WALDEN UNIVERSITY NRNP 6665 –
ACADEMIC YEAR 2026/2027
MIDTERM COMPREHENSIVE EXAM:
VERIFIED QUESTIONS WITH CORRECT
ANSWER RATIONALES || NEWEST
1. Biofeedback, deep breathing, mindfulness, and progressive muscle relaxation are
strategies that are typically used in which of the following therapies?
• A. Relaxation therapy
• B. Social skills training
• C. Motivational Interviewing
• D. Applied behavioral analysis
Correct Answer: A. Relaxation therapy
Rationale: These strategies are core components of relaxation therapy, aimed at
reducing stress and promoting physical and mental well-being by managing
physiological and psychological responses to stress.
2. According to the APA, which of the following are required to support a child's
DSM-5 diagnosis?
• A. The child's clinical presentation fulfills the specific symptom-based
diagnostic criteria.
• B. The child's symptoms are not caused by other diagnoses or stressors.
• C. The child's symptoms are impairing a child's functioning in at least two
settings.
• D. A and B
Correct Answer: D. A and B
Rationale: The APA requires that a child's symptoms meet specific diagnostic criteria
and are not better explained by another condition or stressor. While impairment
(Option C) is a consideration for many diagnoses, the primary requirements are the
symptom criteria and ruling out alternative explanations.
3. Which of the following is NOT consistent with good sleep hygiene?
, • A. Allow child to keep a cell phone at bedside.
• B. Establish bedtime routines and maintain consistency.
• C. Limit use of electronics in the evening i.e., television, computer, etc.
• D. Set and maintain a bedtime that will allow for adequate sleep.
Correct Answer: A. Allow child to keep a cell phone at bedside.
Rationale: Good sleep hygiene involves practices that facilitate restful sleep. Keeping
a cell phone at the bedside can lead to distractions, exposure to blue light, and
interruptions from notifications, all of which can disrupt sleep patterns.
4. Unless the patient provides consent for releasing information, HIPAA prohibits the
disclosure of personal health identifiers to all of the following except:
• A. The patient's next of kin
• B. The patient's health insurance company
• C. The patient's clergy
• D. The patient's attorney
Correct Answer: B. The patient's health insurance company
Rationale: Under HIPAA, personal health identifiers can be disclosed to certain
parties without patient consent, primarily for treatment, payment, and healthcare
operations. Health insurance companies receive PHI for billing and payment
purposes as part of standard healthcare operations.
5. All of the following circumstances would allow the release of medical information
without the patient's consent except:
• A. If the client reveals intent to harm self or others
• B. Records to the insurance company
• C. Responding to court orders, subpoenas, or summons
• D. Next of kin wanting to help the patient make decisions
Correct Answer: D. Next of kin wanting to help the patient make decisions
Rationale: HIPAA permits PHI disclosure without consent for specific purposes like
preventing harm (A), billing (B), and legal compliance (C). However, disclosing
information to next of kin for decision-making (D) generally requires patient consent,
unless the patient is incapacitated and no surrogate is designated.
6. A PMHNP is asked to determine if the patient has the capacity for informed
consent. All of the following elements are necessary for making this determination
except:
, • A. The patient understands the purpose of the proposed treatment or
procedure
• B. The patient understands the risks and discomforts and benefits of the
treatment
• C. The patient understands alternatives to the intended procedure
• D. The patient has a therapeutic alliance with the surgeon
Correct Answer: D. The patient has a therapeutic alliance with the surgeon
Rationale: Capacity for informed consent requires understanding the treatment's
purpose, risks/benefits, and alternatives. A therapeutic alliance, while important, is
not a necessary element for determining capacity.
7. A patient who is refusing psychiatric treatment has their case adjudicated. The
judge orders treatment over objection for the good of the patient. Which ethical
principle is trumped?
• A. Beneficence
• B. Nonmaleficence
• C. Justice
• D. Autonomy
Correct Answer: D. Autonomy
Rationale: Autonomy is the principle that respects a patient's right to make their
own healthcare decisions. When a judge orders treatment against the patient's will,
autonomy is overridden to prioritize beneficence (the patient's well-being).
