Wilkes University NSG 526 Exam 1 – Original
PMHNP Exam 1 Questions and Verified
Answers with Rationale 2026-2027
Question 1
A 27-year-old woman presents with depressed mood, insomnia, fatigue, poor
concentration, and feelings of worthlessness for the past month. She denies suicidal
ideation. Which DSM-5 criterion is still required before diagnosing Major
Depressive Disorder (MDD)?
A. At least one manic episode
B. Symptoms must be due to schizophrenia
C. Symptoms cause clinically significant distress or impairment
D. Symptoms must occur for at least 6 months
� Correct Answer: C. Symptoms cause clinically significant distress or
impairment
� Rationale:
A diagnosis of MDD requires five or more symptoms during the same 2-week
period, with at least one being depressed mood or loss of interest/pleasure. The
symptoms must also cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning. A history of mania suggests
bipolar disorder rather than MDD.
� Question 2
,A patient states, "My coworkers are poisoning my lunch every day." Laboratory
studies and collateral information reveal no evidence supporting this belief. Which
thought content abnormality is present?
A. Obsession
B. Delusion
C. Illusion
D. Hallucination
� Correct Answer: B. Delusion
� Rationale:
A delusion is a fixed, false belief maintained despite clear contradictory evidence.
This example is consistent with a persecutory delusion.
� Question 3
A patient diagnosed with Generalized Anxiety Disorder asks why relaxation
exercises help reduce symptoms. The PMHNP explains that relaxation techniques
primarily:
A. Eliminate unconscious conflict.
B. Reduce physiologic sympathetic nervous system activation.
C. Cure anxiety disorders permanently.
D. Increase dopamine production.
� Correct Answer: B. Reduce physiologic sympathetic nervous system
activation.
, � Rationale:
Relaxation strategies such as diaphragmatic breathing, progressive muscle
relaxation, and mindfulness reduce autonomic arousal and interrupt the cycle of
anxiety.
� Question 4
During therapy, a patient frequently changes the topic whenever childhood trauma
is discussed. The PMHNP recognizes this behavior as:
A. Transference
B. Countertransference
C. Resistance
D. Sublimation
� Correct Answer: C. Resistance
� Rationale:
Resistance is an unconscious attempt to avoid anxiety-provoking thoughts,
feelings, or memories that emerge during therapy.
� Question 5
Which patient is at highest risk for suicide?
A. A college student experiencing examination stress
B. A patient with depression who has a detailed suicide plan, intent, and access to a
firearm
C. A patient with mild anxiety
PMHNP Exam 1 Questions and Verified
Answers with Rationale 2026-2027
Question 1
A 27-year-old woman presents with depressed mood, insomnia, fatigue, poor
concentration, and feelings of worthlessness for the past month. She denies suicidal
ideation. Which DSM-5 criterion is still required before diagnosing Major
Depressive Disorder (MDD)?
A. At least one manic episode
B. Symptoms must be due to schizophrenia
C. Symptoms cause clinically significant distress or impairment
D. Symptoms must occur for at least 6 months
� Correct Answer: C. Symptoms cause clinically significant distress or
impairment
� Rationale:
A diagnosis of MDD requires five or more symptoms during the same 2-week
period, with at least one being depressed mood or loss of interest/pleasure. The
symptoms must also cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning. A history of mania suggests
bipolar disorder rather than MDD.
� Question 2
,A patient states, "My coworkers are poisoning my lunch every day." Laboratory
studies and collateral information reveal no evidence supporting this belief. Which
thought content abnormality is present?
A. Obsession
B. Delusion
C. Illusion
D. Hallucination
� Correct Answer: B. Delusion
� Rationale:
A delusion is a fixed, false belief maintained despite clear contradictory evidence.
This example is consistent with a persecutory delusion.
� Question 3
A patient diagnosed with Generalized Anxiety Disorder asks why relaxation
exercises help reduce symptoms. The PMHNP explains that relaxation techniques
primarily:
A. Eliminate unconscious conflict.
B. Reduce physiologic sympathetic nervous system activation.
C. Cure anxiety disorders permanently.
D. Increase dopamine production.
� Correct Answer: B. Reduce physiologic sympathetic nervous system
activation.
, � Rationale:
Relaxation strategies such as diaphragmatic breathing, progressive muscle
relaxation, and mindfulness reduce autonomic arousal and interrupt the cycle of
anxiety.
� Question 4
During therapy, a patient frequently changes the topic whenever childhood trauma
is discussed. The PMHNP recognizes this behavior as:
A. Transference
B. Countertransference
C. Resistance
D. Sublimation
� Correct Answer: C. Resistance
� Rationale:
Resistance is an unconscious attempt to avoid anxiety-provoking thoughts,
feelings, or memories that emerge during therapy.
� Question 5
Which patient is at highest risk for suicide?
A. A college student experiencing examination stress
B. A patient with depression who has a detailed suicide plan, intent, and access to a
firearm
C. A patient with mild anxiety
