NR606 Week 1: Diagnosis & Management in Psychiatric-Mental Health II Practicum Examination Chamberlain University 2026/2027
NR606 / NR 606 Week 1 (Latest Update 2026/2027)
Diagnosis and Management in Psychiatric-Mental Health II Practicum
Complete Guide with Questions and Verified Answers
Chamberlain University | PMHNP Advanced Practice Nursing
75 Questions | Aligned with DSM-5-TR, 2026-2027 Curriculum Standards
Section 1: Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) Criteria and
Differential Diagnosis
Questions 1-15
Q1: A 28-year-old patient presents with auditory hallucinations, delusions of persecution, and disorganized speech
lasting for 6 months. Negative symptoms including flat affect and social withdrawal are also present. There is no
identifiable mood episode concurrent with these symptoms. What is the most likely DSM-5-TR diagnosis?
A. Brief psychotic disorder
B. Schizoaffective disorder
C. Schizophrenia [CORRECT]
D. Delusional disorder
Correct Answer: C
Rationale: The patient meets DSM-5-TR criteria for schizophrenia with two or more characteristic symptoms (hallucinations,
delusions, disorganized speech, negative symptoms) present for more than six months, significantly impairing functioning. Brief
psychotic disorder requires symptoms lasting less than one month. Schizoaffective disorder requires a major mood episode concurrent
with the psychotic symptoms. Delusional disorder does not present with hallucinations or disorganized speech.
Q2: A 32-year-old woman reports episodes of elevated mood, increased energy, decreased need for sleep, and racing
thoughts lasting 7 days that required hospitalization. She also has a history of one major depressive episode. Which
bipolar disorder diagnosis is most appropriate per DSM-5-TR?
A. Bipolar II disorder
B. Cyclothymic disorder
C. Bipolar I disorder [CORRECT]
D. Persistent depressive disorder
Correct Answer: C
Rationale: Bipolar I disorder is characterized by at least one lifetime manic episode, which this patient demonstrates with a 7-day
period of elevated mood and increased energy requiring hospitalization. The presence of a prior major depressive episode is common
in Bipolar I but does not change the diagnosis. Bipolar II requires hypomania plus major depression, not mania. Cyclothymic disorder
involves chronic fluctuating mood symptoms that do not meet full episode criteria.
Q3: A PMHNP is evaluating a 10-year-old boy who exhibits persistent patterns of inattention, hyperactivity, and
impulsivity both at home and at school for the past 14 months. Symptoms were present before age 7 and cause
significant academic impairment. Which neurodevelopmental disorder best fits this presentation?
A. Autism spectrum disorder
Page 1
, B. Specific learning disorder
C. Attention-deficit/hyperactivity disorder (ADHD) [CORRECT]
D. Oppositional defiant disorder
Correct Answer: C
Rationale: ADHD requires a persistent pattern of inattention and/or hyperactivity-impulsivity present for at least 6 months, with
several symptoms present prior to age 12, symptoms present in two or more settings, and evidence of functional impairment. This child
meets all DSM-5-TR criteria. Autism spectrum disorder primarily involves social communication deficits and restricted repetitive
behaviors. Specific learning disorder affects academic skills specifically. ODD involves a pattern of angry/irritable mood and
argumentative/defiant behavior.
Q4: A 22-year-old college student experiences recurrent unexpected panic attacks with palpitations, sweating,
trembling, and fear of losing control. She now worries persistently about having additional attacks and has altered her
behavior to avoid situations where attacks might occur. What is the correct diagnosis?
A. Generalized anxiety disorder (GAD)
B. Social anxiety disorder
C. Agoraphobia
D. Panic disorder [CORRECT]
Correct Answer: D
Rationale: Panic disorder is diagnosed when recurrent unexpected panic attacks are followed by at least one month of persistent
concern about additional attacks, worry about the implications of the attacks, or a significant maladaptive change in behavior related
to the attacks. GAD involves excessive anxiety about multiple events. Social anxiety disorder involves fear of social situations where
scrutiny may occur. Agoraphobia involves fear of open spaces or situations from which escape might be difficult.
