WGU D344
WGU D344 PMHNP Objective Assessment (OA) |
200 Questions and Answers | 2026 Update | 100%
Correct.
Section 1: Foundational Theories & Biopsychosocial Model (Questions 1-8)
1. A PMHNP is evaluating a patient with treatment-resistant depression. The provider assesses the
patient's genetic profile, childhood trauma history, and current access to community support
groups. This comprehensive approach BEST reflects which model?
A) Medical Model
B) Behavioral Model
C) Biopsychosocial Model
D) Cognitive Model
Answer: C
Rationale: The Biopsychosocial model requires evaluation of biological (genetics), psychological
(trauma history), and social (community support) domains simultaneously to form a holistic
understanding of the patient.
2. (MRQ) According to the Biopsychosocial model, which of the following are considered
BIOLOGICAL factors that a PMHNP should assess? (Select all that apply)
A) Neurotransmitter function
B) Coping mechanisms
C) Medication side effects
D) Cultural stigma regarding mental health
E) Genetic predisposition
Answer: A, C, E
Rationale: Biological factors include genetics, neurobiology (neurotransmitters), and physiological
responses to medication. Coping mechanisms are psychological; cultural stigma is a social factor.
3. A PMHNP uses "true presence" and guides a client to illuminate the meaning of their lived
experience with chronic psychosis. This approach aligns with which nursing theory?
A) Health Belief Model
B) Parse's Theory of Humanbecoming
C) Peplau's Interpersonal Theory
D) Watson's Theory of Caring
Answer: B
Rationale: Parse's Theory of Humanbecoming specifically emphasizes the client as the leader in the
relationship, with the nurse providing "true presence" to help the client illuminate personal meaning.
, WGU D344
4. A patient refuses to take their antipsychotic medication because they believe the pills are
"poison." The PMHNP assesses the patient's perceived susceptibility to side effects and their
perceived benefits of the medication to understand the refusal. This approach is rooted in which
model?
A) Transtheoretical Model
B) Health Belief Model
C) Biopsychosocial Model
D) Ecological Model
Answer: B
Rationale: The Health Belief Model focuses on patient perceptions (perceived susceptibility, severity,
benefits, and barriers) to understand and predict health behaviors, making it useful for addressing
medication non-adherence and stigma.
5. A patient with schizophrenia lives alone, has no family nearby, and lost their job. The PMHNP
prioritizes connecting the patient to a supported employment program and a peer support group.
The provider is primarily addressing which domain of the Biopsychosocial model?
A) Biological
B) Psychological
C) Social
D) Spiritual
Answer: C
Rationale: Social factors involve support systems, community resources, employment, and living
situations. Connecting the patient to peer groups and employment programs directly addresses the
social domain.
6. A PMHNP is formulating a case conceptualization for a new patient. Which component is
essential to include in a comprehensive case formulation?
A) Only the patient's DSM-5 diagnosis
B) The patient's insurance coverage details
C) An integration of biological, psychological, and social contributors to the patient's condition
D) The clinician's personal emotional response to the patient
Answer: C
Rationale: Case formulation involves synthesizing all data (bio-psycho-social) to develop a
comprehensive understanding of the client's issues, guide treatment direction, and identify patient
needs, going beyond just a diagnostic label.
7. (MRQ) The PMHNP is applying the Health Belief Model to a patient with bipolar disorder who is
non-adherent to mood stabilizers. Which beliefs should the NP assess to understand the patient's
barriers? (Select all that apply)
A) The patient's perceived risk of having a manic episode off medication
B) The patient's belief that the medication causes weight gain
C) The patient's current serum lithium level
D) The patient's perceived efficacy of the medication to stabilize mood
, WGU D344
Answer: A, B, D
Rationale: The Health Belief Model assesses perceived susceptibility (A), perceived barriers (B), and
perceived benefits (D). Serum lithium level (C) is an objective biological measure, not a component of
this specific model.
8. A PMHNP is working with an adolescent who is reluctant to engage in therapy. The nurse sits
quietly with the patient, allowing space for the patient to initiate conversation about their
feelings. This therapeutic technique is known as:
A) Offering self
B) Clarification
C) Therapeutic silence
D) Reflection
Answer: C
Rationale: Therapeutic silence provides time for both the patient and nurse to reflect on what has
been discussed, allowing the patient space to process emotions and take the lead in the
conversation.
Section 2: Screening Tools & Assessment (Questions 9-21)
9. A PMHNP is treating a 45-year-old patient with Major Depressive Disorder. The patient
completes a PHQ-9 today and scores a 10, compared to a score of 22 at the initial visit three
months ago. What is the BEST clinical interpretation of this change?
A) The patient is in remission.
B) The patient has experienced a clinically significant improvement.
C) The patient requires immediate hospitalization.
D) The patient's depression has worsened.
Answer: B
Rationale: A 50% reduction in PHQ-9 score (from 22 to 10 is a 54.5% reduction) indicates clinically
significant improvement. Remission typically requires a score below 5.
10. A PMHNP administers the Mood Disorder Questionnaire (MDQ) to a patient suspected of
having bipolar disorder. The patient endorses 9 out of 13 items and reports that the symptoms
caused "serious" problems in their relationships. What is the correct interpretation of this
screening result?
