NR606 / NR 606 Week 3 (Latest Update 2026/2027)
Diagnosis & Management in Psychiatric-Mental Health II Practicum
Complete Guide with Questions and Verified Answers
Aligned with 2026-2027 Chamberlain University NR606 Curriculum Standards, PMHNP Competencies,
and Advanced Psychiatric Diagnostic and Management Guidelines
Total Questions: 75 Format: Multiple Choice (A-D)
Distribution: 8 Sections Cognitive Levels: 25% Recall, 50% Application, 25%
Analysis
Focus: Psychotic, Personality, Difficulty: Practicum-Level
Neurocognitive,
Substance-Related, Psychopharmacolo
gy,
Non-Pharmacological, Legal/Ethical,
Case Scenarios
________________________________________________________________________________
Section 1: Psychotic Disorders (Schizophrenia Spectrum, Schizoaffective, Delusional, &
Brief Psychotic Disorders)
Q1. A 28-year-old patient presents to the psychiatric emergency department with reports of hearing voices that comment on
his behavior. He states, 'They tell me I'm being watched by the FBI.' On examination, the patient is guarded, suspicious, and
makes loose associations. Which of the following symptom clusters is this patient primarily exhibiting?
A. Negative symptoms
B. Cognitive symptoms
C. Positive symptoms [CORRECT]
D. Mood symptoms
Correct Answer: C
Rationale: This patient demonstrates positive symptoms of schizophrenia, specifically auditory hallucinations (hearing voices commenting
on his behavior) and delusions (paranoid belief of FBI surveillance). Positive symptoms reflect an excess or distortion of normal
functioning and include hallucinations, delusions, disorganized speech, and grossly disorganized behavior. Negative symptoms (alogia,
affective flattening, avolition, anhedonia, asociality) reflect a diminution or loss of normal functions. Cognitive symptoms involve
impairments in executive function, attention, and working memory. Mood symptoms are not a core symptom cluster of schizophrenia.
________________________________________________________________________________
Q2. A PMHNP is evaluating a 22-year-old college student who has experienced progressively worsening symptoms over the
past 8 months, including social withdrawal, decline in academic performance, disorganized speech, and blunted affect. The
patient reports hearing a voice narrating his actions for the past 3 months. There is no history of a mood episode meeting
criteria for mania or major depression. Which of the following DSM-5-TR criteria must be present for a diagnosis of
,NR606 Week 3 | Diagnosis & Management in Psychiatric-Mental Health II Practicum 75 Questions - Complete Guide
schizophrenia?
A. At least three of five characteristic symptoms for at least 2 weeks
B. At least two of five characteristic symptoms (including delusions, hallucinations, or disorganized speech)
for at least 1 month, with continuous signs for at least 6 months [CORRECT]
C. At least one symptom from any domain for at least 6 continuous months
D. At least two of five characteristic symptoms for at least 2 weeks, with continuous signs for at least 3 months
Correct Answer: B
Rationale: DSM-5-TR criteria for schizophrenia require at least two of five characteristic symptoms (delusions, hallucinations,
disorganized speech, grossly disorganized or catatonic behavior, negative symptoms) present for at least 1 month. At least one symptom
must be delusions, hallucinations, or disorganized speech. Continuous signs of disturbance must persist for at least 6 months, which may
include prodromal or residual periods. This patient meets criteria with disorganized speech, auditory hallucinations (1 month active), and
negative symptoms (blunted affect), with 8 months total duration. Option A is incorrect because only two symptoms are required and
duration must be 1 month active/6 months continuous. Option C is incorrect because at least two symptoms are required and the 1-month
active phase threshold must be met. Option D is incorrect because the continuous duration must be 6 months, not 3 months.
________________________________________________________________________________
Q3. Which of the following is considered a negative symptom of schizophrenia as defined by the DSM-5-TR?
A. Tangentiality
B. Avolition [CORRECT]
C. Visual hallucinations
D. Catatonic behavior
Correct Answer: B
Rationale: Avolition, defined as a lack of initiative or drive, is a negative symptom of schizophrenia. The five recognized negative
symptoms include alogia (poverty of speech), affective flattening (blunted affect), avolition (lack of motivation), anhedonia (inability to
experience pleasure), and asociality (social withdrawal). Tangentiality is a thought disorder classified under disorganized speech (a
positive symptom). Visual hallucinations are also positive symptoms. Catatonic behavior falls under grossly disorganized or catatonic
behavior, another positive symptom category.
________________________________________________________________________________
Q4. A 26-year-old patient presents with a 4-month history of delusions, auditory hallucinations, and disorganized behavior.
