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

A serum lithium level of 1.8 mEq/L is above the therapeutic range (0.6–1.2 mEq/L) and indicates toxicity requiring immediate intervention.

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

A thorough assessment of command hallucinations—including content, frequency, and the patient's intent to act—is the priority before determining next steps.

Question 3

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

Accepted Answer

Dopamine excess in the mesolimbic pathway

Answer

Hyperactivity of dopamine in the mesolimbic pathway is the primary mechanism underlying positive symptoms such as hallucinations and delusions.

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

An ANC below 500 cells/mm³ indicates severe neutropenia (agranulocytosis), requiring immediate discontinuation of clozapine to prevent fatal infection.

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

PE works through extinction learning by having patients repeatedly confront avoided trauma cues, reducing fear responses over time.

Psychiatric-Mental Health Nurse Practitioner Exam Practice Test

Psychiatric-Mental Health Nurse Practitioner Exam Practice Test

Psychiatric-Mental Health Nurse Practitioner Exam Nursing MCQ 2