NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Page 1 | Passing Score: 80%
WALDEN UNIVERSITY
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and
Verified Answers| 100% Correct| Grade A 2026/2027
NRNP 6665 · Official Exam 2026/2027
100 80% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Psychopathology & Diagnostic Reasoning Q1-Q20
Section 2 Psychopharmacology & Treatment Planning Q21-Q40
Section 3 Psychotherapy & Therapeutic Modalities Q41-Q60
Section 4 Legal, Ethical & Professional Issues Q61-Q80
Section 5 Special Populations & Lifespan Considerations Q81-Q100
Instructions: Select the single best answer for each question. This exam is designed for NRNP 6665 midterm exam preparation.
Passing score: 80% (80 questions correct).
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 1 of 1
, SECTION 1 | Psychopathology & Diagnostic Reasoning | Q1-Q20 | NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions
and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027
Q1 Question 1 of 100
A 32-year-old woman presents to the psychiatric clinic with persistent sadness, insomnia, and anhedonia
lasting 8 weeks. She denies any history of manic or hypomanic episodes. What is the most appropriate
initial diagnostic step before assigning a diagnosis of major depressive disorder?
A. Administering the PHQ-9 and immediately initiating antidepressant therapy
B. Referring the patient for neuropsychological testing to rule out cognitive decline
C. Ordering a brain MRI to exclude structural pathology
D. Conducting a comprehensive biopsychosocial assessment including medical history and substance use
screening
Correct Answer: B
Rationale:
A comprehensive biopsychosocial assessment is the foundation of psychiatric differential diagnosis, ensuring that
medical conditions, substance use, and psychosocial stressors are evaluated before attributing symptoms to a primary
psychiatric disorder. The PHQ-9 is a screening tool, not a diagnostic instrument, and initiating treatment without
thorough evaluation risks misdiagnosis. Neuroimaging and neuropsychological testing are not first-line for a
straightforward depressive presentation.
Q2 Question 2 of 100
A 45-year-old man is brought to the emergency department after being found disoriented and confused at
a bus station. He cannot recall his name or current location. Physical examination reveals tachycardia,
diaphoresis, and a tremor. What condition must be ruled out first in the differential diagnosis?
A. Dissociative fugue associated with a trauma-related disorder
B. Schizophrenia with disorganized symptoms
C. Major neurocognitive disorder in the early stages
D. Delirium due to a medical condition or substance withdrawal
Correct Answer: B
Rationale:
In any presentation of acute-onset altered mental status with autonomic signs, delirium due to a medical condition or
substance withdrawal must be ruled out first because it can be life-threatening. The acute onset, disorientation, and
autonomic instability are classic for delirium. Dissociative fugue does not typically present with autonomic signs, and
schizophrenia and neurocognitive disorder have more insidious onsets without the fluctuating consciousness
characteristic of delirium.
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 2 of 1
, Q3 Question 3 of 100
A 28-year-old man reports a 6-month history of intrusive thoughts about contamination and compulsive
hand washing that consumes 3 hours daily. He recognizes the thoughts are excessive but cannot resist
the urge to wash. What feature distinguishes obsessive-compulsive disorder from obsessive-compulsive
personality disorder?
A. OCD always involves contamination fears, while OCPD involves hoarding behaviors
B. OCD is responsive to medication, while OCPD is only treated with psychotherapy
C. OCD requires both obsessions and compulsions, while OCPD requires only obsessions
D. OCD involves ego-dystonic obsessions and compulsions, while OCPD involves ego-syntonic
preoccupation with orderliness and perfectionism
Correct Answer: B
Rationale:
The key distinction is that OCD involves ego-dystonic symptoms, meaning the patient recognizes the obsessions and
compulsions as excessive and unwanted, while OCPD traits are ego-syntonic, meaning the individual views their
perfectionism and rigidity as appropriate and desirable. Both conditions can involve various themes beyond
contamination, and both may respond to treatment. OCPD does not involve true obsessions or compulsions.
Q4 Question 4 of 100
A 19-year-old college student is brought by her roommate after being found cutting her forearms with a
razor blade. The patient reports she cuts herself to relieve emotional pain and has no intention of dying.
She describes chronic feelings of emptiness and fears of abandonment. What is the most likely diagnosis?
A. Major depressive disorder with suicidal ideation
B. Post-traumatic stress disorder with self-injurious behavior
C. Adjustment disorder with disturbance of conduct
D. Borderline personality disorder with non-suicidal self-injury
Correct Answer: B
Rationale:
Non-suicidal self-injury to relieve emotional distress, combined with chronic emptiness and fear of abandonment, is
characteristic of borderline personality disorder. The self-harm serves an affect-regulating function rather than
representing a genuine suicide attempt. While PTSD can involve self-harm, the interpersonal sensitivity and identity
disturbance are more suggestive of BPD. Adjustment disorder would require a specific recent stressor and does not
explain the chronic pattern.