A) Negative screen; bipolar disorder is unlikely
B) Positive screen; warrants further diagnostic evaluation
C) Inconclusive; requires a second screening in 2 weeks
D) Positive for major depressive disorder, not bipolar
Answer: B
Rationale: A positive MDQ screen requires 7+ of 13 items endorsed AND the symptoms must cause
moderate or serious functional impairment. This patient meets both criteria, warranting a full
diagnostic interview.
, WGU D344
11. A 72-year-old patient presents with complaints of memory loss. The PMHNP administers a
MoCA, and the patient scores a 24. How should the NP interpret this finding?
A) Normal cognitive function
B) Mild cognitive impairment
C) Moderate dementia
D) Severe dementia
Answer: B
Rationale: On the MoCA, a score of 26-30 is normal. A score of 18-25 indicates mild cognitive
impairment (MCI). The MMSE is the tool with the 24-30 normal range, but for MoCA, 24 is considered
MCI.
12. A PMHNP screens a 3-year-old child for autism spectrum disorder during a well-child visit.
Which screening tool is the MOST appropriate for this age group?
A) CAGE
B) Columbia-Suicide Severity Rating Scale
C) PHQ-9
D) M-CHAT-R
Answer: D
Rationale: The M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) is specifically designed
for screening toddlers and young children (typically 16-30 months) for Autism Spectrum Disorder.
13. A patient presents with symptoms of depression, but the PMHNP suspects an underlying
medical condition. The patient also reports tremors and protrusion of the eyeballs. Which
screening test should the PMHNP order first to rule out a medical cause?
A) Urine toxicology
B) TSH and Free T4
C) Complete blood count
D) Liver function tests
Answer: B
Rationale: New-onset anxiety or depressive symptoms in older adults without a psychiatric history
require ruling out medical causes. Tremors and exophthalmos (protruding eyeballs) are classic signs
of hyperthyroidism, making TSH/Free T4 the most appropriate initial test.
14. A PMHNP is assessing a patient with alcohol use disorder. Using the CAGE questionnaire,
which of the following questions would the nurse ask?
A) "Have you ever felt you should cut down on your drinking?"
B) "Have you ever had a drink first thing in the morning to steady your nerves?"
C) "Do you need to drink more than you used to to get the same effect?"
D) "Have you ever experienced withdrawal symptoms when stopping drinking?"
Answer: A
Rationale: CAGE stands for Cut down, Annoyed, Guilty, and Eye-opener. Option A reflects the "Cut
WGU D344 PMHNP Objective Assessment (OA) |
200 Questions and Answers | 2026 Update | 100%
Correct.
Section 1: Foundational Theories & Biopsychosocial Model (Questions 1-8)
1. A PMHNP is evaluating a patient with treatment-resistant depression. The provider assesses the
patient's genetic profile, childhood trauma history, and current access to community support
groups. This comprehensive approach BEST reflects which model?
A) Medical Model
B) Behavioral Model
C) Biopsychosocial Model
D) Cognitive Model
Answer: C
Rationale: The Biopsychosocial model requires evaluation of biological (genetics), psychological
(trauma history), and social (community support) domains simultaneously to form a holistic
understanding of the patient.
2. (MRQ) According to the Biopsychosocial model, which of the following are considered
BIOLOGICAL factors that a PMHNP should assess? (Select all that apply)
A) Neurotransmitter function
B) Coping mechanisms
C) Medication side effects
D) Cultural stigma regarding mental health
E) Genetic predisposition
Answer: A, C, E
Rationale: Biological factors include genetics, neurobiology (neurotransmitters), and physiological
responses to medication. Coping mechanisms are psychological; cultural stigma is a social factor.
3. A PMHNP uses "true presence" and guides a client to illuminate the meaning of their lived
experience with chronic psychosis. This approach aligns with which nursing theory?
A) Health Belief Model
B) Parse's Theory of Humanbecoming
C) Peplau's Interpersonal Theory
D) Watson's Theory of Caring
Answer: B
Rationale: Parse's Theory of Humanbecoming specifically emphasizes the client as the leader in the
relationship, with the nurse providing "true presence" to help the client illuminate personal meaning.
, WGU D344
4. A patient refuses to take their antipsychotic medication because they believe the pills are
"poison." The PMHNP assesses the patient's perceived susceptibility to side effects and their
perceived benefits of the medication to understand the refusal. This approach is rooted in which
model?
A) Transtheoretical Model
B) Health Belief Model
C) Biopsychosocial Model
D) Ecological Model
Answer: B
Rationale: The Health Belief Model focuses on patient perceptions (perceived susceptibility, severity,
benefits, and barriers) to understand and predict health behaviors, making it useful for addressing
medication non-adherence and stigma.
5. A patient with schizophrenia lives alone, has no family nearby, and lost their job. The PMHNP
prioritizes connecting the patient to a supported employment program and a peer support group.
The provider is primarily addressing which domain of the Biopsychosocial model?
