NR548 PMHNP PRACTICE EXAM
REVIEW QUESTIONS AND ANSWERS
1. During a Mental Status Examination (MSE), a patient provides excessive detail and
unnecessary information but eventually answers the original question. Which thought
process does this describe?
A. Circumstantiality
B. Tangentiality
C. Flight of ideas
D. Derailment
Answer: A
Conceptual Explanation: Circumstantiality is characterized by a patient including many
unnecessary details but eventually reaching the point. Tangentiality involves never
returning to the original point.
2. When assessing a patient for Lithium therapy, which of the following laboratory tests is the
most critical baseline requirement?
A. Liver Function Tests (LFTs)
,B. Complete Blood Count (CBC) with differential
C. Serum Creatinine and GFR
D. Amylase and Lipase
Answer: C
Conceptual Explanation: Lithium is primarily excreted by the kidneys. Baseline Renal
function tests (Creatinine and GFR) and Thyroid function tests are essential prior to
starting Lithium.
3. A PMHNP is evaluating a patient using the Abnormal Involuntary Movement Scale (AIMS).
What is the primary purpose of this tool?
A. To diagnose Parkinson’s Disease
B. To measure the severity of Akathisia
C. To screen for and monitor Tardive Dyskinesia
D. To assess for Serotonin Syndrome
Answer: C
Conceptual Explanation: The AIMS is specifically designed to detect and track the severity
of Tardive Dyskinesia (TD) in patients taking antipsychotic medications.
4. A 45-year-old female presents with fatigue, weight gain, and depressed mood. Her TSH is
12.5 mIU/L (High). What is the appropriate initial action?
A. Refer to Primary Care or Endocrinology for treatment of hypothyroidism
, B. Start Bupropion to address the weight gain and fatigue
C. Diagnose Major Depressive Disorder and start an SSRI
D. Order a Brain MRI to rule out pituitary adenoma
Answer: A
Conceptual Explanation: Elevated TSH suggests hypothyroidism, which can mimic
depressive symptoms. Medical causes of psychiatric symptoms must be addressed first.
5. A patient scoring a 22 on the Patient Health Questionnaire-9 (PHQ-9) would be categorized
as having which level of depression?
A. Mild depression
B. Moderate depression
C. Moderately severe depression
D. Severe depression
Answer: D
Conceptual Explanation: PHQ-9 scores of 20-27 indicate severe depression. Scores of 15-
19 are moderately severe, and 10-14 are moderate.
6. Which neurotransmitter pathway is primarily associated with the ‘negative symptoms’ of
Schizophrenia, such as alogia and avolition?
A. Nigrostriatal pathway
B. Mesolimbic pathway
REVIEW QUESTIONS AND ANSWERS
1. During a Mental Status Examination (MSE), a patient provides excessive detail and
unnecessary information but eventually answers the original question. Which thought
process does this describe?
A. Circumstantiality
B. Tangentiality
C. Flight of ideas
D. Derailment
Answer: A
Conceptual Explanation: Circumstantiality is characterized by a patient including many
unnecessary details but eventually reaching the point. Tangentiality involves never
returning to the original point.
2. When assessing a patient for Lithium therapy, which of the following laboratory tests is the
most critical baseline requirement?
A. Liver Function Tests (LFTs)
,B. Complete Blood Count (CBC) with differential
C. Serum Creatinine and GFR
D. Amylase and Lipase
Answer: C
Conceptual Explanation: Lithium is primarily excreted by the kidneys. Baseline Renal
function tests (Creatinine and GFR) and Thyroid function tests are essential prior to
starting Lithium.
3. A PMHNP is evaluating a patient using the Abnormal Involuntary Movement Scale (AIMS).
What is the primary purpose of this tool?
A. To diagnose Parkinson’s Disease
B. To measure the severity of Akathisia
C. To screen for and monitor Tardive Dyskinesia
D. To assess for Serotonin Syndrome
Answer: C
Conceptual Explanation: The AIMS is specifically designed to detect and track the severity
of Tardive Dyskinesia (TD) in patients taking antipsychotic medications.
4. A 45-year-old female presents with fatigue, weight gain, and depressed mood. Her TSH is
12.5 mIU/L (High). What is the appropriate initial action?
A. Refer to Primary Care or Endocrinology for treatment of hypothyroidism
, B. Start Bupropion to address the weight gain and fatigue
C. Diagnose Major Depressive Disorder and start an SSRI
D. Order a Brain MRI to rule out pituitary adenoma
Answer: A
Conceptual Explanation: Elevated TSH suggests hypothyroidism, which can mimic
depressive symptoms. Medical causes of psychiatric symptoms must be addressed first.
5. A patient scoring a 22 on the Patient Health Questionnaire-9 (PHQ-9) would be categorized
as having which level of depression?
A. Mild depression
B. Moderate depression
C. Moderately severe depression
D. Severe depression
Answer: D
Conceptual Explanation: PHQ-9 scores of 20-27 indicate severe depression. Scores of 15-
19 are moderately severe, and 10-14 are moderate.
6. Which neurotransmitter pathway is primarily associated with the ‘negative symptoms’ of
Schizophrenia, such as alogia and avolition?
A. Nigrostriatal pathway
B. Mesolimbic pathway