8. Actions judged based on their inherent value regardless of their consequences is
based on which ethical decision-making approach?
• A. Teleological theory
• B. Deontological theory
• C. Virtue ethics
• D. Justice principle
Correct Answer: B. Deontological theory
Rationale: Deontological ethics focuses on the inherent rightness or wrongness of
actions themselves, regardless of consequences. This approach emphasizes duty and
moral rules, contrasting with teleological theory which judges actions by their results.
9. The theory that depression results from specific thought distortions is consistent
with which of the following?
• A. Learned helplessness theory
, • B. Cognitive theory
• C. Psychoanalytic theory
• D. Behavioral theory
Correct Answer: B. Cognitive theory
Rationale: Cognitive theory, particularly Beck's cognitive model, posits that
depression is caused by negative and distorted thought patterns, such as a negative
view of self, the world, and the future.
10. Discrepancy between anatomical sex and gender is known as which of the
following?
• A. Transvestic disorder
• B. Gender dysphoria
• C. Intersex condition
• D. Gender identity disorder
Correct Answer: B. Gender dysphoria
Rationale: Gender dysphoria refers to the psychological distress that results from an
incongruence between one's experienced/expressed gender and their assigned
gender.
11. The diagnosis used to describe a syndrome characterized by specific symptoms
resulting from recent ingestion or exposure to a substance is known as which of the
following?
• A. Substance use disorder
• B. Substance-induced disorder
• C. Substance intoxication
• D. Withdrawal syndrome
Correct Answer: C. Substance intoxication
Rationale: Substance intoxication is a reversible syndrome caused by recent
ingestion or exposure to a substance, characterized by specific maladaptive
behavioral or psychological changes.
12. Abnormal involuntary movements in a rhythmic pattern affecting the face,
mouth, tongue, and jaw is known as which of the following?
• A. Akathisia
• B. Dystonia
• C. Tardive dyskinesia
• D. Parkinsonism
ACADEMIC YEAR 2026/2027
MIDTERM COMPREHENSIVE EXAM:
VERIFIED QUESTIONS WITH CORRECT
ANSWER RATIONALES || NEWEST
1. Biofeedback, deep breathing, mindfulness, and progressive muscle relaxation are
strategies that are typically used in which of the following therapies?
• A. Relaxation therapy
• B. Social skills training
• C. Motivational Interviewing
• D. Applied behavioral analysis
Correct Answer: A. Relaxation therapy
Rationale: These strategies are core components of relaxation therapy, aimed at
reducing stress and promoting physical and mental well-being by managing
physiological and psychological responses to stress.
2. According to the APA, which of the following are required to support a child's
DSM-5 diagnosis?
• A. The child's clinical presentation fulfills the specific symptom-based
diagnostic criteria.
• B. The child's symptoms are not caused by other diagnoses or stressors.
• C. The child's symptoms are impairing a child's functioning in at least two
settings.
• D. A and B
Correct Answer: D. A and B
Rationale: The APA requires that a child's symptoms meet specific diagnostic criteria
and are not better explained by another condition or stressor. While impairment
(Option C) is a consideration for many diagnoses, the primary requirements are the
symptom criteria and ruling out alternative explanations.
3. Which of the following is NOT consistent with good sleep hygiene?
, • A. Allow child to keep a cell phone at bedside.
• B. Establish bedtime routines and maintain consistency.
• C. Limit use of electronics in the evening i.e., television, computer, etc.
• D. Set and maintain a bedtime that will allow for adequate sleep.
Correct Answer: A. Allow child to keep a cell phone at bedside.
Rationale: Good sleep hygiene involves practices that facilitate restful sleep. Keeping
a cell phone at the bedside can lead to distractions, exposure to blue light, and
interruptions from notifications, all of which can disrupt sleep patterns.
