1
NR607 – Diagnosis & Management in Psychiatric
Mental Health III (Chamberlain University,
2025/2026) – Final Exam Complete Review
(Weeks 5–8) with Verified Questions and 100%
Correct Answers
Question 1
A nurse practitioner is assessing a client with suspected borderline
personality disorder (BPD) who presents with intense fear of
abandonment and recurrent suicidal gestures. According to the DSM-5-
TR (2022 update), what is the primary diagnostic criterion for BPD?
A. Persistent depressed mood lasting at least two weeks B. Frantic
efforts to avoid real or imagined abandonment C. Excessive social
withdrawal and anhedonia D. Preoccupation with fantasies of unlimited
success
B. Frantic efforts to avoid real or imagined abandonment
Rationale: The DSM-5-TR emphasizes frantic efforts to avoid
abandonment as a core criterion for BPD, distinguishing it from mood
disorders; this guides differential diagnosis and management with
dialectical behavior therapy (DBT) to address emotional dysregulation.
Question 2
In managing a client with treatment-resistant depression, the nurse
practitioner considers augmentation with aripiprazole. What is the
recommended starting dose per the 2025 APA guidelines?
A. 2 mg daily B. 5 mg daily C. 10 mg daily D. 15 mg daily
A. 2 mg daily
, 2
Rationale: APA 2025 guidelines recommend low-dose aripiprazole (2
mg/day) for augmentation to minimize metabolic side effects;
therapeutic monitoring includes metabolic panels q3 months, aligning
with pharmacotherapeutic principles for efficacy and safety.
Question 3
A client with schizophrenia spectrum disorder is experiencing akathisia
on haloperidol. What is the first-line intervention per the 2026
psychopharmacology update?
A. Switch to clozapine immediately B. Beta-blocker such as propranolol
10-20 mg BID C. Increase haloperidol dose D. Administer
diphenhydramine IV
B. Beta-blocker such as propranolol 10-20 mg BID
Rationale: Akathisia, an extrapyramidal symptom, responds to beta-
blockers like propranolol by blocking peripheral beta-2 receptors; this
non-anticholinergic approach is preferred in updates to avoid sedation,
with AIMS scale monitoring.
Question 4
During a telepsychiatry session, a client with PTSD endorses nightmares
and hypervigilance. What evidence-based therapy should the NP
recommend based on VA/DOD 2025 guidelines?
A. Eye movement desensitization and reprocessing (EMDR) B.
Supportive psychotherapy C. Psychoeducation only D. Hypnotherapy
A. Eye movement desensitization and reprocessing (EMDR)
Rationale: VA/DOD 2025 guidelines strongly recommend EMDR for
PTSD symptom reduction via bilateral stimulation; this trauma-focused
, 3
therapy addresses re-experiencing, with follow-up on avoidance
behaviors.
Question 5
A 25-year-old client with anorexia nervosa has a BMI of 15. What is the
priority in the multidisciplinary management plan per ANAD 2026
standards?
A. Immediate inpatient admission for refeeding syndrome risk B.
Outpatient nutritional counseling C. Cognitive-behavioral therapy (CBT)
sessions D. Family-based therapy (FBT) only
A. Immediate inpatient admission for refeeding syndrome risk
Rationale: ANAD 2026 standards prioritize hospitalization for BMI
<15 due to cardiac instability and refeeding risks; monitoring includes
q4h electrolytes, with gradual caloric increase starting at 1,200 kcal.
Question 6
In evaluating a client for bipolar I disorder, the NP notes manic episodes
lasting 7 days with psychosis. What pharmacologic first-line per
CANMAT 2025 guidelines?
A. Lithium monotherapy B. Valproate with antipsychotic C.
Lamotrigine alone D. Carbamazepine
B. Valproate with antipsychotic
Rationale: CANMAT 2025 recommends divalproex plus quetiapine for
acute mania with psychosis to stabilize mood and reduce symptoms
rapidly; valproate levels 50-125 mcg/mL, with LFT monitoring.
Question 7
, 4
A client with social anxiety disorder avoids public speaking. What is the
gold standard non-pharmacologic intervention per NICE 2025 update?
A. Group cognitive-behavioral therapy (CBT) B. Exposure therapy C.
Mindfulness-based stress reduction (MBSR) D. Psychodynamic therapy
B. Exposure therapy
Rationale: NICE 2025 updates endorse graded exposure as first-line for
social anxiety, systematically desensitizing fear responses; combined
with CBT, it achieves 60% remission rates.
Question 8
A nurse practitioner is prescribing buprenorphine/naloxone for opioid
use disorder (OUD). What is the induction dosing schedule per ASAM
2026 guidelines?
A. 2/0.5 mg SL on day 1, titrate to 8-16 mg B. 8 mg immediate start C.
16 mg day 1 D. Taper from methadone directly
A. 2/0.5 mg SL on day 1, titrate to 8-16 mg
Rationale: ASAM 2026 guidelines advocate micro-dosing induction to
minimize withdrawal; naloxone deters abuse, with urine tox and
cravings assessed weekly.
Question 9
In assessing a client with suspected ADHD in adults, which DSM-5-TR
criterion is essential for diagnosis?
