NR548 PSYCHIATRIC ASSESSMENT
COMPREHENSIVE EXAM REVIEW
QUESTIONS AND ANSWERS
1. During a Mental Status Examination (MSE), the PMHNP observes a patient providing
excessive detail and many unnecessary departures from the main point but eventually
returning to answer the original question. How should this be documented?
A. Circumstantiality
B. Tangentiality
C. Derailment
D. Flight of ideas
Answer: A
Conceptual Explanation: Circumstantiality is characterized by a patient who includes
many unnecessary details but eventually reaches the point. Tangentiality is when the
patient never returns to the original point.
,2. When assessing a patient for suicide risk, which of the following is considered a ‘static’ risk
factor?
A. Current suicidal ideation
B. Access to firearms
C. Active substance intoxication
D. History of past suicide attempts
Answer: D
Conceptual Explanation: Static risk factors are historical and cannot be changed, such as a
prior attempt. Dynamic factors are modifiable, like current ideation or substance use.
3. A patient reports feeling that the television is sending special, personalized messages
specifically to them. This is an example of:
A. Thought broadcasting
B. Grandiosity
C. Ideas of reference
D. Illusion
Answer: C
Conceptual Explanation: Ideas of reference involve the false belief that irrelevant
occurrences or external events have a direct personal significance to the individual.
, 4. Which standardized tool is most appropriate for a PMHNP to screen for alcohol use
disorder severity in a primary care setting?
A. CAGE Questionnaire
B. AUDIT
C. PHQ-9
D. GDS
Answer: B
Conceptual Explanation: The Alcohol Use Disorders Identification Test (AUDIT) is a
comprehensive 10-item tool that is more sensitive to hazardous drinking than the 4-item
CAGE.
5. In the Mental Status Exam, the difference between ‘mood’ and ‘affect’ is best described as:
A. Mood is objective; affect is subjective
B. Mood is the patient’s internal emotional state; affect is the clinician’s observation of
emotional expression
C. Mood refers to the patient’s thought process; affect refers to thought content
D. Mood changes rapidly; affect is stable over time
Answer: B
Conceptual Explanation: Mood is the patient’s self-reported emotional state (subjective),
while affect is the observable, external expression of emotion (objective).
COMPREHENSIVE EXAM REVIEW
QUESTIONS AND ANSWERS
1. During a Mental Status Examination (MSE), the PMHNP observes a patient providing
excessive detail and many unnecessary departures from the main point but eventually
returning to answer the original question. How should this be documented?
A. Circumstantiality
B. Tangentiality
C. Derailment
D. Flight of ideas
Answer: A
Conceptual Explanation: Circumstantiality is characterized by a patient who includes
many unnecessary details but eventually reaches the point. Tangentiality is when the
patient never returns to the original point.
,2. When assessing a patient for suicide risk, which of the following is considered a ‘static’ risk
factor?
A. Current suicidal ideation
B. Access to firearms
C. Active substance intoxication
D. History of past suicide attempts
Answer: D
Conceptual Explanation: Static risk factors are historical and cannot be changed, such as a
prior attempt. Dynamic factors are modifiable, like current ideation or substance use.
3. A patient reports feeling that the television is sending special, personalized messages
specifically to them. This is an example of:
A. Thought broadcasting
B. Grandiosity
C. Ideas of reference
D. Illusion
Answer: C
Conceptual Explanation: Ideas of reference involve the false belief that irrelevant
occurrences or external events have a direct personal significance to the individual.
, 4. Which standardized tool is most appropriate for a PMHNP to screen for alcohol use
disorder severity in a primary care setting?
A. CAGE Questionnaire
B. AUDIT
C. PHQ-9
D. GDS
Answer: B
Conceptual Explanation: The Alcohol Use Disorders Identification Test (AUDIT) is a
comprehensive 10-item tool that is more sensitive to hazardous drinking than the 4-item
CAGE.
5. In the Mental Status Exam, the difference between ‘mood’ and ‘affect’ is best described as:
A. Mood is objective; affect is subjective
B. Mood is the patient’s internal emotional state; affect is the clinician’s observation of
emotional expression
C. Mood refers to the patient’s thought process; affect refers to thought content
D. Mood changes rapidly; affect is stable over time
Answer: B
Conceptual Explanation: Mood is the patient’s self-reported emotional state (subjective),
while affect is the observable, external expression of emotion (objective).
