The correct option is A Cannot be determined
For simplicity, let us replace all the Ps with 4 as P=4 (given).
MNO4
AQR4–––––––
ZZZZ–––––––
As 4+4=Z that means Z=4+4=8. Now, replacing all Zs by 8.
MNO4
AQRS––––––––
8888–––––
When N= 6 and M > N, then M= 7. But since the value of R has no relation with the values of either M or N, therefore, the value of R cannot be determined with the given information.