1
NR607 – Diagnosis & Management in
Psychiatric Mental Health III Final Exam
Review (Weeks 5–8) | Verified Questions
and Answers | 100% Correct |
Chamberlain 2025/2026 Update
Question 1
A 28-year-old female presents with persistent low mood, anhedonia, and
fatigue for 6 months, meeting DSM-5 criteria for major depressive
disorder (MDD). She has no prior history. What is the first-line
pharmacotherapy per PMHNP guidelines? A. Bupropion XL 150 mg
daily B. Sertraline 50 mg daily C. Venlafaxine XR 75 mg daily D.
Mirtazapine 15 mg at bedtime
Rationale: SSRIs like sertraline are first-line for MDD per APA
guidelines and DSM-5, offering efficacy with favorable side-effect
profile for initial treatment in PMHNP practice, minimizing sexual
dysfunction and weight gain risks.
Question 2
In DSM-5, bipolar I disorder requires at least one manic episode. Which
symptom must be present for a manic episode diagnosis? A. Depressed
mood B. Elevated, expansive, or irritable mood C. Excessive sleep D.
Suicidal ideation
Rationale: DSM-5 specifies elevated/expansive/irritable mood plus
increased energy/activity for mania in bipolar I; PMHNPs assess this to
differentiate from hypomania or unipolar depression, guiding mood
stabilizer initiation.
, 2
Question 3
A patient with generalized anxiety disorder (GAD) reports ongoing
worry and muscle tension. After SSRIs fail, what is the next
pharmacotherapeutic step? A. Buspirone 15 mg BID B. Duloxetine 60
mg daily C. Lorazepam 1 mg PRN D. Propranolol 40 mg BID
Rationale: SNRIs like duloxetine are second-line for GAD per DSM-5
and VA/DoD guidelines; PMHNPs prefer them over benzodiazepines to
avoid dependence, targeting both anxiety and somatic symptoms.
Question 4
For schizophrenia, DSM-5 requires delusions, hallucinations, or
disorganized speech for diagnosis. What is the recommended initial
antipsychotic for a first-episode patient? A. Haloperidol 5 mg BID B.
Risperidone 2 mg daily C. Clozapine 100 mg BID D. Olanzapine 10 mg
daily
Rationale: Second-generation antipsychotics like risperidone are first-
line per APA guidelines for schizophrenia; PMHNPs select atypicals for
lower extrapyramidal side effects, aligning with DSM-5 positive
symptom management.
Question 5
A 45-year-old male with alcohol use disorder (AUD) in remission seeks
maintenance therapy. What is the evidence-based pharmacotherapy? A.
Disulfiram 250 mg daily B. Naltrexone 50 mg daily C. Acamprosate 666
mg TID D. Topiramate 100 mg BID
Rationale: Naltrexone reduces relapse in AUD per DSM-5 criteria and
ASAM guidelines; PMHNPs use it to block opioid-mediated reward,
monitoring LFTs for safety in outpatient management.
, 3
Question 6
DSM-5 criteria for PTSD include exposure to trauma and symptoms in
four clusters. Which is NOT a cluster? A. Intrusion B. Avoidance C.
Euthymic mood D. Arousal/reactivity
Rationale: Euthymia is not a PTSD cluster; DSM-5 requires intrusion,
avoidance, negative cognitions/mood, and arousal for diagnosis—
PMHNPs use this to tailor trauma-focused CBT or prazosin for
nightmares.
Question 7
In PMHNP practice, what is the black-box warning for all
antidepressants in young adults? A. Seizure risk B. Increased suicidality
C. QT prolongation D. Agranulocytosis
Rationale: FDA black-box warning per DSM-5-related
pharmacotherapy mandates suicidality monitoring in <25-year-olds;
PMHNPs conduct frequent follow-ups during initiation to mitigate risk.
Question 8
A patient with borderline personality disorder (BPD) exhibits splitting
and self-harm. What is the primary psychotherapeutic approach? A.
CBT B. Dialectical behavior therapy (DBT) C. Psychoanalysis D.
Supportive therapy
Rationale: DSM-5 BPD criteria emphasize emotional dysregulation;
DBT is gold standard per APA, teaching PMHNPs skills for distress
tolerance and interpersonal effectiveness in BPD management.
Question 9
For obsessive-compulsive disorder (OCD), DSM-5 requires obsessions
and/or compulsions causing distress. First-line treatment is? A.
