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Regis NU664C Week 10 Final Exam 2025
– Actual Questions & Verified Correct
Answers | 100% Graded A+ | Updated for
2025 Exam Requirements
.
1. Which of the following is a core component of informed consent in psychiatric care?
A. Providing only the benefits of treatment
B. Ensuring the patient understands risks, benefits, and alternatives
C. Requiring a family member’s approval
D. Obtaining consent only for medication management
Correct Answer: B
Rationale: Informed consent is an ethical and legal obligation that respects patient
autonomy. It requires providing comprehensive information about the nature of the
condition, treatment options, potential risks, benefits, and alternatives, ensuring the
patient can make an informed decision. Family approval is not required for competent
adults, and consent applies to all interventions, not just medications.
2. What is the primary difference between decisional capacity and competency?
A. Decisional capacity is determined by courts, while competency is a clinical judgment
B. Competency is a clinical term, while decisional capacity is a legal term
C. Decisional capacity is assessed by clinicians, while competency is determined by
courts
D. Both terms are interchangeable in psychiatric practice
Correct Answer: C
Rationale: Decisional capacity is a clinical determination made by healthcare providers,
assessing a patient’s ability to understand and make informed decisions about their care.
Competency is a legal term, determined by a judge, often in cases of guardianship or
involuntary treatment. These terms are not interchangeable.
3. A patient with bipolar disorder presents in an acute manic episode. What is the
first-line treatment?
A. Fluoxetine monotherapy
B. Lithium monotherapy
C. Valproate with an atypical antipsychotic
D. Cognitive behavioral therapy (CBT) alone
Correct Answer: C
Rationale: Acute mania is a medical emergency requiring rapid stabilization. Valproate,
, 2
combined with an atypical antipsychotic (e.g., olanzapine), is a first-line treatment due to
its faster onset compared to lithium, which has a slower therapeutic effect. Fluoxetine can
exacerbate mania, and CBT is not effective as a standalone treatment for acute mania.
4. Which laboratory test is essential before initiating lithium therapy?
A. Liver function tests (LFTs)
B. Thyroid function tests
C. Complete blood count (CBC)
D. Lipid panel
Correct Answer: B
Rationale: Lithium can affect thyroid function, potentially causing hypothyroidism.
Baseline thyroid function tests (e.g., TSH, free T4) are essential before starting therapy to
monitor for changes. While CBC and renal function tests are also important, thyroid
function is specifically critical due to lithium’s direct impact.
5. What is the therapeutic range for valproate in treating acute mania?
A. 25–50 mcg/mL
B. 50–125 mcg/mL
C. 125–200 mcg/mL
D. 200–300 mcg/mL
Correct Answer: B
Rationale: The therapeutic range for valproate in mania is 50–125 mcg/mL, with a target
around 80 mcg/mL for optimal efficacy. Levels below this range may be subtherapeutic,
while higher levels increase toxicity risk. Monitoring includes serum levels, LFTs, and
CBC.
6. Which screening tool is most appropriate for assessing suicide risk in a primary
care setting?
A. PHQ-9
B. Columbia-Suicide Severity Rating Scale (C-SSRS)
C. GAD-7
D. MMSE
Correct Answer: B
Rationale: The C-SSRS is a validated tool specifically designed to assess suicide risk,
including ideation, intent, and behavior. PHQ-9 screens for depression, GAD-7 for
anxiety, and MMSE for cognitive impairment, none of which directly target suicide risk.
7. A patient with schizophrenia experiences anhedonia due to their antipsychotic
medication. Which pathway is most likely affected?
A. Nigrostriatal pathway
B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Correct Answer: B
Rationale: Anhedonia, or reduced pleasure, is associated with blockade of the
mesolimbic pathway, which is involved in the brain’s reward system. First-generation
antipsychotics, which block dopamine in this pathway, can cause this side effect.
