NRNP 6665 PMHNP Care Across the
Lifespan I Midterm Exam Actual
2026/2027 – 100% Verified | Detailed
Rationales – Pass Guaranteed – A+
Graded
Question 1
A 45-year-old male presents with symptoms of depressed mood, anhedonia,
significant weight loss (15 lbs in 2 months), insomnia, psychomotor agitation,
fatigue, feelings of worthlessness, and recurrent thoughts of death. These
symptoms have been present most of the day, nearly every day, for the past 4
weeks. What is the most appropriate DSM-5-TR diagnosis?
A. Persistent Depressive Disorder (Dysthymia)
B. Major Depressive Disorder, Single Episode, Severe
C. Adjustment Disorder with Depressed Mood
D. Bipolar II Disorder, Current Episode Depressed
Correct Answer: B
Rationale: This client meets full criteria for Major Depressive Disorder with 8 of 9
possible symptoms, indicating severe depression. Persistent Depressive Disorder
requires symptoms for at least 2 years. Adjustment Disorder is diagnosed when
,symptoms occur within 3 months of a stressor and are less severe. Bipolar II
requires a history of hypomanic episodes, which is not indicated here.
Question 2
A 16-year-old female is brought to the clinic by her parents who report she has
been "acting out" for the past 6 months. She has been skipping school, staying out
past curfew, and has been caught stealing from stores. She is argumentative with
her parents and refuses to follow rules. She recently got into a physical altercation
with another student at school. What is the most likely diagnosis?
A. Oppositional Defiant Disorder
B. Conduct Disorder
C. Intermittent Explosive Disorder
D. Antisocial Personality Disorder
Correct Answer: B
Rationale: Conduct Disorder is characterized by a repetitive and persistent pattern
of behavior that violates the rights of others or major age-appropriate societal
norms, with at least 3 criteria from 4 categories over 12 months. This client exhibits
aggression (physical altercation), destruction of property, deceitfulness (stealing),
and serious rule violations (skipping school, breaking curfew). Oppositional Defiant
Disorder involves defiant behavior without the serious violations seen here.
Antisocial Personality Disorder cannot be diagnosed before age 18.
Question 3
A 30-year-old female presents with a history of unstable interpersonal
,relationships, identity disturbance, impulsivity, chronic feelings of emptiness, and
recurrent suicidal gestures. She reports intense fears of abandonment and has a
pattern of idealizing and devaluing people in her life. What is the most likely
diagnosis?
A. Histrionic Personality Disorder
B. Borderline Personality Disorder
C. Narcissistic Personality Disorder
D. Dependent Personality Disorder
Correct Answer: B
Rationale: Borderline Personality Disorder is characterized by a pervasive pattern
of instability in interpersonal relationships, self-image, and affect, with marked
impulsivity. Key features include frantic efforts to avoid abandonment, unstable
relationships alternating between idealization and devaluation, identity
disturbance, impulsivity, recurrent suicidal behavior, affective instability, chronic
emptiness, intense anger, and transient paranoid ideation.
Question 4
During a mental status exam, a client reports hearing voices that comment on their
behavior and converse with each other. This symptom is best described as:
A. Delusion
B. Hallucination
C. Illusion
D. Obsession
Correct Answer: B
, Rationale: Auditory hallucinations are perceptual disturbances in which the
individual hears voices or sounds that are not actually present. Voices commenting
on the person's behavior or conversing with each other are characteristic of
schizophrenia. Delusions are fixed false beliefs. Illusions are misperceptions of real
stimuli. Obsessions are recurrent, intrusive thoughts.
Question 5
A 72-year-old male is brought to the clinic by his daughter who reports that he has
been experiencing progressive memory loss, difficulty with problem-solving, and
personality changes over the past 2 years. He often forgets appointments, repeats
questions, and has difficulty managing finances. He has also become suspicious of
his caregivers. What is the most likely diagnosis?
A. Normal age-related cognitive decline
B. Delirium
C. Major Neurocognitive Disorder (Dementia)
D. Mild Neurocognitive Disorder
Correct Answer: C
Rationale: Major Neurocognitive Disorder (Dementia) is characterized by
significant cognitive decline from a previous level of performance in one or more
cognitive domains, interfering with independence. This client has progressive
decline in memory, executive function, and personality changes that interfere with
daily functioning. Normal age-related cognitive decline does not cause significant
functional impairment. Delirium is acute and fluctuating.