Symptoms began abruptly after a job loss. The patient has no prior psychiatric history and has been functioning well until
this episode. There are no prominent mood symptoms. The patient shows partial improvement with risperidone therapy.
What is the most accurate diagnosis at this time?
A. Schizophrenia
B. Brief psychotic disorder
C. Schizophreniform disorder [CORRECT]
D. Delusional disorder
Correct Answer: C
Rationale: Schizophreniform disorder is diagnosed when the patient meets symptom criteria for schizophrenia but the duration of illness
is between 1 and 6 months. This patient has had symptoms for 4 months, which falls within this window. Schizophrenia requires
continuous signs for at least 6 months, which has not yet been met. Brief psychotic disorder lasts less than 1 month, and this patient has
had symptoms for 4 months, excluding that diagnosis. Delusional disorder requires delusions lasting at least 1 month without prominent
hallucinations, and this patient has both delusions and hallucinations.
________________________________________________________________________________
Q5. A 32-year-old woman is brought to the emergency department by her family 5 days after the unexpected death of her
spouse. She is agitated, believes she can communicate with her deceased husband through the television, and has been
2
, NR606 Week 3 | Diagnosis & Management in Psychiatric-Mental Health II Practicum 75 Questions - Complete Guide
behaving in a disorganized manner. She reports visual hallucinations of her husband. Prior to this event, she had no
psychiatric history and functioned normally. What is the most likely diagnosis?
A. Schizophrenia
B. Schizoaffective disorder
C. Brief psychotic disorder with marked stressor(s) [CORRECT]
D. Delusional disorder, erotomanic type
Correct Answer: C
Rationale: Brief psychotic disorder is characterized by one or more psychotic symptoms (delusions, hallucinations, disorganized speech,
or grossly disorganized/catatonic behavior) lasting at least 1 day but less than 1 month, with full return to premorbid functioning. The
'with marked stressor(s)' specifier applies when psychotic symptoms occur in response to a traumatic or highly stressful event, such as the
sudden death of a spouse. Schizophrenia requires a 6-month duration, which has not been met. Schizoaffective disorder requires a
concurrent major mood episode during the psychotic period, which is not described here. Delusional disorder, erotomanic type involves
delusions that another person is in love with the patient, which is not the presentation.
________________________________________________________________________________
Q6. A PMHNP is evaluating a 35-year-old patient with a 3-year history of psychiatric symptoms. The patient experienced a
major depressive episode lasting 6 months, during which she also had persistent auditory hallucinations and delusions of
persecution. After the depressive episode resolved, the patient continued to have auditory hallucinations and paranoia for 4
additional months before remitting. She then had a second major depressive episode 8 months later, again accompanied by
hallucinations and delusions that persisted for 3 months after the mood symptoms resolved. What is the most accurate
diagnosis?
A. Schizophrenia with comorbid major depressive disorder
B. Schizoaffective disorder, depressive type [CORRECT]
C. Psychotic depression
D. Delusional disorder
Correct Answer: B
Rationale: Schizoaffective disorder is diagnosed when there is an uninterrupted period of illness with a major mood episode (manic or
depressive) concurrent with psychotic symptoms, AND delusions or hallucinations persist for at least 2 weeks in the absence of a major
mood episode during the illness duration. This patient had hallucinations and delusions continuing for months after her depressive
episodes resolved, meeting the 2-week criterion. Additionally, mood symptoms must be present for the majority of the total illness
duration, which this history supports. Schizophrenia with comorbid depression would not account for the mood-psychotic overlap pattern.
Psychotic depression describes a single episode of major depression with psychotic features, not a recurrent pattern with inter-episode
psychosis. Delusional disorder does not involve the mood episodes or hallucinations described.
________________________________________________________________________________
Q7. A 45-year-old attorney presents to the clinic convinced that his law partner is systematically trying to undermine his
career. He provides detailed documentation of perceived slights and minor oversights over a 15-month period. He functions
normally at work, maintains relationships with other colleagues, and shows no evidence of hallucinations, disorganized
speech, or mood disturbance. His daily functioning is not significantly impaired. What is the most likely diagnosis?
