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NRNP 6675 Final Exam Test Bank 2025/2026 |
Walden University PMHNP | 250 Verified NGN
Questions & Answers with Rationales
1. A PMHNP is evaluating a patient with symptoms of persistent sadness, hypersomnia,
and psychomotor retardation. What is the most appropriate diagnosis?
A) Generalized anxiety disorder
B) Persistent depressive disorder
C) Major depressive disorder
D) Bipolar II disorder
, ✅ Answer: C
🧠 Rationale: The presence of depressed mood, hypersomnia, and psychomotor changes meets
DSM-5 criteria for Major Depressive Disorder.
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2. Which medication is FDA-approved for treatment-resistant depression and works as an
NMDA receptor antagonist?
A) Vortioxetine
B) Esketamine
C) Brexanolone
D) Aripiprazole
✅ Answer: B
🧠 Rationale: Esketamine (Spravato) is an NMDA receptor antagonist approved for treatment-
resistant depression.
3. A patient is started on lithium. Which of the following should the PMHNP monitor
routinely?
A) TSH, BUN/Creatinine
B) Hemoglobin A1C
C) Lipid panel
D) Liver function tests
, ✅ Answer: A
🧠 Rationale: Lithium affects thyroid and renal function, so TSH and kidney labs must be
checked frequently.
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4. Which therapy is most appropriate for a patient with Borderline Personality Disorder?
A) Interpersonal therapy
B) Exposure therapy
C) Dialectical Behavior Therapy (DBT)
D) Cognitive Processing Therapy (CPT)
✅ Answer: C
🧠 Rationale: DBT is first-line psychotherapy for BPD, focusing on emotion regulation and
distress tolerance.
5. Which psychotropic medication is associated with a high risk of metabolic syndrome?
A) Aripiprazole
B) Risperidone
C) Olanzapine
D) Ziprasidone
✅ Answer: C
, 🧠 Rationale: Olanzapine carries the highest risk for weight gain, dyslipidemia, and glucose
intolerance.
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6. A patient with schizophrenia reports tremors and muscle rigidity. What is the likely
cause?
A) Tardive dyskinesia
B) Akathisia
C) Pseudoparkinsonism
D) Neuroleptic malignant syndrome
✅ Answer: C
🧠 Rationale: Pseudoparkinsonism mimics Parkinson’s and includes rigidity, tremor, and
bradykinesia as EPS.
7. Which lab should be checked before starting carbamazepine?
A) Vitamin D
B) CBC with differential
C) Hemoglobin
D) Liver enzymes
✅ Answer: B
🧠 Rationale: Carbamazepine may cause agranulocytosis, so a baseline CBC is essential.
NRNP 6675 Final Exam Test Bank 2025/2026 |
Walden University PMHNP | 250 Verified NGN
Questions & Answers with Rationales
1. A PMHNP is evaluating a patient with symptoms of persistent sadness, hypersomnia,
and psychomotor retardation. What is the most appropriate diagnosis?
A) Generalized anxiety disorder
B) Persistent depressive disorder
C) Major depressive disorder
D) Bipolar II disorder
, ✅ Answer: C
🧠 Rationale: The presence of depressed mood, hypersomnia, and psychomotor changes meets
DSM-5 criteria for Major Depressive Disorder.
Page | 2
2. Which medication is FDA-approved for treatment-resistant depression and works as an
NMDA receptor antagonist?
A) Vortioxetine
B) Esketamine
C) Brexanolone
D) Aripiprazole
✅ Answer: B
🧠 Rationale: Esketamine (Spravato) is an NMDA receptor antagonist approved for treatment-
resistant depression.
3. A patient is started on lithium. Which of the following should the PMHNP monitor
routinely?
A) TSH, BUN/Creatinine
B) Hemoglobin A1C
C) Lipid panel
D) Liver function tests
, ✅ Answer: A
🧠 Rationale: Lithium affects thyroid and renal function, so TSH and kidney labs must be
checked frequently.
Page | 3
4. Which therapy is most appropriate for a patient with Borderline Personality Disorder?
A) Interpersonal therapy
B) Exposure therapy
C) Dialectical Behavior Therapy (DBT)
D) Cognitive Processing Therapy (CPT)
✅ Answer: C
🧠 Rationale: DBT is first-line psychotherapy for BPD, focusing on emotion regulation and
distress tolerance.
5. Which psychotropic medication is associated with a high risk of metabolic syndrome?
A) Aripiprazole
B) Risperidone
C) Olanzapine
D) Ziprasidone
✅ Answer: C
, 🧠 Rationale: Olanzapine carries the highest risk for weight gain, dyslipidemia, and glucose
intolerance.
Page | 4
6. A patient with schizophrenia reports tremors and muscle rigidity. What is the likely
cause?
A) Tardive dyskinesia
B) Akathisia
C) Pseudoparkinsonism
D) Neuroleptic malignant syndrome
✅ Answer: C
🧠 Rationale: Pseudoparkinsonism mimics Parkinson’s and includes rigidity, tremor, and
bradykinesia as EPS.
7. Which lab should be checked before starting carbamazepine?
A) Vitamin D
B) CBC with differential
C) Hemoglobin
D) Liver enzymes
✅ Answer: B
🧠 Rationale: Carbamazepine may cause agranulocytosis, so a baseline CBC is essential.
