NR 547 CEA EXAM UNIVERSITY | ACTUAL EXAM
QUESTIONS AND CORRECT ANSWERS 2026/2027 WITH
RATIONALES GRADED A+ LATEST
NR 547 CEA Exam Chamberlain University | Actual Exam
Style Practice Pack | 150+ Comprehensive Questions &
Detailed Rationales (Latest 2026/2027 Update, Verified A+
Grade)
, 1. A 28-year-old female is brought to the outpatient psychiatric clinic by her partner.
She presents with acute auditory hallucinations ("voices commenting on her
actions") and severe paranoia that began abruptly 4 days ago. She has no
known psychiatric history. According to the foundational steps of psychiatric
differential diagnosis, which action must the Psychiatric-Mental Health Nurse
Practitioner (PMHNP) prioritize first? [
A) Differentiate between auditory hallucinations in a primary psychotic disorder versus a
dissociative disorder
B) Assess for a primary mood disorder with psychotic features, such as Bipolar I
disorder
C) Rule out an underlying general medical condition or substance-induced etiology
D) Formulate a safety plan and immediately initiate a first-generation antipsychotic
Correct Answer: C) Rule out an underlying general medical condition or
substance-induced etiology [1]
Rationale: In psychiatric differential diagnosis, organic, toxic, and general medical
causes must always be excluded before diagnosing a primary DSM-5-TR psychiatric
disorder. Conditions such as temporal lobe epilepsy, thyroid storm, encephalitis, or
substance intoxication/withdrawal can perfectly mimic acute psychosis and require
immediate medical intervention rather than primary psychiatric labeling. [1, 2]
Q2: Cognitive Assessment Interpretation
During a clinical evaluation, the PMHNP administers the Montreal Cognitive
Assessment (MoCA) to a 72-year-old male whose family reports progressive memory
decline over the last two years. The patient scores a 15 on the assessment. Based on
standardized psychometric parameters, how should the provider classify the patient’s
current cognitive status? [1, 2]
A) Normal cognitive functioning
B) Mild Cognitive Impairment (MCI)
C) Moderate Cognitive Impairment
D) Severe Cognitive Impairment
Correct Answer: C) Moderate Cognitive Impairment
Rationale: MoCA scores range from 0 to 30. A score of 26 or above is considered
normal. Scores between 18 and 25 typically indicate mild cognitive impairment, while a
score of 15 falls squarely within the moderate cognitive impairment range (typically
spanning 10–17), signaling significant neurocognitive pathology that warrants
neuroimaging and further diagnostic workup. [1, 2]
, Q3: Differentiating Delirium from Dementia
The daughter of an 81-year-old patient asks the PMHNP to explain how her father’s
underlying dementia differs from "delirium," which he experienced during a recent
hospitalization for a urinary tract infection (UTI). Which feature most accurately
distinguishes delirium from dementia? [1]
A) Dementia presents with an acute onset, whereas delirium develops gradually
B) Delirium features a fluctuating course of awareness, whereas dementia is
characteristically progressive and stable day-to-day
C) Cognitive attention is typically intact during delirium but severely impaired in early
dementia
D) Delirium is a permanent, irreversible structural brain failure, whereas dementia is
frequently reversible [1]
Correct Answer: B) Delirium features a fluctuating course of awareness, whereas
dementia is characteristically progressive and stable day-to-day [1]
Rationale: Delirium is characterized by an acute onset, fluctuating course of
consciousness, and impaired attention, typically triggered by an underlying medical
condition (like a UTI) or toxicity. In contrast, major neurocognitive disorder (dementia)
exhibits a gradual, progressive decline in cognitive domains without the signature
acute fluctuations in alertness and primary attention fields seen in delirium. [1]
Q4: Clinical Risk Assessment and Protective Factors
A 34-year-old male diagnosed with Schizophrenia presents for a routine follow-up
appointment. During the assessment, the PMHNP conducts a comprehensive suicide
risk appraisal. Which client feature represents a verified protective factor against
suicide completion for this individual? [1, 2]
A) A history of frequent psychiatric hospitalizations
B) The distressing presence of extrapyramidal medication side effects
