NR 555 CEA EXAM (CLINICAL EVALUATION
ASSESSMENT) Advanced Clinical Practice for
Psychiatric-Mental Health Nurse
Practitioners | Chamberlain
UniversityPractice Questions with Answers &
Rationales
This exam covers advanced clinical practice including differential diagnosis,
psychopharmacology, psychotherapy integration, and management of complex
psychiatric conditions across the lifespan.
SECTION 1: CLINICAL ASSESSMENT & DIFFERENTIAL DIAGNOSIS (Questions
1–25)
QUESTION 1
A 28-year-old client presents with a 6-month history of excessive worry about work
performance, relationships, and health. The client reports muscle tension, fatigue,
difficulty concentrating, and sleep disturbance. Which of the following is the most
likely diagnosis?
A) Panic disorder
B) Generalized anxiety disorder (GAD)
,C) Social anxiety disorder
D) Obsessive-compulsive disorder
Correct Answer: B) Generalized anxiety disorder (GAD)
Rationale: GAD is characterized by excessive, uncontrollable worry about multiple
domains for at least 6 months, accompanied by physical symptoms such as
muscle tension, fatigue, and sleep disturbance. The client's symptoms meet DSM-
5 criteria for GAD.
QUESTION 2
A 32-year-old client reports recurrent, unexpected episodes of intense fear
accompanied by palpitations, sweating, trembling, shortness of breath, and a fear
of dying. These episodes began 3 months ago and the client now worries constantly
about having another episode. This presentation is most consistent with:
A) Generalized anxiety disorder
B) Panic disorder
C) Social anxiety disorder
D) Post-traumatic stress disorder
Correct Answer: B) Panic disorder
Rationale: Panic disorder is characterized by recurrent, unexpected panic attacks
followed by at least 1 month of persistent concern about having additional attacks
or significant maladaptive behavioral changes related to the attacks. The client's
symptoms meet these criteria.
,QUESTION 3
A 45-year-old client presents with depressed mood, anhedonia, significant weight
loss, insomnia, psychomotor retardation, fatigue, feelings of worthlessness, and
recurrent thoughts of death. These symptoms have been present for 3 weeks. This
is most consistent with:
A) Persistent depressive disorder
B) Major depressive disorder (MDD), single episode
C) Adjustment disorder with depressed mood
D) Bipolar disorder, depressive episode
Correct Answer: B) Major depressive disorder (MDD), single episode
Rationale: The client meets DSM-5 criteria for MDD with the presence of five or
more depressive symptoms during a 2-week period, including depressed mood or
anhedonia. The symptoms cause significant distress and impairment.
QUESTION 4
A 22-year-old client presents with a 2-year history of depressed mood, feelings of
hopelessness, low self-esteem, and poor appetite. The client reports never having
a period of normal mood lasting more than 2 months. This is most consistent with:
A) Major depressive disorder
B) Persistent depressive disorder (dysthymia)
C) Bipolar II disorder
D) Cyclothymic disorder
Correct Answer: B) Persistent depressive disorder (dysthymia)
, Rationale: Persistent depressive disorder (dysthymia) is characterized by a
depressed mood for most of the day, for more days than not, for at least 2 years,
without a period of normal mood lasting more than 2 months.
QUESTION 5
A 19-year-old client presents with a 1-week history of elevated mood, decreased
need for sleep, grandiosity, racing thoughts, and increased goal-directed activity.
The client has been engaging in reckless spending and risky behaviors. This is most
consistent with:
A) Hypomanic episode
B) Manic episode
C) Mixed episode
D) Cyclothymic episode
Correct Answer: B) Manic episode
Rationale: A manic episode is characterized by a distinct period of abnormally and
persistently elevated, expansive, or irritable mood, lasting at least 1 week, with
symptoms including grandiosity, decreased need for sleep, pressured speech,
flight of ideas, and increased goal-directed activity causing marked impairment.
