NR 606 Week 4 Midterm Exam 2025|
Chamberlain University| Actual Exam
Questions and Correct Answers
Question 1
Which of the following are considered essential features of sexual dysfunction?
A. Persistent difficulty with sexual response, desire, or orgasm causing distress
B. Occasional difficulty with sexual performance
C. Lack of interest in sexual activity due to stress
D. Temporary erectile dysfunction due to fatigue
Correct Answer: A. Persistent difficulty with sexual response, desire, or orgasm causing distress
Explanation: Sexual dysfunction, per DSM-5, involves persistent issues with sexual response,
desire, or orgasm that cause significant distress or interpersonal difficulty, distinguishing it from
transient issues.
Question 2
Select the appropriate treatment modalities for a client with circadian rhythm sleep-wake
disorder: (Select all that apply.)
A. Light therapy
B. Melatonin supplementation
C. Cognitive behavioral therapy
D. Benzodiazepines
E. Chronotherapy
Correct Answer: A, B, C, E
Explanation: Circadian rhythm sleep-wake disorder treatments include light therapy (to reset the
sleep-wake cycle), melatonin (to promote sleep), cognitive behavioral therapy (to address
maladaptive behaviors), and chronotherapy (adjusting sleep times). Benzodiazepines are not
first-line due to dependency risks.
,Question 3
A client with GAD reports no relief of symptoms after taking paroxetine 20 mg daily for 4
weeks. What is the appropriate next step?
A. Increase the dose or switch to another SSRI
B. Discontinue paroxetine immediately
C. Add a benzodiazepine long-term
D. Recommend immediate psychotherapy only
Correct Answer: A. Increase the dose or switch to another SSRI
Explanation: If paroxetine 20 mg fails to relieve generalized anxiety disorder (GAD) symptoms
after 4 weeks, the next step is to increase the dose (up to 50 mg/day) or switch to another SSRI,
as response may take 6–8 weeks or require a different agent.
Question 4
A client presents to the clinic complaining of fatigue, anhedonia, and low mood. Which action is
the PMHNP’s priority?
A. Screen for depression using a validated tool
B. Order thyroid function tests
C. Prescribe an antidepressant immediately
D. Refer to a psychiatrist for hospitalization
Correct Answer: A. Screen for depression using a validated tool
Explanation: Fatigue, anhedonia, and low mood suggest depression. The PMHNP’s priority is to
screen using a tool like PHQ-9 to confirm the diagnosis before initiating treatment or further
testing.
Question 5
A 32-year-old presents to the PMHNP following four brief episodes of intense anxiety occurring
at home and at work over the last two months. He reports the episodes come out of the blue, with
dyspnea, heart palpitations, chest pain, tingling in his lips and fingers, and sweating. His
symptoms are so severe he fears he is going to die. His primary care physician has ruled out a
medical cause. He has canceled several work meetings out of fear of another attack. The client
meets DSM-5 criteria for what listed diagnosis?
,A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Post-traumatic stress disorder
Correct Answer: A. Panic disorder
Explanation: Recurrent, unexpected panic attacks with intense physical symptoms (dyspnea,
palpitations, etc.) and fear of future attacks, leading to avoidance behavior, meet DSM-5 criteria
for panic disorder.
Question 6
A client presents with auditory hallucinations. Which medication has an adverse effect profile
that includes this primary symptom?
A. Quetiapine
B. Fluoxetine
C. Bupropion
D. Levodopa
Correct Answer: D. Levodopa
Explanation: Levodopa, used for Parkinson’s disease, can cause auditory hallucinations as an
adverse effect, particularly in high doses or advanced disease, due to increased dopamine levels.
Question 7
Which diagnosis presents with minimal spontaneous sexual thinking or minimal desire for sex
ahead of sexual experiences?
A. Hypoactive sexual desire disorder
B. Erectile disorder
C. Premature ejaculation
D. Female orgasmic disorder
Correct Answer: A. Hypoactive sexual desire disorder
Explanation: Hypoactive sexual desire disorder is characterized by a persistent lack of sexual
thoughts or desire for sexual activity, causing distress.
, Question 8
A client presents with symptoms of anxiety. Which lab test indicates a possible medical cause of
symptoms?
A. Thyroid function tests
B. Complete blood count
C. Lipid panel
D. Blood glucose
Correct Answer: A. Thyroid function tests
Explanation: Thyroid dysfunction (e.g., hyperthyroidism) can mimic anxiety symptoms (e.g.,
palpitations, nervousness). Thyroid function tests (TSH, T4) are critical to rule out medical
causes.
Question 9
Which statement is true regarding sleep-wake disorders?
A. They involve disruptions in the timing, quality, or amount of sleep
B. They are always caused by psychiatric conditions
C. They do not impact daytime functioning
D. They are treated solely with sedatives
Correct Answer: A. They involve disruptions in the timing, quality, or amount of sleep
Explanation: Sleep-wake disorders (e.g., insomnia, circadian rhythm disorders) are characterized
by issues with sleep timing, quality, or duration, impacting daytime functioning, and are not
always psychiatric in origin.
Question 10
Which factor determines whether a client presents with symptoms of psychosis and disordered
mood?
