Description
NR547 Final Exam and Study Guide
Question 1
A 21-year-old client presents to the emergency department after initiating a physical fight with a coworker. The client states, “The guy disparaged my work. I do the best work of anyone in the whole company; in fact, my productivity increased so much in the last 2 weeks – I don’t really need to sleep anymore! My thoughts just race right through my head and come out on paper. It’s amazing!” Based on the client’s initial presentation, what is the priority differential diagnosis?
- narcissistic personality disorder
B. schizotypal personality disorder
C. bipolar I disorder ✅
D. bipolar II disorder
Question 2
Which medication is most likely to be used to treat symptoms of psychosis in a client with delirium?
- clozapine
B. haloperidol ✅
C. risperidone
D. ziprasidone
Correct Answer: B. haloperidol
Question 3
An inpatient client has a CIWA-Ar score of 12. What is the most appropriate action by the nurse practitioner?
- prescribe STAT dose of oral lorazepam and reassess CIWA-Ar every hour
B. prescribe oral lorazepam every 4 hours and reassess CIWA-Ar every hour ✅
C. prescribe STAT dose of oral diazepam and reassess CIWA-Ar every 4 hours
D. reassess CIWA-Ar every 4 hours; do not prescribe medication at this time
Correct Answer: B. prescribe oral lorazepam every 4 hours and reassess CIWA-Ar every hour
Question 4
A client is started on lamotrigine for bipolar disorder and presents with blistering skin and mouth sores shortly after an increase in dose. Labs indicate normal renal and liver function. What is the most likely cause of the symptoms?
- DRESS syndrome
B. atopic dermatitis
C. Steven-Johnson syndrome ✅
D. serotonin syndrome
Correct Answer: C. Steven-Johnson syndrome
Question 5
Which description best describes cluster A personality disorders?
- characterized by anxious, fearful thinking or behavior
B. characterized by odd, eccentric thinking or behavior. ✅
C. characterized by dramatic, overly emotional, or unpredictable thinking or behavior
D. characterized by oppositional or sadistic behavior
Correct Answer: B. characterized by odd, eccentric thinking or behavior.
Question 6
A client diagnosed with a personality disorder states that he does not trust any of his work colleagues because they constantly “spy on” his work and “verbally attack” him during meetings. He also states that he doesn’t trust his wife because she is probably cheating on him with the Amazon deliveryman and is more loyal to their children than to him. Which is the most likely diagnosis?
- schizoid personality disorder
B. paranoid personality disorder ✅
C. schizotypal personality disorder
D. histrionic personality disorder
Correct Answer: B. paranoid personality disorder



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