NR607 – Diagnosis & Management in
Psychiatric Mental Health III Final Exam
Review (Weeks 5–8) | Verified Questions
and Answers | 100% Correct |
Chamberlain 2025/2026 Update
Question 1
A 28-year-old female presents with persistent low mood, anhedonia, and
fatigue for 6 months, meeting DSM-5 criteria for major depressive
disorder (MDD). She has no prior history. What is the first-line
pharmacotherapy per PMHNP guidelines? A. Bupropion XL 150 mg
daily B. Sertraline 50 mg daily C. Venlafaxine XR 75 mg daily D.
Mirtazapine 15 mg at bedtime
Rationale: SSRIs like sertraline are first-line for MDD per APA
guidelines and DSM-5, offering efficacy with favorable side-effect
profile for initial treatment in PMHNP practice, minimizing sexual
dysfunction and weight gain risks.
Question 2
In DSM-5, bipolar I disorder requires at least one manic episode. Which
symptom must be present for a manic episode diagnosis? A. Depressed
mood B. Elevated, expansive, or irritable mood C. Excessive sleep D.
Suicidal ideation
Rationale: DSM-5 specifies elevated/expansive/irritable mood plus
increased energy/activity for mania in bipolar I; PMHNPs assess this to
differentiate from hypomania or unipolar depression, guiding mood
stabilizer initiation.
, 2
Question 3
A patient with generalized anxiety disorder (GAD) reports ongoing
worry and muscle tension. After SSRIs fail, what is the next
pharmacotherapeutic step? A. Buspirone 15 mg BID B. Duloxetine 60
mg daily C. Lorazepam 1 mg PRN D. Propranolol 40 mg BID
Rationale: SNRIs like duloxetine are second-line for GAD per DSM-5
and VA/DoD guidelines; PMHNPs prefer them over benzodiazepines to
avoid dependence, targeting both anxiety and somatic symptoms.
Question 4
For schizophrenia, DSM-5 requires delusions, hallucinations, or
disorganized speech for diagnosis. What is the recommended initial
antipsychotic for a first-episode patient? A. Haloperidol 5 mg BID B.
Risperidone 2 mg daily C. Clozapine 100 mg BID D. Olanzapine 10 mg
daily
Rationale: Second-generation antipsychotics like risperidone are first-
line per APA guidelines for schizophrenia; PMHNPs select atypicals for
lower extrapyramidal side effects, aligning with DSM-5 positive
symptom management.
Question 5
A 45-year-old male with alcohol use disorder (AUD) in remission seeks
maintenance therapy. What is the evidence-based pharmacotherapy? A.
Disulfiram 250 mg daily B. Naltrexone 50 mg daily C. Acamprosate 666
mg TID D. Topiramate 100 mg BID
Rationale: Naltrexone reduces relapse in AUD per DSM-5 criteria and
ASAM guidelines; PMHNPs use it to block opioid-mediated reward,
monitoring LFTs for safety in outpatient management.
, 3
Question 6
DSM-5 criteria for PTSD include exposure to trauma and symptoms in
four clusters. Which is NOT a cluster? A. Intrusion B. Avoidance C.
Euthymic mood D. Arousal/reactivity
Rationale: Euthymia is not a PTSD cluster; DSM-5 requires intrusion,
avoidance, negative cognitions/mood, and arousal for diagnosis—
PMHNPs use this to tailor trauma-focused CBT or prazosin for
nightmares.
Question 7
In PMHNP practice, what is the black-box warning for all
antidepressants in young adults? A. Seizure risk B. Increased suicidality
C. QT prolongation D. Agranulocytosis
Rationale: FDA black-box warning per DSM-5-related
pharmacotherapy mandates suicidality monitoring in <25-year-olds;
PMHNPs conduct frequent follow-ups during initiation to mitigate risk.
Question 8
A patient with borderline personality disorder (BPD) exhibits splitting
and self-harm. What is the primary psychotherapeutic approach? A.
CBT B. Dialectical behavior therapy (DBT) C. Psychoanalysis D.
Supportive therapy
Rationale: DSM-5 BPD criteria emphasize emotional dysregulation;
DBT is gold standard per APA, teaching PMHNPs skills for distress
tolerance and interpersonal effectiveness in BPD management.
Question 9
For obsessive-compulsive disorder (OCD), DSM-5 requires obsessions
and/or compulsions causing distress. First-line treatment is? A.
