NR605 / NR 605 Psychiatric Mental Health Across
Lifespan I ACTUAL FINAL EXAM PRACTICE
2026/2027 | Verified Questions and Answers | DSM-5-
TR & Evidence-Based Prescribing Focus | Grade A
Target | Pass Guaranteed
SECTION 1: ASSESSMENT, DIAGNOSIS, & LIFESPAN CONSIDERATIONS (25
Questions)
Q1: A 19-year-old college freshman presents to the university counseling center. His roommate
reports he has been "talking to people who aren't there" and believes the FBI is monitoring his
computer because he "knows too much about government secrets." The patient has not slept in 3
days, has minimal appetite, and was found wandering campus at 3 AM "looking for the
surveillance van." He has no prior psychiatric history and denies substance use. His affect is flat,
and he shows poor insight. What is the most likely diagnosis?
A. Brief Psychotic Disorder
B. Schizophreniform Disorder
C. Schizophrenia
D. Delusional Disorder
E. Substance-Induced Psychotic Disorder [CORRECT]
Correct Answer: E
Q2: A 67-year-old woman is brought by her daughter for evaluation. The daughter reports her
mother has become "increasingly forgetful" over the past 2 years. The patient repeats questions,
got lost driving to her familiar grocery store, and recently paid the same bill three times. She
scored 18/30 on the MMSE, with deficits in recall, orientation, and executive function. MRI
shows cortical atrophy and hippocampal volume loss. Which additional finding would BEST
support a diagnosis of Major Neurocognitive Disorder due to Alzheimer's Disease rather than
another etiology?
A. History of multiple small strokes on imaging
B. Gradual onset and steady decline in cognition without plateaus [CORRECT]
C. Prominent early personality changes and disinhibition
,D. Rapid progression over 6 months with myoclonus
E. Visual hallucinations and fluctuating cognition
Correct Answer: B
Q3: A 14-year-old male is referred by his pediatrician for evaluation. His teachers report he is
"always in motion," blurts out answers before questions are completed, loses materials daily, and
cannot remain seated during class. These symptoms have been present since age 7 and occur in
both school and home settings. His grades have declined from A's to C's. His mother has ADHD.
Which assessment finding would be MOST consistent with DSM-5-TR criteria for ADHD,
Combined Presentation?
A. Symptoms exclusively present during academic tasks
B. Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity
[CORRECT]
C. Onset of symptoms at age 13 following a concussion
D. Symptoms that improve significantly on weekends
E. Intellectual disability with IQ below 70
Correct Answer: B
Q4: A 28-year-old woman presents stating, "I can't stop washing my hands. They're bleeding, but
I'm terrified of germs." She spends 4 hours daily on cleaning rituals, avoids public restrooms,
and has intrusive thoughts about contamination that cause severe anxiety. She recognizes these
thoughts are her own but cannot resist the compulsions. She denies depressed mood or psychotic
symptoms. What is the most appropriate initial screening tool?
A. PHQ-9
B. GAD-7
C. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) [CORRECT]
D. Columbia Suicide Severity Rating Scale
E. AUDIT-C
Correct Answer: C
Q5: A 52-year-old man presents for his first psychiatric evaluation. He reports, "I haven't been
able to sleep more than 2 hours a night for 3 weeks, I've lost 15 pounds because I have no
appetite, and I can't concentrate at work." He describes feeling "completely worthless" and
states, "My family would be better off without me." He has no energy and has stopped attending
, his weekly golf games. Which component of the mental status examination is MOST critical to
assess immediately?
A. Thought process
B. Suicidal ideation and plan [CORRECT]
C. Perceptual disturbances
D. Insight and judgment
E. Cognitive function
Correct Answer: B
Q6: A 34-year-old woman presents with episodic palpitations, sweating, trembling, and a fear of
dying that peaks within 10 minutes. These episodes occur unpredictably and have led her to
avoid crowds, driving, and being alone. She has had 4 emergency department visits in 2 months,
with cardiac workups negative. She states, "I'm terrified of having another attack." Which
diagnosis BEST fits this clinical picture?
A. Generalized Anxiety Disorder
B. Panic Disorder with Agoraphobia [CORRECT]
C. Social Anxiety Disorder
D. Acute Stress Disorder
E. Somatic Symptom Disorder
Correct Answer: B
Q7: During a routine psychiatric follow-up, a 45-year-old patient with bipolar disorder states, "I
stopped taking my lithium because I felt great and didn't need it anymore. I've been sleeping 3
hours a night, spending $8,000 on online shopping, and my wife says I'm talking too fast." His
lithium level 3 months ago was 0.8 mEq/L. Today he is irritable, has pressured speech, and is
easily distracted. What is the priority nursing intervention?
