NR548 PSYCHIATRIC ASSESSMENT FOR
THE PMHNP - EXAM 3 REVIEW
QUESTIONS AND ANSWERS
1. During a psychiatric assessment, a PMHNP notes that a patient is unable to stay on topic
and provides detailed, unnecessary information but eventually returns to the original point.
This thought process is best described as:
A. Tangentiality
B. Flight of ideas
C. Circumstantiality
D. Loose associations
Answer: C
Conceptual Explanation: Circumstantiality involves providing excessive detail and
tedious trivia but eventually returning to the point. Tangentiality never returns to the
original point.
,2. Which neurobiological pathway is most associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is believed to
mediate the positive symptoms of psychosis.
3. A 45-year-old male presents with sudden onset of confusion, visual hallucinations, and
autonomic instability (tachycardia and hypertension) 48 hours after his last drink. What is the
most likely diagnosis?
A. Wernicke’s Encephalopathy
B. Delirium Tremens
C. Alcoholic Hallucinosis
D. Korsakoff Syndrome
Answer: B
Conceptual Explanation: Delirium Tremens (DTs) typically occurs 48–96 hours after the
last drink and is characterized by delirium and autonomic hyperreactivity.
, 4. When assessing a pediatric patient for ADHD, which of the following is a requirement
according to DSM-5-TR criteria?
A. Symptoms must persist for at least 12 months
B. Symptoms must be present before age 7
C. Symptoms must only occur in the school setting
D. Symptoms must be present before age 12
Answer: D
Conceptual Explanation: The DSM-5 expanded the age of onset from 7 to 12 years and
requires symptoms in at least two settings (e.g., home and school) for at least 6 months.
5. A patient reports a persistent depressed mood for most of the day, more days than not, for
at least two years. They have not been without symptoms for more than 2 months. This best
fits the criteria for:
A. Persistent Depressive Disorder (Dysthymia)
B. Cyclothymic Disorder
C. Major Depressive Disorder
D. Adjustment Disorder with Depressed Mood
Answer: A
Conceptual Explanation: Persistent Depressive Disorder is characterized by a chronic
depressed mood for at least 2 years in adults (1 year in children).
THE PMHNP - EXAM 3 REVIEW
QUESTIONS AND ANSWERS
1. During a psychiatric assessment, a PMHNP notes that a patient is unable to stay on topic
and provides detailed, unnecessary information but eventually returns to the original point.
This thought process is best described as:
A. Tangentiality
B. Flight of ideas
C. Circumstantiality
D. Loose associations
Answer: C
Conceptual Explanation: Circumstantiality involves providing excessive detail and
tedious trivia but eventually returning to the point. Tangentiality never returns to the
original point.
,2. Which neurobiological pathway is most associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is believed to
mediate the positive symptoms of psychosis.
3. A 45-year-old male presents with sudden onset of confusion, visual hallucinations, and
autonomic instability (tachycardia and hypertension) 48 hours after his last drink. What is the
most likely diagnosis?
A. Wernicke’s Encephalopathy
B. Delirium Tremens
C. Alcoholic Hallucinosis
D. Korsakoff Syndrome
Answer: B
Conceptual Explanation: Delirium Tremens (DTs) typically occurs 48–96 hours after the
last drink and is characterized by delirium and autonomic hyperreactivity.
, 4. When assessing a pediatric patient for ADHD, which of the following is a requirement
according to DSM-5-TR criteria?
A. Symptoms must persist for at least 12 months
B. Symptoms must be present before age 7
C. Symptoms must only occur in the school setting
D. Symptoms must be present before age 12
Answer: D
Conceptual Explanation: The DSM-5 expanded the age of onset from 7 to 12 years and
requires symptoms in at least two settings (e.g., home and school) for at least 6 months.
5. A patient reports a persistent depressed mood for most of the day, more days than not, for
at least two years. They have not been without symptoms for more than 2 months. This best
fits the criteria for:
A. Persistent Depressive Disorder (Dysthymia)
B. Cyclothymic Disorder
C. Major Depressive Disorder
D. Adjustment Disorder with Depressed Mood
Answer: A
Conceptual Explanation: Persistent Depressive Disorder is characterized by a chronic
depressed mood for at least 2 years in adults (1 year in children).
