NR606 Week 3 Exam V3 | NR606 Diagnosis
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 3 Exam) | Chamberlain
University
1. A 45-year-old male is prescribed Lithium for Bipolar I Disorder maintenance. Which of the
following serum lithium levels represents the standard therapeutic range?
A. 0.6 to 1.2 mEq/L
B. 0.4 to 0.8 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.0 to 2.5 mEq/L
Answer: A
Rationale: The standard therapeutic range for Lithium carbonate in the maintenance
phase of Bipolar Disorder is 0.6 to 1.2 mEq/L. Monitoring serum levels is critical because
the drug has a narrow therapeutic index. Levels exceeding 1.5 mEq/L are generally
considered toxic and require immediate clinical intervention.
2. When initiating Lamotrigine (Lamictal) for a patient with Bipolar II Disorder, the PMHNP
must educate the patient on which life-threatening side effect?
A. Agranulocytosis
,B. Hepatotoxicity
C. Stevens-Johnson Syndrome
D. Pancreatitis
Answer: C
Rationale: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening dermatological
reaction associated with Lamotrigine. Patients must be instructed to stop the medication
and seek emergency care if any new rash or mucosal lesions develop. Slow titration is used
specifically to mitigate the risk of this serious adverse effect.
3. Which screening tool is most appropriate for a PMHNP to utilize when assessing for the
presence of a manic or hypomanic episode in a primary care setting?
A. PHQ-9
B. GAD-7
C. MDQ
D. CAGE
Answer: C
Rationale: The Mood Disorder Questionnaire (MDQ) is a validated screening instrument
designed to identify symptoms of Bipolar Disorder. While the PHQ-9 screens for
depression, the MDQ specifically targets manic and hypomanic symptoms. A positive
screen indicates the need for a more comprehensive diagnostic clinical interview.
, 4. A patient on Valproic Acid (Depakote) for mood stabilization presents with right upper
quadrant pain and jaundice. Which laboratory test is most critical to evaluate?
A. Serum Creatinine
B. Complete Blood Count (CBC)
C. Liver Function Tests (LFTs)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Rationale: Valproic acid carries a black box warning for hepatotoxicity, particularly during
the first six months of treatment. Symptoms like jaundice and abdominal pain are clinical
indicators of potential liver failure. Periodic monitoring of Liver Function Tests is a
standard of care for patients on this medication.
5. According to the DSM-5, which of the following is a requirement for a diagnosis of Bipolar I
Disorder?
A. At least one hypomanic episode and one major depressive episode
B. At least one manic episode lasting at least one week
C. Persistent depressive symptoms for at least two years
D. Mood swings that do not meet full criteria for hypomania
Answer: B
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 3 Exam) | Chamberlain
University
1. A 45-year-old male is prescribed Lithium for Bipolar I Disorder maintenance. Which of the
following serum lithium levels represents the standard therapeutic range?
A. 0.6 to 1.2 mEq/L
B. 0.4 to 0.8 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.0 to 2.5 mEq/L
Answer: A
Rationale: The standard therapeutic range for Lithium carbonate in the maintenance
phase of Bipolar Disorder is 0.6 to 1.2 mEq/L. Monitoring serum levels is critical because
the drug has a narrow therapeutic index. Levels exceeding 1.5 mEq/L are generally
considered toxic and require immediate clinical intervention.
2. When initiating Lamotrigine (Lamictal) for a patient with Bipolar II Disorder, the PMHNP
must educate the patient on which life-threatening side effect?
A. Agranulocytosis
,B. Hepatotoxicity
C. Stevens-Johnson Syndrome
D. Pancreatitis
Answer: C
Rationale: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening dermatological
reaction associated with Lamotrigine. Patients must be instructed to stop the medication
and seek emergency care if any new rash or mucosal lesions develop. Slow titration is used
specifically to mitigate the risk of this serious adverse effect.
3. Which screening tool is most appropriate for a PMHNP to utilize when assessing for the
presence of a manic or hypomanic episode in a primary care setting?
A. PHQ-9
B. GAD-7
C. MDQ
D. CAGE
Answer: C
Rationale: The Mood Disorder Questionnaire (MDQ) is a validated screening instrument
designed to identify symptoms of Bipolar Disorder. While the PHQ-9 screens for
depression, the MDQ specifically targets manic and hypomanic symptoms. A positive
screen indicates the need for a more comprehensive diagnostic clinical interview.
, 4. A patient on Valproic Acid (Depakote) for mood stabilization presents with right upper
quadrant pain and jaundice. Which laboratory test is most critical to evaluate?
A. Serum Creatinine
B. Complete Blood Count (CBC)
C. Liver Function Tests (LFTs)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Rationale: Valproic acid carries a black box warning for hepatotoxicity, particularly during
the first six months of treatment. Symptoms like jaundice and abdominal pain are clinical
indicators of potential liver failure. Periodic monitoring of Liver Function Tests is a
standard of care for patients on this medication.
5. According to the DSM-5, which of the following is a requirement for a diagnosis of Bipolar I
Disorder?
A. At least one hypomanic episode and one major depressive episode
B. At least one manic episode lasting at least one week
C. Persistent depressive symptoms for at least two years
D. Mood swings that do not meet full criteria for hypomania
Answer: B
