NR548 PSYCHIATRIC ASSESSMENT FOR
THE PMHNP STUDY GUIDE QUESTIONS
AND ANSWERS
1. During a Mental Status Examination (MSE), the PMHNP notes that the patient is using
invented words that have no meaning to others. This thought process is best described as:
A. Neologisms
B. Clang associations
C. Word salad
D. Echolalia
Answer: A
Conceptual Explanation: Neologisms are newly coined words or expressions that have
symbolic meaning to the patient but are meaningless to others, often seen in schizophrenia.
2. Which of the following represents a ‘static’ risk factor in a suicide risk assessment?
A. Active suicidal ideation
B. Current substance intoxication
C. History of a prior suicide attempt
,D. Access to firearms
Answer: C
Conceptual Explanation: Static risk factors are historical facts that cannot be changed,
such as a prior attempt. Active ideation and intoxication are dynamic factors.
3. A patient reports feeling ‘depressed’ for the last two weeks. The PMHNP observes the
patient smiling and laughing during the interview. How should the PMHNP document this?
A. Mood is depressed; Affect is incongruent
B. Mood is depressed; Affect is congruent
C. Mood is euthymic; Affect is flat
D. Mood is expansive; Affect is restricted
Answer: A
Conceptual Explanation: Mood is the subjective internal state reported by the patient,
while affect is the objective, outward expression. Since they don’t match, it is incongruent.
4. When assessing a patient for lithium therapy, which baseline laboratory test is most critical
due to the drug’s narrow therapeutic index?
A. Serum creatinine and BUN
B. Liver function tests (LFTs)
C. Amylase and lipase
D. Hemoglobin A1c
, Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys; therefore,
renal function (Creatinine/BUN) must be assessed baseline and periodically.
5. A 75-year-old patient presents with acute onset of confusion, fluctuating levels of
consciousness, and visual hallucinations. What is the most likely diagnosis?
A. Major Depressive Disorder with Psychosis
B. Alzheimer’s Disease
C. Vascular Dementia
D. Delirium
Answer: D
Conceptual Explanation: Delirium is characterized by an acute onset, fluctuating course,
and disturbances in consciousness/attention, unlike the gradual decline of dementia.
6. The ‘Tarasoff Rule’ relates to which legal and ethical obligation of the PMHNP?
A. Involuntary commitment
B. Maintaining strict HIPAA confidentiality regardless of threats
C. Right to refuse treatment
D. Duty to warn a potential victim
Answer: D
THE PMHNP STUDY GUIDE QUESTIONS
AND ANSWERS
1. During a Mental Status Examination (MSE), the PMHNP notes that the patient is using
invented words that have no meaning to others. This thought process is best described as:
A. Neologisms
B. Clang associations
C. Word salad
D. Echolalia
Answer: A
Conceptual Explanation: Neologisms are newly coined words or expressions that have
symbolic meaning to the patient but are meaningless to others, often seen in schizophrenia.
2. Which of the following represents a ‘static’ risk factor in a suicide risk assessment?
A. Active suicidal ideation
B. Current substance intoxication
C. History of a prior suicide attempt
,D. Access to firearms
Answer: C
Conceptual Explanation: Static risk factors are historical facts that cannot be changed,
such as a prior attempt. Active ideation and intoxication are dynamic factors.
3. A patient reports feeling ‘depressed’ for the last two weeks. The PMHNP observes the
patient smiling and laughing during the interview. How should the PMHNP document this?
A. Mood is depressed; Affect is incongruent
B. Mood is depressed; Affect is congruent
C. Mood is euthymic; Affect is flat
D. Mood is expansive; Affect is restricted
Answer: A
Conceptual Explanation: Mood is the subjective internal state reported by the patient,
while affect is the objective, outward expression. Since they don’t match, it is incongruent.
4. When assessing a patient for lithium therapy, which baseline laboratory test is most critical
due to the drug’s narrow therapeutic index?
A. Serum creatinine and BUN
B. Liver function tests (LFTs)
C. Amylase and lipase
D. Hemoglobin A1c
, Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys; therefore,
renal function (Creatinine/BUN) must be assessed baseline and periodically.
5. A 75-year-old patient presents with acute onset of confusion, fluctuating levels of
consciousness, and visual hallucinations. What is the most likely diagnosis?
A. Major Depressive Disorder with Psychosis
B. Alzheimer’s Disease
C. Vascular Dementia
D. Delirium
Answer: D
Conceptual Explanation: Delirium is characterized by an acute onset, fluctuating course,
and disturbances in consciousness/attention, unlike the gradual decline of dementia.
6. The ‘Tarasoff Rule’ relates to which legal and ethical obligation of the PMHNP?
A. Involuntary commitment
B. Maintaining strict HIPAA confidentiality regardless of threats
C. Right to refuse treatment
D. Duty to warn a potential victim
Answer: D
