NRNP 6665 PMHNP Care Across the
Lifespan I – Academic Year 2026/2027 –
Midterm Comprehensive Exam
ACTUAL QUESTIONS
Domain 1: Psychiatric Assessment and Diagnostic Reasoning
Question 1. Which of the following is a core component of the psychiatric
mental status examination?
A. Only the patient's medical history
B. Appearance, behavior, speech, mood, affect, thought process, thought content,
perception, cognition, and insight/judgment
C. Only laboratory values
D. Only the physical examination
Correct Answer: B
Rationale: The mental status examination systematically assesses appearance,
behavior, speech, mood, affect, thought process and content, perceptual
disturbances, cognition, and insight/judgment to support diagnostic formulation.
Question 2. When assessing a patient for suicidal ideation, the clinician
should:
A. Avoid asking directly about suicide to prevent suggesting the idea
B. Ask directly about ideation, plan, intent, and means, and assess protective
factors
C. Rely solely on the patient's spontaneous report
D. Document only if the patient is actively suicidal
Correct Answer: B
Rationale: Direct, nonjudgmental inquiry about suicidal ideation, plan, intent, and
access to means is a standard of care. Assessing protective factors and risk severity
guides safety planning and level of care.
Question 3. Which screening tool is commonly used to assess depression
severity in adults?
A. MMSE
B. PHQ-9
C. CIWA-Ar
,D. AIMS
Correct Answer: B
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a validated self-report
instrument widely used to screen for and monitor the severity of depressive
symptoms in clinical settings.
Question 4. A patient describes hearing voices commenting on their actions.
This is an example of:
A. A delusion
B. An auditory hallucination
C. An idea of reference
D. Circumstantial thought process
Correct Answer: B
Rationale: Hallucinations are perceptual experiences occurring without external
stimuli. Commenting voices are a form of auditory hallucination often associated
with psychotic disorders.
Question 5. Which of the following is a validated tool for assessing generalized
anxiety disorder?
A. GAD-7
B. PHQ-9
C. MMSE
D. MoCA
Correct Answer: A
Rationale: The GAD-7 is a brief, validated self-report scale used to screen for and
measure the severity of generalized anxiety disorder.
Question 6. A patient presents with a sudden onset of confusion,
disorientation, and hallucinations. They are also dehydrated. What is the most
likely diagnosis?
A. Delirium
B. Dementia
C. Psychosis
D. Depression
Correct Answer: A
Rationale: Delirium is an acute, fluctuating disturbance in attention and awareness,
often precipitated by an underlying medical condition such as dehydration or
infection.
,Question 7. Which assessment finding is a sign of neuroleptic malignant
syndrome (NMS)?
A. Muscle rigidity, fever, altered mental status, and autonomic instability
B. Dry mouth, constipation, and blurred vision
C. Involuntary repetitive movements of the tongue and face
D. Restlessness and inability to sit still
Correct Answer: A
Rationale: NMS is a life-threatening reaction to antipsychotic medications
characterized by muscle rigidity, fever, altered mental status, and autonomic
instability.
Question 8. What is the primary purpose of the Mini-Mental State
Examination (MMSE)?
A. To assess cognitive function
B. To assess depression
C. To assess anxiety
D. To assess alcohol use
Correct Answer: A
Rationale: The MMSE is a widely used tool for assessing cognitive function,
including orientation, memory, attention, and language.
Question 9. A patient with schizophrenia is experiencing delusions of
reference. What does this mean?
A. The patient believes others are plotting against them
B. The patient believes external events or objects have a special personal
significance
C. The patient believes they are a famous person
D. The patient believes their thoughts are being broadcast
Correct Answer: B
Rationale: Delusions of reference involve a false belief that external events or
objects have a special personal significance directed at the individual.
Question 10. Which tool is used to assess alcohol withdrawal severity?
A. CIWA-Ar
B. COWS
C. PHQ-9
D. GAD-7
Correct Answer: A
, Rationale: The Clinical Institute Withdrawal Assessment for Alcohol, Revised
(CIWA-Ar) is the gold standard for assessing and monitoring alcohol withdrawal
severity.
Question 11. What is the primary difference between hallucinations and
illusions?
A. Hallucinations are false sensory perceptions; illusions are misinterpretations of
real stimuli
B. Hallucinations are always visual; illusions are always auditory
C. Hallucinations are controllable; illusions are not
D. There is no difference
Correct Answer: A
Rationale: Hallucinations are false sensory perceptions that occur without an
external stimulus. Illusions are misperceptions or misinterpretations of actual
external stimuli.
Question 12. A patient reports feeling "worthless" and "hopeless." What is
the priority nursing assessment?
A. Suicidal ideation
B. Nutritional status
C. Pain level
D. Sleep pattern
Correct Answer: A
Rationale: Feelings of worthlessness and hopelessness are significant risk factors
for suicide. The nurse must assess for suicidal ideation immediately.
Question 13. Which of the following is a positive symptom of schizophrenia?
A. Flat affect
B. Anhedonia
C. Delusions
D. Social withdrawal
Correct Answer: C
Rationale: Positive symptoms reflect an excess or distortion of normal functions.
Delusions, hallucinations, and disorganized speech are positive symptoms.
Question 14. What is the purpose of the CAGE questionnaire?
