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
Section 1: Assessment, Diagnosis, & Lifespan Considerations (25 questions)
Q1: A 19-year-old college student is brought to the emergency department by campus security
after being found wandering outside in winter without a coat. The patient states, "I don't need a
coat because the voices told me my skin is made of fire and cannot burn." Mental status exam
reveals disorganized speech, flat affect, and poor eye contact. The patient admits to hearing
commanding voices for the past 3 months but has been hiding this from family. Which diagnosis
is most appropriate?
A. Brief Psychotic Disorder B. Schizophreniform Disorder C. Schizophrenia D. Delusional
Disorder
Correct Answer: C
Q2: A 7-year-old boy is referred by his teacher for evaluation. Parents report, "He's constantly
moving, cannot finish tasks, and blurts out answers before questions are completed." Symptoms
began at age 5 and occur in both school and home settings. The child has no history of trauma or
medical problems. Which assessment tool is considered gold standard for aiding in the diagnosis
of this condition?
A. Conners' Rating Scales B. Beck Depression Inventory-II C. Hamilton Anxiety Rating Scale D.
Positive and Negative Syndrome Scale (PANSS)
Correct Answer: A
Q3: During a psychiatric interview, a 45-year-old patient with depression states, "I don't see the
point in anything anymore. My family would be better off without me. I have a plan to use my
father's gun." Which is the priority nursing action?
A. Complete a full mental status examination B. Assess the patient's insight and judgment C.
Initiate immediate suicide precautions and remove means D. Schedule outpatient follow-up
within one week
Correct Answer: C
,Q4: A 68-year-old widow presents with 6 weeks of depressed mood, anhedonia, early morning
awakening, and poor appetite following her husband's death. She states, "I just miss him so
much, but I know he'd want me to keep going." She denies suicidal ideation and maintains social
connections. Which is the most appropriate diagnosis?
A. Major Depressive Disorder, Single Episode B. Persistent Depressive Disorder (Dysthymia) C.
Adjustment Disorder with Depressed Mood D. No diagnosis; normal bereavement
Correct Answer: D
Q5: A PMHNP is conducting a mental status examination. The patient demonstrates inability to
recall three unrelated words after 5 minutes despite being able to register them initially. This
finding indicates impairment in which cognitive domain?
A. Attention B. Immediate memory C. Recent memory D. Remote memory
Correct Answer: C
Q6: A 16-year-old female is brought in by her mother who reports the patient has lost 20 pounds
in 2 months, exercises excessively, and has amenorrhea. The patient states, "I'm still too fat. I
can't eat that or I'll blow up like a balloon." She is bradycardic with a BMI of 16.5. Which
laboratory finding requires immediate attention?
A. Elevated thyroid-stimulating hormone (TSH) B. QTc prolongation on ECG C. Elevated liver
enzymes D. Leukocytosis
Correct Answer: B
Q7: A 34-year-old veteran presents for evaluation. He reports, "Every time I hear a car backfire,
I'm right back in the convoy. I can't sleep because the nightmares are so real. I avoid driving
anywhere near the VA because it reminds me of the explosion." Symptoms have persisted for 14
months. Which diagnosis best fits this presentation?
A. Acute Stress Disorder B. Post-Traumatic Stress Disorder C. Adjustment Disorder D.
Generalized Anxiety Disorder
Correct Answer: B
, Q8: During assessment of a 28-year-old patient, the PMHNP notes the patient is alternately
hostile and overly familiar, makes sexually inappropriate comments, and cannot recall what was
discussed 10 minutes prior. The patient has a history of heavy alcohol use. This presentation is
most consistent with:
A. Wernicke's encephalopathy B. Korsakoff's syndrome C. Alcohol intoxication D. Alcohol
withdrawal delirium
Correct Answer: A
Q9: A 52-year-old patient with bipolar I disorder is being evaluated. The patient reports, "I feel
fantastic! I only need 2 hours of sleep and I've cleaned the entire house twice. I'm starting three
new businesses next week." The patient is speaking rapidly, is easily distracted, and has engaged
in excessive spending. This presentation meets criteria for:
A. Hypomanic episode B. Manic episode C. Mixed features D. Rapid cycling
Correct Answer: B
Q10: A PMHNP is assessing a 14-year-old who has been cutting their forearms with a razor
blade "to feel something" when emotionally numb. The cuts are superficial, parallel, and hidden
under long sleeves. The teen denies suicidal intent. Which statement about non-suicidal self-
injury (NSSI) is accurate?
A. NSSI always indicates underlying borderline personality disorder B. NSSI is primarily an
attention-seeking behavior C. NSSI functions as a maladaptive emotion regulation strategy D.
NSSI requires immediate psychiatric hospitalization in all cases
Correct Answer: C
Q11: A 71-year-old patient with dementia is being evaluated. The family reports the patient
"sundowns" every evening, becoming agitated, confused, and wandering. Which intervention is
most appropriate for managing sundowning syndrome?