A. Underlying neurochemical imbalances
B. Environmental stressors alone
C. Genetic predisposition only
Chamberlain University| Actual Exam
Questions and Correct Answers
Question 1
Which of the following are considered essential features of sexual dysfunction?
A. Persistent difficulty with sexual response, desire, or orgasm causing distress
B. Occasional difficulty with sexual performance
C. Lack of interest in sexual activity due to stress
D. Temporary erectile dysfunction due to fatigue
Correct Answer: A. Persistent difficulty with sexual response, desire, or orgasm causing distress
Explanation: Sexual dysfunction, per DSM-5, involves persistent issues with sexual response,
desire, or orgasm that cause significant distress or interpersonal difficulty, distinguishing it from
transient issues.
Question 2
Select the appropriate treatment modalities for a client with circadian rhythm sleep-wake
disorder: (Select all that apply.)
A. Light therapy
B. Melatonin supplementation
C. Cognitive behavioral therapy
D. Benzodiazepines
E. Chronotherapy
Correct Answer: A, B, C, E
Explanation: Circadian rhythm sleep-wake disorder treatments include light therapy (to reset the
sleep-wake cycle), melatonin (to promote sleep), cognitive behavioral therapy (to address
maladaptive behaviors), and chronotherapy (adjusting sleep times). Benzodiazepines are not
first-line due to dependency risks.
,Question 3
A client with GAD reports no relief of symptoms after taking paroxetine 20 mg daily for 4
weeks. What is the appropriate next step?
A. Increase the dose or switch to another SSRI
B. Discontinue paroxetine immediately
C. Add a benzodiazepine long-term
D. Recommend immediate psychotherapy only
Correct Answer: A. Increase the dose or switch to another SSRI
Explanation: If paroxetine 20 mg fails to relieve generalized anxiety disorder (GAD) symptoms
after 4 weeks, the next step is to increase the dose (up to 50 mg/day) or switch to another SSRI,
as response may take 6–8 weeks or require a different agent.
Question 4
A client presents to the clinic complaining of fatigue, anhedonia, and low mood. Which action is
the PMHNP’s priority?
A. Screen for depression using a validated tool
B. Order thyroid function tests
C. Prescribe an antidepressant immediately
D. Refer to a psychiatrist for hospitalization
Correct Answer: A. Screen for depression using a validated tool
Explanation: Fatigue, anhedonia, and low mood suggest depression. The PMHNP’s priority is to
screen using a tool like PHQ-9 to confirm the diagnosis before initiating treatment or further
testing.
Question 5
A 32-year-old presents to the PMHNP following four brief episodes of intense anxiety occurring
at home and at work over the last two months. He reports the episodes come out of the blue, with
dyspnea, heart palpitations, chest pain, tingling in his lips and fingers, and sweating. His
symptoms are so severe he fears he is going to die. His primary care physician has ruled out a
medical cause. He has canceled several work meetings out of fear of another attack. The client
meets DSM-5 criteria for what listed diagnosis?
,A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Post-traumatic stress disorder
Correct Answer: A. Panic disorder
Explanation: Recurrent, unexpected panic attacks with intense physical symptoms (dyspnea,
palpitations, etc.) and fear of future attacks, leading to avoidance behavior, meet DSM-5 criteria
for panic disorder.
Question 6
A client presents with auditory hallucinations. Which medication has an adverse effect profile
that includes this primary symptom?
A. Quetiapine
B. Fluoxetine
C. Bupropion
D. Levodopa
Correct Answer: D. Levodopa
Explanation: Levodopa, used for Parkinson’s disease, can cause auditory hallucinations as an
adverse effect, particularly in high doses or advanced disease, due to increased dopamine levels.
Question 7
Which diagnosis presents with minimal spontaneous sexual thinking or minimal desire for sex
ahead of sexual experiences?
A. Hypoactive sexual desire disorder
B. Erectile disorder
C. Premature ejaculation
D. Female orgasmic disorder
Correct Answer: A. Hypoactive sexual desire disorder
Explanation: Hypoactive sexual desire disorder is characterized by a persistent lack of sexual
thoughts or desire for sexual activity, causing distress.
, Question 8
A client presents with symptoms of anxiety. Which lab test indicates a possible medical cause of
symptoms?
A. Thyroid function tests
B. Complete blood count
C. Lipid panel
D. Blood glucose
Correct Answer: A. Thyroid function tests
Explanation: Thyroid dysfunction (e.g., hyperthyroidism) can mimic anxiety symptoms (e.g.,
palpitations, nervousness). Thyroid function tests (TSH, T4) are critical to rule out medical
causes.
Question 9
Which statement is true regarding sleep-wake disorders?
A. They involve disruptions in the timing, quality, or amount of sleep
B. They are always caused by psychiatric conditions
C. They do not impact daytime functioning
D. They are treated solely with sedatives
Correct Answer: A. They involve disruptions in the timing, quality, or amount of sleep
Explanation: Sleep-wake disorders (e.g., insomnia, circadian rhythm disorders) are characterized
by issues with sleep timing, quality, or duration, impacting daytime functioning, and are not
always psychiatric in origin.
Question 10
Which factor determines whether a client presents with symptoms of psychosis and disordered
mood?
A. Underlying neurochemical imbalances
B. Environmental stressors alone
C. Genetic predisposition only