A. Schizophrenia, paranoid type
B. Delusional disorder, persecutory type [CORRECT]
C. Paranoid personality disorder
D. Brief psychotic disorder
Correct Answer: B
Rationale: Delusional disorder is characterized by non-bizarre delusions lasting at least 1 month without prominent hallucinations,
disorganized speech or behavior, or negative symptoms. Functioning is not markedly impaired beyond the delusion's impact. The
persecutory subtype involves beliefs that the person is being malevolently treated. This patient meets all criteria: 15-month duration,
3
Diagnosis & Management in Psychiatric-Mental Health II Practicum
Complete Guide with Questions and Verified Answers
Aligned with 2026-2027 Chamberlain University NR606 Curriculum Standards, PMHNP Competencies,
and Advanced Psychiatric Diagnostic and Management Guidelines
Total Questions: 75 Format: Multiple Choice (A-D)
Distribution: 8 Sections Cognitive Levels: 25% Recall, 50% Application, 25%
Analysis
Focus: Psychotic, Personality, Difficulty: Practicum-Level
Neurocognitive,
Substance-Related, Psychopharmacolo
gy,
Non-Pharmacological, Legal/Ethical,
Case Scenarios
________________________________________________________________________________
Section 1: Psychotic Disorders (Schizophrenia Spectrum, Schizoaffective, Delusional, &
Brief Psychotic Disorders)
Q1. A 28-year-old patient presents to the psychiatric emergency department with reports of hearing voices that comment on
his behavior. He states, 'They tell me I'm being watched by the FBI.' On examination, the patient is guarded, suspicious, and
makes loose associations. Which of the following symptom clusters is this patient primarily exhibiting?
A. Negative symptoms
B. Cognitive symptoms
C. Positive symptoms [CORRECT]
D. Mood symptoms
Correct Answer: C
Rationale: This patient demonstrates positive symptoms of schizophrenia, specifically auditory hallucinations (hearing voices commenting
on his behavior) and delusions (paranoid belief of FBI surveillance). Positive symptoms reflect an excess or distortion of normal
functioning and include hallucinations, delusions, disorganized speech, and grossly disorganized behavior. Negative symptoms (alogia,
affective flattening, avolition, anhedonia, asociality) reflect a diminution or loss of normal functions. Cognitive symptoms involve
impairments in executive function, attention, and working memory. Mood symptoms are not a core symptom cluster of schizophrenia.
________________________________________________________________________________
Q2. A PMHNP is evaluating a 22-year-old college student who has experienced progressively worsening symptoms over the
past 8 months, including social withdrawal, decline in academic performance, disorganized speech, and blunted affect. The
patient reports hearing a voice narrating his actions for the past 3 months. There is no history of a mood episode meeting
criteria for mania or major depression. Which of the following DSM-5-TR criteria must be present for a diagnosis of
,NR606 Week 3 | Diagnosis & Management in Psychiatric-Mental Health II Practicum 75 Questions - Complete Guide
schizophrenia?
A. At least three of five characteristic symptoms for at least 2 weeks
B. At least two of five characteristic symptoms (including delusions, hallucinations, or disorganized speech)
for at least 1 month, with continuous signs for at least 6 months [CORRECT]
C. At least one symptom from any domain for at least 6 continuous months
D. At least two of five characteristic symptoms for at least 2 weeks, with continuous signs for at least 3 months
Correct Answer: B
Rationale: DSM-5-TR criteria for schizophrenia require at least two of five characteristic symptoms (delusions, hallucinations,
disorganized speech, grossly disorganized or catatonic behavior, negative symptoms) present for at least 1 month. At least one symptom
must be delusions, hallucinations, or disorganized speech. Continuous signs of disturbance must persist for at least 6 months, which may
include prodromal or residual periods. This patient meets criteria with disorganized speech, auditory hallucinations (1 month active), and
negative symptoms (blunted affect), with 8 months total duration. Option A is incorrect because only two symptoms are required and
duration must be 1 month active/6 months continuous. Option C is incorrect because at least two symptoms are required and the 1-month
active phase threshold must be met. Option D is incorrect because the continuous duration must be 6 months, not 3 months.
________________________________________________________________________________
Q3. Which of the following is considered a negative symptom of schizophrenia as defined by the DSM-5-TR?
A. Tangentiality
B. Avolition [CORRECT]
C. Visual hallucinations
D. Catatonic behavior
Correct Answer: B
Rationale: Avolition, defined as a lack of initiative or drive, is a negative symptom of schizophrenia. The five recognized negative
symptoms include alogia (poverty of speech), affective flattening (blunted affect), avolition (lack of motivation), anhedonia (inability to
experience pleasure), and asociality (social withdrawal). Tangentiality is a thought disorder classified under disorganized speech (a
positive symptom). Visual hallucinations are also positive symptoms. Catatonic behavior falls under grossly disorganized or catatonic
behavior, another positive symptom category.
________________________________________________________________________________
Q4. A 26-year-old patient presents with a 4-month history of delusions, auditory hallucinations, and disorganized behavior.
