NRNP 6665 / NRNP6665 Final Exam
OBJECTIVE ASSESSMENT - EXAM
NRNP 6665 / NRNP6665 Final Exam (Latest
Update 2026/2027) PMHNP Care Across the
Lifespan I | Questions and Answers | Grade
A | 100% Correct | Verified Solutions -
Walden 2026/2027
Walden University | PMHNP Care Across the Lifespan I
75 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
• Psychiatric Assessment & Diagnostic Formulation • Ethics, Legal Principles & Cultural Care
• Psychopharmacology & Biological Treatments • Lifespan Development & Special Populations
• Psychotherapy & Therapeutic Interventions • Evidence-Based Practice & Clinical Decision-Making
COVER PAGE - 1
NRNP 6665 Final Exam - 2026/2027 | Passing Score: 80% | Page 1
,SECTION 1 | Psychiatric Assessment & Diagnostic Formulation | Q1-Q15 | NRNP 6665 Final Exam 2026/2027
Q1 Question 1 of 75
A 34-year-old woman presents to the emergency department after a motor vehicle accident. She
reports intrusive memories of the crash, severe anxiety when driving, and recurrent nightmares
for the past 6 weeks. She denies any prior psychiatric history. Her vital signs are stable, and she
has no signs of traumatic brain injury. Which of the following is the most appropriate initial
diagnosis?
A. Acute stress disorder
B. Posttraumatic stress disorder
C. Adjustment disorder with anxiety
D. Generalized anxiety disorder
Correct Answer: B
Rationale:
Posttraumatic stress disorder requires exposure to actual or threatened death, serious injury, or sexual violence, with
symptoms persisting longer than 1 month. This patient meets Criterion B (intrusive memories), Criterion C (avoidance of
driving), and Criterion E (hyperarousal with nightmares) for more than 1 month. Acute stress disorder lasts 3 days to 1
month. Adjustment disorder requires symptoms that do not meet criteria for another disorder and occur within 3 months
of a stressor.
Q2 Question 2 of 75
During a mental status examination, a 67-year-old man with a history of Parkinson disease
demonstrates slow, labored speech with long pauses between words, reduced facial
expression, and a shuffling gait. His affect is flat, and he reports feeling 'empty inside' for the
past 3 months. Which clinical feature most strongly supports a diagnosis of major depressive
disorder rather than apathy related to Parkinson disease?
A. Flat affect
B. Psychomotor retardation
C. Anhedonia and hopelessness about the future
D. Shuffling gait
Correct Answer: C
Rationale:
While both Parkinson disease and major depressive disorder can present with psychomotor retardation and flat affect,
anhedonia and hopelessness are core mood symptoms of depression. Apathy in Parkinson disease typically lacks the
pervasive sadness, guilt, and suicidal ideation seen in depression. The presence of a dysphoric mood with pessimism
about the future distinguishes depression from the apathy syndrome common in neurodegenerative disorders.
NRNP 6665 Final Exam - 2026/2027 | Passing Score: 80% | Page 2
, SECTION 1 | Psychiatric Assessment & Diagnostic Formulation | Q1-Q15 | NRNP 6665 Final Exam 2026/2027
Q3 Question 3 of 75
A 19-year-old college freshman is brought to the student health center by his roommate
because he has been hearing a voice commenting on his actions for the past 2 weeks. He
reports that the voice is clear, speaks in complete sentences, and occurs multiple times daily.
He denies substance use and has no family history of psychosis. His physical examination is
unremarkable. Which of the following is the most appropriate next step in evaluation?
A. Start risperidone 2 mg daily
B. Order urine drug screen and comprehensive metabolic panel
C. Schedule outpatient cognitive behavioral therapy
D. Refer for immediate inpatient psychiatric admission
Correct Answer: B
Rationale:
First-episode psychosis in a young adult requires a thorough medical workup to rule out organic causes before initiating
antipsychotic treatment. A urine drug screen can identify substance-induced psychosis (e.g., cannabis, stimulants), and a
comprehensive metabolic panel assesses for medical conditions such as thyroid dysfunction or electrolyte abnormalities.
Inpatient admission is not indicated unless the patient is acutely dangerous to self or others.
Q4 Question 4 of 75
A 42-year-old woman with a 10-year history of bipolar I disorder presents for routine follow-up.
