MNP 687 Psychiatric Nurse Practitioner Handbook Exam
Grand Canyon University Actual Exam 2026/2027 – Complete
75 Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
SECTION A: Psychiatric Assessment, Diagnosis & the DSM-5-TR
(Q1–Q12)
Q1: During a mental status examination, a patient tearfully states, "Everything feels
hopeless," while the examiner observes an expressionless, blunted face. The NP
documents "mood: depressed; affect: blunted." Which distinction is correct?
A. Mood is the examiner's observation of facial expression; affect is the patient's
internal report.
B. Mood and affect are interchangeable terms for the patient's emotional state.
C. Mood is the patient's subjective emotional report, whereas affect is the examiner's
objective observation of emotional expression. [CORRECT]
D. Affect refers to thought content, whereas mood refers to cognitive functioning.
Correct Answer: C
Rationale: Mood is the patient's self-reported feeling state; affect is the clinician's
observed emotional expression, described by range, intensity, and congruence. The
other options reverse or conflate these MSE components.
Q2: A 34-year-old completes a PHQ-9 and scores 14. According to standard
interpretation, this score indicates depression of what severity, and what is the
appropriate next step?
A. Mild depression; provide reassurance and recheck in 1 year
B. Moderate depression; initiate treatment such as psychotherapy and/or
pharmacotherapy [CORRECT]
C. Severe depression; arrange immediate hospitalization
D. Normal range; no follow-up needed
Correct Answer: B
Rationale: PHQ-9 scores of 10–14 indicate moderate depression and warrant active
treatment; 5–9 is mild, 15–19 moderately severe, and 20–27 severe. Hospitalization
requires imminent safety risk, which a score alone does not establish.
,Q3: A 45-year-old reports 3 weeks of depressed mood most of the day, loss of interest
in gardening, a 4-kg unintentional weight loss, insomnia, fatigue, and impaired
concentration. Which conclusion is correct?
A. Four symptoms are present; MDD criteria are not met.
B. Five symptoms are present; the correct diagnosis is adjustment disorder.
C. Six symptoms are present, but MDD requires 6 months of symptoms.
D. Six symptoms are present for more than 2 weeks, including depressed mood and
anhedonia, so DSM-5-TR criteria for major depressive disorder are met. [CORRECT]
Correct Answer: D
Rationale: MDD requires at least 5 of 9 symptoms for at least 2 weeks, with at least one
being depressed mood or anhedonia — she meets 6. Adjustment disorder would apply
only to subthreshold syndromes, and MDD requires 2 weeks, not 6 months.
Q4: Before starting an antidepressant in a patient presenting with depressive
symptoms, the NP administers the Mood Disorder Questionnaire (MDQ), which screens
positive. The most important reason for this screening is:
A. The MDQ determines the correct antidepressant dose.
B. The MDQ is legally required before all prescriptions.
C. The MDQ measures depression severity to guide drug selection.
D. The MDQ screens for bipolarity, because unrecognized bipolar disorder risks
antidepressant-induced manic switching. [CORRECT]
Correct Answer: D
Rationale: Screening for past hypomania/mania before prescribing antidepressants
prevents precipitating a manic switch; positive screens call for mood-stabilizer-first
strategies. The MDQ does not set doses, measure severity, or satisfy a legal
requirement.
Q5: A 68-year-old with no psychiatric history develops new-onset depressed mood,
fatigue, weight loss, and psychomotor slowing over 2 months. Before finalizing a
diagnosis of MDD, the NP should first:
A. Begin fluoxetine immediately and reassess in 3 months
B. Diagnose major neurocognitive disorder based on the age of onset
C. Order a medical evaluation including TSH, CBC, vitamin B12, and comprehensive
metabolic panel to rule out medical mimics [CORRECT]
D. Refer directly for electroconvulsive therapy
Correct Answer: C
Rationale: New-onset psychiatric symptoms in later life require excluding medical
causes such as hypothyroidism, anemia, B12 deficiency, malignancy, and medications
, before diagnosing a primary mood disorder. ECT and antidepressants are premature
without medical clearance and full assessment.
