NR 548 PSYCHIATRIC ASSESSMENT PMHNP EXAM 3 2026/2027 - Complete Practice Questions & Verified Answers | Chamberlain College of Nursing

NR 548 PSYCHIATRIC ASSESSMENT FOR THE PMHNP |CHAMBERLAIN
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SECTION 1: FOUNDATIONS OF PSYCHIATRIC ASSESSMENT (Questions 1-25)
QUESTION 1
Which component of the psychiatric assessment provides the MOST
objective data regarding a patient's current cognitive and emotional
state?

A. Patient's self-reported mood rating
B. Collateral information from family members
C. The Mental Status Examination (MSE)
D. The patient's medical history

Correct Answer: C
Detailed Rationale: The MSE is a structured, clinician-observed
assessment of the patient's appearance, behavior, speech, mood, affect,
thought process, thought content, cognition, and insight. Unlike
subjective reports (A) or collateral (B), the MSE relies on the
clinician's direct observation, making it the most objective component
of the psychiatric interview. Medical history (D) provides context but
does not capture the current mental state.


QUESTION 2
A PMHNP is conducting a mental status exam. The patient speaks very
rapidly, jumps from topic to topic, and is difficult to interrupt.
This speech pattern is BEST described as:

A. Circumstantiality
B. Pressured speech
C. Tangentiality
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,D. Word salad

Correct Answer: B
Detailed Rationale: Pressured speech is rapid, accelerated speech that
is difficult to interrupt and often increased in amount. It is commonly
seen in mania or hypomania. Circumstantiality (A) involves excessive
detail but eventually reaches the point. Tangentiality (C) involves
wandering off topic without returning. Word salad (D) is a jumble of
unconnected words, seen in severe schizophrenia.


QUESTION 3
During an MSE, a patient reports that they are "feeling down" but
laughs inappropriately throughout the interview. The PMHNP notes
this discrepancy as:

A. Euthymic mood with congruent affect
B. Depressed mood with incongruent affect
C. Labile mood with flat affect
D. Anxious mood with blunted affect

Correct Answer: B
Detailed Rationale: Mood is the patient's subjective internal state
("feeling down" = depressed). Affect is the clinician's observation
of the patient's emotional expression (laughing inappropriately =
incongruent, as it does not match the depressed mood). Flat affect
would be no emotional expression; labile mood refers to rapid shifts.


QUESTION 4
Which of the following assessment findings is MOST characteristic of
a patient experiencing a manic episode?

A. Psychomotor retardation and anhedonia
B. Grandiose delusions and decreased need for sleep
C. Avolition and alogia
D. Somatic complaints and excessive worry

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,Correct Answer: B
Detailed Rationale: Mania is defined by a distinct period of abnormally
and persistently elevated, expansive, or irritable mood, lasting at
least 1 week. Grandiose delusions and a decreased need for sleep
(feeling rested after only 3 hours) are hallmark symptoms. A describes
depression; C describes negative symptoms of schizophrenia; D describes
somatic symptom or anxiety disorders.


QUESTION 5
The PMHNP asks the patient to interpret the proverb, "People who live
in glass houses shouldn't throw stones." The patient responds, "Because
the stones will break the windows." This response indicates a deficit
in:

A. Insight
B. Abstract reasoning
C. Memory
D. Attention

Correct Answer: B
Detailed Rationale: Proverb interpretation tests abstract reasoning
(concrete vs. abstract thinking). A concrete response (breaking windows)
versus the abstract meaning (don't criticize others for faults you also
have) suggests concrete thinking, often seen in schizophrenia, dementia,
or intellectual disability. Insight (A) refers to awareness of illness;
memory (C) and attention (D) are assessed separately.


QUESTION 6
The PMHNP is assessing a patient's capacity to provide informed consent.
Which of the following is a necessary component of decisional capacity?

A. The patient agrees with the recommended treatment
B. The patient demonstrates understanding of the risks and benefits
C. The patient has a family member present
D. The patient has been in treatment for at least 6 months

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, Correct Answer: B
Detailed Rationale: Decisional capacity requires four elements:
communicating a choice, understanding relevant information,
appreciating the situation and its consequences, and reasoning
through the options. Agreement with treatment (A) is not required;
the patient can refuse. Family presence (C) is not a legal requirement.
Duration of treatment (D) is irrelevant.


QUESTION 7
The PMHNP is performing a risk assessment for suicide. Which question
is the MOST direct and effective way to assess suicidal ideation?

A. "You're not thinking of hurting yourself, are you?"
B. "Have you had any thoughts of death or suicide in the past week?"
C. "Are you feeling depressed?"
D. "Do you have a plan?"

Correct Answer: B
Detailed Rationale: Asking directly and non-judgmentally about suicidal
thoughts is evidence-based. This open-ended question normalizes the
inquiry. "Are you?" (A) is a leading question that encourages a "no."
(C) is too vague. (D) is important but should follow the screening
question, not replace it, as asking about a plan presumes ideation.


QUESTION 8
A patient presents with a 2-week history of depressed mood, anhedonia,
significant weight loss, insomnia, fatigue, feelings of worthlessness,
and recurrent thoughts of death. The PMHNP should recognize this
constellation of symptoms as consistent with:

A. Adjustment disorder with depressed mood
B. Major Depressive Disorder (MDD), single episode
C. Persistent Depressive Disorder (Dysthymia)
D. Bipolar II disorder, current episode depressed

Correct Answer: B
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