NR548 Final Exam Actual Exam Style V1 |
NR 548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. During a psychiatric interview, a patient describes their thoughts as ‘racing’ and jumps
rapidly from one topic to another, though the topics are loosely connected. Which term best
describes this thought process?
A. Clang associations
B. Flight of ideas
C. Word salad
D. Neologisms
Answer: B
Rationale: Flight of ideas is characterized by a rapid succession of thoughts that are
frequently connected but move quickly from one to the next. This is commonly observed in
patients experiencing a manic episode. Unlike word salad, the connections between
thoughts are usually still discernable to the listener.
2. When assessing a patient for suicide risk, which of the following is considered a ‘static’ risk
factor?
A. History of prior suicide attempts
,B. Access to firearms
C. Active suicidal ideation
D. Current hopelessness
Answer: A
Rationale: A history of prior suicide attempts is a static risk factor because it is a historical
fact that cannot be changed. Dynamic risk factors, such as current ideation or hopelessness,
can fluctuate over time. Identifying static factors is crucial for long-term risk stratification
in psychiatric patients.
3. A 24-year-old female presents with a 2-week history of persistently elevated mood,
decreased need for sleep (3 hours per night), and excessive spending that has depleted her
savings. She has no history of hospitalization or psychotic features. What is the most likely
diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder
Answer: B
Rationale: The presence of a manic episode, defined by at least one week of elevated mood
and significant functional impairment (such as excessive spending), meets the criteria for
, Bipolar I Disorder. Even without a history of depression, a single manic episode is sufficient
for this diagnosis. The lack of hospitalization does not rule out Bipolar I if the symptoms
meet the severity or duration criteria for mania.
4. In the Mental Status Examination (MSE), ‘affect’ is defined as:
A. The patient’s internal emotional state as reported by them.
B. The clinician’s observation of the patient’s emotional expression.
C. The patient’s ability to maintain a steady mood.
D. The patient’s belief system regarding their emotions.
Answer: B
Rationale: Affect refers to the outward, observable manifestation of a person’s expressed
feelings or emotional state. It is assessed by the clinician during the interview through
facial expressions, tone of voice, and body language. This differs from mood, which is the
patient’s subjective, self-reported emotional climate.
5. A PMHNP is using the PHQ-9 to screen a patient for depression. The patient scores a 17.
How should the nurse practitioner interpret this score?
A. Moderately severe depression
B. Moderate depression
C. Mild depression
D. Severe depression
NR 548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. During a psychiatric interview, a patient describes their thoughts as ‘racing’ and jumps
rapidly from one topic to another, though the topics are loosely connected. Which term best
describes this thought process?
A. Clang associations
B. Flight of ideas
C. Word salad
D. Neologisms
Answer: B
Rationale: Flight of ideas is characterized by a rapid succession of thoughts that are
frequently connected but move quickly from one to the next. This is commonly observed in
patients experiencing a manic episode. Unlike word salad, the connections between
thoughts are usually still discernable to the listener.
2. When assessing a patient for suicide risk, which of the following is considered a ‘static’ risk
factor?
A. History of prior suicide attempts
,B. Access to firearms
C. Active suicidal ideation
D. Current hopelessness
Answer: A
Rationale: A history of prior suicide attempts is a static risk factor because it is a historical
fact that cannot be changed. Dynamic risk factors, such as current ideation or hopelessness,
can fluctuate over time. Identifying static factors is crucial for long-term risk stratification
in psychiatric patients.
3. A 24-year-old female presents with a 2-week history of persistently elevated mood,
decreased need for sleep (3 hours per night), and excessive spending that has depleted her
savings. She has no history of hospitalization or psychotic features. What is the most likely
diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder
Answer: B
Rationale: The presence of a manic episode, defined by at least one week of elevated mood
and significant functional impairment (such as excessive spending), meets the criteria for
, Bipolar I Disorder. Even without a history of depression, a single manic episode is sufficient
for this diagnosis. The lack of hospitalization does not rule out Bipolar I if the symptoms
meet the severity or duration criteria for mania.
4. In the Mental Status Examination (MSE), ‘affect’ is defined as:
A. The patient’s internal emotional state as reported by them.
B. The clinician’s observation of the patient’s emotional expression.
C. The patient’s ability to maintain a steady mood.
D. The patient’s belief system regarding their emotions.
Answer: B
Rationale: Affect refers to the outward, observable manifestation of a person’s expressed
feelings or emotional state. It is assessed by the clinician during the interview through
facial expressions, tone of voice, and body language. This differs from mood, which is the
patient’s subjective, self-reported emotional climate.
5. A PMHNP is using the PHQ-9 to screen a patient for depression. The patient scores a 17.
How should the nurse practitioner interpret this score?
A. Moderately severe depression
B. Moderate depression
C. Mild depression
D. Severe depression