A) Biological
B) Psychological
C) Social
D) Spiritual
Answer: C
Rationale: Social factors involve support systems, community resources, employment, and living
situations. Connecting the patient to peer groups and employment programs directly addresses the
social domain.
6. A PMHNP is formulating a case conceptualization for a new patient. Which component is
essential to include in a comprehensive case formulation?
A) Only the patient's DSM-5 diagnosis
B) The patient's insurance coverage details
C) An integration of biological, psychological, and social contributors to the patient's condition
D) The clinician's personal emotional response to the patient
Answer: C
Rationale: Case formulation involves synthesizing all data (bio-psycho-social) to develop a
comprehensive understanding of the client's issues, guide treatment direction, and identify patient
needs, going beyond just a diagnostic label.
7. (MRQ) The PMHNP is applying the Health Belief Model to a patient with bipolar disorder who is
non-adherent to mood stabilizers. Which beliefs should the NP assess to understand the patient's
barriers? (Select all that apply)
A) The patient's perceived risk of having a manic episode off medication
B) The patient's belief that the medication causes weight gain
C) The patient's current serum lithium level
D) The patient's perceived efficacy of the medication to stabilize mood
, WGU D344
Answer: A, B, D
Rationale: The Health Belief Model assesses perceived susceptibility (A), perceived barriers (B), and
perceived benefits (D). Serum lithium level (C) is an objective biological measure, not a component of
this specific model.
8. A PMHNP is working with an adolescent who is reluctant to engage in therapy. The nurse sits
quietly with the patient, allowing space for the patient to initiate conversation about their
feelings. This therapeutic technique is known as:
A) Offering self
B) Clarification
C) Therapeutic silence
D) Reflection
Answer: C
Rationale: Therapeutic silence provides time for both the patient and nurse to reflect on what has
been discussed, allowing the patient space to process emotions and take the lead in the
conversation.
Section 2: Screening Tools & Assessment (Questions 9-21)
9. A PMHNP is treating a 45-year-old patient with Major Depressive Disorder. The patient
completes a PHQ-9 today and scores a 10, compared to a score of 22 at the initial visit three
months ago. What is the BEST clinical interpretation of this change?
A) The patient is in remission.
B) The patient has experienced a clinically significant improvement.
C) The patient requires immediate hospitalization.
D) The patient's depression has worsened.
Answer: B
Rationale: A 50% reduction in PHQ-9 score (from 22 to 10 is a 54.5% reduction) indicates clinically
significant improvement. Remission typically requires a score below 5.
10. A PMHNP administers the Mood Disorder Questionnaire (MDQ) to a patient suspected of
having bipolar disorder. The patient endorses 9 out of 13 items and reports that the symptoms
caused "serious" problems in their relationships. What is the correct interpretation of this
screening result?
A) Negative screen; bipolar disorder is unlikely
B) Positive screen; warrants further diagnostic evaluation
C) Inconclusive; requires a second screening in 2 weeks
D) Positive for major depressive disorder, not bipolar
Answer: B
Rationale: A positive MDQ screen requires 7+ of 13 items endorsed AND the symptoms must cause
moderate or serious functional impairment. This patient meets both criteria, warranting a full
diagnostic interview.
, WGU D344
11. A 72-year-old patient presents with complaints of memory loss. The PMHNP administers a
MoCA, and the patient scores a 24. How should the NP interpret this finding?
A) Normal cognitive function
B) Mild cognitive impairment
C) Moderate dementia
D) Severe dementia
Answer: B
Rationale: On the MoCA, a score of 26-30 is normal. A score of 18-25 indicates mild cognitive
impairment (MCI). The MMSE is the tool with the 24-30 normal range, but for MoCA, 24 is considered
MCI.
12. A PMHNP screens a 3-year-old child for autism spectrum disorder during a well-child visit.
Which screening tool is the MOST appropriate for this age group?
A) CAGE
B) Columbia-Suicide Severity Rating Scale
C) PHQ-9
D) M-CHAT-R
Answer: D
Rationale: The M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) is specifically designed
for screening toddlers and young children (typically 16-30 months) for Autism Spectrum Disorder.
13. A patient presents with symptoms of depression, but the PMHNP suspects an underlying
medical condition. The patient also reports tremors and protrusion of the eyeballs. Which
screening test should the PMHNP order first to rule out a medical cause?
A) Urine toxicology
B) TSH and Free T4
C) Complete blood count
D) Liver function tests
Answer: B
Rationale: New-onset anxiety or depressive symptoms in older adults without a psychiatric history
require ruling out medical causes. Tremors and exophthalmos (protruding eyeballs) are classic signs
of hyperthyroidism, making TSH/Free T4 the most appropriate initial test.
14. A PMHNP is assessing a patient with alcohol use disorder. Using the CAGE questionnaire,
which of the following questions would the nurse ask?
A) "Have you ever felt you should cut down on your drinking?"
B) "Have you ever had a drink first thing in the morning to steady your nerves?"
C) "Do you need to drink more than you used to to get the same effect?"
D) "Have you ever experienced withdrawal symptoms when stopping drinking?"
Answer: A
Rationale: CAGE stands for Cut down, Annoyed, Guilty, and Eye-opener. Option A reflects the "Cut
