NR 605 EXAM / NR 605 FINAL EXAM 2026/2027 ACTUAL EXAM
COMPLETE ACCURATE QUESTIONS AND CORRECT VERIFIED ANSWERS
1. A 34-year-old client presents for an initial psychiatric evaluation after
experiencing six weeks of depressed mood, loss of interest in previously
enjoyable activities, fatigue, impaired concentration, insomnia, and feelings
of worthlessness. The client denies current suicidal intent but reports
increasing difficulty functioning at work. Which approach should the
PMHNP prioritize when formulating the initial treatment plan?
A. Begin treatment without completing a comprehensive psychiatric
assessment
B. Establish a therapeutic alliance while completing a comprehensive
history, mental status examination, diagnostic assessment, and safety
evaluation
C. Focus exclusively on medication selection before discussing psychosocial
factors
D. Delay treatment until symptoms have been present for at least one year
Answer: B
2. During an initial psychiatric interview, a client repeatedly changes subjects,
provides lengthy descriptions of unrelated events, and becomes frustrated
when redirected. The PMHNP wants to obtain accurate information while
maintaining rapport. Which interviewing strategy is most appropriate?
A. Interrupt the client frequently to control the conversation
B. Allow unrestricted discussion without obtaining specific information
C. Use respectful redirection and focused questions while preserving the
therapeutic alliance
D. End the interview because the client is unwilling to cooperate
Answer: C
3. A client presents for treatment of anxiety and asks whether the PMHNP can
guarantee that therapy will eliminate all symptoms permanently. Which
response best demonstrates appropriate therapeutic communication and
1
, realistic treatment planning?
A. “Yes, effective therapy should completely eliminate anxiety.”
B. “Your symptoms are entirely caused by your childhood.”
C. “Treatment can help you develop effective ways to manage symptoms
and improve functioning, although responses vary.”
D. “Therapy will not help unless you take medication at the same time.”
Answer: C
4. A client reports depressed mood and difficulty functioning but is reluctant
to discuss personal experiences because of previous negative healthcare
encounters. Which initial action is most likely to strengthen the therapeutic
alliance?
A. Establish trust through empathy, consistency, respect, collaboration, and
clear explanation of the treatment process
B. Immediately confront the client's reluctance as resistance
C. Avoid discussing confidentiality because it may increase anxiety
D. Focus exclusively on completing diagnostic questions as quickly as
possible
Answer: A
5. A PMHNP is completing an initial evaluation of a client with anxiety,
insomnia, and recent behavioral changes. The client reports using several
prescription medications, alcohol, and an over-the-counter sleep product.
Which component of the assessment is especially important before
selecting treatment?
A. Only the client's family psychiatric history
B. Only the client's occupational history
C. A complete medication and substance-use assessment to identify
interactions, adverse effects, and possible contributing factors
D. Only the client's childhood developmental history
Answer: C
2
, 6. A client reports persistent worry, muscle tension, irritability, fatigue, and
difficulty concentrating about multiple areas of life for more than six
months. The symptoms cause substantial occupational impairment and are
difficult for the client to control. Which diagnosis is most consistent with
this presentation?
A. Generalized anxiety disorder
B. Panic disorder
C. Social anxiety disorder
D. Adjustment disorder
Answer: A
7. A client experiences recurrent unexpected episodes of intense fear
accompanied by palpitations, sweating, trembling, shortness of breath,
chest discomfort, and fear of dying. Between episodes, the client worries
about having another attack and has begun avoiding certain locations.
Which diagnosis is most appropriate?
A. Generalized anxiety disorder
B. Panic disorder
C. Obsessive-compulsive disorder
D. Post-traumatic stress disorder
Answer: B
8. A client reports intense fear of being scrutinized or embarrassed in social
situations and has stopped attending meetings because of concern about
being judged. The client recognizes that the fear is excessive but cannot
control it. Which diagnosis is most appropriate?
A. Social anxiety disorder
B. Panic disorder
C. Specific phobia
D. Generalized anxiety disorder
Answer: A
3
, 9. A client repeatedly experiences intrusive thoughts about contamination and
performs prolonged handwashing rituals to reduce anxiety. The client
recognizes that the thoughts and behaviors are excessive but feels unable
to stop them. Which diagnosis is most consistent with these findings?
A. Illness anxiety disorder
B. Generalized anxiety disorder
C. Obsessive-compulsive disorder
D. Somatic symptom disorder
Answer: C
10. A client reports experiencing recurrent panic attacks only when required to
speak in front of groups and has begun avoiding professional presentations.
Which treatment approach is most consistent with evidence-based
management of social anxiety?
A. Encourage permanent avoidance of social situations
B. Use psychotherapy involving cognitive restructuring and gradual
exposure to feared situations
C. Provide reassurance without addressing avoidance
D. Recommend complete social isolation until anxiety resolves
Answer: B
11. A client presents after a traumatic event with intrusive memories,
nightmares, avoidance of reminders, hypervigilance, exaggerated startle
response, and sleep disturbance that have persisted for several months.
Which diagnosis should be considered?
