NU 673 Midterm Exam Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
1. A patient is brought to the emergency department by police after being found
wandering in traffic. He is disoriented to time and place, unable to recall recent events,
and his speech is incoherent. The APRN observes that the patient is unable to focus
attention and appears to be experiencing visual hallucinations. Which condition is most
consistent with these findings?
A. Delirium
B. Dementia
C. Schizophrenia
D. Major depressive disorder with psychotic features
Answer: A. Delirium
Explanation: Delirium is characterized by acute onset, fluctuating course, inattention,
disorganized thinking, and altered level of consciousness. Visual hallucinations are common in
delirium, distinguishing it from dementia which has a gradual onset.
2. When assessing a patient's orientation, the APRN notes that the patient is drowsy and
falls asleep quickly. The examiner is able to arouse the patient with verbal stimulation.
What is the patient's level of consciousness?
A. Alert
B. Coma
C. Lethargic
D. Stupor
Answer: C. Lethargic
Explanation: Lethargy is characterized by drowsiness and the ability to be aroused with verbal
stimulation. Stupor requires painful stimuli for arousal, and coma involves no response to any
stimuli.
,3. Which part of the nervous system is primarily involved in balance and spatial
orientation?
A. Vestibular
B. Motor
C. Sensory
D. Autonomic
Answer: A. Vestibular
Explanation: The vestibular system, located in the inner ear, is responsible for balance, spatial
orientation, and coordination of head and eye movements.
4. During a Mental Status Examination, which component assesses a patient's ability to
sustain attention and concentration?
A. Orientation
B. Memory
C. Attention
D. Language
Answer: C. Attention
Explanation: Attention includes the ability to focus and sustain concentration, typically assessed
through tasks such as serial 7s, spelling "world" backward, or digit span testing.
5. A 45-year-old patient presents with complaints of feeling "down" for the past month.
She reports difficulty sleeping, poor appetite, and loss of interest in activities she
previously enjoyed. She denies suicidal ideation. The APRN notes that the patient's affect
is constricted and mood is depressed. What is the most appropriate next step?
A. Prescribe an SSRI immediately
B. Complete a full psychiatric assessment including risk assessment
C. Refer to a psychologist for therapy only
D. Order a brain CT scan
Answer: B. Complete a full psychiatric assessment including risk assessment
Explanation: A comprehensive psychiatric assessment is always the first step before initiating
treatment. This includes a thorough history, mental status exam, and risk assessment (suicide,
homicide, self-harm).
,6. The APRN is assessing a patient's thought process. The patient's speech is characterized
by a continuous flow of speech with abrupt topic changes that are related to the previous
topic. This is best described as:
A. Flight of ideas
B. Tangentiality
C. Circumstantiality
D. Loose associations
Answer: A. Flight of ideas
Explanation: Flight of ideas is a rapid, continuous flow of speech with abrupt topic changes that
are loosely connected. Tangentiality involves going off on tangents and never returning to the
original topic. Circumstantiality involves excessive detail but eventually returning to the point.
7. When documenting findings from a Mental Status Examination, which component
describes the patient's emotional tone and range of expression?
A. Mood
B. Affect
C. Insight
D. Judgment
Answer: B. Affect
Explanation: Affect refers to the external expression of emotion observed by the examiner,
including range (full, restricted, blunted, flat), intensity, and appropriateness to the situation.
Mood is the patient's subjective internal emotional state.
8. A 30-year-old patient with a history of bipolar disorder presents for routine follow-up.
The APRN notes that the patient is speaking very rapidly, jumping from topic to topic,
and appears irritable. The patient reports sleeping only 3 hours per night but feeling
energetic. Which phase of bipolar disorder is most consistent with these findings?
A. Depressive episode
B. Mixed episode
C. Manic episode
D. Hypomanic episode
Answer: C. Manic episode
, Explanation: Manic episodes are characterized by elevated or irritable mood, increased energy,
decreased need for sleep, rapid speech, and flight of ideas. These symptoms are present for at
least 1 week and cause significant functional impairment.
9. Which of the following is considered an appropriate initial screening tool for cognitive
impairment in older adults?
A. Beck Depression Inventory
B. Montreal Cognitive Assessment (MoCA)
C. Generalized Anxiety Disorder-7 (GAD-7)
D. Alcohol Use Disorders Identification Test (AUDIT)
Answer: B. Montreal Cognitive Assessment (MoCA)
Explanation: The MoCA is a validated screening tool for cognitive impairment that assesses
multiple domains including attention, memory, language, and executive function. The Mini-
Mental State Examination (MMSE) is another commonly used tool.
10. A patient with schizophrenia is being assessed. The APRN notes that the patient is
staring at the wall and appears to be responding to internal stimuli. The patient speaks in
a disorganized manner with invented words. What is the term for the word invention
noted in the patient's speech?
A. Neologism
B. Echolalia
C. Clang association
D. Word salad
Answer: A. Neologism
Explanation: Neologisms are made-up words that have meaning only to the patient. Echolalia is
repetition of others' words. Clang association is connecting words based on sound rather than
meaning. Word salad is completely incomprehensible speech.
11. The APRN is assessing a patient's insight. Which question best assesses this domain?
A. "What is your understanding of your current situation?"
B. "Can you spell 'world' backward?"
C. "Who is the current president?"
D. "How are you feeling today?"
Answer: A. "What is your understanding of your current situation?"
