NRNP 6635 WEEK 6 MIDTERM EXAM –
ACTUAL 2026-2027
Psychiatric Mental Health Nurse
Practitioner (PMHNP) | Graded A+ |
Complete 100-Question Exam &
Rationales
.
SECTION 1: MOOD DISORDERS
(Questions 1–25)
1. A 45-year-old patient presents with
depressed mood, anhedonia, significant
weight loss (15 lbs in 2 months), insomnia,
psychomotor agitation, fatigue, feelings of
worthlessness, diminished concentration,
,and recurrent thoughts of death. Symptoms
have been present daily for 6 weeks. Which
diagnosis is most appropriate?
A) Major Depressive Disorder, Single
Episode
B) Persistent Depressive Disorder
(Dysthymia)
C) Adjustment Disorder with Depressed
Mood
D) Bipolar II Disorder, Depressed Episode
Answer: A) Major Depressive Disorder,
Single Episode
Rationale: MDD requires ≥5 of 9 symptoms
(including depressed mood or anhedonia)
present for ≥2 weeks. This patient has 8
symptoms for 6 weeks. Dysthymia (B)
requires ≥2 years; Adjustment Disorder (C)
follows identifiable stressor and is <6
,months; Bipolar II (D) would requireahistory of
hypomanicepisodes.
2. Apatientwith MDD has been on sertraline
50 mg dailyfor 6 weeks. Thepatientreports
"feeling alittlebetter" but still has significant
anhedoniaandlowenergy. The PHQ-9 score
has decreasedfrom 22 to 16. Whatisthemost
appropriatenext step?
A) Addaripiprazole (Abilify) foraugmentation
B) Increasesertraline to 100 mg daily
C) Switchtobupropion (Wellbutrin)
D) Start electroconvulsive therapy(ECT)
Answer: B) Increasesertraline to 100 mg daily
Rationale: Thepatient has hadapartial
responseat 6 weeks. Thenextstep is totitrate
the SSRI upward(sertraline usual dose 50–200
mg). Augmentation (A) is usedafter multiple
, medicationfailures; switching (C) is
appropriateafterlack of response; ECT(D) is
fortreatment-resistant or severe depression
with psychosis/suicidal risk.
3. Apatientwithbipolar Idisorder is currently
in a manic episode. Which medication is
considered first-line foracute mania?
A) Fluoxetine(Prozac)
B) Lithium (Lithobid)
C) Bupropion (Wellbutrin)
D) Venlafaxine(Effexor XR)
Answer: B) Lithium (Lithobid)
Rationale: Lithium, valproate, andatypical
antipsychotics(quetiapine, olanzapine,
risperidone) arefirst-line foracute mania.
Antidepressants (A, C, D) canprecipitate or
ACTUAL 2026-2027
Psychiatric Mental Health Nurse
Practitioner (PMHNP) | Graded A+ |
Complete 100-Question Exam &
Rationales
.
SECTION 1: MOOD DISORDERS
(Questions 1–25)
1. A 45-year-old patient presents with
depressed mood, anhedonia, significant
weight loss (15 lbs in 2 months), insomnia,
psychomotor agitation, fatigue, feelings of
worthlessness, diminished concentration,
,and recurrent thoughts of death. Symptoms
have been present daily for 6 weeks. Which
diagnosis is most appropriate?
A) Major Depressive Disorder, Single
Episode
B) Persistent Depressive Disorder
(Dysthymia)
C) Adjustment Disorder with Depressed
Mood
D) Bipolar II Disorder, Depressed Episode
Answer: A) Major Depressive Disorder,
Single Episode
Rationale: MDD requires ≥5 of 9 symptoms
(including depressed mood or anhedonia)
present for ≥2 weeks. This patient has 8
symptoms for 6 weeks. Dysthymia (B)
requires ≥2 years; Adjustment Disorder (C)
follows identifiable stressor and is <6
,months; Bipolar II (D) would requireahistory of
hypomanicepisodes.
2. Apatientwith MDD has been on sertraline
50 mg dailyfor 6 weeks. Thepatientreports
"feeling alittlebetter" but still has significant
anhedoniaandlowenergy. The PHQ-9 score
has decreasedfrom 22 to 16. Whatisthemost
appropriatenext step?
A) Addaripiprazole (Abilify) foraugmentation
B) Increasesertraline to 100 mg daily
C) Switchtobupropion (Wellbutrin)
D) Start electroconvulsive therapy(ECT)
Answer: B) Increasesertraline to 100 mg daily
Rationale: Thepatient has hadapartial
responseat 6 weeks. Thenextstep is totitrate
the SSRI upward(sertraline usual dose 50–200
mg). Augmentation (A) is usedafter multiple
, medicationfailures; switching (C) is
appropriateafterlack of response; ECT(D) is
fortreatment-resistant or severe depression
with psychosis/suicidal risk.
3. Apatientwithbipolar Idisorder is currently
in a manic episode. Which medication is
considered first-line foracute mania?
A) Fluoxetine(Prozac)
B) Lithium (Lithobid)
C) Bupropion (Wellbutrin)
D) Venlafaxine(Effexor XR)
Answer: B) Lithium (Lithobid)
Rationale: Lithium, valproate, andatypical
antipsychotics(quetiapine, olanzapine,
risperidone) arefirst-line foracute mania.
Antidepressants (A, C, D) canprecipitate or