A. Symptoms present before age 12 and impair multiple settings B.
Hyperactivity only C. Inattention in one domain D. Onset after 18
A. Symptoms present before age 12 and impair multiple settings
NR607 – Diagnosis & Management in Psychiatric
Mental Health III (Chamberlain University,
2025/2026) – Final Exam Complete Review
(Weeks 5–8) with Verified Questions and 100%
Correct Answers
Question 1
A nurse practitioner is assessing a client with suspected borderline
personality disorder (BPD) who presents with intense fear of
abandonment and recurrent suicidal gestures. According to the DSM-5-
TR (2022 update), what is the primary diagnostic criterion for BPD?
A. Persistent depressed mood lasting at least two weeks B. Frantic
efforts to avoid real or imagined abandonment C. Excessive social
withdrawal and anhedonia D. Preoccupation with fantasies of unlimited
success
B. Frantic efforts to avoid real or imagined abandonment
Rationale: The DSM-5-TR emphasizes frantic efforts to avoid
abandonment as a core criterion for BPD, distinguishing it from mood
disorders; this guides differential diagnosis and management with
dialectical behavior therapy (DBT) to address emotional dysregulation.
Question 2
In managing a client with treatment-resistant depression, the nurse
practitioner considers augmentation with aripiprazole. What is the
recommended starting dose per the 2025 APA guidelines?
A. 2 mg daily B. 5 mg daily C. 10 mg daily D. 15 mg daily
A. 2 mg daily
, 2
Rationale: APA 2025 guidelines recommend low-dose aripiprazole (2
mg/day) for augmentation to minimize metabolic side effects;
therapeutic monitoring includes metabolic panels q3 months, aligning
with pharmacotherapeutic principles for efficacy and safety.
Question 3
A client with schizophrenia spectrum disorder is experiencing akathisia
on haloperidol. What is the first-line intervention per the 2026
psychopharmacology update?
A. Switch to clozapine immediately B. Beta-blocker such as propranolol
10-20 mg BID C. Increase haloperidol dose D. Administer
diphenhydramine IV
B. Beta-blocker such as propranolol 10-20 mg BID
Rationale: Akathisia, an extrapyramidal symptom, responds to beta-
blockers like propranolol by blocking peripheral beta-2 receptors; this
non-anticholinergic approach is preferred in updates to avoid sedation,
with AIMS scale monitoring.
Question 4
During a telepsychiatry session, a client with PTSD endorses nightmares
and hypervigilance. What evidence-based therapy should the NP
recommend based on VA/DOD 2025 guidelines?
A. Eye movement desensitization and reprocessing (EMDR) B.
Supportive psychotherapy C. Psychoeducation only D. Hypnotherapy
A. Eye movement desensitization and reprocessing (EMDR)
Rationale: VA/DOD 2025 guidelines strongly recommend EMDR for
PTSD symptom reduction via bilateral stimulation; this trauma-focused
, 3
therapy addresses re-experiencing, with follow-up on avoidance
behaviors.
Question 5
A 25-year-old client with anorexia nervosa has a BMI of 15. What is the
priority in the multidisciplinary management plan per ANAD 2026
standards?
A. Immediate inpatient admission for refeeding syndrome risk B.
Outpatient nutritional counseling C. Cognitive-behavioral therapy (CBT)
sessions D. Family-based therapy (FBT) only
A. Immediate inpatient admission for refeeding syndrome risk
Rationale: ANAD 2026 standards prioritize hospitalization for BMI
<15 due to cardiac instability and refeeding risks; monitoring includes
q4h electrolytes, with gradual caloric increase starting at 1,200 kcal.
Question 6
In evaluating a client for bipolar I disorder, the NP notes manic episodes
lasting 7 days with psychosis. What pharmacologic first-line per
CANMAT 2025 guidelines?
A. Lithium monotherapy B. Valproate with antipsychotic C.
Lamotrigine alone D. Carbamazepine
B. Valproate with antipsychotic
Rationale: CANMAT 2025 recommends divalproex plus quetiapine for
acute mania with psychosis to stabilize mood and reduce symptoms
rapidly; valproate levels 50-125 mcg/mL, with LFT monitoring.
Question 7
, 4
A client with social anxiety disorder avoids public speaking. What is the
gold standard non-pharmacologic intervention per NICE 2025 update?
A. Group cognitive-behavioral therapy (CBT) B. Exposure therapy C.
Mindfulness-based stress reduction (MBSR) D. Psychodynamic therapy
B. Exposure therapy
Rationale: NICE 2025 updates endorse graded exposure as first-line for
social anxiety, systematically desensitizing fear responses; combined
with CBT, it achieves 60% remission rates.
Question 8
A nurse practitioner is prescribing buprenorphine/naloxone for opioid
use disorder (OUD). What is the induction dosing schedule per ASAM
2026 guidelines?
A. 2/0.5 mg SL on day 1, titrate to 8-16 mg B. 8 mg immediate start C.
16 mg day 1 D. Taper from methadone directly
A. 2/0.5 mg SL on day 1, titrate to 8-16 mg
Rationale: ASAM 2026 guidelines advocate micro-dosing induction to
minimize withdrawal; naloxone deters abuse, with urine tox and
cravings assessed weekly.
Question 9
In assessing a client with suspected ADHD in adults, which DSM-5-TR
criterion is essential for diagnosis?
A. Symptoms present before age 12 and impair multiple settings B.
Hyperactivity only C. Inattention in one domain D. Onset after 18
A. Symptoms present before age 12 and impair multiple settings