A. Acute stress disorder
B. Generalized anxiety disorder
C. Post-traumatic stress disorder
D. Panic disorder
Answer: C
12. A client experienced a serious motor vehicle accident three weeks ago and
now has intrusive memories, avoidance, dissociation, disturbed sleep, and
4
COMPLETE ACCURATE QUESTIONS AND CORRECT VERIFIED ANSWERS
1. A 34-year-old client presents for an initial psychiatric evaluation after
experiencing six weeks of depressed mood, loss of interest in previously
enjoyable activities, fatigue, impaired concentration, insomnia, and feelings
of worthlessness. The client denies current suicidal intent but reports
increasing difficulty functioning at work. Which approach should the
PMHNP prioritize when formulating the initial treatment plan?
A. Begin treatment without completing a comprehensive psychiatric
assessment
B. Establish a therapeutic alliance while completing a comprehensive
history, mental status examination, diagnostic assessment, and safety
evaluation
C. Focus exclusively on medication selection before discussing psychosocial
factors
D. Delay treatment until symptoms have been present for at least one year
Answer: B
2. During an initial psychiatric interview, a client repeatedly changes subjects,
provides lengthy descriptions of unrelated events, and becomes frustrated
when redirected. The PMHNP wants to obtain accurate information while
maintaining rapport. Which interviewing strategy is most appropriate?
A. Interrupt the client frequently to control the conversation
B. Allow unrestricted discussion without obtaining specific information
C. Use respectful redirection and focused questions while preserving the
therapeutic alliance
D. End the interview because the client is unwilling to cooperate
Answer: C
3. A client presents for treatment of anxiety and asks whether the PMHNP can
guarantee that therapy will eliminate all symptoms permanently. Which
response best demonstrates appropriate therapeutic communication and
1
, realistic treatment planning?
A. “Yes, effective therapy should completely eliminate anxiety.”
B. “Your symptoms are entirely caused by your childhood.”
C. “Treatment can help you develop effective ways to manage symptoms
and improve functioning, although responses vary.”
D. “Therapy will not help unless you take medication at the same time.”
Answer: C
4. A client reports depressed mood and difficulty functioning but is reluctant
to discuss personal experiences because of previous negative healthcare
encounters. Which initial action is most likely to strengthen the therapeutic
alliance?
A. Establish trust through empathy, consistency, respect, collaboration, and
clear explanation of the treatment process
B. Immediately confront the client's reluctance as resistance
C. Avoid discussing confidentiality because it may increase anxiety
D. Focus exclusively on completing diagnostic questions as quickly as
possible
Answer: A
5. A PMHNP is completing an initial evaluation of a client with anxiety,
insomnia, and recent behavioral changes. The client reports using several
prescription medications, alcohol, and an over-the-counter sleep product.
Which component of the assessment is especially important before
selecting treatment?
A. Only the client's family psychiatric history
B. Only the client's occupational history
C. A complete medication and substance-use assessment to identify
interactions, adverse effects, and possible contributing factors
D. Only the client's childhood developmental history
Answer: C
2
, 6. A client reports persistent worry, muscle tension, irritability, fatigue, and
difficulty concentrating about multiple areas of life for more than six
months. The symptoms cause substantial occupational impairment and are
difficult for the client to control. Which diagnosis is most consistent with
this presentation?
A. Generalized anxiety disorder
B. Panic disorder
C. Social anxiety disorder
D. Adjustment disorder
Answer: A
7. A client experiences recurrent unexpected episodes of intense fear
accompanied by palpitations, sweating, trembling, shortness of breath,
chest discomfort, and fear of dying. Between episodes, the client worries
about having another attack and has begun avoiding certain locations.
Which diagnosis is most appropriate?
A. Generalized anxiety disorder
B. Panic disorder
C. Obsessive-compulsive disorder
D. Post-traumatic stress disorder
Answer: B
8. A client reports intense fear of being scrutinized or embarrassed in social
situations and has stopped attending meetings because of concern about
being judged. The client recognizes that the fear is excessive but cannot
control it. Which diagnosis is most appropriate?
A. Social anxiety disorder
B. Panic disorder
C. Specific phobia
D. Generalized anxiety disorder
Answer: A
3
, 9. A client repeatedly experiences intrusive thoughts about contamination and
performs prolonged handwashing rituals to reduce anxiety. The client
recognizes that the thoughts and behaviors are excessive but feels unable
to stop them. Which diagnosis is most consistent with these findings?
A. Illness anxiety disorder
B. Generalized anxiety disorder
C. Obsessive-compulsive disorder
D. Somatic symptom disorder
Answer: C
10. A client reports experiencing recurrent panic attacks only when required to
speak in front of groups and has begun avoiding professional presentations.
Which treatment approach is most consistent with evidence-based
management of social anxiety?
A. Encourage permanent avoidance of social situations
B. Use psychotherapy involving cognitive restructuring and gradual
exposure to feared situations
C. Provide reassurance without addressing avoidance
D. Recommend complete social isolation until anxiety resolves
Answer: B
11. A client presents after a traumatic event with intrusive memories,
nightmares, avoidance of reminders, hypervigilance, exaggerated startle
response, and sleep disturbance that have persisted for several months.
Which diagnosis should be considered?
A. Acute stress disorder
B. Generalized anxiety disorder
C. Post-traumatic stress disorder
D. Panic disorder
Answer: C
12. A client experienced a serious motor vehicle accident three weeks ago and
now has intrusive memories, avoidance, dissociation, disturbed sleep, and
4