4. Unless the patient provides consent for releasing information, HIPAA prohibits the
disclosure of personal health identifiers to all of the following except:
• A. The patient's next of kin
• B. The patient's health insurance company
• C. The patient's clergy
• D. The patient's attorney
Correct Answer: B. The patient's health insurance company
Rationale: Under HIPAA, personal health identifiers can be disclosed to certain
parties without patient consent, primarily for treatment, payment, and healthcare
operations. Health insurance companies receive PHI for billing and payment
purposes as part of standard healthcare operations.
5. All of the following circumstances would allow the release of medical information
without the patient's consent except:
• A. If the client reveals intent to harm self or others
• B. Records to the insurance company
• C. Responding to court orders, subpoenas, or summons
• D. Next of kin wanting to help the patient make decisions
Correct Answer: D. Next of kin wanting to help the patient make decisions
Rationale: HIPAA permits PHI disclosure without consent for specific purposes like
preventing harm (A), billing (B), and legal compliance (C). However, disclosing
information to next of kin for decision-making (D) generally requires patient consent,
unless the patient is incapacitated and no surrogate is designated.
6. A PMHNP is asked to determine if the patient has the capacity for informed
consent. All of the following elements are necessary for making this determination
except:
, • A. The patient understands the purpose of the proposed treatment or
procedure
• B. The patient understands the risks and discomforts and benefits of the
treatment
• C. The patient understands alternatives to the intended procedure
• D. The patient has a therapeutic alliance with the surgeon
Correct Answer: D. The patient has a therapeutic alliance with the surgeon
Rationale: Capacity for informed consent requires understanding the treatment's
purpose, risks/benefits, and alternatives. A therapeutic alliance, while important, is
not a necessary element for determining capacity.
7. A patient who is refusing psychiatric treatment has their case adjudicated. The
judge orders treatment over objection for the good of the patient. Which ethical
principle is trumped?
• A. Beneficence
• B. Nonmaleficence
• C. Justice
• D. Autonomy
Correct Answer: D. Autonomy
Rationale: Autonomy is the principle that respects a patient's right to make their
own healthcare decisions. When a judge orders treatment against the patient's will,
autonomy is overridden to prioritize beneficence (the patient's well-being).
8. Actions judged based on their inherent value regardless of their consequences is
based on which ethical decision-making approach?
• A. Teleological theory
• B. Deontological theory
• C. Virtue ethics
• D. Justice principle
Correct Answer: B. Deontological theory
Rationale: Deontological ethics focuses on the inherent rightness or wrongness of
actions themselves, regardless of consequences. This approach emphasizes duty and
moral rules, contrasting with teleological theory which judges actions by their results.
9. The theory that depression results from specific thought distortions is consistent
with which of the following?
• A. Learned helplessness theory
, • B. Cognitive theory
• C. Psychoanalytic theory
• D. Behavioral theory
Correct Answer: B. Cognitive theory
Rationale: Cognitive theory, particularly Beck's cognitive model, posits that
depression is caused by negative and distorted thought patterns, such as a negative
view of self, the world, and the future.
10. Discrepancy between anatomical sex and gender is known as which of the
following?
• A. Transvestic disorder
• B. Gender dysphoria
• C. Intersex condition
• D. Gender identity disorder
Correct Answer: B. Gender dysphoria
Rationale: Gender dysphoria refers to the psychological distress that results from an
incongruence between one's experienced/expressed gender and their assigned
gender.
11. The diagnosis used to describe a syndrome characterized by specific symptoms
resulting from recent ingestion or exposure to a substance is known as which of the
following?
• A. Substance use disorder
• B. Substance-induced disorder
• C. Substance intoxication
• D. Withdrawal syndrome
Correct Answer: C. Substance intoxication
Rationale: Substance intoxication is a reversible syndrome caused by recent
ingestion or exposure to a substance, characterized by specific maladaptive
behavioral or psychological changes.
12. Abnormal involuntary movements in a rhythmic pattern affecting the face,
mouth, tongue, and jaw is known as which of the following?
• A. Akathisia
• B. Dystonia
• C. Tardive dyskinesia
• D. Parkinsonism