Q5: A patient reports recurrent, intrusive thoughts about contamination and engages in excessive hand-washing rituals
that consume approximately 3 hours daily. These behaviors cause significant distress and interfere with occupational
functioning. The patient recognizes the obsessions are excessive. What is the most accurate DSM-5-TR diagnosis?
A. Body dysmorphic disorder
B. Obsessive-compulsive disorder (OCD) [CORRECT]
C. Illness anxiety disorder
D. Specific phobia
Correct Answer: B
Rationale: OCD is characterized by the presence of obsessions (recurrent intrusive thoughts about contamination) and compulsions
(excessive hand-washing) that are time-consuming (more than one hour per day), cause significant distress, and impair functioning.
The patient has good insight, which is consistent with OCD. Body dysmorphic disorder involves preoccupation with perceived
appearance defects. Illness anxiety disorder involves preoccupation with having or acquiring a serious illness without somatic
symptoms. Specific phobia involves fear of a specific object or situation.
Q6: Following a motor vehicle accident in which she sustained serious injuries, a 30-year-old woman experiences
intrusive memories, nightmares, hypervigilance, and avoidance of driving for the past 10 weeks. Symptoms cause
significant impairment in her daily functioning. What diagnosis best fits this presentation?
A. Acute stress disorder
B. Adjustment disorder
C. Post-traumatic stress disorder (PTSD) [CORRECT]
D. Persistent depressive disorder
, Correct Answer: C
Rationale: PTSD requires exposure to a traumatic event, plus at least one intrusion symptom (intrusive memories, nightmares), one
avoidance symptom (avoiding driving), two negative alterations in cognition and mood, and two arousal reactivity symptoms
(hypervigilance) persisting for more than one month. This patient meets all criteria at 10 weeks post-trauma. Acute stress disorder has
the same symptom profile but lasts 3 days to 1 month. Adjustment disorder involves emotional/behavioral symptoms in response to a
stressor but does not meet PTSD criteria.
Q7: A 19-year-old woman presents with dramatic shifts in her self-image, mood, and relationships. She exhibits
recurrent suicidal gestures, self-cutting behavior, chronic feelings of emptiness, and intense fear of abandonment. Her
symptoms are not better explained by a mood disorder with psychotic features. Which personality disorder is most
consistent with this presentation?
A. Antisocial personality disorder
B. Histrionic personality disorder
C. Narcissistic personality disorder
D. Borderline personality disorder [CORRECT]
Correct Answer: D
Rationale: Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability in interpersonal relationships,
self-image, and affects, plus marked impulsivity beginning by early adulthood. This patient demonstrates at least five of the nine
DSM-5-TR criteria: frantic efforts to avoid abandonment, unstable relationships, identity disturbance, impulsivity, recurrent suicidal
behavior, affective instability, chronic feelings of emptiness, and inappropriate intense anger. Antisocial PD involves disregard for
others rights. Histrionic PD involves excessive emotionality and attention-seeking. Narcissistic PD involves grandiosity and need for
admiration.
Q8: A 55-year-old man presents with persistent difficulty falling and staying asleep for the past 6 months. He reports
daytime fatigue, irritability, and difficulty concentrating. The sleep disturbance causes significant distress and is not
attributable to substance use or another medical condition. What is the appropriate diagnosis?
A. Narcolepsy
B. Hypersomnolence disorder
C. Insomnia disorder [CORRECT]
D. Circadian rhythm sleep-wake disorder
Correct Answer: C
Rationale: Insomnia disorder requires difficulty initiating or maintaining sleep (or early morning awakening) occurring at least 3
nights per week for at least 3 months, causing significant distress or impairment, and not being better explained by another sleep
disorder, substance use, or coexisting medical condition. This patient meets all criteria at 6 months duration. Narcolepsy involves
excessive daytime sleepiness with cataplexy. Hypersomnolence involves excessive sleepiness despite adequate sleep. Circadian rhythm
disorders involve misalignment between endogenous circadian rhythm and external environment.
Q9: A 45-year-old patient reports preoccupation with a perceived defect in facial appearance that is not observable or
appears only slight to others. This preoccupation causes significant distress and has led to excessive mirror checking
and skin picking. What is the most likely diagnosis?