QUESTION 6
A client presents with symptoms of a manic episode lasting 4 days, without marked
impairment in social or occupational functioning. This would be classified as:
ASSESSMENT) Advanced Clinical Practice for
Psychiatric-Mental Health Nurse
Practitioners | Chamberlain
UniversityPractice Questions with Answers &
Rationales
This exam covers advanced clinical practice including differential diagnosis,
psychopharmacology, psychotherapy integration, and management of complex
psychiatric conditions across the lifespan.
SECTION 1: CLINICAL ASSESSMENT & DIFFERENTIAL DIAGNOSIS (Questions
1–25)
QUESTION 1
A 28-year-old client presents with a 6-month history of excessive worry about work
performance, relationships, and health. The client reports muscle tension, fatigue,
difficulty concentrating, and sleep disturbance. Which of the following is the most
likely diagnosis?
A) Panic disorder
B) Generalized anxiety disorder (GAD)
,C) Social anxiety disorder
D) Obsessive-compulsive disorder
Correct Answer: B) Generalized anxiety disorder (GAD)
Rationale: GAD is characterized by excessive, uncontrollable worry about multiple
domains for at least 6 months, accompanied by physical symptoms such as
muscle tension, fatigue, and sleep disturbance. The client's symptoms meet DSM-
5 criteria for GAD.
QUESTION 2
A 32-year-old client reports recurrent, unexpected episodes of intense fear
accompanied by palpitations, sweating, trembling, shortness of breath, and a fear
of dying. These episodes began 3 months ago and the client now worries constantly
about having another episode. This presentation is most consistent with:
A) Generalized anxiety disorder
B) Panic disorder
C) Social anxiety disorder
D) Post-traumatic stress disorder
Correct Answer: B) Panic disorder
Rationale: Panic disorder is characterized by recurrent, unexpected panic attacks
followed by at least 1 month of persistent concern about having additional attacks
or significant maladaptive behavioral changes related to the attacks. The client's
symptoms meet these criteria.
,QUESTION 3
A 45-year-old client presents with depressed mood, anhedonia, significant weight
loss, insomnia, psychomotor retardation, fatigue, feelings of worthlessness, and
recurrent thoughts of death. These symptoms have been present for 3 weeks. This
is most consistent with:
A) Persistent depressive disorder
B) Major depressive disorder (MDD), single episode
C) Adjustment disorder with depressed mood
D) Bipolar disorder, depressive episode
Correct Answer: B) Major depressive disorder (MDD), single episode
Rationale: The client meets DSM-5 criteria for MDD with the presence of five or
more depressive symptoms during a 2-week period, including depressed mood or
anhedonia. The symptoms cause significant distress and impairment.
QUESTION 4
A 22-year-old client presents with a 2-year history of depressed mood, feelings of
hopelessness, low self-esteem, and poor appetite. The client reports never having
a period of normal mood lasting more than 2 months. This is most consistent with:
A) Major depressive disorder
B) Persistent depressive disorder (dysthymia)
C) Bipolar II disorder
D) Cyclothymic disorder
Correct Answer: B) Persistent depressive disorder (dysthymia)
, Rationale: Persistent depressive disorder (dysthymia) is characterized by a
depressed mood for most of the day, for more days than not, for at least 2 years,
without a period of normal mood lasting more than 2 months.
QUESTION 5
A 19-year-old client presents with a 1-week history of elevated mood, decreased
need for sleep, grandiosity, racing thoughts, and increased goal-directed activity.
The client has been engaging in reckless spending and risky behaviors. This is most
consistent with:
A) Hypomanic episode
B) Manic episode
C) Mixed episode
D) Cyclothymic episode
Correct Answer: B) Manic episode
Rationale: A manic episode is characterized by a distinct period of abnormally and
persistently elevated, expansive, or irritable mood, lasting at least 1 week, with
symptoms including grandiosity, decreased need for sleep, pressured speech,
flight of ideas, and increased goal-directed activity causing marked impairment.
QUESTION 6
A client presents with symptoms of a manic episode lasting 4 days, without marked
impairment in social or occupational functioning. This would be classified as:
