Paroxetine
☐ D. Doxepin
