PSYCHIATRIC ASSESSMENT FOR THE
PMHNP PRACTICE EXAM 2026 FULL
QUESTIONS AND DETAILED SOLUTIONS
●● An absence of speech is seen with some diagnoses such as
___________ Answer: dementia
●● non-sensical speech is often associated with _______________
Answer: psychotic disorders
●● MSE: Mood and Affect Answer: Mood
-client's state of mind or prevalent emotional state
-subjective
-typically self-reported
-Stable: mood is appropriate to their current situation
-other: bright, happy, angry, agitated, irritable, labile, anxious, depressed,
or euphoric
Affect
-physical manifestation of the client's emotional state as observed by the
provider
-normal, blunted, flat, bizarre, dysphoric, or euphoric
-Qualities of affect
,• stability (stable or labile)
• appropriateness
• range (does it change with diff. situations)
• intensity
●● MSE: Thought Process Answer: -rate of thoughts and how they flow
and are connected
-coherent vs. incoherent
-Normal: linear & goal-directed
-Other: loose, circumstantial, or tangential
-Clients may experience flight of ideas with little connection between
thoughts or words
-Assessment: questioning client, listening to responses
●● MSE: Suicidal and Homicidal Ideation Answer: -Direct terms should
be used to assess suicide preoccupation and planning
-assess for homicidal ideation, intent, attempts, and plans
-critical to determine whether a plan exists
• access to the resources needed to execute the plan
• more detailed and thorough the plan, the higher the risk
• assess if plan is composed of fleeting thoughts rather than action steps
• assess whether the client is angry and lashing out or intending to bring
actual harm
, -SCREENING FOR SUICIDAL AND HOMICIDAL IDEATIONS IS
AN ETHICAL OBLIGATION OF THE PMHNP & IS ESSENTIAL
FOR PROTECTING ONESELF, THE CLIENT, & THE PUBLIC
●● MSE: Cognitive Assessment Answer: -evaluation of a client's level
of awareness, attention, concentration, and memory
-Awareness: observation with emphasis on the client's eyes and speech
-alertness or wakefulness provides information about cognitive function
• help rule out potential substance use or intoxication
-levels of awareness: alert and oriented, somnolent, drowsy, or even
comatose
-Attention and concentration: observation of responses during the
interview
• can they stay on topic?
• able to focus and respond to Q's?
• can use standardized tools such as the Mini-Mental State Exam
(MMSE), digit span test and the SSST
-Memory assessment: immediate recall, short-term, and long-term
memory
• particularly important when ruling out dementia or Alzheimer's disease
• Stress, anxiety, and depression can also impact memory
• orientation, three-object recall
-Mini-Cog exam is commonly used to help rule out significant cognitive
issues
PMHNP PRACTICE EXAM 2026 FULL
QUESTIONS AND DETAILED SOLUTIONS
●● An absence of speech is seen with some diagnoses such as
___________ Answer: dementia
●● non-sensical speech is often associated with _______________
Answer: psychotic disorders
●● MSE: Mood and Affect Answer: Mood
-client's state of mind or prevalent emotional state
-subjective
-typically self-reported
-Stable: mood is appropriate to their current situation
-other: bright, happy, angry, agitated, irritable, labile, anxious, depressed,
or euphoric
Affect
-physical manifestation of the client's emotional state as observed by the
provider
-normal, blunted, flat, bizarre, dysphoric, or euphoric
-Qualities of affect
,• stability (stable or labile)
• appropriateness
• range (does it change with diff. situations)
• intensity
●● MSE: Thought Process Answer: -rate of thoughts and how they flow
and are connected
-coherent vs. incoherent
-Normal: linear & goal-directed
-Other: loose, circumstantial, or tangential
-Clients may experience flight of ideas with little connection between
thoughts or words
-Assessment: questioning client, listening to responses
●● MSE: Suicidal and Homicidal Ideation Answer: -Direct terms should
be used to assess suicide preoccupation and planning
-assess for homicidal ideation, intent, attempts, and plans
-critical to determine whether a plan exists
• access to the resources needed to execute the plan
• more detailed and thorough the plan, the higher the risk
• assess if plan is composed of fleeting thoughts rather than action steps
• assess whether the client is angry and lashing out or intending to bring
actual harm
, -SCREENING FOR SUICIDAL AND HOMICIDAL IDEATIONS IS
AN ETHICAL OBLIGATION OF THE PMHNP & IS ESSENTIAL
FOR PROTECTING ONESELF, THE CLIENT, & THE PUBLIC
●● MSE: Cognitive Assessment Answer: -evaluation of a client's level
of awareness, attention, concentration, and memory
-Awareness: observation with emphasis on the client's eyes and speech
-alertness or wakefulness provides information about cognitive function
• help rule out potential substance use or intoxication
-levels of awareness: alert and oriented, somnolent, drowsy, or even
comatose
-Attention and concentration: observation of responses during the
interview
• can they stay on topic?
• able to focus and respond to Q's?
• can use standardized tools such as the Mini-Mental State Exam
(MMSE), digit span test and the SSST
-Memory assessment: immediate recall, short-term, and long-term
memory
• particularly important when ruling out dementia or Alzheimer's disease
• Stress, anxiety, and depression can also impact memory
• orientation, three-object recall
-Mini-Cog exam is commonly used to help rule out significant cognitive
issues
