NR547 CEA EXAM | PRE-CLINICAL DIAGNOSTIC
COMPREHENSIVE ASSESSMENT | 2 VERSIONS |
QUESTIONS & ANSWERS COMPLETE STUDY
GUIDE – CHAMBERLAIN UNIVERSITY | LATEST
2026/2027 | 100% VERIFIED.
Core Domains
• Psychiatric Assessment and Mental Status Examination (MSE)
• Therapeutic Communication and the Therapeutic Alliance
• Psychopharmacology and Neurobiologic Foundations
• Differential Diagnosis Process and Clinical Reasoning
• Psychotherapy Modalities and Somatic Treatments
• Mental Health Disorders Across the Lifespan
• Cultural Formulation and Health Disparities
• Ethical, Legal, and Crisis Management Principles
Introduction
The NR547 Clinical Evaluation Assessment (CEA) is a comprehensive cumulative evaluation
administered at Chamberlain University for students in the Psychiatric-Mental Health
Nurse Practitioner (PMHNP) track. This exam assesses key PMHNP competencies including
psychiatric assessment, therapeutic communication, psychopharmacology, psychotherapy
modalities, differential diagnosis, and mental health disorders across the lifespan. The
assessment employs multiple-choice and scenario-based questions to evaluate clinical
judgment, diagnostic reasoning, and application of evidence-based practice. Emphasis is
placed on formulating differential diagnoses, distinguishing medical mimics from primary
psychiatric conditions, and developing patient-centered treatment plans grounded in DSM-
5-TR criteria.
SECTION ONE: QUESTIONS 1–150
Question 1
,The PMHNP is conducting a mental status examination on a patient who reports feeling
"on edge" and having difficulty sleeping. The patient speaks rapidly, jumps from topic to
topic, and is easily distracted. Which MSE domain is the provider assessing when noting
the patient's speech pattern?
A. Thought content
B. Thought process
C. Affect
D. Cognition
Correct answer: B. Thought process
RATIONALE: Thought process evaluates how thoughts flow and are connected. Rapid
speech with jumping between topics describes a flight of ideas, which is a thought process
abnormality often seen in mania or hypomania. Thought content assesses what the patient
is thinking. Affect is the observed emotional expression. Cognition includes attention,
memory, and orientation.
Question 2
A patient presents with a flat affect, poverty of speech, and psychomotor retardation. The
patient reports feeling hopeless and worthless. The PMHNP should further assess for:
A. Mania
B. Major depressive disorder
C. Schizophrenia
D. Generalized anxiety disorder
Correct answer: B. Major depressive disorder
RATIONALE: Flat affect, poverty of speech, psychomotor retardation, hopelessness,
and worthlessness are classic features of major depressive disorder with melancholic
features. Mania presents with elevated mood and pressured speech. Schizophrenia
includes psychotic symptoms and thought disorders. GAD involves excessive worry and
hyperarousal.
Question 3
During the MSE, the PMHNP asks the patient to repeat the phrase "No ifs, ands, or buts."
This assesses which cognitive domain?
,A. Attention
B. Memory
C. Language
D. Executive function
Correct answer: C. Language
RATIONALE: Repeating a phrase assesses language function, specifically the ability to
produce complex speech and the integrity of the motor aspects of language. Attention is
assessed with digit span or serial sevens. Memory is tested with recall tasks. Executive
function involves problem-solving and abstraction.
Question 4
The PMHNP is assessing a patient's insight and judgment. Which question best assesses
judgment?
A. "What would you do if you found a stamped envelope on the street?"
B. "How would you describe your current mood?"
C. "Can you tell me the name of the current president?"
D. "What does the phrase 'people in glass houses shouldn't throw stones' mean?"
Correct answer: A. "What would you do if you found a stamped envelope on the
street?"
RATIONALE: Judgment is assessed by asking patients what they would do in
hypothetical situations, such as finding a stamped envelope. This evaluates their ability to
make appropriate decisions and anticipate consequences. Abstract reasoning assesses the
ability to interpret proverbs.
Question 5
The PMHNP is evaluating a patient who reports hearing voices commenting on their
actions. The provider notes that the patient responds to the voices during the interview.
This finding should be documented as:
A. Auditory hallucinations
B. Illusions
C. Delusions
D. Loose associations
, Correct answer: A. Auditory hallucinations
RATIONALE: Auditory hallucinations are the perception of sounds or voices without
external stimuli. When voices comment on the patient's actions, this is a specific type of
auditory hallucination. Illusions are misinterpretations of real stimuli. Delusions are fixed
false beliefs.
Question 6
When assessing a patient's mood, the PMHNP should document:
A. The patient's subjective report of their emotional state
B. The provider's observation of the patient's emotional expression
C. The patient's facial expressions during the interview
D. The patient's tone of voice
Correct answer: A. The patient's subjective report of their emotional state
RATIONALE: Mood is the patient's subjective experience of their emotional state and
should be documented as reported by the patient. Affect is the provider's observation of
the patient's emotional expression. It is important to document both mood and affect and
note any incongruence between them.
Question 7
A patient tells the PMHNP, "I'm not sure I can go on." Which response is most therapeutic?
A. "Everyone has tough times. You'll be fine."
B. "You're feeling like you can't go on. Tell me more about that."
C. "You have so much to live for. Think about your family."
D. "Are you thinking about killing yourself?"
Correct answer: B. "You're feeling like you can't go on. Tell me more about that."
RATIONALE: Reflecting the patient's statement and asking for elaboration is
therapeutic and allows the patient to explore their feelings. Dismissing the patient's
feelings or offering platitudes is non-therapeutic. Asking directly about suicidal ideation is
appropriate but should follow the patient's disclosure.