A. Obsessive-compulsive disorder
B. Body dysmorphic disorder (BDD) [CORRECT]
C. Excoriation disorder
D. Illness anxiety disorder
NR606 / NR 606 Week 1 (Latest Update 2026/2027)
Diagnosis and Management in Psychiatric-Mental Health II Practicum
Complete Guide with Questions and Verified Answers
Chamberlain University | PMHNP Advanced Practice Nursing
75 Questions | Aligned with DSM-5-TR, 2026-2027 Curriculum Standards
Section 1: Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) Criteria and
Differential Diagnosis
Questions 1-15
Q1: A 28-year-old patient presents with auditory hallucinations, delusions of persecution, and disorganized speech
lasting for 6 months. Negative symptoms including flat affect and social withdrawal are also present. There is no
identifiable mood episode concurrent with these symptoms. What is the most likely DSM-5-TR diagnosis?
A. Brief psychotic disorder
B. Schizoaffective disorder
C. Schizophrenia [CORRECT]
D. Delusional disorder
Correct Answer: C
Rationale: The patient meets DSM-5-TR criteria for schizophrenia with two or more characteristic symptoms (hallucinations,
delusions, disorganized speech, negative symptoms) present for more than six months, significantly impairing functioning. Brief
psychotic disorder requires symptoms lasting less than one month. Schizoaffective disorder requires a major mood episode concurrent
with the psychotic symptoms. Delusional disorder does not present with hallucinations or disorganized speech.
Q2: A 32-year-old woman reports episodes of elevated mood, increased energy, decreased need for sleep, and racing
thoughts lasting 7 days that required hospitalization. She also has a history of one major depressive episode. Which
bipolar disorder diagnosis is most appropriate per DSM-5-TR?
A. Bipolar II disorder
B. Cyclothymic disorder
C. Bipolar I disorder [CORRECT]
D. Persistent depressive disorder
Correct Answer: C
Rationale: Bipolar I disorder is characterized by at least one lifetime manic episode, which this patient demonstrates with a 7-day
period of elevated mood and increased energy requiring hospitalization. The presence of a prior major depressive episode is common
in Bipolar I but does not change the diagnosis. Bipolar II requires hypomania plus major depression, not mania. Cyclothymic disorder
involves chronic fluctuating mood symptoms that do not meet full episode criteria.
Q3: A PMHNP is evaluating a 10-year-old boy who exhibits persistent patterns of inattention, hyperactivity, and
impulsivity both at home and at school for the past 14 months. Symptoms were present before age 7 and cause
significant academic impairment. Which neurodevelopmental disorder best fits this presentation?
A. Autism spectrum disorder
Page 1
, B. Specific learning disorder
C. Attention-deficit/hyperactivity disorder (ADHD) [CORRECT]
D. Oppositional defiant disorder
Correct Answer: C
Rationale: ADHD requires a persistent pattern of inattention and/or hyperactivity-impulsivity present for at least 6 months, with
several symptoms present prior to age 12, symptoms present in two or more settings, and evidence of functional impairment. This child
meets all DSM-5-TR criteria. Autism spectrum disorder primarily involves social communication deficits and restricted repetitive
behaviors. Specific learning disorder affects academic skills specifically. ODD involves a pattern of angry/irritable mood and
argumentative/defiant behavior.
Q4: A 22-year-old college student experiences recurrent unexpected panic attacks with palpitations, sweating,
trembling, and fear of losing control. She now worries persistently about having additional attacks and has altered her
behavior to avoid situations where attacks might occur. What is the correct diagnosis?
A. Generalized anxiety disorder (GAD)
B. Social anxiety disorder
C. Agoraphobia
D. Panic disorder [CORRECT]
Correct Answer: D
Rationale: Panic disorder is diagnosed when recurrent unexpected panic attacks are followed by at least one month of persistent
concern about additional attacks, worry about the implications of the attacks, or a significant maladaptive change in behavior related
to the attacks. GAD involves excessive anxiety about multiple events. Social anxiety disorder involves fear of social situations where
scrutiny may occur. Agoraphobia involves fear of open spaces or situations from which escape might be difficult.
Q5: A patient reports recurrent, intrusive thoughts about contamination and engages in excessive hand-washing rituals
that consume approximately 3 hours daily. These behaviors cause significant distress and interfere with occupational
functioning. The patient recognizes the obsessions are excessive. What is the most accurate DSM-5-TR diagnosis?