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 3 of 1
, Q5 Question 5 of 100
A 56-year-old woman presents with fatigue, weight gain, cold intolerance, and depressed mood. Her TSH
level is 28 mIU/L with low free T4. What diagnostic principle does this case best illustrate?
A. Depression in midlife women is almost always related to perimenopausal hormonal changes
B. Hypothyroidism screening is unnecessary in patients presenting with depression
C. Somatic symptom disorder should be the default diagnosis when physical symptoms are vague
D. Medical conditions can mimic psychiatric disorders and must be excluded before psychiatric diagnosis is
assigned
Correct Answer: B
Rationale:
This case illustrates the critical principle that medical conditions such as hypothyroidism can produce symptoms
indistinguishable from major depressive disorder. The elevated TSH and low free T4 confirm a medical etiology
requiring thyroid hormone replacement rather than antidepressant therapy. Assuming a psychiatric cause without
laboratory evaluation would result in misdiagnosis and inappropriate treatment.
Q6 Question 6 of 100
A 23-year-old man describes hearing voices that comment on his behavior for the past 3 months. He also
believes his thoughts are being broadcast on the radio. He has no mood symptoms and his cognitive
functioning is preserved. What is the most likely diagnosis?
A. Schizoaffective disorder based on the psychotic symptoms
B. Brief psychotic disorder since the symptoms have been present less than 6 months
C. Delusional disorder with auditory hallucinations
D. Schizophrenia based on the presence of hallucinations and delusions lasting more than 1 month
Correct Answer: B
Rationale:
The presence of auditory hallucinations and thought-broadcasting delusions for 3 months meets the DSM-5-TR
duration criterion for schizophrenia, which requires at least 1 month of active phase symptoms. Schizoaffective
disorder requires a concurrent major mood episode, which is absent here. Brief psychotic disorder lasts less than 1
month. Delusional disorder does not typically involve prominent hallucinations and the delusions are non-bizarre.
Q7 Question 7 of 100
A PMHNP evaluates a 38-year-old woman who reports intense mood swings, irritability, and feelings of
emptiness that have persisted since early adulthood. She has a history of unstable relationships and
impulsive spending. The differential includes borderline personality disorder and bipolar II disorder. What
clinical feature most strongly favors borderline personality disorder?
A. Periods of elevated mood and increased energy lasting at least 4 consecutive days
B. A positive family history of bipolar disorder in a first-degree relative
C. Complete remission of mood symptoms between episodes
D. Mood shifts triggered by interpersonal events with rapid onset and short duration
Correct Answer: B
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 4 of 1
WALDEN UNIVERSITY
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and
Verified Answers| 100% Correct| Grade A 2026/2027
NRNP 6665 · Official Exam 2026/2027
100 80% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Psychopathology & Diagnostic Reasoning Q1-Q20
Section 2 Psychopharmacology & Treatment Planning Q21-Q40
Section 3 Psychotherapy & Therapeutic Modalities Q41-Q60
Section 4 Legal, Ethical & Professional Issues Q61-Q80
Section 5 Special Populations & Lifespan Considerations Q81-Q100
Instructions: Select the single best answer for each question. This exam is designed for NRNP 6665 midterm exam preparation.
Passing score: 80% (80 questions correct).
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 1 of 1
, SECTION 1 | Psychopathology & Diagnostic Reasoning | Q1-Q20 | NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions
and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027
Q1 Question 1 of 100
A 32-year-old woman presents to the psychiatric clinic with persistent sadness, insomnia, and anhedonia
lasting 8 weeks. She denies any history of manic or hypomanic episodes. What is the most appropriate
initial diagnostic step before assigning a diagnosis of major depressive disorder?
A. Administering the PHQ-9 and immediately initiating antidepressant therapy
B. Referring the patient for neuropsychological testing to rule out cognitive decline
C. Ordering a brain MRI to exclude structural pathology
D. Conducting a comprehensive biopsychosocial assessment including medical history and substance use
screening
Correct Answer: B
Rationale:
A comprehensive biopsychosocial assessment is the foundation of psychiatric differential diagnosis, ensuring that
medical conditions, substance use, and psychosocial stressors are evaluated before attributing symptoms to a primary
psychiatric disorder. The PHQ-9 is a screening tool, not a diagnostic instrument, and initiating treatment without
thorough evaluation risks misdiagnosis. Neuroimaging and neuropsychological testing are not first-line for a
straightforward depressive presentation.
Q2 Question 2 of 100
A 45-year-old man is brought to the emergency department after being found disoriented and confused at
a bus station. He cannot recall his name or current location. Physical examination reveals tachycardia,
diaphoresis, and a tremor. What condition must be ruled out first in the differential diagnosis?
A. Dissociative fugue associated with a trauma-related disorder
B. Schizophrenia with disorganized symptoms
C. Major neurocognitive disorder in the early stages
D. Delirium due to a medical condition or substance withdrawal
Correct Answer: B
Rationale:
In any presentation of acute-onset altered mental status with autonomic signs, delirium due to a medical condition or
substance withdrawal must be ruled out first because it can be life-threatening. The acute onset, disorientation, and
autonomic instability are classic for delirium. Dissociative fugue does not typically present with autonomic signs, and
schizophrenia and neurocognitive disorder have more insidious onsets without the fluctuating consciousness
characteristic of delirium.