Lifespan I Midterm Exam Actual
2026/2027 – 100% Verified | Detailed
Rationales – Pass Guaranteed – A+
Graded
Question 1
A 45-year-old male presents with symptoms of depressed mood, anhedonia,
significant weight loss (15 lbs in 2 months), insomnia, psychomotor agitation,
fatigue, feelings of worthlessness, and recurrent thoughts of death. These
symptoms have been present most of the day, nearly every day, for the past 4
weeks. What is the most appropriate DSM-5-TR diagnosis?
A. Persistent Depressive Disorder (Dysthymia)
B. Major Depressive Disorder, Single Episode, Severe
C. Adjustment Disorder with Depressed Mood
D. Bipolar II Disorder, Current Episode Depressed
Correct Answer: B
Rationale: This client meets full criteria for Major Depressive Disorder with 8 of 9
possible symptoms, indicating severe depression. Persistent Depressive Disorder
requires symptoms for at least 2 years. Adjustment Disorder is diagnosed when
,symptoms occur within 3 months of a stressor and are less severe. Bipolar II
requires a history of hypomanic episodes, which is not indicated here.
Question 2
A 16-year-old female is brought to the clinic by her parents who report she has
been "acting out" for the past 6 months. She has been skipping school, staying out
past curfew, and has been caught stealing from stores. She is argumentative with
her parents and refuses to follow rules. She recently got into a physical altercation
with another student at school. What is the most likely diagnosis?
A. Oppositional Defiant Disorder
B. Conduct Disorder
C. Intermittent Explosive Disorder
D. Antisocial Personality Disorder
Correct Answer: B
Rationale: Conduct Disorder is characterized by a repetitive and persistent pattern
of behavior that violates the rights of others or major age-appropriate societal
norms, with at least 3 criteria from 4 categories over 12 months. This client exhibits
aggression (physical altercation), destruction of property, deceitfulness (stealing),
and serious rule violations (skipping school, breaking curfew). Oppositional Defiant
Disorder involves defiant behavior without the serious violations seen here.
Antisocial Personality Disorder cannot be diagnosed before age 18.
Question 3
A 30-year-old female presents with a history of unstable interpersonal
,relationships, identity disturbance, impulsivity, chronic feelings of emptiness, and
recurrent suicidal gestures. She reports intense fears of abandonment and has a
pattern of idealizing and devaluing people in her life. What is the most likely
diagnosis?
A. Histrionic Personality Disorder
B. Borderline Personality Disorder
C. Narcissistic Personality Disorder
D. Dependent Personality Disorder
Correct Answer: B
Rationale: Borderline Personality Disorder is characterized by a pervasive pattern
of instability in interpersonal relationships, self-image, and affect, with marked
impulsivity. Key features include frantic efforts to avoid abandonment, unstable
relationships alternating between idealization and devaluation, identity
disturbance, impulsivity, recurrent suicidal behavior, affective instability, chronic
emptiness, intense anger, and transient paranoid ideation.
Question 4
During a mental status exam, a client reports hearing voices that comment on their
behavior and converse with each other. This symptom is best described as:
A. Delusion
B. Hallucination
C. Illusion
D. Obsession
Correct Answer: B
, Rationale: Auditory hallucinations are perceptual disturbances in which the
individual hears voices or sounds that are not actually present. Voices commenting
on the person's behavior or conversing with each other are characteristic of
schizophrenia. Delusions are fixed false beliefs. Illusions are misperceptions of real
stimuli. Obsessions are recurrent, intrusive thoughts.
Question 5
A 72-year-old male is brought to the clinic by his daughter who reports that he has
been experiencing progressive memory loss, difficulty with problem-solving, and
personality changes over the past 2 years. He often forgets appointments, repeats
questions, and has difficulty managing finances. He has also become suspicious of
his caregivers. What is the most likely diagnosis?
A. Normal age-related cognitive decline
B. Delirium
C. Major Neurocognitive Disorder (Dementia)
D. Mild Neurocognitive Disorder
Correct Answer: C
Rationale: Major Neurocognitive Disorder (Dementia) is characterized by
significant cognitive decline from a previous level of performance in one or more
cognitive domains, interfering with independence. This client has progressive
decline in memory, executive function, and personality changes that interfere with
daily functioning. Normal age-related cognitive decline does not cause significant
functional impairment. Delirium is acute and fluctuating.
