Fitzgerald PMHNP
Psychiatric-Mental Health
Nurse Practitioner Final
Exam
1. A 35-year-old patient presents with depressed mood, anhedonia, and fatigue for 3
months. No history of mania or substance use. What is the most likely diagnosis?
A. Bipolar II disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Dysthymia
Answer: ✅ B. Major depressive disorder
Rationale: Meets DSM-5 criteria for MDD—≥2 weeks of depressed mood or
anhedonia with ≥4 additional symptoms, no history of mania/hypomania.
2. Which antidepressant is contraindicated in patients with a history of seizures or
eating disorders?
A. Fluoxetine
B. Bupropion
C. Sertraline
D. Duloxetine
Answer: ✅ B. Bupropion
Rationale: Lowers seizure threshold; avoid in bulimia, anorexia, or seizure disorders.
,3. Which neurotransmitter is primarily targeted by SSRIs?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. Acetylcholine
Answer: ✅ C. Serotonin
Rationale: SSRIs inhibit serotonin reuptake, increasing synaptic serotonin levels.
4. Which of the following medications is most effective for acute mania?
A. Lamotrigine
B. Lithium
C. Sertraline
D. Bupropion
Answer: ✅ B. Lithium
Rationale: Lithium is first-line for acute mania and maintenance in bipolar I disorder.
5. What is the therapeutic serum range for lithium?
A. 0.1–0.4 mEq/L
B. 0.6–1.2 mEq/L
C. 1.5–2.5 mEq/L
D. 2.0–3.0 mEq/L
Answer: ✅ B. 0.6–1.2 mEq/L
Rationale: Levels >1.5 are toxic; monitor renal and thyroid function.
6. Which of the following antipsychotics has the highest risk of metabolic syndrome?
A. Aripiprazole
B. Risperidone
, C. Clozapine
D. Ziprasidone
Answer: ✅ C. Clozapine
Rationale: Causes significant weight gain, dyslipidemia, and insulin resistance.
7. What is the black box warning for all antidepressants?
A. Risk of serotonin syndrome
B. Risk of suicidal ideation in children, adolescents, and young adults
C. Risk of cardiac arrhythmia
D. Risk of seizures
Answer: ✅ B. Suicidal ideation
Rationale: Increased risk of suicidal thoughts in patients under 25.
8. Which therapy focuses on changing maladaptive thought patterns?
A. DBT
B. CBT
C. IPT
D. EMDR
Answer: ✅ B. CBT (Cognitive Behavioral Therapy)
Rationale: Focuses on identifying and restructuring distorted thoughts.
9. Which antidepressant class is contraindicated with tyramine-rich foods?
A. SSRIs
B. SNRIs
C. MAOIs
D. TCAs
Answer: ✅ C. MAOIs
Rationale: Risk of hypertensive crisis due to tyramine interaction.
Psychiatric-Mental Health
Nurse Practitioner Final
Exam
1. A 35-year-old patient presents with depressed mood, anhedonia, and fatigue for 3
months. No history of mania or substance use. What is the most likely diagnosis?
A. Bipolar II disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Dysthymia
Answer: ✅ B. Major depressive disorder
Rationale: Meets DSM-5 criteria for MDD—≥2 weeks of depressed mood or
anhedonia with ≥4 additional symptoms, no history of mania/hypomania.
2. Which antidepressant is contraindicated in patients with a history of seizures or
eating disorders?
A. Fluoxetine
B. Bupropion
C. Sertraline
D. Duloxetine
Answer: ✅ B. Bupropion
Rationale: Lowers seizure threshold; avoid in bulimia, anorexia, or seizure disorders.
,3. Which neurotransmitter is primarily targeted by SSRIs?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. Acetylcholine
Answer: ✅ C. Serotonin
Rationale: SSRIs inhibit serotonin reuptake, increasing synaptic serotonin levels.
4. Which of the following medications is most effective for acute mania?
A. Lamotrigine
B. Lithium
C. Sertraline
D. Bupropion
Answer: ✅ B. Lithium
Rationale: Lithium is first-line for acute mania and maintenance in bipolar I disorder.
5. What is the therapeutic serum range for lithium?
A. 0.1–0.4 mEq/L
B. 0.6–1.2 mEq/L
C. 1.5–2.5 mEq/L
D. 2.0–3.0 mEq/L
Answer: ✅ B. 0.6–1.2 mEq/L
Rationale: Levels >1.5 are toxic; monitor renal and thyroid function.
6. Which of the following antipsychotics has the highest risk of metabolic syndrome?
A. Aripiprazole
B. Risperidone
, C. Clozapine
D. Ziprasidone
Answer: ✅ C. Clozapine
Rationale: Causes significant weight gain, dyslipidemia, and insulin resistance.
7. What is the black box warning for all antidepressants?
A. Risk of serotonin syndrome
B. Risk of suicidal ideation in children, adolescents, and young adults
C. Risk of cardiac arrhythmia
D. Risk of seizures
Answer: ✅ B. Suicidal ideation
Rationale: Increased risk of suicidal thoughts in patients under 25.
8. Which therapy focuses on changing maladaptive thought patterns?
A. DBT
B. CBT
C. IPT
D. EMDR
Answer: ✅ B. CBT (Cognitive Behavioral Therapy)
Rationale: Focuses on identifying and restructuring distorted thoughts.
9. Which antidepressant class is contraindicated with tyramine-rich foods?
A. SSRIs
B. SNRIs
C. MAOIs
D. TCAs
Answer: ✅ C. MAOIs
Rationale: Risk of hypertensive crisis due to tyramine interaction.