COMPREHENSIVE ASSESSMENT | 2 VERSIONS |
QUESTIONS & ANSWERS COMPLETE STUDY
GUIDE – CHAMBERLAIN UNIVERSITY | LATEST
2026/2027 | 100% VERIFIED.
Core Domains
• Psychiatric Assessment and Mental Status Examination (MSE)
• Therapeutic Communication and the Therapeutic Alliance
• Psychopharmacology and Neurobiologic Foundations
• Differential Diagnosis Process and Clinical Reasoning
• Psychotherapy Modalities and Somatic Treatments
• Mental Health Disorders Across the Lifespan
• Cultural Formulation and Health Disparities
• Ethical, Legal, and Crisis Management Principles
Introduction
The NR547 Clinical Evaluation Assessment (CEA) is a comprehensive cumulative evaluation
administered at Chamberlain University for students in the Psychiatric-Mental Health
Nurse Practitioner (PMHNP) track. This exam assesses key PMHNP competencies including
psychiatric assessment, therapeutic communication, psychopharmacology, psychotherapy
modalities, differential diagnosis, and mental health disorders across the lifespan. The
assessment employs multiple-choice and scenario-based questions to evaluate clinical
judgment, diagnostic reasoning, and application of evidence-based practice. Emphasis is
placed on formulating differential diagnoses, distinguishing medical mimics from primary
psychiatric conditions, and developing patient-centered treatment plans grounded in DSM-
5-TR criteria.
SECTION ONE: QUESTIONS 1–150
Question 1
,The PMHNP is conducting a mental status examination on a patient who reports feeling
"on edge" and having difficulty sleeping. The patient speaks rapidly, jumps from topic to
topic, and is easily distracted. Which MSE domain is the provider assessing when noting
the patient's speech pattern?
A. Thought content
B. Thought process
C. Affect
D. Cognition
Correct answer: B. Thought process
RATIONALE: Thought process evaluates how thoughts flow and are connected. Rapid
speech with jumping between topics describes a flight of ideas, which is a thought process
abnormality often seen in mania or hypomania. Thought content assesses what the patient
is thinking. Affect is the observed emotional expression. Cognition includes attention,
memory, and orientation.
Question 2
A patient presents with a flat affect, poverty of speech, and psychomotor retardation. The
patient reports feeling hopeless and worthless. The PMHNP should further assess for:
A. Mania
B. Major depressive disorder
C. Schizophrenia
D. Generalized anxiety disorder
Correct answer: B. Major depressive disorder
RATIONALE: Flat affect, poverty of speech, psychomotor retardation, hopelessness,
and worthlessness are classic features of major depressive disorder with melancholic
features. Mania presents with elevated mood and pressured speech. Schizophrenia
includes psychotic symptoms and thought disorders. GAD involves excessive worry and
hyperarousal.
Question 3
During the MSE, the PMHNP asks the patient to repeat the phrase "No ifs, ands, or buts."
This assesses which cognitive domain?
,A. Attention
B. Memory
C. Language
D. Executive function
Correct answer: C. Language
RATIONALE: Repeating a phrase assesses language function, specifically the ability to
produce complex speech and the integrity of the motor aspects of language. Attention is
assessed with digit span or serial sevens. Memory is tested with recall tasks. Executive
function involves problem-solving and abstraction.
Question 4
The PMHNP is assessing a patient's insight and judgment. Which question best assesses
judgment?
A. "What would you do if you found a stamped envelope on the street?"
B. "How would you describe your current mood?"
C. "Can you tell me the name of the current president?"
D. "What does the phrase 'people in glass houses shouldn't throw stones' mean?"
Correct answer: A. "What would you do if you found a stamped envelope on the
street?"
RATIONALE: Judgment is assessed by asking patients what they would do in
hypothetical situations, such as finding a stamped envelope. This evaluates their ability to
make appropriate decisions and anticipate consequences. Abstract reasoning assesses the
ability to interpret proverbs.
Question 5
The PMHNP is evaluating a patient who reports hearing voices commenting on their
actions. The provider notes that the patient responds to the voices during the interview.
This finding should be documented as:
A. Auditory hallucinations
B. Illusions
C. Delusions
D. Loose associations
, Correct answer: A. Auditory hallucinations
RATIONALE: Auditory hallucinations are the perception of sounds or voices without
external stimuli. When voices comment on the patient's actions, this is a specific type of
auditory hallucination. Illusions are misinterpretations of real stimuli. Delusions are fixed
false beliefs.
Question 6
When assessing a patient's mood, the PMHNP should document:
A. The patient's subjective report of their emotional state
B. The provider's observation of the patient's emotional expression
C. The patient's facial expressions during the interview
D. The patient's tone of voice
Correct answer: A. The patient's subjective report of their emotional state
RATIONALE: Mood is the patient's subjective experience of their emotional state and
should be documented as reported by the patient. Affect is the provider's observation of
the patient's emotional expression. It is important to document both mood and affect and
note any incongruence between them.
Question 7
A patient tells the PMHNP, "I'm not sure I can go on." Which response is most therapeutic?
A. "Everyone has tough times. You'll be fine."
B. "You're feeling like you can't go on. Tell me more about that."
C. "You have so much to live for. Think about your family."
D. "Are you thinking about killing yourself?"
Correct answer: B. "You're feeling like you can't go on. Tell me more about that."
RATIONALE: Reflecting the patient's statement and asking for elaboration is
therapeutic and allows the patient to explore their feelings. Dismissing the patient's
feelings or offering platitudes is non-therapeutic. Asking directly about suicidal ideation is
appropriate but should follow the patient's disclosure.
