A+ Graded Full-Length Practice Exam with
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Rationales, DSM-5-TR-Aligned Questions,
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Question 1
A 45-year-old patient presents with anhedonia, fatigue,
and sleep disturbances for the last two months. As a
PMHNP, which initial diagnostic step is most
appropriate?
A) Order a brain MRI
B) Conduct a comprehensive psychiatric interview
C) Begin antidepressant therapy immediately
D) Recommend mindfulness training
Correct Answer: B
Rationale: A comprehensive psychiatric interview allows
for a thorough assessment of history, symptoms, and
differential diagnoses before initiating treatment .
,Question 2
Which neurotransmitter imbalance is most closely
associated with the positive symptoms of schizophrenia?
A) Decreased serotonin
B) Increased dopamine
C) Decreased glutamate
D) Increased GABA
Correct Answer: B
Rationale: Hyperactivity of dopamine in the mesolimbic
pathway is linked to hallucinations and delusions—core
positive symptoms of schizophrenia .
Question 3
Which symptom best differentiates PTSD from Acute
Stress Disorder?
A) Flashbacks
B) Dissociation
C) Duration of symptoms
D) Nightmares
Correct Answer: C
,Rationale: PTSD symptoms persist beyond one month;
Acute Stress Disorder is characterized by symptoms
lasting less than one month .
Question 4
Which personality disorder is most characterized by
instability in relationships, identity disturbance, and
impulsivity?
A) Narcissistic
B) Borderline
C) Antisocial
D) Dependent
Correct Answer: B
Rationale: Borderline Personality Disorder involves
emotional volatility, splitting, identity disturbance,
impulsivity, and fear of abandonment .
Question 5
What is the primary feature distinguishing delirium from
dementia?
A) Chronic course
B) Gradual memory decline
, C) Acute onset and fluctuating consciousness
D) Associated depressive symptoms
Correct Answer: C
Rationale: Delirium presents acutely and fluctuates,
while dementia develops insidiously over months to
years .
Question 6
The Mini-Mental State Examination (MMSE) primarily
assesses which cognitive domain?
A) Memory and orientation
B) Executive function and abstraction
C) Language comprehension
D) Emotional regulation
Correct Answer: A
Rationale: The MMSE focuses on memory, attention, and
orientation; executive function is better tested by the
MoCA .
Question 7
In a patient presenting with new-onset confusion, which