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
1. A patient is brought to the emergency department by police after being found
wandering in traffic. He is disoriented to time and place, unable to recall recent events,
and his speech is incoherent. The APRN observes that the patient is unable to focus
attention and appears to be experiencing visual hallucinations. Which condition is most
consistent with these findings?
A. Delirium
B. Dementia
C. Schizophrenia
D. Major depressive disorder with psychotic features
Answer: A. Delirium
Explanation: Delirium is characterized by acute onset, fluctuating course, inattention,
disorganized thinking, and altered level of consciousness. Visual hallucinations are common in
delirium, distinguishing it from dementia which has a gradual onset.
2. When assessing a patient's orientation, the APRN notes that the patient is drowsy and
falls asleep quickly. The examiner is able to arouse the patient with verbal stimulation.
What is the patient's level of consciousness?
A. Alert
B. Coma
C. Lethargic
D. Stupor
Answer: C. Lethargic
Explanation: Lethargy is characterized by drowsiness and the ability to be aroused with verbal
stimulation. Stupor requires painful stimuli for arousal, and coma involves no response to any
stimuli.
,3. Which part of the nervous system is primarily involved in balance and spatial
orientation?
A. Vestibular
B. Motor
C. Sensory
D. Autonomic
Answer: A. Vestibular
Explanation: The vestibular system, located in the inner ear, is responsible for balance, spatial
orientation, and coordination of head and eye movements.
4. During a Mental Status Examination, which component assesses a patient's ability to
sustain attention and concentration?
A. Orientation
B. Memory
C. Attention
D. Language
Answer: C. Attention
Explanation: Attention includes the ability to focus and sustain concentration, typically assessed
through tasks such as serial 7s, spelling "world" backward, or digit span testing.
5. A 45-year-old patient presents with complaints of feeling "down" for the past month.
She reports difficulty sleeping, poor appetite, and loss of interest in activities she
previously enjoyed. She denies suicidal ideation. The APRN notes that the patient's affect
is constricted and mood is depressed. What is the most appropriate next step?
A. Prescribe an SSRI immediately
B. Complete a full psychiatric assessment including risk assessment
C. Refer to a psychologist for therapy only
D. Order a brain CT scan
Answer: B. Complete a full psychiatric assessment including risk assessment
Explanation: A comprehensive psychiatric assessment is always the first step before initiating
treatment. This includes a thorough history, mental status exam, and risk assessment (suicide,
homicide, self-harm).
,6. The APRN is assessing a patient's thought process. The patient's speech is characterized
by a continuous flow of speech with abrupt topic changes that are related to the previous
topic. This is best described as:
A. Flight of ideas
B. Tangentiality
C. Circumstantiality
D. Loose associations
Answer: A. Flight of ideas
Explanation: Flight of ideas is a rapid, continuous flow of speech with abrupt topic changes that
are loosely connected. Tangentiality involves going off on tangents and never returning to the
original topic. Circumstantiality involves excessive detail but eventually returning to the point.
7. When documenting findings from a Mental Status Examination, which component
describes the patient's emotional tone and range of expression?
A. Mood
B. Affect
C. Insight
D. Judgment
Answer: B. Affect
Explanation: Affect refers to the external expression of emotion observed by the examiner,
including range (full, restricted, blunted, flat), intensity, and appropriateness to the situation.
Mood is the patient's subjective internal emotional state.
8. A 30-year-old patient with a history of bipolar disorder presents for routine follow-up.
The APRN notes that the patient is speaking very rapidly, jumping from topic to topic,
and appears irritable. The patient reports sleeping only 3 hours per night but feeling
energetic. Which phase of bipolar disorder is most consistent with these findings?
A. Depressive episode
B. Mixed episode
C. Manic episode
D. Hypomanic episode
Answer: C. Manic episode
, Explanation: Manic episodes are characterized by elevated or irritable mood, increased energy,
decreased need for sleep, rapid speech, and flight of ideas. These symptoms are present for at
least 1 week and cause significant functional impairment.
9. Which of the following is considered an appropriate initial screening tool for cognitive
impairment in older adults?
A. Beck Depression Inventory
B. Montreal Cognitive Assessment (MoCA)
C. Generalized Anxiety Disorder-7 (GAD-7)
D. Alcohol Use Disorders Identification Test (AUDIT)
Answer: B. Montreal Cognitive Assessment (MoCA)
Explanation: The MoCA is a validated screening tool for cognitive impairment that assesses
multiple domains including attention, memory, language, and executive function. The Mini-
Mental State Examination (MMSE) is another commonly used tool.
10. A patient with schizophrenia is being assessed. The APRN notes that the patient is
staring at the wall and appears to be responding to internal stimuli. The patient speaks in
a disorganized manner with invented words. What is the term for the word invention
noted in the patient's speech?
A. Neologism
B. Echolalia
C. Clang association
D. Word salad
Answer: A. Neologism
Explanation: Neologisms are made-up words that have meaning only to the patient. Echolalia is
repetition of others' words. Clang association is connecting words based on sound rather than
meaning. Word salad is completely incomprehensible speech.
11. The APRN is assessing a patient's insight. Which question best assesses this domain?
A. "What is your understanding of your current situation?"
B. "Can you spell 'world' backward?"
C. "Who is the current president?"
D. "How are you feeling today?"
Answer: A. "What is your understanding of your current situation?"