8. What is the primary goal of primary prevention in mental health?
A. Reducing the impact of an existing mental illness
B. Early detection and treatment of mental disorders
, 3
C. Preventing the onset of mental disorders
D. Managing chronic mental health conditions
Correct Answer: C
Rationale: Primary prevention aims to prevent the onset of mental disorders by
addressing risk factors and promoting protective factors (e.g., community education,
stress reduction programs). Secondary prevention focuses on early detection, and tertiary
prevention reduces the impact of existing conditions.
9. Which of the following is a contraindication for prescribing bupropion in a patient
with depression?
A. History of hypertension
B. History of seizure disorder
C. History of diabetes mellitus
D. History of asthma
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold, making it contraindicated in patients
with a history of seizure disorders. It is generally safe in patients with hypertension,
diabetes, or asthma, provided other clinical factors are considered.
10. What is the role of the National Organization of Nurse Practitioner Faculties
(NONPF) in psychiatric nursing?
A. Setting licensure requirements for APRNs
B. Developing standards for NP education
C. Enforcing state nursing regulations
D. Certifying psychiatric NPs
Correct Answer: B
Rationale: NONPF is dedicated to promoting high-quality NP education by establishing
competencies, evaluation methods, and curricular frameworks. It does not set licensure
requirements, enforce regulations, or certify NPs.
11. A patient with major depressive disorder (MDD) has failed two trials of SSRIs.
What is the next step in management?
A. Continue the current SSRI and add psychotherapy
B. Switch to a different SSRI
C. Initiate an SNRI or atypical antidepressant
D. Recommend electroconvulsive therapy (ECT)
Correct Answer: C
Rationale: After two failed SSRI trials, switching to a different class, such as an SNRI
(e.g., venlafaxine) or atypical antidepressant (e.g., bupropion), is recommended. Adding
psychotherapy is beneficial but not sufficient alone, and ECT is typically reserved for
treatment-resistant depression after multiple medication failures.
12. Which medication is considered the gold standard for treating bipolar depression?
A. Lithium
B. Lamotrigine
C. Valproate
D. Olanzapine
Correct Answer: B
Rationale: Lamotrigine is the gold standard for bipolar depression due to its efficacy and
lower risk of inducing mania. It carries a risk of Stevens-Johnson syndrome (SJS),
Regis NU664C Week 10 Final Exam 2025
– Actual Questions & Verified Correct
Answers | 100% Graded A+ | Updated for
2025 Exam Requirements
.
1. Which of the following is a core component of informed consent in psychiatric care?
A. Providing only the benefits of treatment
B. Ensuring the patient understands risks, benefits, and alternatives
C. Requiring a family member’s approval
D. Obtaining consent only for medication management
Correct Answer: B
Rationale: Informed consent is an ethical and legal obligation that respects patient
autonomy. It requires providing comprehensive information about the nature of the
condition, treatment options, potential risks, benefits, and alternatives, ensuring the
patient can make an informed decision. Family approval is not required for competent
adults, and consent applies to all interventions, not just medications.
2. What is the primary difference between decisional capacity and competency?
A. Decisional capacity is determined by courts, while competency is a clinical judgment
B. Competency is a clinical term, while decisional capacity is a legal term
C. Decisional capacity is assessed by clinicians, while competency is determined by
courts
D. Both terms are interchangeable in psychiatric practice
Correct Answer: C
Rationale: Decisional capacity is a clinical determination made by healthcare providers,
assessing a patient’s ability to understand and make informed decisions about their care.
Competency is a legal term, determined by a judge, often in cases of guardianship or
involuntary treatment. These terms are not interchangeable.
3. A patient with bipolar disorder presents in an acute manic episode. What is the
first-line treatment?
A. Fluoxetine monotherapy
B. Lithium monotherapy
C. Valproate with an atypical antipsychotic
D. Cognitive behavioral therapy (CBT) alone
Correct Answer: C
Rationale: Acute mania is a medical emergency requiring rapid stabilization. Valproate,
, 2
combined with an atypical antipsychotic (e.g., olanzapine), is a first-line treatment due to
its faster onset compared to lithium, which has a slower therapeutic effect. Fluoxetine can
exacerbate mania, and CBT is not effective as a standalone treatment for acute mania.
