Page 1 of 100
TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| **1** | **Psychiatric Assessment & Diagnostic Reasoning** | 1–15 |
| **2** | **Therapeutic Interventions & Modalities** | 16–30 |
| **3** | **Pharmacology & Psychopharmacology** | 31–50 |
| **4** | **Mood Disorders** | 51–65 |
| **5** | **Anxiety & Trauma-Related Disorders** | 66–80 |
| **6** | **Psychotic Disorders** | 81–95 |
| **7** | **Substance Use Disorders** | 96–105 |
| **8** | **Child & Adolescent Psychiatry** | 106–120 |
| **9** | **Geriatric Psychiatry & Cognitive Disorders** | 121–135 |
| **10** | **Suicide Risk Assessment & Crisis Intervention** | 136–145 |
| **11** | **Legal & Ethical Issues in Psychiatric Practice** | 146–155 |
| **12** | **Integrated Care & Interprofessional Collaboration** | 156–165 |
,Page 2 of 100
SECTION 1: PSYCHIATRIC ASSESSMENT & DIAGNOSTIC REASONING
## Question 1
**A 34-year-old patient presents with a 6-month history of depressed mood, anhedonia, fatigue,
and poor concentration. The patient reports that these symptoms began shortly after the birth of
her second child. Which of the following is the MOST appropriate initial step in the psychiatric
assessment?**
A. Immediately prescribe an SSRI antidepressant
B. Conduct a comprehensive biopsychosocial assessment including psychiatric history, mental
status exam, and risk assessment
C. Refer the patient to a psychologist for psychotherapy
D. Order a complete blood count and thyroid function tests only
**Correct Answer: B**
**Rationale:** A comprehensive biopsychosocial assessment is the foundation of psychiatric
care. This includes a detailed psychiatric history, mental status examination, risk assessment
(suicide, homicide, self-harm), and evaluation of psychosocial factors. While laboratory work
may be indicated, it should not precede a thorough clinical assessment. Immediate prescribing
without assessment is inappropriate and potentially harmful.
---
## Question 2
**During a mental status examination, a patient demonstrates a flat affect, poverty of speech, and
psychomotor retardation. These findings are MOST consistent with which of the following?**
A. Mania
B. Major depressive episode
,Page 3 of 100
C. Panic disorder
D. Obsessive-compulsive disorder
**Correct Answer: B**
**Rationale:** Flat affect, poverty of speech (alogia), and psychomotor retardation are hallmark
signs of a major depressive episode. Mania is characterized by elevated mood, pressured speech,
and increased psychomotor activity. Panic disorder presents with acute episodes of intense fear,
and OCD is characterized by obsessions and compulsions.
---
## Question 3
**Which of the following is the BEST description of the purpose of the psychiatric mental status
examination (MSE)?**
A. To diagnose specific psychiatric disorders
B. To provide a systematic evaluation of the patient's current psychological functioning
C. To determine the patient's IQ
D. To assess the patient's social support system
**Correct Answer: B**
**Rationale:** The MSE provides a systematic, objective evaluation of the patient's current
psychological functioning across multiple domains, including appearance, behavior, speech,
mood, affect, thought process, thought content, perception, cognition, and insight/judgment.
While it contributes to diagnosis, it is not itself a diagnostic tool.
---
, Page 4 of 100
## Question 4
**A patient reports hearing voices that comment on their actions and command them to harm
themselves. Which of the following terms BEST describes this symptom?**
A. Illusion
B. Hallucination
C. Delusion
D. Obsession
**Correct Answer: B**
**Rationale:** Hallucinations are perceptual experiences that occur without an external
stimulus. Auditory hallucinations, particularly those that comment on behavior or command self-
harm, are concerning symptoms that require immediate risk assessment. Illusions are
misperceptions of real stimuli, delusions are fixed false beliefs, and obsessions are intrusive
thoughts.
