Midterm Exam: NR547 NR-547

Midterm Exam: NR547 / NR-547

(Latest 2025 / 2026) Differential Diagnosis in Psychiatric-Mental Health across the Lifespan Practicum | Questions and Answers | 100% Correct | Grade A - Chamberlain

Question:

First-generation antipsychotics, also known as typical antipsychotics,

Answer:

-effective for positive symptoms but have a higher incidence of unwanted side effects, such as dystonia, parkinsonism, akathisia, and tardive dyskinesia, which increase with long-term use.

-may be selected for a hospitalized client with psychosis when medication is required to quickly target presenting positive symptoms.

• / 4

Question:

Erica is a 24-year-old with a newly diagnosed schizophreniform disorder. She is a current smoker. She does not use alcohol or other drugs. She has no medical history. Which of the following would be the least appropriate initial medication for Erica?

a) Aripiprazole

b) Lurasidone

• olanzapine
• quetiapine

Answer:

Olanzapine requires up to 30% increased dosage for clients who smoke concurrently. Initiating a medication that does not interact with smoking is preferable.

Question:

Tony is a 56-year-old who has recently been diagnosed with schizophrenia. He takes amiodarone for a history of cardiac dysrhythmias. He does not use alcohol or other drugs. He is a nonsmoker. Which of the following is the most appropriate medication for Tony?

a) Aripiprazole

b) Lurasidone

c) Quetiapine

• risperidone

Answer:

Amiodarone is a moderate CYP3A4 inhibitor. Risperidone does not interact with CYP3A4 inhibitors or inducers.

• / 4

Question:

Jenny is a 22-year-old who has been prescribed aripiprazole 15 mg/day for the past 8 months. She has gained approximately 30 lbs. during treatment.Jenny's psychiatric symptoms have been managed well on aripiprazole and she has no other adverse effects. What is the most appropriate initial intervention for Jenny?

• switch to a different antipsychotic medication
• prescribe metformin
• refer to a bariatric specialist

Answer:

Prescribing metformin as an adjunct treatment to assist with weight loss associated with antipsychotics is appropriate. Jenny is well-managed on the current dose of aripiprazole; switching to a different medication is not indicated at this time. Referral to a bariatric specialist may be indicated if the client continues to gain weight but is not indicated as the most appropriate initial intervention.

Question:

A client has been on clozapine for 9 months. Absolute neutrophil counts (ANC) have consistently been less than 1500/microliter? At what frequency should a CBC be drawn?

Answer:

With a normal baseline ANC, the CBC should be monitored weekly for 6 months; every 2 weeks for months 6-12; and monthly thereafter

• / 4

Question:

Scott is a 33-year-old who is currently without housing. He has been unable to adhere to his prescribed oral medication regimen. The PMHNP recommends a long-acting intramuscular form of medication. Scott is willing to try but would like to receive the medication at the community clinic near the shelter where he is staying. Which medication option is the least appropriate for Scott at this time?

• aripiprazole monohydrate
• olanzapine
• paliperidone palmitate
• risperidone

Answer:

Olanzapine must be given in a registered health care facility with available emergency medical services. The client receiving olanzapine must be monitored for 3 hours post-injection.

Question:

Which of the following laboratory tests are indicated for a client who is taking olanzapine?

a) BMI

b) CBC

c) HbA1C

d) Lipid panel

e) Kidney function tests

Answer:

Monitoring should include fasting glucose or hemoglobin A1C, lipid profile, weight, and BMI at regular intervals during the first year of antipsychotic therapy and then annually.

• / 4