4. Which laboratory test is essential before initiating lithium therapy?
A. Liver function tests (LFTs)
B. Thyroid function tests
C. Complete blood count (CBC)
D. Lipid panel
Correct Answer: B
Rationale: Lithium can affect thyroid function, potentially causing hypothyroidism.
Baseline thyroid function tests (e.g., TSH, free T4) are essential before starting therapy to
monitor for changes. While CBC and renal function tests are also important, thyroid
function is specifically critical due to lithium’s direct impact.
5. What is the therapeutic range for valproate in treating acute mania?
A. 25–50 mcg/mL
B. 50–125 mcg/mL
C. 125–200 mcg/mL
D. 200–300 mcg/mL
Correct Answer: B
Rationale: The therapeutic range for valproate in mania is 50–125 mcg/mL, with a target
around 80 mcg/mL for optimal efficacy. Levels below this range may be subtherapeutic,
while higher levels increase toxicity risk. Monitoring includes serum levels, LFTs, and
CBC.
6. Which screening tool is most appropriate for assessing suicide risk in a primary
care setting?
A. PHQ-9
B. Columbia-Suicide Severity Rating Scale (C-SSRS)
C. GAD-7
D. MMSE
Correct Answer: B
Rationale: The C-SSRS is a validated tool specifically designed to assess suicide risk,
including ideation, intent, and behavior. PHQ-9 screens for depression, GAD-7 for
anxiety, and MMSE for cognitive impairment, none of which directly target suicide risk.
7. A patient with schizophrenia experiences anhedonia due to their antipsychotic
medication. Which pathway is most likely affected?
A. Nigrostriatal pathway
B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Correct Answer: B
Rationale: Anhedonia, or reduced pleasure, is associated with blockade of the
mesolimbic pathway, which is involved in the brain’s reward system. First-generation
antipsychotics, which block dopamine in this pathway, can cause this side effect.
8. What is the primary goal of primary prevention in mental health?
A. Reducing the impact of an existing mental illness
B. Early detection and treatment of mental disorders
, 3
C. Preventing the onset of mental disorders
D. Managing chronic mental health conditions
Correct Answer: C
Rationale: Primary prevention aims to prevent the onset of mental disorders by
addressing risk factors and promoting protective factors (e.g., community education,
stress reduction programs). Secondary prevention focuses on early detection, and tertiary
prevention reduces the impact of existing conditions.
9. Which of the following is a contraindication for prescribing bupropion in a patient
with depression?
A. History of hypertension
B. History of seizure disorder
C. History of diabetes mellitus
D. History of asthma
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold, making it contraindicated in patients
with a history of seizure disorders. It is generally safe in patients with hypertension,
diabetes, or asthma, provided other clinical factors are considered.
10. What is the role of the National Organization of Nurse Practitioner Faculties
(NONPF) in psychiatric nursing?
A. Setting licensure requirements for APRNs
B. Developing standards for NP education
C. Enforcing state nursing regulations
D. Certifying psychiatric NPs
Correct Answer: B
Rationale: NONPF is dedicated to promoting high-quality NP education by establishing
competencies, evaluation methods, and curricular frameworks. It does not set licensure
requirements, enforce regulations, or certify NPs.
11. A patient with major depressive disorder (MDD) has failed two trials of SSRIs.
What is the next step in management?
A. Continue the current SSRI and add psychotherapy
B. Switch to a different SSRI
C. Initiate an SNRI or atypical antidepressant
D. Recommend electroconvulsive therapy (ECT)
Correct Answer: C
Rationale: After two failed SSRI trials, switching to a different class, such as an SNRI
(e.g., venlafaxine) or atypical antidepressant (e.g., bupropion), is recommended. Adding
psychotherapy is beneficial but not sufficient alone, and ECT is typically reserved for
treatment-resistant depression after multiple medication failures.
12. Which medication is considered the gold standard for treating bipolar depression?
A. Lithium
B. Lamotrigine
C. Valproate
D. Olanzapine
Correct Answer: B
Rationale: Lamotrigine is the gold standard for bipolar depression due to its efficacy and
lower risk of inducing mania. It carries a risk of Stevens-Johnson syndrome (SJS),