C) A deeply held personal sense of purpose or strong spiritual/familial obligations
D) A history of prior non-suicidal self-injury or suicide attempts [1]
Correct Answer: C) A deeply held personal sense of purpose or strong
spiritual/familial obligations [1]
Rationale: In suicide risk management, internal protective factors include a strong
sense of purpose, positive coping mechanisms, and religious or moral beliefs against
, suicide. Frequent hospitalizations, medication side effects, and a history of previous
suicide attempts are well-documented risk factors that elevate a patient's vulnerability
rather than lowering it. [1]
Q5: Geriatric Psychopharmacology
A 75-year-old female presents with symptoms completely matching the DSM-5-TR
criteria for a new-onset Major Depressive Disorder (MDD). She has a medical history of
osteoporosis and mild hypertension. Which agent represents the most appropriate,
safe, and well-tolerated initial pharmacological choice for this patient? [1, 2]
A) Amitriptyline (Elavil)
B) Phenelzine (Nardil)
C) Escitalopram (Lexapro)
D) Haloperidol (Haldol)
Correct Answer: C) Escitalopram (Lexapro) [1, 2]
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs) like escitalopram or
sertraline are first-line choices for depression in geriatric patients due to their favorable
safety profile and minimal side effects. Tricyclic antidepressants (TCAs) like
amitriptyline are highly anticholinergic and increase fall risks, while Monoamine Oxidase
Inhibitors (MAOIs) like phenelzine present severe dietary interaction restrictions. [1]
Q6: Personality Disorder Differential
During a clinical intake, a 24-year-old male exhibits a pervasive pattern of grandiosity,
an explicit need for constant external admiration, and a profound lack of empathy
toward peers. He frequently exaggerates his achievements and insists he should only
associate with "elite" institutions. These characteristics are most indicative of which
personality disorder? [1]
A) Borderline Personality Disorder
B) Antisocial Personality Disorder
C) Narcissistic Personality Disorder
D) Histrionic Personality Disorder [1]
Correct Answer: C) Narcissistic Personality Disorder [1]
QUESTIONS AND CORRECT ANSWERS 2026/2027 WITH
RATIONALES GRADED A+ LATEST
NR 547 CEA Exam Chamberlain University | Actual Exam
Style Practice Pack | 150+ Comprehensive Questions &
Detailed Rationales (Latest 2026/2027 Update, Verified A+
Grade)
, 1. A 28-year-old female is brought to the outpatient psychiatric clinic by her partner.
She presents with acute auditory hallucinations ("voices commenting on her
actions") and severe paranoia that began abruptly 4 days ago. She has no
known psychiatric history. According to the foundational steps of psychiatric
differential diagnosis, which action must the Psychiatric-Mental Health Nurse
Practitioner (PMHNP) prioritize first? [
A) Differentiate between auditory hallucinations in a primary psychotic disorder versus a
dissociative disorder
B) Assess for a primary mood disorder with psychotic features, such as Bipolar I
disorder
C) Rule out an underlying general medical condition or substance-induced etiology
D) Formulate a safety plan and immediately initiate a first-generation antipsychotic
Correct Answer: C) Rule out an underlying general medical condition or
substance-induced etiology [1]
Rationale: In psychiatric differential diagnosis, organic, toxic, and general medical
causes must always be excluded before diagnosing a primary DSM-5-TR psychiatric
disorder. Conditions such as temporal lobe epilepsy, thyroid storm, encephalitis, or
substance intoxication/withdrawal can perfectly mimic acute psychosis and require
immediate medical intervention rather than primary psychiatric labeling. [1, 2]
Q2: Cognitive Assessment Interpretation
During a clinical evaluation, the PMHNP administers the Montreal Cognitive
Assessment (MoCA) to a 72-year-old male whose family reports progressive memory
decline over the last two years. The patient scores a 15 on the assessment. Based on
standardized psychometric parameters, how should the provider classify the patient’s
current cognitive status? [1, 2]
A) Normal cognitive functioning
B) Mild Cognitive Impairment (MCI)
C) Moderate Cognitive Impairment
D) Severe Cognitive Impairment
Correct Answer: C) Moderate Cognitive Impairment
