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 (Questions 1-25)
Q1: A 19-year-old college freshman is brought to the student health center by her roommate. The
patient reports, "I haven't slept in three days because I have to finish writing my novel—it's
going to change the world. I stopped taking my 'mood pills' two weeks ago because they were
slowing me down." She is dressed in bright, mismatched clothing, speaks rapidly, and interrupts
the provider frequently. Her thoughts appear loosely connected as she jumps from topic to topic.
Which diagnosis is most likely?
A. Major Depressive Disorder, single episode B. Generalized Anxiety Disorder C. Bipolar I
Disorder, current episode manic [CORRECT] D. Attention-Deficit/Hyperactivity Disorder,
combined presentation
Correct Answer: C
Q2: During a routine psychiatric evaluation, a 45-year-old male states, "I know the FBI is
monitoring my phone calls because I discovered their secret code in the static on my TV." He
reports hearing voices commenting on his actions for the past six months. He is disheveled,
maintains poor eye contact, and shows flat affect. His mother has a history of schizophrenia.
Which symptom is considered a "first-rank" symptom of schizophrenia according to Schneider?
A. Auditory hallucinations in the third person [CORRECT] B. Disorganized speech C. Flat affect
D. Poor grooming
Correct Answer: A
Q3: A PMHNP is conducting a mental status examination (MSE) on a 67-year-old patient
recently admitted to an inpatient unit. The patient is alert and oriented to person, place, and time.
When asked to spell "world" backwards, the patient struggles and becomes frustrated. The
patient can recall two out of three objects after five minutes. Which MSE domain is being
assessed?
A. Thought process B. Cognition [CORRECT] C. Perception D. Insight/Judgment
Correct Answer: B
,Q4: A 14-year-old male is brought to the emergency department by his parents after they found a
noose in his closet. When interviewed alone, he states, "I just wanted to see if I could tie the knot
correctly. I'm not going to use it." He denies current suicidal intent but admits to feeling hopeless
about his future for the past two months since his girlfriend broke up with him. He has no
previous psychiatric history. What is the safest next step?
A. Discharge home with outpatient therapy referral within one week B. Admit to inpatient
psychiatric unit for safety monitoring [CORRECT] C. Prescribe fluoxetine 20mg daily and
follow up in two weeks D. Recommend family therapy only and reassess in one month
Correct Answer: B
Q5: A 38-year-old female presents for her initial psychiatric evaluation. She reports, "I've been
washing my hands until they bleed because I can't stop thinking about germs killing my
children." She spends 4-5 hours daily on cleaning rituals, recognizes these thoughts are
excessive, and describes significant distress. She denies mood symptoms or psychotic features.
Which diagnosis best fits this presentation?
A. Obsessive-Compulsive Disorder [CORRECT] B. Obsessive-Compulsive Personality Disorder
C. Generalized Anxiety Disorder D. Schizoaffective Disorder
Correct Answer: A
Q6: A PMHNP is evaluating a 72-year-old widower whose daughter reports he has become
increasingly forgetful over the past year. The patient misplaces items, repeats questions
frequently, and recently got lost driving home from the grocery store. He scores 18/30 on the
MMSE. Which additional finding would most strongly support a diagnosis of Major
Neurocognitive Disorder due to Alzheimer's Disease rather than another etiology?
A. Gradual onset and progressive decline in multiple cognitive domains [CORRECT] B. Acute
onset following a fall last month C. History of heavy alcohol use in his 40s D. Presence of visual
hallucinations and fluctuating cognition
Correct Answer: A
Q7: A 25-year-old veteran presents for evaluation stating, "I can't stop replaying the explosion in
my head. I avoid driving because every loud noise makes me dive for cover. I haven't slept
through the night in six months." He reports survivor's guilt and emotional numbness. Symptoms
began after his convoy was attacked 18 months ago. Which diagnosis is most appropriate?
, A. Acute Stress Disorder B. Post-Traumatic Stress Disorder [CORRECT] C. Adjustment
Disorder with Anxiety D. Panic Disorder
Correct Answer: B
Q8: A PMHNP is assessing suicide risk in a 52-year-old male with major depression. Which
factor is considered the strongest predictor of imminent suicide risk?
A. History of previous suicide attempts [CORRECT] B. Male gender C. Age over 50 D.
Unemployment status
Correct Answer: A
Q9: A 16-year-old female is referred by her pediatrician for "mood swings." Her mother reports,
"One minute she's the life of the party, the next she's screaming and throwing things. She's been
cutting herself when boyfriends break up with her." These patterns have occurred since age 14,
with episodes lasting hours to days. She maintains good grades and friendships. Which diagnosis
is most likely?
A. Bipolar II Disorder B. Borderline Personality Disorder [CORRECT] C. Disruptive Mood
Dysregulation Disorder D. Cyclothymic Disorder
Correct Answer: B
Q10: During a mental status examination, a patient describes his mood as "terrible" but appears
cheerful and animated. His affect changes rapidly from laughing to tearfulness within minutes.
Which term best describes this affective presentation?
A. Flat affect B. Inappropriate affect C. Labile affect [CORRECT] D. Restricted affect
Correct Answer: C
Q11: A 9-year-old boy is brought for evaluation due to academic decline. His teacher reports,
"He stares off into space for 10-15 seconds at a time, blinking rapidly. When he comes back, he
doesn't know what happened." These episodes occur 15-20 times daily. Which condition should
be suspected?