A. Body dysmorphic disorder
B. Obsessive-compulsive disorder (OCD) [CORRECT]
C. Illness anxiety disorder
D. Specific phobia
Correct Answer: B
Rationale: OCD is characterized by the presence of obsessions (recurrent intrusive thoughts about contamination) and compulsions
(excessive hand-washing) that are time-consuming (more than one hour per day), cause significant distress, and impair functioning.
The patient has good insight, which is consistent with OCD. Body dysmorphic disorder involves preoccupation with perceived
appearance defects. Illness anxiety disorder involves preoccupation with having or acquiring a serious illness without somatic
symptoms. Specific phobia involves fear of a specific object or situation.
Q6: Following a motor vehicle accident in which she sustained serious injuries, a 30-year-old woman experiences
intrusive memories, nightmares, hypervigilance, and avoidance of driving for the past 10 weeks. Symptoms cause
significant impairment in her daily functioning. What diagnosis best fits this presentation?
A. Acute stress disorder
B. Adjustment disorder
C. Post-traumatic stress disorder (PTSD) [CORRECT]
D. Persistent depressive disorder
, Correct Answer: C
Rationale: PTSD requires exposure to a traumatic event, plus at least one intrusion symptom (intrusive memories, nightmares), one
avoidance symptom (avoiding driving), two negative alterations in cognition and mood, and two arousal reactivity symptoms
(hypervigilance) persisting for more than one month. This patient meets all criteria at 10 weeks post-trauma. Acute stress disorder has
the same symptom profile but lasts 3 days to 1 month. Adjustment disorder involves emotional/behavioral symptoms in response to a
stressor but does not meet PTSD criteria.
Q7: A 19-year-old woman presents with dramatic shifts in her self-image, mood, and relationships. She exhibits
recurrent suicidal gestures, self-cutting behavior, chronic feelings of emptiness, and intense fear of abandonment. Her
symptoms are not better explained by a mood disorder with psychotic features. Which personality disorder is most
consistent with this presentation?
A. Antisocial personality disorder
B. Histrionic personality disorder
C. Narcissistic personality disorder
D. Borderline personality disorder [CORRECT]
Correct Answer: D
Rationale: Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability in interpersonal relationships,
self-image, and affects, plus marked impulsivity beginning by early adulthood. This patient demonstrates at least five of the nine
DSM-5-TR criteria: frantic efforts to avoid abandonment, unstable relationships, identity disturbance, impulsivity, recurrent suicidal
behavior, affective instability, chronic feelings of emptiness, and inappropriate intense anger. Antisocial PD involves disregard for
others rights. Histrionic PD involves excessive emotionality and attention-seeking. Narcissistic PD involves grandiosity and need for
admiration.
Q8: A 55-year-old man presents with persistent difficulty falling and staying asleep for the past 6 months. He reports
daytime fatigue, irritability, and difficulty concentrating. The sleep disturbance causes significant distress and is not
attributable to substance use or another medical condition. What is the appropriate diagnosis?
A. Narcolepsy
B. Hypersomnolence disorder
C. Insomnia disorder [CORRECT]
D. Circadian rhythm sleep-wake disorder
Correct Answer: C
Rationale: Insomnia disorder requires difficulty initiating or maintaining sleep (or early morning awakening) occurring at least 3
nights per week for at least 3 months, causing significant distress or impairment, and not being better explained by another sleep
disorder, substance use, or coexisting medical condition. This patient meets all criteria at 6 months duration. Narcolepsy involves
excessive daytime sleepiness with cataplexy. Hypersomnolence involves excessive sleepiness despite adequate sleep. Circadian rhythm
disorders involve misalignment between endogenous circadian rhythm and external environment.
Q9: A 45-year-old patient reports preoccupation with a perceived defect in facial appearance that is not observable or
appears only slight to others. This preoccupation causes significant distress and has led to excessive mirror checking
and skin picking. What is the most likely diagnosis?
A. Obsessive-compulsive disorder
B. Body dysmorphic disorder (BDD) [CORRECT]
C. Excoriation disorder
D. Illness anxiety disorder
