WGU D344: Assessment and Diagnostic
Process of Psychiatric Nurse Practitioner -
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Q1.
A patient presents with sadness, anhedonia, fatigue, and poor
concentration for 12 days. No prior psychiatric history.
Correct Answer: Major Depressive Disorder (MDD)
Rationale:
• DSM-5-TR requires ≥5 depressive symptoms for ≥2 weeks
• Symptoms impair functioning
• No substance or medical cause indicated
• Duration meets threshold
Q2.
A patient reports elevated mood, decreased need for sleep, grandiosity,
and impulsive spending for 9 days, requiring hospitalization.
Correct Answer: Bipolar I Disorder (Manic Episode)
, Rationale:
• Mania lasts ≥7 days OR requires hospitalization
• Impairment is severe
• Bipolar I requires at least one manic episode
Q3.
Patient has racing thoughts, pressured speech, increased productivity for
4 days, no impairment.
Correct Answer: Hypomanic Episode
Rationale:
• Duration 4–6 days
• No marked impairment
• Distinguishes hypomania from mania
Q4.
Patient reports anxiety, palpitations, tremor, heat intolerance, and weight
loss.
Correct Answer: Rule out hyperthyroidism before diagnosing
anxiety
Rationale:
• Medical causes must be excluded
• Physical symptoms suggest endocrine disorder
• Diagnostic process requires labs first
,Q5.
Patient hears voices commenting on actions for 7 months, social
withdrawal present.
Correct Answer: Schizophrenia
Rationale:
• Hallucinations + functional decline
• ≥6 months total duration
• Psychotic symptoms not mood-dependent
Q6.
Patient has psychotic symptoms for 2 months, then full recovery.
Correct Answer: Brief Psychotic Disorder
Rationale:
• Duration <3 months
• Complete return to baseline
• Duration differentiates from schizophrenia
Q7.
Patient has hallucinations only during depressive episodes.
, Correct Answer: Major Depressive Disorder with psychotic
features
Rationale:
• Psychosis occurs exclusively with mood episodes
• Rules out schizophrenia and schizoaffective disorder
Q8.
Patient meets criteria for MDD and psychosis continues after mood
symptoms resolve.
Correct Answer: Schizoaffective Disorder
Rationale:
• Psychosis ≥2 weeks without mood symptoms
• Combination of mood + psychotic disorder
Q9.
Patient exposed to trauma, has nightmares, hypervigilance, and
avoidance for 3 weeks.
Correct Answer: Acute Stress Disorder
Rationale:
• Duration 3 days to 1 month
• Same symptom clusters as PTSD
• Duration is diagnostic key
Process of Psychiatric Nurse Practitioner -
Highlight topics/study guide | Expert
Strategies, Review of Key Quizzes, an d
Practice Questions for Guaranteed
Success This D344:2026 updated
Q1.
A patient presents with sadness, anhedonia, fatigue, and poor
concentration for 12 days. No prior psychiatric history.
Correct Answer: Major Depressive Disorder (MDD)
Rationale:
• DSM-5-TR requires ≥5 depressive symptoms for ≥2 weeks
• Symptoms impair functioning
• No substance or medical cause indicated
• Duration meets threshold
Q2.
A patient reports elevated mood, decreased need for sleep, grandiosity,
and impulsive spending for 9 days, requiring hospitalization.
Correct Answer: Bipolar I Disorder (Manic Episode)
, Rationale:
• Mania lasts ≥7 days OR requires hospitalization
• Impairment is severe
• Bipolar I requires at least one manic episode
Q3.
Patient has racing thoughts, pressured speech, increased productivity for
4 days, no impairment.
Correct Answer: Hypomanic Episode
Rationale:
• Duration 4–6 days
• No marked impairment
• Distinguishes hypomania from mania
Q4.
Patient reports anxiety, palpitations, tremor, heat intolerance, and weight
loss.
Correct Answer: Rule out hyperthyroidism before diagnosing
anxiety
Rationale:
• Medical causes must be excluded
• Physical symptoms suggest endocrine disorder
• Diagnostic process requires labs first
,Q5.
Patient hears voices commenting on actions for 7 months, social
withdrawal present.
Correct Answer: Schizophrenia
Rationale:
• Hallucinations + functional decline
• ≥6 months total duration
• Psychotic symptoms not mood-dependent
Q6.
Patient has psychotic symptoms for 2 months, then full recovery.
Correct Answer: Brief Psychotic Disorder
Rationale:
• Duration <3 months
• Complete return to baseline
• Duration differentiates from schizophrenia
Q7.
Patient has hallucinations only during depressive episodes.
, Correct Answer: Major Depressive Disorder with psychotic
features
Rationale:
• Psychosis occurs exclusively with mood episodes
• Rules out schizophrenia and schizoaffective disorder
Q8.
Patient meets criteria for MDD and psychosis continues after mood
symptoms resolve.
Correct Answer: Schizoaffective Disorder
Rationale:
• Psychosis ≥2 weeks without mood symptoms
• Combination of mood + psychotic disorder
Q9.
Patient exposed to trauma, has nightmares, hypervigilance, and
avoidance for 3 weeks.
Correct Answer: Acute Stress Disorder
Rationale:
• Duration 3 days to 1 month
• Same symptom clusters as PTSD
• Duration is diagnostic key