A. Attention-Deficit/Hyperactivity Disorder B. Absence seizures [CORRECT] C. Childhood
schizophrenia D. Conduct Disorder
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 (Questions 1-25)
Q1: A 19-year-old college freshman is brought to the student health center by her roommate. The
patient reports, "I haven't slept in three days because I have to finish writing my novel—it's
going to change the world. I stopped taking my 'mood pills' two weeks ago because they were
slowing me down." She is dressed in bright, mismatched clothing, speaks rapidly, and interrupts
the provider frequently. Her thoughts appear loosely connected as she jumps from topic to topic.
Which diagnosis is most likely?
A. Major Depressive Disorder, single episode B. Generalized Anxiety Disorder C. Bipolar I
Disorder, current episode manic [CORRECT] D. Attention-Deficit/Hyperactivity Disorder,
combined presentation
Correct Answer: C
Q2: During a routine psychiatric evaluation, a 45-year-old male states, "I know the FBI is
monitoring my phone calls because I discovered their secret code in the static on my TV." He
reports hearing voices commenting on his actions for the past six months. He is disheveled,
maintains poor eye contact, and shows flat affect. His mother has a history of schizophrenia.
Which symptom is considered a "first-rank" symptom of schizophrenia according to Schneider?
A. Auditory hallucinations in the third person [CORRECT] B. Disorganized speech C. Flat affect
D. Poor grooming
Correct Answer: A
Q3: A PMHNP is conducting a mental status examination (MSE) on a 67-year-old patient
recently admitted to an inpatient unit. The patient is alert and oriented to person, place, and time.
When asked to spell "world" backwards, the patient struggles and becomes frustrated. The
patient can recall two out of three objects after five minutes. Which MSE domain is being
assessed?
A. Thought process B. Cognition [CORRECT] C. Perception D. Insight/Judgment
Correct Answer: B
,Q4: A 14-year-old male is brought to the emergency department by his parents after they found a
noose in his closet. When interviewed alone, he states, "I just wanted to see if I could tie the knot
correctly. I'm not going to use it." He denies current suicidal intent but admits to feeling hopeless
about his future for the past two months since his girlfriend broke up with him. He has no
previous psychiatric history. What is the safest next step?
A. Discharge home with outpatient therapy referral within one week B. Admit to inpatient
psychiatric unit for safety monitoring [CORRECT] C. Prescribe fluoxetine 20mg daily and
follow up in two weeks D. Recommend family therapy only and reassess in one month
Correct Answer: B
Q5: A 38-year-old female presents for her initial psychiatric evaluation. She reports, "I've been
washing my hands until they bleed because I can't stop thinking about germs killing my
children." She spends 4-5 hours daily on cleaning rituals, recognizes these thoughts are
excessive, and describes significant distress. She denies mood symptoms or psychotic features.
Which diagnosis best fits this presentation?
A. Obsessive-Compulsive Disorder [CORRECT] B. Obsessive-Compulsive Personality Disorder
C. Generalized Anxiety Disorder D. Schizoaffective Disorder
Correct Answer: A
Q6: A PMHNP is evaluating a 72-year-old widower whose daughter reports he has become
increasingly forgetful over the past year. The patient misplaces items, repeats questions
frequently, and recently got lost driving home from the grocery store. He scores 18/30 on the
MMSE. Which additional finding would most strongly support a diagnosis of Major
Neurocognitive Disorder due to Alzheimer's Disease rather than another etiology?
A. Gradual onset and progressive decline in multiple cognitive domains [CORRECT] B. Acute
onset following a fall last month C. History of heavy alcohol use in his 40s D. Presence of visual
hallucinations and fluctuating cognition
Correct Answer: A
Q7: A 25-year-old veteran presents for evaluation stating, "I can't stop replaying the explosion in
my head. I avoid driving because every loud noise makes me dive for cover. I haven't slept
through the night in six months." He reports survivor's guilt and emotional numbness. Symptoms
began after his convoy was attacked 18 months ago. Which diagnosis is most appropriate?
, A. Acute Stress Disorder B. Post-Traumatic Stress Disorder [CORRECT] C. Adjustment
Disorder with Anxiety D. Panic Disorder
Correct Answer: B
Q8: A PMHNP is assessing suicide risk in a 52-year-old male with major depression. Which
factor is considered the strongest predictor of imminent suicide risk?
A. History of previous suicide attempts [CORRECT] B. Male gender C. Age over 50 D.
Unemployment status
Correct Answer: A
Q9: A 16-year-old female is referred by her pediatrician for "mood swings." Her mother reports,
"One minute she's the life of the party, the next she's screaming and throwing things. She's been
cutting herself when boyfriends break up with her." These patterns have occurred since age 14,
with episodes lasting hours to days. She maintains good grades and friendships. Which diagnosis
is most likely?
A. Bipolar II Disorder B. Borderline Personality Disorder [CORRECT] C. Disruptive Mood
Dysregulation Disorder D. Cyclothymic Disorder
Correct Answer: B
Q10: During a mental status examination, a patient describes his mood as "terrible" but appears
cheerful and animated. His affect changes rapidly from laughing to tearfulness within minutes.
Which term best describes this affective presentation?
A. Flat affect B. Inappropriate affect C. Labile affect [CORRECT] D. Restricted affect
Correct Answer: C
Q11: A 9-year-old boy is brought for evaluation due to academic decline. His teacher reports,
"He stares off into space for 10-15 seconds at a time, blinking rapidly. When he comes back, he
doesn't know what happened." These episodes occur 15-20 times daily. Which condition should
be suspected?
A. Attention-Deficit/Hyperactivity Disorder B. Absence seizures [CORRECT] C. Childhood
schizophrenia D. Conduct Disorder
Correct Answer: B