She reports stable mood for 6 months on lithium 1200 mg daily. Laboratory studies reveal a
serum lithium level of 1.4 mEq/L, serum creatinine of 1.8 mg/dL, and TSH of 6.5 mIU/L. Which of
the following is the most appropriate next step in management?
A. Continue current lithium dose and recheck labs in 3 months
B. Discontinue lithium and switch to valproic acid
C. Reduce lithium dose and add levothyroxine
D. Reduce lithium dose, add levothyroxine, and monitor renal function closely
Correct Answer: D
Rationale:
A lithium level of 1.4 mEq/L is at the upper limit of the therapeutic range (0.6-1.2 mEq/L for maintenance, up to 1.5 mEq/L
for acute mania) and may contribute to renal impairment. The elevated creatinine suggests nephrotoxicity, and the
elevated TSH indicates hypothyroidism, both known adverse effects of lithium. The appropriate action is to reduce the
lithium dose, treat the hypothyroidism with levothyroxine, and closely monitor renal function. Discontinuing lithium entirely
may risk mood destabilization.
Q5 Question 5 of 75
A 28-year-old man with major depressive disorder has failed trials of sertraline and venlafaxine.
His psychiatrist decides to initiate phenelzine, a monoamine oxidase inhibitor. Which dietary
instruction is most critical to prevent a hypertensive crisis?
A. Avoid all dairy products
B. Avoid aged cheeses, cured meats, and fermented foods
C. Limit caffeine to one cup daily
D. Take with food to reduce gastrointestinal upset
Correct Answer: B
Rationale:
MAOIs such as phenelzine irreversibly inhibit monoamine oxidase, preventing the breakdown of tyramine. Foods high in
tyramine (aged cheeses, cured meats, fermented soy products, draft beer, wine) can cause dangerous hypertensive
crises due to excessive norepinephrine release. Patients must follow a strict tyramine-restricted diet. Dairy products are
NRNP 6665 Final Exam - 2026/2027 | Passing Score: 80% | Page 3
generally safe except for aged cheeses. Caffeine restriction is not specifically required for MAOIs.
OBJECTIVE ASSESSMENT - EXAM
NRNP 6665 / NRNP6665 Final Exam (Latest
Update 2026/2027) PMHNP Care Across the
Lifespan I | Questions and Answers | Grade
A | 100% Correct | Verified Solutions -
Walden 2026/2027
Walden University | PMHNP Care Across the Lifespan I
75 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
• Psychiatric Assessment & Diagnostic Formulation • Ethics, Legal Principles & Cultural Care
• Psychopharmacology & Biological Treatments • Lifespan Development & Special Populations
• Psychotherapy & Therapeutic Interventions • Evidence-Based Practice & Clinical Decision-Making
COVER PAGE - 1
NRNP 6665 Final Exam - 2026/2027 | Passing Score: 80% | Page 1
,SECTION 1 | Psychiatric Assessment & Diagnostic Formulation | Q1-Q15 | NRNP 6665 Final Exam 2026/2027
Q1 Question 1 of 75
A 34-year-old woman presents to the emergency department after a motor vehicle accident. She
reports intrusive memories of the crash, severe anxiety when driving, and recurrent nightmares
for the past 6 weeks. She denies any prior psychiatric history. Her vital signs are stable, and she
has no signs of traumatic brain injury. Which of the following is the most appropriate initial
diagnosis?
A. Acute stress disorder
B. Posttraumatic stress disorder
C. Adjustment disorder with anxiety
D. Generalized anxiety disorder
Correct Answer: B
Rationale:
Posttraumatic stress disorder requires exposure to actual or threatened death, serious injury, or sexual violence, with
symptoms persisting longer than 1 month. This patient meets Criterion B (intrusive memories), Criterion C (avoidance of
driving), and Criterion E (hyperarousal with nightmares) for more than 1 month. Acute stress disorder lasts 3 days to 1
month. Adjustment disorder requires symptoms that do not meet criteria for another disorder and occur within 3 months
of a stressor.