Q6: Which DSM-5-TR tool is designed to systematically explore a patient's cultural
identity, explanatory models, and psychosocial context during clinical assessment?
A. The Global Assessment of Functioning scale
B. The Cultural Formulation Interview [CORRECT]
C. The Abnormal Involuntary Movement Scale
D. The Hamilton Depression Rating Scale
Correct Answer: B
Rationale: The Cultural Formulation Interview is a DSM-5-TR semistructured tool for
eliciting cultural definitions of the problem and treatment expectations. The other
instruments assess functioning, movements, or depression severity — not cultural
context.
Q7: A 72-year-old reports subtle memory complaints and scores 25/30 on the MMSE.
The NP suspects mild cognitive impairment but the MMSE may be insensitive. The
most appropriate next step is to:
A. Reassure the patient that no further evaluation is needed
B. Diagnose dementia based on the MMSE score alone
C. Order an MRI of the lumbar spine
D. Administer the Montreal Cognitive Assessment (MoCA), which is more sensitive for
detecting mild impairment [CORRECT]
Correct Answer: D
Rationale: The MoCA detects mild cognitive impairment with greater sensitivity than the
MMSE, particularly executive and recall deficits. An MMSE of 25 does not rule out
pathology, and dementia cannot be diagnosed from a screening score alone.
Q8: During an interview, a patient answers each question with excessive, unnecessary
detail and takes far longer than needed, but ultimately returns to and answers the
original question. This thought process is documented as:
A. Circumstantiality [CORRECT]
B. Tangentiality
C. Loose associations
D. Perseveration
Correct Answer: A
Rationale: Circumstantiality includes excessive detail with eventual return to the point;
tangentiality never returns, loose associations shift between unrelated topics, and
perseveration repeats the same response. Correctly distinguishing these terms guides
documentation of thought coherence.
Grand Canyon University Actual Exam 2026/2027 – Complete
75 Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
SECTION A: Psychiatric Assessment, Diagnosis & the DSM-5-TR
(Q1–Q12)
Q1: During a mental status examination, a patient tearfully states, "Everything feels
hopeless," while the examiner observes an expressionless, blunted face. The NP
documents "mood: depressed; affect: blunted." Which distinction is correct?
A. Mood is the examiner's observation of facial expression; affect is the patient's
internal report.
B. Mood and affect are interchangeable terms for the patient's emotional state.
C. Mood is the patient's subjective emotional report, whereas affect is the examiner's
objective observation of emotional expression. [CORRECT]
D. Affect refers to thought content, whereas mood refers to cognitive functioning.
Correct Answer: C
Rationale: Mood is the patient's self-reported feeling state; affect is the clinician's
observed emotional expression, described by range, intensity, and congruence. The
other options reverse or conflate these MSE components.
Q2: A 34-year-old completes a PHQ-9 and scores 14. According to standard
interpretation, this score indicates depression of what severity, and what is the
appropriate next step?
A. Mild depression; provide reassurance and recheck in 1 year
B. Moderate depression; initiate treatment such as psychotherapy and/or
pharmacotherapy [CORRECT]
C. Severe depression; arrange immediate hospitalization
D. Normal range; no follow-up needed
Correct Answer: B
Rationale: PHQ-9 scores of 10–14 indicate moderate depression and warrant active
treatment; 5–9 is mild, 15–19 moderately severe, and 20–27 severe. Hospitalization
requires imminent safety risk, which a score alone does not establish.
,Q3: A 45-year-old reports 3 weeks of depressed mood most of the day, loss of interest
in gardening, a 4-kg unintentional weight loss, insomnia, fatigue, and impaired
concentration. Which conclusion is correct?
