NR606 Week 4 Exam V1 | NR606 Diagnosis
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 4 Exam) | Chamberlain
University
1. A 28-year-old female patient presents with persistent worry about her health, finances,
and performance at work for the last seven months. She reports muscle tension and difficulty
sleeping. What is the most likely diagnosis according to DSM-5 criteria?
A. Panic Disorder
B. Adjustment Disorder with Anxiety
C. Social Anxiety Disorder
D. Generalized Anxiety Disorder (GAD)
Answer: D
Rationale: Generalized Anxiety Disorder is characterized by excessive anxiety and worry
occurring more days than not for at least 6 months about a number of events or activities.
The patient must experience at least three associated symptoms such as muscle tension,
sleep disturbance, or restlessness. In this case, the duration and the multi-focal nature of
her worries align perfectly with GAD criteria.
,2. Which of the following is considered the first-line pharmacological treatment for a patient
newly diagnosed with Panic Disorder?
A. Alprazolam
B. Buspirone
C. Selective Serotonin Reuptake Inhibitors (SSRIs)
D. Propranolol
Answer: C
Rationale: SSRIs are considered first-line treatment for Panic Disorder due to their efficacy
and lower side effect profile compared to older antidepressants. While benzodiazepines
like alprazolam can provide rapid relief, they carry a high risk of dependence and are not
recommended for long-term monotherapy. The provider should educate the patient that
full therapeutic effects may take 4 to 6 weeks to manifest.
3. A patient with Post-Traumatic Stress Disorder (PTSD) reports frequent distressing
nightmares related to a past combat experience. Which medication is most appropriate to
specifically target these nightmares?
A. Sertraline
B. Risperidone
C. Lorazepam
D. Prazosin
,Answer: D
Rationale: Prazosin is an alpha-1 adrenergic antagonist that is frequently used off-label to
reduce the frequency and intensity of PTSD-related nightmares. It works by inhibiting the
overactive sympathetic nervous system response during sleep. Monitoring for orthostatic
hypotension is essential when initiating this medication or increasing the dosage.
4. A 10-year-old child displays extreme distress when separated from his mother, refusing to
go to school and experiencing stomachaches every morning. Which diagnosis should the
PMHNP prioritize?
A. Separation Anxiety Disorder
B. Conduct Disorder
C. Oppositional Defiant Disorder
D. Specific Phobia
Answer: A
Rationale: Separation Anxiety Disorder involves developmentally inappropriate and
excessive fear concerning separation from attachment figures. Children with this disorder
often report somatic symptoms like headaches or stomachaches when separation is
anticipated. Diagnosis requires symptoms to persist for at least 4 weeks in children and
adolescents.
, 5. When assessing a patient for Obsessive-Compulsive Disorder (OCD), which characteristic
best defines a compulsion?
A. Repetitive behaviors or mental acts that the individual feels driven to perform
B. Recurrent and persistent thoughts that are intrusive and unwanted
C. A sudden, rapid, recurrent non-rhythmic motor movement
D. Persistent difficulty discarding or parting with possessions
Answer: A
Rationale: Compulsions are repetitive behaviors or mental acts that an individual feels
driven to perform in response to an obsession or according to rules that must be applied
rigidly. These acts are aimed at preventing or reducing anxiety or preventing a dreaded
event, though they are not connected in a realistic way. Obsessions, conversely, are the
intrusive thoughts that trigger the need for these compulsions.
6. An elderly patient with anxiety is prescribed a benzodiazepine. Which of the following
concerns is most significant for this population according to the Beers Criteria?
A. Increased risk of weight gain
B. Development of tardive dyskinesia
C. Increased risk of falls and cognitive impairment
D. Risk of hypertensive crisis
Answer: C
& Management in Psychiatric-Mental
Health II Practicum | Q&A with Rationale
(NR606 Week 4 Exam) | Chamberlain
University
1. A 28-year-old female patient presents with persistent worry about her health, finances,
and performance at work for the last seven months. She reports muscle tension and difficulty
sleeping. What is the most likely diagnosis according to DSM-5 criteria?
A. Panic Disorder
B. Adjustment Disorder with Anxiety
C. Social Anxiety Disorder
D. Generalized Anxiety Disorder (GAD)
Answer: D
Rationale: Generalized Anxiety Disorder is characterized by excessive anxiety and worry
occurring more days than not for at least 6 months about a number of events or activities.
The patient must experience at least three associated symptoms such as muscle tension,
sleep disturbance, or restlessness. In this case, the duration and the multi-focal nature of
her worries align perfectly with GAD criteria.
,2. Which of the following is considered the first-line pharmacological treatment for a patient
newly diagnosed with Panic Disorder?
A. Alprazolam
B. Buspirone
C. Selective Serotonin Reuptake Inhibitors (SSRIs)
D. Propranolol
Answer: C
Rationale: SSRIs are considered first-line treatment for Panic Disorder due to their efficacy
and lower side effect profile compared to older antidepressants. While benzodiazepines
like alprazolam can provide rapid relief, they carry a high risk of dependence and are not
recommended for long-term monotherapy. The provider should educate the patient that
full therapeutic effects may take 4 to 6 weeks to manifest.
3. A patient with Post-Traumatic Stress Disorder (PTSD) reports frequent distressing
nightmares related to a past combat experience. Which medication is most appropriate to
specifically target these nightmares?
A. Sertraline
B. Risperidone
C. Lorazepam
D. Prazosin
,Answer: D
Rationale: Prazosin is an alpha-1 adrenergic antagonist that is frequently used off-label to
reduce the frequency and intensity of PTSD-related nightmares. It works by inhibiting the
overactive sympathetic nervous system response during sleep. Monitoring for orthostatic
hypotension is essential when initiating this medication or increasing the dosage.
4. A 10-year-old child displays extreme distress when separated from his mother, refusing to
go to school and experiencing stomachaches every morning. Which diagnosis should the
PMHNP prioritize?
A. Separation Anxiety Disorder
B. Conduct Disorder
C. Oppositional Defiant Disorder
D. Specific Phobia
Answer: A
Rationale: Separation Anxiety Disorder involves developmentally inappropriate and
excessive fear concerning separation from attachment figures. Children with this disorder
often report somatic symptoms like headaches or stomachaches when separation is
anticipated. Diagnosis requires symptoms to persist for at least 4 weeks in children and
adolescents.
, 5. When assessing a patient for Obsessive-Compulsive Disorder (OCD), which characteristic
best defines a compulsion?
A. Repetitive behaviors or mental acts that the individual feels driven to perform
B. Recurrent and persistent thoughts that are intrusive and unwanted
C. A sudden, rapid, recurrent non-rhythmic motor movement
D. Persistent difficulty discarding or parting with possessions
Answer: A
Rationale: Compulsions are repetitive behaviors or mental acts that an individual feels
driven to perform in response to an obsession or according to rules that must be applied
rigidly. These acts are aimed at preventing or reducing anxiety or preventing a dreaded
event, though they are not connected in a realistic way. Obsessions, conversely, are the
intrusive thoughts that trigger the need for these compulsions.
6. An elderly patient with anxiety is prescribed a benzodiazepine. Which of the following
concerns is most significant for this population according to the Beers Criteria?
A. Increased risk of weight gain
B. Development of tardive dyskinesia
C. Increased risk of falls and cognitive impairment
D. Risk of hypertensive crisis
Answer: C
