NR548 PSYCHIATRIC ASSESSMENT
PMHNP COMPREHENSIVE EXAM
REVIEW QUESTIONS AND ANSWERS
1. A PMHNP is conducting a Mental Status Examination (MSE) and notes that the patient
provides excessive detail and unnecessary information before eventually answering the
question. This thought process is best described as:
A. Tangentiality
B. Flight of ideas
C. Circumstantiality
D. Derailment
Answer: C
Conceptual Explanation: Circumstantiality is characterized by a patient including
excessive, tedious details but eventually returning to the point or answering the original
question.
2. When assessing for suicide risk, which of the following is considered a ‘static’ risk factor?
A. History of previous suicide attempts
,B. Access to firearms
C. Current command hallucinations
D. Active substance intoxication
Answer: A
Conceptual Explanation: Static risk factors are historical and unchangeable, such as a
history of previous attempts. Dynamic risk factors, like substance use or access to weapons,
can change over time.
3. The Tarasoff rule, which emerged from the California Supreme Court case Tarasoff v.
Regents of the University of California, establishes what legal obligation for PMHNPs?
A. Duty to provide informed consent for all medications
B. Duty to treat patients regardless of ability to pay
C. Duty to protect intended victims of a patient’s violence
D. Duty to maintain absolute confidentiality in all circumstances
Answer: C
Conceptual Explanation: The Tarasoff rule establishes a ‘duty to protect’ (often referred
to as ‘duty to warn’) when a patient presents a serious danger of violence to a specific,
identifiable third party.
, 4. Which laboratory finding would be most suggestive of chronic alcohol use disorder in a
patient presenting for psychiatric assessment?
A. Decreased Aspartate Aminotransferase (AST)
B. Decreased Gamma-glutamyl transferase (GGT)
C. Elevated Blood Urea Nitrogen (BUN)
D. Elevated Mean Corpuscular Volume (MCV)
Answer: D
Conceptual Explanation: Chronic alcohol use often leads to macrocytic anemia,
characterized by an elevated MCV. GGT and AST are typically elevated, not decreased, in
chronic alcohol use.
5. A patient exhibits a triad of symptoms including cognitive changes, autonomic
hyperactivity, and neuromuscular abnormalities (such as hyperreflexia and clonus). The
PMHNP should immediately suspect:
A. Neuroleptic Malignant Syndrome
B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. Tardive Dyskinesia
Answer: C
PMHNP COMPREHENSIVE EXAM
REVIEW QUESTIONS AND ANSWERS
1. A PMHNP is conducting a Mental Status Examination (MSE) and notes that the patient
provides excessive detail and unnecessary information before eventually answering the
question. This thought process is best described as:
A. Tangentiality
B. Flight of ideas
C. Circumstantiality
D. Derailment
Answer: C
Conceptual Explanation: Circumstantiality is characterized by a patient including
excessive, tedious details but eventually returning to the point or answering the original
question.
2. When assessing for suicide risk, which of the following is considered a ‘static’ risk factor?
A. History of previous suicide attempts
,B. Access to firearms
C. Current command hallucinations
D. Active substance intoxication
Answer: A
Conceptual Explanation: Static risk factors are historical and unchangeable, such as a
history of previous attempts. Dynamic risk factors, like substance use or access to weapons,
can change over time.
3. The Tarasoff rule, which emerged from the California Supreme Court case Tarasoff v.
Regents of the University of California, establishes what legal obligation for PMHNPs?
A. Duty to provide informed consent for all medications
B. Duty to treat patients regardless of ability to pay
C. Duty to protect intended victims of a patient’s violence
D. Duty to maintain absolute confidentiality in all circumstances
Answer: C
Conceptual Explanation: The Tarasoff rule establishes a ‘duty to protect’ (often referred
to as ‘duty to warn’) when a patient presents a serious danger of violence to a specific,
identifiable third party.
, 4. Which laboratory finding would be most suggestive of chronic alcohol use disorder in a
patient presenting for psychiatric assessment?
A. Decreased Aspartate Aminotransferase (AST)
B. Decreased Gamma-glutamyl transferase (GGT)
C. Elevated Blood Urea Nitrogen (BUN)
D. Elevated Mean Corpuscular Volume (MCV)
Answer: D
Conceptual Explanation: Chronic alcohol use often leads to macrocytic anemia,
characterized by an elevated MCV. GGT and AST are typically elevated, not decreased, in
chronic alcohol use.
5. A patient exhibits a triad of symptoms including cognitive changes, autonomic
hyperactivity, and neuromuscular abnormalities (such as hyperreflexia and clonus). The
PMHNP should immediately suspect:
A. Neuroleptic Malignant Syndrome
B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. Tardive Dyskinesia
Answer: C
