Psychiatric-Mental Health Nurse Practitioner Exam Nursing MCQ 2

Question 1

A patient with bipolar I disorder is prescribed lithium. Which laboratory value requires the most immediate intervention?

Accepted Answer

Serum lithium level of 1.8 mEq/L

Answer

Serum lithium level of 0.8 mEq/L

Answer

Serum creatinine of 0.9 mg/dL

Answer

TSH of 3.2 mIU/L

Question 2

A PMHNP is evaluating a patient who reports 'hearing voices telling me to hurt myself.' What is the priority intervention?

Accepted Answer

Assess the nature, frequency, and command quality of the hallucinations

Answer

Administer a PRN antipsychotic

Answer

Immediately initiate involuntary hospitalization

Answer

Teach the patient to distract from the voices

Question 3

Which neurotransmitter imbalance is most strongly associated with the positive symptoms of schizophrenia?

Accepted Answer

Dopamine excess in the mesolimbic pathway

Answer

Serotonin excess in the prefrontal cortex

Answer

GABA deficiency in the hippocampus

Answer

Norepinephrine deficiency in the locus coeruleus

Question 4

A patient on clozapine develops a fever, sore throat, and absolute neutrophil count (ANC) of 400 cells/mm³. What is the appropriate action?

Accepted Answer

Discontinue clozapine immediately and notify the prescriber

Answer

Reduce the clozapine dose by 50%

Answer

Administer prophylactic antibiotics and continue clozapine

Answer

Recheck the ANC in 48 hours before making changes

Question 5

A patient with PTSD is treated with Prolonged Exposure (PE) therapy. What is the core mechanism of this treatment?

Accepted Answer

Reducing avoidance by systematically confronting trauma-related stimuli

Answer

Replacing traumatic memories with positive ones through EMDR

Answer

Restructuring maladaptive core beliefs through Socratic questioning

Answer

Teaching relaxation skills to manage physiological arousal

Question 6

A PMHNP prescribes an SSRI for a 16-year-old with major depressive disorder. Which FDA-mandated action is required?

Accepted Answer

Provide a black box warning about increased suicidal ideation risk in children and adolescents

Answer

Obtain written parental consent before prescribing

Answer

Limit the prescription to a 2-week supply

Answer

Order a baseline EEG before initiating treatment

Question 7

Which statement best describes the ethical principle of autonomy in psychiatric nursing practice?

Accepted Answer

The patient has the right to make informed decisions about their own care

Answer

The provider acts in the patient's best interest even against their stated wishes

Answer

Resources are distributed fairly across all patients in the system

Answer

The nurse avoids actions that could harm the patient