---
## Question 5
**A patient with a history of bipolar disorder presents with grandiose delusions, decreased need
for sleep, and impulsive spending. The PMHNP should prioritize which of the following?**
A. Safety assessment and stabilization
B. Cognitive behavioral therapy
C. Referral to a financial counselor
D. Observation without intervention
**Correct Answer: A**
TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| **1** | **Psychiatric Assessment & Diagnostic Reasoning** | 1–15 |
| **2** | **Therapeutic Interventions & Modalities** | 16–30 |
| **3** | **Pharmacology & Psychopharmacology** | 31–50 |
| **4** | **Mood Disorders** | 51–65 |
| **5** | **Anxiety & Trauma-Related Disorders** | 66–80 |
| **6** | **Psychotic Disorders** | 81–95 |
| **7** | **Substance Use Disorders** | 96–105 |
| **8** | **Child & Adolescent Psychiatry** | 106–120 |
| **9** | **Geriatric Psychiatry & Cognitive Disorders** | 121–135 |
| **10** | **Suicide Risk Assessment & Crisis Intervention** | 136–145 |
| **11** | **Legal & Ethical Issues in Psychiatric Practice** | 146–155 |
| **12** | **Integrated Care & Interprofessional Collaboration** | 156–165 |
,Page 2 of 100
SECTION 1: PSYCHIATRIC ASSESSMENT & DIAGNOSTIC REASONING
## Question 1
**A 34-year-old patient presents with a 6-month history of depressed mood, anhedonia, fatigue,
and poor concentration. The patient reports that these symptoms began shortly after the birth of
her second child. Which of the following is the MOST appropriate initial step in the psychiatric
assessment?**
A. Immediately prescribe an SSRI antidepressant
B. Conduct a comprehensive biopsychosocial assessment including psychiatric history, mental
status exam, and risk assessment
C. Refer the patient to a psychologist for psychotherapy
D. Order a complete blood count and thyroid function tests only
**Correct Answer: B**
**Rationale:** A comprehensive biopsychosocial assessment is the foundation of psychiatric
care. This includes a detailed psychiatric history, mental status examination, risk assessment
(suicide, homicide, self-harm), and evaluation of psychosocial factors. While laboratory work
may be indicated, it should not precede a thorough clinical assessment. Immediate prescribing
without assessment is inappropriate and potentially harmful.
---
## Question 2
**During a mental status examination, a patient demonstrates a flat affect, poverty of speech, and
psychomotor retardation. These findings are MOST consistent with which of the following?**
A. Mania
B. Major depressive episode
,Page 3 of 100
C. Panic disorder
D. Obsessive-compulsive disorder
**Correct Answer: B**
**Rationale:** Flat affect, poverty of speech (alogia), and psychomotor retardation are hallmark
signs of a major depressive episode. Mania is characterized by elevated mood, pressured speech,
and increased psychomotor activity. Panic disorder presents with acute episodes of intense fear,
and OCD is characterized by obsessions and compulsions.
---
## Question 3
**Which of the following is the BEST description of the purpose of the psychiatric mental status
examination (MSE)?**
A. To diagnose specific psychiatric disorders
B. To provide a systematic evaluation of the patient's current psychological functioning
C. To determine the patient's IQ
D. To assess the patient's social support system
**Correct Answer: B**
**Rationale:** The MSE provides a systematic, objective evaluation of the patient's current
psychological functioning across multiple domains, including appearance, behavior, speech,
mood, affect, thought process, thought content, perception, cognition, and insight/judgment.
While it contributes to diagnosis, it is not itself a diagnostic tool.
---
, Page 4 of 100
## Question 4
**A patient reports hearing voices that comment on their actions and command them to harm
themselves. Which of the following terms BEST describes this symptom?**
A. Illusion
B. Hallucination
C. Delusion
D. Obsession
**Correct Answer: B**
**Rationale:** Hallucinations are perceptual experiences that occur without an external
stimulus. Auditory hallucinations, particularly those that comment on behavior or command self-
harm, are concerning symptoms that require immediate risk assessment. Illusions are
misperceptions of real stimuli, delusions are fixed false beliefs, and obsessions are intrusive
thoughts.
---
## Question 5
**A patient with a history of bipolar disorder presents with grandiose delusions, decreased need
for sleep, and impulsive spending. The PMHNP should prioritize which of the following?**
A. Safety assessment and stabilization
B. Cognitive behavioral therapy
C. Referral to a financial counselor
D. Observation without intervention
**Correct Answer: A**
