NR548 Final Exam Actual Exam Style V3 |
NR 548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. A patient reports feeling ‘sad and empty’ for the past three weeks. Which component of
the Mental Status Examination (MSE) is the PMHNP assessing when the patient describes
their internal emotional state?
A. Affect
B. Thought Process
C. Mood
D. Cognition
Answer: C
Rationale: Mood is the patient’s internal, self-reported emotional state over a period of
time. In contrast, affect refers to the clinician’s external observation of the patient’s current
emotional expression. Assessing mood is a fundamental step in the MSE to identify
potential depressive or bipolar disorders.
2. During an assessment, a patient demonstrates a rapid shift from one topic to another
where the ideas are connected but difficult to follow. This is best described as:
A. Flight of Ideas
,B. Looseness of Association
C. Word Salad
D. Tangentiality
Answer: A
Rationale: Flight of ideas is characterized by rapid speech with frequent shifts in topic,
often seen in manic episodes. While the topics are usually connected by some logic, the
speed makes it challenging for the listener. This differs from word salad, where there is no
logical connection between words at all.
3. Which of the following represents a static risk factor for suicide that the PMHNP must
document during the safety assessment?
A. Current substance intoxication
B. Access to firearms
C. Recent job loss
D. Previous suicide attempt
Answer: D
Rationale: Static risk factors are historical facts that cannot be changed by intervention. A
previous suicide attempt is one of the strongest predictors of future completed suicide.
Dynamic risk factors, such as job loss or substance use, are modifiable and can change over
time.
, 4. A 10-year-old child presents with frequent temper outbursts and a persistently irritable
mood for over a year. Which diagnosis should the PMHNP prioritize for consideration?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder (ODD)
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Conduct Disorder
Answer: C
Rationale: DMDD was added to the DSM-5 to address concerns about the over-diagnosis of
bipolar disorder in children. It requires a persistent irritable mood and frequent severe
temper outbursts in at least two settings. This diagnosis is specific to children between the
ages of 6 and 18.
5. The PMHNP is assessing an elderly patient for cognitive decline. The patient performs
poorly on the ‘serial 7s’ task. This specifically evaluates which cognitive domain?
A. Orientation
B. Memory
C. Attention and Concentration
D. Language
Answer: C
NR 548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. A patient reports feeling ‘sad and empty’ for the past three weeks. Which component of
the Mental Status Examination (MSE) is the PMHNP assessing when the patient describes
their internal emotional state?
A. Affect
B. Thought Process
C. Mood
D. Cognition
Answer: C
Rationale: Mood is the patient’s internal, self-reported emotional state over a period of
time. In contrast, affect refers to the clinician’s external observation of the patient’s current
emotional expression. Assessing mood is a fundamental step in the MSE to identify
potential depressive or bipolar disorders.
2. During an assessment, a patient demonstrates a rapid shift from one topic to another
where the ideas are connected but difficult to follow. This is best described as:
A. Flight of Ideas
,B. Looseness of Association
C. Word Salad
D. Tangentiality
Answer: A
Rationale: Flight of ideas is characterized by rapid speech with frequent shifts in topic,
often seen in manic episodes. While the topics are usually connected by some logic, the
speed makes it challenging for the listener. This differs from word salad, where there is no
logical connection between words at all.
3. Which of the following represents a static risk factor for suicide that the PMHNP must
document during the safety assessment?
A. Current substance intoxication
B. Access to firearms
C. Recent job loss
D. Previous suicide attempt
Answer: D
Rationale: Static risk factors are historical facts that cannot be changed by intervention. A
previous suicide attempt is one of the strongest predictors of future completed suicide.
Dynamic risk factors, such as job loss or substance use, are modifiable and can change over
time.
, 4. A 10-year-old child presents with frequent temper outbursts and a persistently irritable
mood for over a year. Which diagnosis should the PMHNP prioritize for consideration?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder (ODD)
C. Disruptive Mood Dysregulation Disorder (DMDD)
D. Conduct Disorder
Answer: C
Rationale: DMDD was added to the DSM-5 to address concerns about the over-diagnosis of
bipolar disorder in children. It requires a persistent irritable mood and frequent severe
temper outbursts in at least two settings. This diagnosis is specific to children between the
ages of 6 and 18.
5. The PMHNP is assessing an elderly patient for cognitive decline. The patient performs
poorly on the ‘serial 7s’ task. This specifically evaluates which cognitive domain?
A. Orientation
B. Memory
C. Attention and Concentration
D. Language
Answer: C