Rationale: MoCA scores range from 0 to 30. A score of 26 or above is considered
normal. Scores between 18 and 25 typically indicate mild cognitive impairment, while a
score of 15 falls squarely within the moderate cognitive impairment range (typically
spanning 10–17), signaling significant neurocognitive pathology that warrants
neuroimaging and further diagnostic workup. [1, 2]
, Q3: Differentiating Delirium from Dementia
The daughter of an 81-year-old patient asks the PMHNP to explain how her father’s
underlying dementia differs from "delirium," which he experienced during a recent
hospitalization for a urinary tract infection (UTI). Which feature most accurately
distinguishes delirium from dementia? [1]
A) Dementia presents with an acute onset, whereas delirium develops gradually
B) Delirium features a fluctuating course of awareness, whereas dementia is
characteristically progressive and stable day-to-day
C) Cognitive attention is typically intact during delirium but severely impaired in early
dementia
D) Delirium is a permanent, irreversible structural brain failure, whereas dementia is
frequently reversible [1]
Correct Answer: B) Delirium features a fluctuating course of awareness, whereas
dementia is characteristically progressive and stable day-to-day [1]
Rationale: Delirium is characterized by an acute onset, fluctuating course of
consciousness, and impaired attention, typically triggered by an underlying medical
condition (like a UTI) or toxicity. In contrast, major neurocognitive disorder (dementia)
exhibits a gradual, progressive decline in cognitive domains without the signature
acute fluctuations in alertness and primary attention fields seen in delirium. [1]
Q4: Clinical Risk Assessment and Protective Factors
A 34-year-old male diagnosed with Schizophrenia presents for a routine follow-up
appointment. During the assessment, the PMHNP conducts a comprehensive suicide
risk appraisal. Which client feature represents a verified protective factor against
suicide completion for this individual? [1, 2]
A) A history of frequent psychiatric hospitalizations
B) The distressing presence of extrapyramidal medication side effects
C) A deeply held personal sense of purpose or strong spiritual/familial obligations
D) A history of prior non-suicidal self-injury or suicide attempts [1]
Correct Answer: C) A deeply held personal sense of purpose or strong
spiritual/familial obligations [1]
Rationale: In suicide risk management, internal protective factors include a strong
sense of purpose, positive coping mechanisms, and religious or moral beliefs against
, suicide. Frequent hospitalizations, medication side effects, and a history of previous
suicide attempts are well-documented risk factors that elevate a patient's vulnerability
rather than lowering it. [1]
Q5: Geriatric Psychopharmacology
A 75-year-old female presents with symptoms completely matching the DSM-5-TR
criteria for a new-onset Major Depressive Disorder (MDD). She has a medical history of
osteoporosis and mild hypertension. Which agent represents the most appropriate,
safe, and well-tolerated initial pharmacological choice for this patient? [1, 2]
A) Amitriptyline (Elavil)
B) Phenelzine (Nardil)
C) Escitalopram (Lexapro)
D) Haloperidol (Haldol)
Correct Answer: C) Escitalopram (Lexapro) [1, 2]
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs) like escitalopram or
sertraline are first-line choices for depression in geriatric patients due to their favorable
safety profile and minimal side effects. Tricyclic antidepressants (TCAs) like
amitriptyline are highly anticholinergic and increase fall risks, while Monoamine Oxidase
Inhibitors (MAOIs) like phenelzine present severe dietary interaction restrictions. [1]
Q6: Personality Disorder Differential
During a clinical intake, a 24-year-old male exhibits a pervasive pattern of grandiosity,
an explicit need for constant external admiration, and a profound lack of empathy
toward peers. He frequently exaggerates his achievements and insists he should only
associate with "elite" institutions. These characteristics are most indicative of which
personality disorder? [1]
A) Borderline Personality Disorder
B) Antisocial Personality Disorder
C) Narcissistic Personality Disorder
D) Histrionic Personality Disorder [1]
Correct Answer: C) Narcissistic Personality Disorder [1]