Q2 Question 2 of 75
During a mental status examination, a 67-year-old man with a history of Parkinson disease
demonstrates slow, labored speech with long pauses between words, reduced facial
expression, and a shuffling gait. His affect is flat, and he reports feeling 'empty inside' for the
past 3 months. Which clinical feature most strongly supports a diagnosis of major depressive
disorder rather than apathy related to Parkinson disease?
A. Flat affect
B. Psychomotor retardation
C. Anhedonia and hopelessness about the future
D. Shuffling gait
Correct Answer: C
Rationale:
While both Parkinson disease and major depressive disorder can present with psychomotor retardation and flat affect,
anhedonia and hopelessness are core mood symptoms of depression. Apathy in Parkinson disease typically lacks the
pervasive sadness, guilt, and suicidal ideation seen in depression. The presence of a dysphoric mood with pessimism
about the future distinguishes depression from the apathy syndrome common in neurodegenerative disorders.
NRNP 6665 Final Exam - 2026/2027 | Passing Score: 80% | Page 2
, SECTION 1 | Psychiatric Assessment & Diagnostic Formulation | Q1-Q15 | NRNP 6665 Final Exam 2026/2027
Q3 Question 3 of 75
A 19-year-old college freshman is brought to the student health center by his roommate
because he has been hearing a voice commenting on his actions for the past 2 weeks. He
reports that the voice is clear, speaks in complete sentences, and occurs multiple times daily.
He denies substance use and has no family history of psychosis. His physical examination is
unremarkable. Which of the following is the most appropriate next step in evaluation?
A. Start risperidone 2 mg daily
B. Order urine drug screen and comprehensive metabolic panel
C. Schedule outpatient cognitive behavioral therapy
D. Refer for immediate inpatient psychiatric admission
Correct Answer: B
Rationale:
First-episode psychosis in a young adult requires a thorough medical workup to rule out organic causes before initiating
antipsychotic treatment. A urine drug screen can identify substance-induced psychosis (e.g., cannabis, stimulants), and a
comprehensive metabolic panel assesses for medical conditions such as thyroid dysfunction or electrolyte abnormalities.
Inpatient admission is not indicated unless the patient is acutely dangerous to self or others.
Q4 Question 4 of 75
A 42-year-old woman with a 10-year history of bipolar I disorder presents for routine follow-up.
She reports stable mood for 6 months on lithium 1200 mg daily. Laboratory studies reveal a
serum lithium level of 1.4 mEq/L, serum creatinine of 1.8 mg/dL, and TSH of 6.5 mIU/L. Which of
the following is the most appropriate next step in management?
A. Continue current lithium dose and recheck labs in 3 months
B. Discontinue lithium and switch to valproic acid
C. Reduce lithium dose and add levothyroxine
D. Reduce lithium dose, add levothyroxine, and monitor renal function closely
Correct Answer: D
Rationale:
A lithium level of 1.4 mEq/L is at the upper limit of the therapeutic range (0.6-1.2 mEq/L for maintenance, up to 1.5 mEq/L
for acute mania) and may contribute to renal impairment. The elevated creatinine suggests nephrotoxicity, and the
elevated TSH indicates hypothyroidism, both known adverse effects of lithium. The appropriate action is to reduce the
lithium dose, treat the hypothyroidism with levothyroxine, and closely monitor renal function. Discontinuing lithium entirely
may risk mood destabilization.
Q5 Question 5 of 75
A 28-year-old man with major depressive disorder has failed trials of sertraline and venlafaxine.
His psychiatrist decides to initiate phenelzine, a monoamine oxidase inhibitor. Which dietary
instruction is most critical to prevent a hypertensive crisis?
A. Avoid all dairy products
B. Avoid aged cheeses, cured meats, and fermented foods
C. Limit caffeine to one cup daily
D. Take with food to reduce gastrointestinal upset
Correct Answer: B
Rationale:
MAOIs such as phenelzine irreversibly inhibit monoamine oxidase, preventing the breakdown of tyramine. Foods high in
tyramine (aged cheeses, cured meats, fermented soy products, draft beer, wine) can cause dangerous hypertensive
crises due to excessive norepinephrine release. Patients must follow a strict tyramine-restricted diet. Dairy products are
NRNP 6665 Final Exam - 2026/2027 | Passing Score: 80% | Page 3
generally safe except for aged cheeses. Caffeine restriction is not specifically required for MAOIs.