A. Increase daytime napping B. Provide a calm, structured routine with adequate daytime
activity C. Administer high-dose antipsychotics at 4 PM daily D. Keep the patient in a dark, quiet
room throughout the evening
Correct Answer: B
Lifespan I ACTUAL FINAL EXAM PRACTICE
2026/2027 | Verified Questions and Answers | DSM-5-
TR & Evidence-Based Prescribing Focus | Grade A
Section 1: Assessment, Diagnosis, & Lifespan Considerations (25 questions)
Q1: A 19-year-old college student is brought to the emergency department by campus security
after being found wandering outside in winter without a coat. The patient states, "I don't need a
coat because the voices told me my skin is made of fire and cannot burn." Mental status exam
reveals disorganized speech, flat affect, and poor eye contact. The patient admits to hearing
commanding voices for the past 3 months but has been hiding this from family. Which diagnosis
is most appropriate?
A. Brief Psychotic Disorder B. Schizophreniform Disorder C. Schizophrenia D. Delusional
Disorder
Correct Answer: C
Q2: A 7-year-old boy is referred by his teacher for evaluation. Parents report, "He's constantly
moving, cannot finish tasks, and blurts out answers before questions are completed." Symptoms
began at age 5 and occur in both school and home settings. The child has no history of trauma or
medical problems. Which assessment tool is considered gold standard for aiding in the diagnosis
of this condition?
A. Conners' Rating Scales B. Beck Depression Inventory-II C. Hamilton Anxiety Rating Scale D.
Positive and Negative Syndrome Scale (PANSS)
Correct Answer: A
Q3: During a psychiatric interview, a 45-year-old patient with depression states, "I don't see the
point in anything anymore. My family would be better off without me. I have a plan to use my
father's gun." Which is the priority nursing action?
A. Complete a full mental status examination B. Assess the patient's insight and judgment C.
Initiate immediate suicide precautions and remove means D. Schedule outpatient follow-up
within one week
Correct Answer: C
,Q4: A 68-year-old widow presents with 6 weeks of depressed mood, anhedonia, early morning
awakening, and poor appetite following her husband's death. She states, "I just miss him so
much, but I know he'd want me to keep going." She denies suicidal ideation and maintains social
connections. Which is the most appropriate diagnosis?
A. Major Depressive Disorder, Single Episode B. Persistent Depressive Disorder (Dysthymia) C.
Adjustment Disorder with Depressed Mood D. No diagnosis; normal bereavement
Correct Answer: D
Q5: A PMHNP is conducting a mental status examination. The patient demonstrates inability to
recall three unrelated words after 5 minutes despite being able to register them initially. This
finding indicates impairment in which cognitive domain?
A. Attention B. Immediate memory C. Recent memory D. Remote memory
Correct Answer: C
Q6: A 16-year-old female is brought in by her mother who reports the patient has lost 20 pounds
in 2 months, exercises excessively, and has amenorrhea. The patient states, "I'm still too fat. I
can't eat that or I'll blow up like a balloon." She is bradycardic with a BMI of 16.5. Which
laboratory finding requires immediate attention?
A. Elevated thyroid-stimulating hormone (TSH) B. QTc prolongation on ECG C. Elevated liver
enzymes D. Leukocytosis
Correct Answer: B
Q7: A 34-year-old veteran presents for evaluation. He reports, "Every time I hear a car backfire,
I'm right back in the convoy. I can't sleep because the nightmares are so real. I avoid driving
anywhere near the VA because it reminds me of the explosion." Symptoms have persisted for 14
months. Which diagnosis best fits this presentation?
A. Acute Stress Disorder B. Post-Traumatic Stress Disorder C. Adjustment Disorder D.
Generalized Anxiety Disorder
Correct Answer: B
, Q8: During assessment of a 28-year-old patient, the PMHNP notes the patient is alternately
hostile and overly familiar, makes sexually inappropriate comments, and cannot recall what was
discussed 10 minutes prior. The patient has a history of heavy alcohol use. This presentation is
most consistent with:
A. Wernicke's encephalopathy B. Korsakoff's syndrome C. Alcohol intoxication D. Alcohol
withdrawal delirium
Correct Answer: A
Q9: A 52-year-old patient with bipolar I disorder is being evaluated. The patient reports, "I feel
fantastic! I only need 2 hours of sleep and I've cleaned the entire house twice. I'm starting three
new businesses next week." The patient is speaking rapidly, is easily distracted, and has engaged
in excessive spending. This presentation meets criteria for:
A. Hypomanic episode B. Manic episode C. Mixed features D. Rapid cycling
Correct Answer: B
Q10: A PMHNP is assessing a 14-year-old who has been cutting their forearms with a razor
blade "to feel something" when emotionally numb. The cuts are superficial, parallel, and hidden
under long sleeves. The teen denies suicidal intent. Which statement about non-suicidal self-
injury (NSSI) is accurate?
A. NSSI always indicates underlying borderline personality disorder B. NSSI is primarily an
attention-seeking behavior C. NSSI functions as a maladaptive emotion regulation strategy D.
NSSI requires immediate psychiatric hospitalization in all cases
Correct Answer: C
Q11: A 71-year-old patient with dementia is being evaluated. The family reports the patient
"sundowns" every evening, becoming agitated, confused, and wandering. Which intervention is
most appropriate for managing sundowning syndrome?
A. Increase daytime napping B. Provide a calm, structured routine with adequate daytime
activity C. Administer high-dose antipsychotics at 4 PM daily D. Keep the patient in a dark, quiet
room throughout the evening
Correct Answer: B
