1|Page
NR 546 Midterm Exam Psychopharmacology PMHNP
2026/2027 Comprehensive Review with Verified
Answers and Detailed Rationales NGN Grade A+
1. What should the PMHNP consider when prescribing chemical restraints? (Select All
That Apply)
A. Allergy status
B. Prior medication history for adverse drug reactions related to the medications
ordered in the chemical restraint
C. State regulations regarding chemical restraints must be reviewed
D. The client's favorite color
Correct Answer: Allergy status, Prior medication history for adverse drug reactions
related to the medications ordered in the chemical restraint, State regulations
regarding chemical restraints must be reviewed
Rationale: When prescribing chemical restraints, the PMHNP must consider allergy
status, prior adverse drug reactions, and state regulations.
,2|Page
2. Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint when the client has been court-
ordered to take prescribed medications and the standing order for chemical restraints
is approved?
A. Yes
B. No
Correct Answer: No
Rationale: The PMHNP and other staff are not liable if the client has an allergic reaction
or adverse side effects when the client has been court-ordered and the standing order is
approved.
3. How does reviewing the genetic makeup of a client help guide the PMHNP in
selecting medication for clients? (Select All That Apply)
A. Genetic testing can assist by providing more information on how clients may respond
to certain psychotropic medications
B. It provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system
C. It determines the client's exact diagnosis
D. It replaces the need for clinical assessment
,3|Page
Correct Answer: Genetic testing can assist by providing more information on how
clients may respond to certain psychotropic medications, It provides information on
how a client may break down and metabolize medications based on the cytochrome
P450 system
Rationale: Genetic testing provides information on medication response and
metabolism via the CYP450 system.
4. Tanrıkulu and Erbaş (2020) investigated identical twins to determine the presence
of an inherited link for schizophrenia and why one twin may develop schizophrenia
when the other does not. Studies of identical Danish twins found that if one twin had
schizophrenia, the other twin had a 50% lifetime risk. Why is there only half the risk?
A. Both environmental and psychosocial stressors can impact mental health. Although
twins may have identical genes, their gene expression may be different
B. One twin had a different genetic mutation
C. The twins were not truly identical
D. Schizophrenia is not genetic
Correct Answer: Both environmental and psychosocial stressors can impact mental
health. Although twins may have identical genes, their gene expression may be
different
, 4|Page
Rationale: Environmental factors and gene expression differences explain why only one
twin may develop schizophrenia despite identical DNA.
5. The field of epigenetics can help explain how gene expression is:
A. Fixed and unchangeable
B. Influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
C. Determined solely by DNA sequence
D. Not relevant to mental health
Correct Answer: Influenced by environmental factors and how epigenetics
contributes to the manifestation of mental illness
Rationale: Epigenetics studies how environmental factors influence gene expression and
contribute to mental illness.
6. How does epigenetics impact a person's mental health?
A. Internal or external factors activate portions of the genome that result in the
manifestation of mental health symptoms
B. It permanently changes DNA sequences
NR 546 Midterm Exam Psychopharmacology PMHNP
2026/2027 Comprehensive Review with Verified
Answers and Detailed Rationales NGN Grade A+
1. What should the PMHNP consider when prescribing chemical restraints? (Select All
That Apply)
A. Allergy status
B. Prior medication history for adverse drug reactions related to the medications
ordered in the chemical restraint
C. State regulations regarding chemical restraints must be reviewed
D. The client's favorite color
Correct Answer: Allergy status, Prior medication history for adverse drug reactions
related to the medications ordered in the chemical restraint, State regulations
regarding chemical restraints must be reviewed
Rationale: When prescribing chemical restraints, the PMHNP must consider allergy
status, prior adverse drug reactions, and state regulations.
,2|Page
2. Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint when the client has been court-
ordered to take prescribed medications and the standing order for chemical restraints
is approved?
A. Yes
B. No
Correct Answer: No
Rationale: The PMHNP and other staff are not liable if the client has an allergic reaction
or adverse side effects when the client has been court-ordered and the standing order is
approved.
3. How does reviewing the genetic makeup of a client help guide the PMHNP in
selecting medication for clients? (Select All That Apply)
A. Genetic testing can assist by providing more information on how clients may respond
to certain psychotropic medications
B. It provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system
C. It determines the client's exact diagnosis
D. It replaces the need for clinical assessment
,3|Page
Correct Answer: Genetic testing can assist by providing more information on how
clients may respond to certain psychotropic medications, It provides information on
how a client may break down and metabolize medications based on the cytochrome
P450 system
Rationale: Genetic testing provides information on medication response and
metabolism via the CYP450 system.
4. Tanrıkulu and Erbaş (2020) investigated identical twins to determine the presence
of an inherited link for schizophrenia and why one twin may develop schizophrenia
when the other does not. Studies of identical Danish twins found that if one twin had
schizophrenia, the other twin had a 50% lifetime risk. Why is there only half the risk?
A. Both environmental and psychosocial stressors can impact mental health. Although
twins may have identical genes, their gene expression may be different
B. One twin had a different genetic mutation
C. The twins were not truly identical
D. Schizophrenia is not genetic
Correct Answer: Both environmental and psychosocial stressors can impact mental
health. Although twins may have identical genes, their gene expression may be
different
, 4|Page
Rationale: Environmental factors and gene expression differences explain why only one
twin may develop schizophrenia despite identical DNA.
5. The field of epigenetics can help explain how gene expression is:
A. Fixed and unchangeable
B. Influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
C. Determined solely by DNA sequence
D. Not relevant to mental health
Correct Answer: Influenced by environmental factors and how epigenetics
contributes to the manifestation of mental illness
Rationale: Epigenetics studies how environmental factors influence gene expression and
contribute to mental illness.
6. How does epigenetics impact a person's mental health?
A. Internal or external factors activate portions of the genome that result in the
manifestation of mental health symptoms
B. It permanently changes DNA sequences