A. To screen for alcohol use disorder
B. To screen for depression
C. To screen for anxiety
Lifespan I – Academic Year 2026/2027 –
Midterm Comprehensive Exam
ACTUAL QUESTIONS
Domain 1: Psychiatric Assessment and Diagnostic Reasoning
Question 1. Which of the following is a core component of the psychiatric
mental status examination?
A. Only the patient's medical history
B. Appearance, behavior, speech, mood, affect, thought process, thought content,
perception, cognition, and insight/judgment
C. Only laboratory values
D. Only the physical examination
Correct Answer: B
Rationale: The mental status examination systematically assesses appearance,
behavior, speech, mood, affect, thought process and content, perceptual
disturbances, cognition, and insight/judgment to support diagnostic formulation.
Question 2. When assessing a patient for suicidal ideation, the clinician
should:
A. Avoid asking directly about suicide to prevent suggesting the idea
B. Ask directly about ideation, plan, intent, and means, and assess protective
factors
C. Rely solely on the patient's spontaneous report
D. Document only if the patient is actively suicidal
Correct Answer: B
Rationale: Direct, nonjudgmental inquiry about suicidal ideation, plan, intent, and
access to means is a standard of care. Assessing protective factors and risk severity
guides safety planning and level of care.
Question 3. Which screening tool is commonly used to assess depression
severity in adults?
A. MMSE
B. PHQ-9
C. CIWA-Ar
,D. AIMS
Correct Answer: B
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a validated self-report
instrument widely used to screen for and monitor the severity of depressive
symptoms in clinical settings.
Question 4. A patient describes hearing voices commenting on their actions.
This is an example of:
A. A delusion
B. An auditory hallucination
C. An idea of reference
D. Circumstantial thought process
Correct Answer: B
Rationale: Hallucinations are perceptual experiences occurring without external
stimuli. Commenting voices are a form of auditory hallucination often associated
with psychotic disorders.
Question 5. Which of the following is a validated tool for assessing generalized
anxiety disorder?
A. GAD-7
B. PHQ-9
C. MMSE
D. MoCA
Correct Answer: A
Rationale: The GAD-7 is a brief, validated self-report scale used to screen for and
measure the severity of generalized anxiety disorder.
Question 6. A patient presents with a sudden onset of confusion,
disorientation, and hallucinations. They are also dehydrated. What is the most
likely diagnosis?
A. Delirium
B. Dementia
C. Psychosis
D. Depression
Correct Answer: A
Rationale: Delirium is an acute, fluctuating disturbance in attention and awareness,
often precipitated by an underlying medical condition such as dehydration or
infection.
,Question 7. Which assessment finding is a sign of neuroleptic malignant
syndrome (NMS)?
A. Muscle rigidity, fever, altered mental status, and autonomic instability
B. Dry mouth, constipation, and blurred vision
C. Involuntary repetitive movements of the tongue and face
D. Restlessness and inability to sit still
Correct Answer: A
Rationale: NMS is a life-threatening reaction to antipsychotic medications
characterized by muscle rigidity, fever, altered mental status, and autonomic
instability.
Question 8. What is the primary purpose of the Mini-Mental State
Examination (MMSE)?
A. To assess cognitive function
B. To assess depression
C. To assess anxiety
D. To assess alcohol use
Correct Answer: A
Rationale: The MMSE is a widely used tool for assessing cognitive function,
including orientation, memory, attention, and language.
Question 9. A patient with schizophrenia is experiencing delusions of
reference. What does this mean?
A. The patient believes others are plotting against them
B. The patient believes external events or objects have a special personal
significance
C. The patient believes they are a famous person
D. The patient believes their thoughts are being broadcast
Correct Answer: B
Rationale: Delusions of reference involve a false belief that external events or
objects have a special personal significance directed at the individual.
Question 10. Which tool is used to assess alcohol withdrawal severity?
A. CIWA-Ar
B. COWS
C. PHQ-9
D. GAD-7
Correct Answer: A
, Rationale: The Clinical Institute Withdrawal Assessment for Alcohol, Revised
(CIWA-Ar) is the gold standard for assessing and monitoring alcohol withdrawal
severity.
Question 11. What is the primary difference between hallucinations and
illusions?
A. Hallucinations are false sensory perceptions; illusions are misinterpretations of
real stimuli
B. Hallucinations are always visual; illusions are always auditory
C. Hallucinations are controllable; illusions are not
D. There is no difference
Correct Answer: A
Rationale: Hallucinations are false sensory perceptions that occur without an
external stimulus. Illusions are misperceptions or misinterpretations of actual
external stimuli.
Question 12. A patient reports feeling "worthless" and "hopeless." What is
the priority nursing assessment?
A. Suicidal ideation
B. Nutritional status
C. Pain level
D. Sleep pattern
Correct Answer: A
Rationale: Feelings of worthlessness and hopelessness are significant risk factors
for suicide. The nurse must assess for suicidal ideation immediately.
Question 13. Which of the following is a positive symptom of schizophrenia?
A. Flat affect
B. Anhedonia
C. Delusions
D. Social withdrawal
Correct Answer: C
Rationale: Positive symptoms reflect an excess or distortion of normal functions.
Delusions, hallucinations, and disorganized speech are positive symptoms.
Question 14. What is the purpose of the CAGE questionnaire?
A. To screen for alcohol use disorder
B. To screen for depression
C. To screen for anxiety