A. Four symptoms are present; MDD criteria are not met.
B. Five symptoms are present; the correct diagnosis is adjustment disorder.
C. Six symptoms are present, but MDD requires 6 months of symptoms.
D. Six symptoms are present for more than 2 weeks, including depressed mood and
anhedonia, so DSM-5-TR criteria for major depressive disorder are met. [CORRECT]
Correct Answer: D
Rationale: MDD requires at least 5 of 9 symptoms for at least 2 weeks, with at least one
being depressed mood or anhedonia — she meets 6. Adjustment disorder would apply
only to subthreshold syndromes, and MDD requires 2 weeks, not 6 months.
Q4: Before starting an antidepressant in a patient presenting with depressive
symptoms, the NP administers the Mood Disorder Questionnaire (MDQ), which screens
positive. The most important reason for this screening is:
A. The MDQ determines the correct antidepressant dose.
B. The MDQ is legally required before all prescriptions.
C. The MDQ measures depression severity to guide drug selection.
D. The MDQ screens for bipolarity, because unrecognized bipolar disorder risks
antidepressant-induced manic switching. [CORRECT]
Correct Answer: D
Rationale: Screening for past hypomania/mania before prescribing antidepressants
prevents precipitating a manic switch; positive screens call for mood-stabilizer-first
strategies. The MDQ does not set doses, measure severity, or satisfy a legal
requirement.
Q5: A 68-year-old with no psychiatric history develops new-onset depressed mood,
fatigue, weight loss, and psychomotor slowing over 2 months. Before finalizing a
diagnosis of MDD, the NP should first:
A. Begin fluoxetine immediately and reassess in 3 months
B. Diagnose major neurocognitive disorder based on the age of onset
C. Order a medical evaluation including TSH, CBC, vitamin B12, and comprehensive
metabolic panel to rule out medical mimics [CORRECT]
D. Refer directly for electroconvulsive therapy
Correct Answer: C
Rationale: New-onset psychiatric symptoms in later life require excluding medical
causes such as hypothyroidism, anemia, B12 deficiency, malignancy, and medications
, before diagnosing a primary mood disorder. ECT and antidepressants are premature
without medical clearance and full assessment.
Q6: Which DSM-5-TR tool is designed to systematically explore a patient's cultural
identity, explanatory models, and psychosocial context during clinical assessment?
A. The Global Assessment of Functioning scale
B. The Cultural Formulation Interview [CORRECT]
C. The Abnormal Involuntary Movement Scale
D. The Hamilton Depression Rating Scale
Correct Answer: B
Rationale: The Cultural Formulation Interview is a DSM-5-TR semistructured tool for
eliciting cultural definitions of the problem and treatment expectations. The other
instruments assess functioning, movements, or depression severity — not cultural
context.
Q7: A 72-year-old reports subtle memory complaints and scores 25/30 on the MMSE.
The NP suspects mild cognitive impairment but the MMSE may be insensitive. The
most appropriate next step is to:
A. Reassure the patient that no further evaluation is needed
B. Diagnose dementia based on the MMSE score alone
C. Order an MRI of the lumbar spine
D. Administer the Montreal Cognitive Assessment (MoCA), which is more sensitive for
detecting mild impairment [CORRECT]
Correct Answer: D
Rationale: The MoCA detects mild cognitive impairment with greater sensitivity than the
MMSE, particularly executive and recall deficits. An MMSE of 25 does not rule out
pathology, and dementia cannot be diagnosed from a screening score alone.
Q8: During an interview, a patient answers each question with excessive, unnecessary
detail and takes far longer than needed, but ultimately returns to and answers the
original question. This thought process is documented as:
A. Circumstantiality [CORRECT]
B. Tangentiality
C. Loose associations
D. Perseveration
Correct Answer: A
Rationale: Circumstantiality includes excessive detail with eventual return to the point;
tangentiality never returns, loose associations shift between unrelated topics, and
perseveration repeats the same response. Correctly distinguishing these terms guides
documentation of thought coherence.