A. Restart lithium at previous dose immediately
B. Assess for suicidality and acute safety risks [CORRECT]
C. Prescribe a benzodiazepine for sleep
D. Schedule outpatient cognitive behavioral therapy
E. Order an ECT consultation
Correct Answer: B
Lifespan I ACTUAL FINAL EXAM PRACTICE
2026/2027 | Verified Questions and Answers | DSM-5-
TR & Evidence-Based Prescribing Focus | Grade A
Target | Pass Guaranteed
SECTION 1: ASSESSMENT, DIAGNOSIS, & LIFESPAN CONSIDERATIONS (25
Questions)
Q1: A 19-year-old college freshman presents to the university counseling center. His roommate
reports he has been "talking to people who aren't there" and believes the FBI is monitoring his
computer because he "knows too much about government secrets." The patient has not slept in 3
days, has minimal appetite, and was found wandering campus at 3 AM "looking for the
surveillance van." He has no prior psychiatric history and denies substance use. His affect is flat,
and he shows poor insight. What is the most likely diagnosis?
A. Brief Psychotic Disorder
B. Schizophreniform Disorder
C. Schizophrenia
D. Delusional Disorder
E. Substance-Induced Psychotic Disorder [CORRECT]
Correct Answer: E
Q2: A 67-year-old woman is brought by her daughter for evaluation. The daughter reports her
mother has become "increasingly forgetful" over the past 2 years. The patient repeats questions,
got lost driving to her familiar grocery store, and recently paid the same bill three times. She
scored 18/30 on the MMSE, with deficits in recall, orientation, and executive function. MRI
shows cortical atrophy and hippocampal volume loss. Which additional finding would BEST
support a diagnosis of Major Neurocognitive Disorder due to Alzheimer's Disease rather than
another etiology?
A. History of multiple small strokes on imaging
B. Gradual onset and steady decline in cognition without plateaus [CORRECT]
C. Prominent early personality changes and disinhibition
,D. Rapid progression over 6 months with myoclonus
E. Visual hallucinations and fluctuating cognition
Correct Answer: B
Q3: A 14-year-old male is referred by his pediatrician for evaluation. His teachers report he is
"always in motion," blurts out answers before questions are completed, loses materials daily, and
cannot remain seated during class. These symptoms have been present since age 7 and occur in
both school and home settings. His grades have declined from A's to C's. His mother has ADHD.
Which assessment finding would be MOST consistent with DSM-5-TR criteria for ADHD,
Combined Presentation?
A. Symptoms exclusively present during academic tasks
B. Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity
[CORRECT]
C. Onset of symptoms at age 13 following a concussion
D. Symptoms that improve significantly on weekends
E. Intellectual disability with IQ below 70
Correct Answer: B
Q4: A 28-year-old woman presents stating, "I can't stop washing my hands. They're bleeding, but
I'm terrified of germs." She spends 4 hours daily on cleaning rituals, avoids public restrooms,
and has intrusive thoughts about contamination that cause severe anxiety. She recognizes these
thoughts are her own but cannot resist the compulsions. She denies depressed mood or psychotic
symptoms. What is the most appropriate initial screening tool?
A. PHQ-9
B. GAD-7
C. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) [CORRECT]
D. Columbia Suicide Severity Rating Scale
E. AUDIT-C
Correct Answer: C
Q5: A 52-year-old man presents for his first psychiatric evaluation. He reports, "I haven't been
able to sleep more than 2 hours a night for 3 weeks, I've lost 15 pounds because I have no
appetite, and I can't concentrate at work." He describes feeling "completely worthless" and
states, "My family would be better off without me." He has no energy and has stopped attending
, his weekly golf games. Which component of the mental status examination is MOST critical to
assess immediately?
A. Thought process
B. Suicidal ideation and plan [CORRECT]
C. Perceptual disturbances
D. Insight and judgment
E. Cognitive function
Correct Answer: B
Q6: A 34-year-old woman presents with episodic palpitations, sweating, trembling, and a fear of
dying that peaks within 10 minutes. These episodes occur unpredictably and have led her to
avoid crowds, driving, and being alone. She has had 4 emergency department visits in 2 months,
with cardiac workups negative. She states, "I'm terrified of having another attack." Which
diagnosis BEST fits this clinical picture?
A. Generalized Anxiety Disorder
B. Panic Disorder with Agoraphobia [CORRECT]
C. Social Anxiety Disorder
D. Acute Stress Disorder
E. Somatic Symptom Disorder
Correct Answer: B
Q7: During a routine psychiatric follow-up, a 45-year-old patient with bipolar disorder states, "I
stopped taking my lithium because I felt great and didn't need it anymore. I've been sleeping 3
hours a night, spending $8,000 on online shopping, and my wife says I'm talking too fast." His
lithium level 3 months ago was 0.8 mEq/L. Today he is irritable, has pressured speech, and is
easily distracted. What is the priority nursing intervention?
A. Restart lithium at previous dose immediately
B. Assess for suicidality and acute safety risks [CORRECT]
C. Prescribe a benzodiazepine for sleep
D. Schedule outpatient cognitive behavioral therapy
E. Order an ECT consultation
Correct Answer: B