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 2 of 1
, Q3 Question 3 of 100
A 28-year-old man reports a 6-month history of intrusive thoughts about contamination and compulsive
hand washing that consumes 3 hours daily. He recognizes the thoughts are excessive but cannot resist
the urge to wash. What feature distinguishes obsessive-compulsive disorder from obsessive-compulsive
personality disorder?
A. OCD always involves contamination fears, while OCPD involves hoarding behaviors
B. OCD is responsive to medication, while OCPD is only treated with psychotherapy
C. OCD requires both obsessions and compulsions, while OCPD requires only obsessions
D. OCD involves ego-dystonic obsessions and compulsions, while OCPD involves ego-syntonic
preoccupation with orderliness and perfectionism
Correct Answer: B
Rationale:
The key distinction is that OCD involves ego-dystonic symptoms, meaning the patient recognizes the obsessions and
compulsions as excessive and unwanted, while OCPD traits are ego-syntonic, meaning the individual views their
perfectionism and rigidity as appropriate and desirable. Both conditions can involve various themes beyond
contamination, and both may respond to treatment. OCPD does not involve true obsessions or compulsions.
Q4 Question 4 of 100
A 19-year-old college student is brought by her roommate after being found cutting her forearms with a
razor blade. The patient reports she cuts herself to relieve emotional pain and has no intention of dying.
She describes chronic feelings of emptiness and fears of abandonment. What is the most likely diagnosis?
A. Major depressive disorder with suicidal ideation
B. Post-traumatic stress disorder with self-injurious behavior
C. Adjustment disorder with disturbance of conduct
D. Borderline personality disorder with non-suicidal self-injury
Correct Answer: B
Rationale:
Non-suicidal self-injury to relieve emotional distress, combined with chronic emptiness and fear of abandonment, is
characteristic of borderline personality disorder. The self-harm serves an affect-regulating function rather than
representing a genuine suicide attempt. While PTSD can involve self-harm, the interpersonal sensitivity and identity
disturbance are more suggestive of BPD. Adjustment disorder would require a specific recent stressor and does not
explain the chronic pattern.
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 3 of 1
, Q5 Question 5 of 100
A 56-year-old woman presents with fatigue, weight gain, cold intolerance, and depressed mood. Her TSH
level is 28 mIU/L with low free T4. What diagnostic principle does this case best illustrate?
A. Depression in midlife women is almost always related to perimenopausal hormonal changes
B. Hypothyroidism screening is unnecessary in patients presenting with depression
C. Somatic symptom disorder should be the default diagnosis when physical symptoms are vague
D. Medical conditions can mimic psychiatric disorders and must be excluded before psychiatric diagnosis is
assigned
Correct Answer: B
Rationale:
This case illustrates the critical principle that medical conditions such as hypothyroidism can produce symptoms
indistinguishable from major depressive disorder. The elevated TSH and low free T4 confirm a medical etiology
requiring thyroid hormone replacement rather than antidepressant therapy. Assuming a psychiatric cause without
laboratory evaluation would result in misdiagnosis and inappropriate treatment.
Q6 Question 6 of 100
A 23-year-old man describes hearing voices that comment on his behavior for the past 3 months. He also
believes his thoughts are being broadcast on the radio. He has no mood symptoms and his cognitive
functioning is preserved. What is the most likely diagnosis?
A. Schizoaffective disorder based on the psychotic symptoms
B. Brief psychotic disorder since the symptoms have been present less than 6 months
C. Delusional disorder with auditory hallucinations
D. Schizophrenia based on the presence of hallucinations and delusions lasting more than 1 month
Correct Answer: B
Rationale:
The presence of auditory hallucinations and thought-broadcasting delusions for 3 months meets the DSM-5-TR
duration criterion for schizophrenia, which requires at least 1 month of active phase symptoms. Schizoaffective
disorder requires a concurrent major mood episode, which is absent here. Brief psychotic disorder lasts less than 1
month. Delusional disorder does not typically involve prominent hallucinations and the delusions are non-bizarre.
Q7 Question 7 of 100
A PMHNP evaluates a 38-year-old woman who reports intense mood swings, irritability, and feelings of
emptiness that have persisted since early adulthood. She has a history of unstable relationships and
impulsive spending. The differential includes borderline personality disorder and bipolar II disorder. What
clinical feature most strongly favors borderline personality disorder?
A. Periods of elevated mood and increased energy lasting at least 4 consecutive days
B. A positive family history of bipolar disorder in a first-degree relative
C. Complete remission of mood symptoms between episodes
D. Mood shifts triggered by interpersonal events with rapid onset and short duration
Correct Answer: B
NRNP 6665/ NRNP6665 Midterm Exam | (2026/2027) Questions and Verified Answers| 100% Correct| Grade A 2026/2027 2026/2027 | Passing Score: 80% | Page 4 of 1