Symptoms began abruptly after a job loss. The patient has no prior psychiatric history and has been functioning well until
this episode. There are no prominent mood symptoms. The patient shows partial improvement with risperidone therapy.
What is the most accurate diagnosis at this time?
A. Schizophrenia
B. Brief psychotic disorder
C. Schizophreniform disorder [CORRECT]
D. Delusional disorder
Correct Answer: C
Rationale: Schizophreniform disorder is diagnosed when the patient meets symptom criteria for schizophrenia but the duration of illness
is between 1 and 6 months. This patient has had symptoms for 4 months, which falls within this window. Schizophrenia requires
continuous signs for at least 6 months, which has not yet been met. Brief psychotic disorder lasts less than 1 month, and this patient has
had symptoms for 4 months, excluding that diagnosis. Delusional disorder requires delusions lasting at least 1 month without prominent
hallucinations, and this patient has both delusions and hallucinations.
________________________________________________________________________________
Q5. A 32-year-old woman is brought to the emergency department by her family 5 days after the unexpected death of her
spouse. She is agitated, believes she can communicate with her deceased husband through the television, and has been
2
, NR606 Week 3 | Diagnosis & Management in Psychiatric-Mental Health II Practicum 75 Questions - Complete Guide
behaving in a disorganized manner. She reports visual hallucinations of her husband. Prior to this event, she had no
psychiatric history and functioned normally. What is the most likely diagnosis?
A. Schizophrenia
B. Schizoaffective disorder
C. Brief psychotic disorder with marked stressor(s) [CORRECT]
D. Delusional disorder, erotomanic type
Correct Answer: C
Rationale: Brief psychotic disorder is characterized by one or more psychotic symptoms (delusions, hallucinations, disorganized speech,
or grossly disorganized/catatonic behavior) lasting at least 1 day but less than 1 month, with full return to premorbid functioning. The
'with marked stressor(s)' specifier applies when psychotic symptoms occur in response to a traumatic or highly stressful event, such as the
sudden death of a spouse. Schizophrenia requires a 6-month duration, which has not been met. Schizoaffective disorder requires a
concurrent major mood episode during the psychotic period, which is not described here. Delusional disorder, erotomanic type involves
delusions that another person is in love with the patient, which is not the presentation.
________________________________________________________________________________
Q6. A PMHNP is evaluating a 35-year-old patient with a 3-year history of psychiatric symptoms. The patient experienced a
major depressive episode lasting 6 months, during which she also had persistent auditory hallucinations and delusions of
persecution. After the depressive episode resolved, the patient continued to have auditory hallucinations and paranoia for 4
additional months before remitting. She then had a second major depressive episode 8 months later, again accompanied by
hallucinations and delusions that persisted for 3 months after the mood symptoms resolved. What is the most accurate
diagnosis?
A. Schizophrenia with comorbid major depressive disorder
B. Schizoaffective disorder, depressive type [CORRECT]
C. Psychotic depression
D. Delusional disorder
Correct Answer: B
Rationale: Schizoaffective disorder is diagnosed when there is an uninterrupted period of illness with a major mood episode (manic or
depressive) concurrent with psychotic symptoms, AND delusions or hallucinations persist for at least 2 weeks in the absence of a major
mood episode during the illness duration. This patient had hallucinations and delusions continuing for months after her depressive
episodes resolved, meeting the 2-week criterion. Additionally, mood symptoms must be present for the majority of the total illness
duration, which this history supports. Schizophrenia with comorbid depression would not account for the mood-psychotic overlap pattern.
Psychotic depression describes a single episode of major depression with psychotic features, not a recurrent pattern with inter-episode
psychosis. Delusional disorder does not involve the mood episodes or hallucinations described.
________________________________________________________________________________
Q7. A 45-year-old attorney presents to the clinic convinced that his law partner is systematically trying to undermine his
career. He provides detailed documentation of perceived slights and minor oversights over a 15-month period. He functions
normally at work, maintains relationships with other colleagues, and shows no evidence of hallucinations, disorganized
speech, or mood disturbance. His daily functioning is not significantly impaired. What is the most likely diagnosis?
A. Schizophrenia, paranoid type
B. Delusional disorder, persecutory type [CORRECT]
C. Paranoid personality disorder
D. Brief psychotic disorder
Correct Answer: B
Rationale: Delusional disorder is characterized by non-bizarre delusions lasting at least 1 month without prominent hallucinations,
disorganized speech or behavior, or negative symptoms. Functioning is not markedly impaired beyond the delusion's impact. The
persecutory subtype involves beliefs that the person is being malevolently treated. This patient meets all criteria: 15-month duration,
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