NR607 PRE-
DIAGNOSTIC EXAM
(CHAMBERLAIN)
NEWEST 2026/2027
ACTUAL EXAM
1. A patient reports depressed mood, anhedonia, fatigue, insomnia,
and guilt for 3 weeks. Which additional finding most strongly
supports a diagnosis of major depressive disorder?
A. Symptoms occur only after interpersonal conflict
B. Symptoms are present nearly every day and cause functional
impairment
C. Symptoms resolve within several hours
D. Symptoms occur exclusively during substance intoxication
Answer: B. Symptoms are present nearly every day and cause
functional impairment
Rationale: Major depressive disorder requires clinically significant
symptoms that persist for at least 2 weeks and cause distress or
impairment, after excluding alternative explanations.
,2. Which finding should be assessed first when evaluating a patient
with a new depressive episode?
A. Dietary preferences
B. Childhood academic performance
C. Suicidal ideation and intent
D. Preferred psychotherapy modality
Answer: C. Suicidal ideation and intent
Rationale: Safety assessment takes priority in patients with
depression because suicide risk may be present even when not
spontaneously disclosed.
3. A patient reports hearing a voice saying, “You are worthless.”
What is the most important initial clarification?
A. Whether the voice is male or female
B. Whether the patient recognizes the voice
C. Whether the voice commands the patient to harm self or others
D. Whether the voice occurs at night
Answer: C. Whether the voice commands the patient to harm self
or others
Rationale: Command hallucinations require immediate assessment of
safety, intent, ability to resist, and access to means.
4. Which feature most strongly suggests mania rather than
hypomania?
A. Increased energy
B. Decreased need for sleep
C. Significant functional impairment or hospitalization
D. Increased talkativeness
,Answer: C. Significant functional impairment or hospitalization
Rationale: Mania is more severe than hypomania and may cause
marked impairment, require hospitalization, or include psychotic
features.
5. A patient has excessive worry about several domains for 8 months.
Which diagnosis is most consistent with this presentation?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Adjustment disorder
Answer: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder involves excessive, difficult-
to-control worry across multiple areas for at least 6 months.
6. A patient repeatedly experiences unexpected episodes of intense
fear accompanied by palpitations, dyspnea, and trembling. Which
diagnosis should be considered?
A. Panic disorder
B. Somatic symptom disorder
C. OCD
D. Persistent depressive disorder
Answer: A. Panic disorder
Rationale: Recurrent unexpected panic attacks with associated
concern or behavioral change are characteristic of panic disorder.
7. Which symptom is particularly characteristic of obsessive-
compulsive disorder?
, A. Delusions
B. Intrusive unwanted thoughts followed by repetitive behaviors
C. Auditory hallucinations
D. Episodic elevated mood
Answer: B. Intrusive unwanted thoughts followed by repetitive
behaviors
Rationale: OCD is characterized by obsessions, compulsions, or both,
with the behaviors often performed to reduce anxiety associated with
intrusive thoughts.
8. A patient repeatedly checks the door 20 times before leaving
despite recognizing the behavior as excessive. This is most consistent
with:
A. Delusion
B. Compulsion
C. Hallucination
D. Confabulation
Answer: B. Compulsion
Rationale: A compulsion is a repetitive behavior performed in
response to an obsession or according to rigid rules.
9. Which assessment is particularly important before diagnosing a
primary psychiatric disorder?
A. Review of systems and medication/substance history
B. Family vacation history
C. Employment satisfaction alone
D. Preferred pharmacy
Answer: A. Review of systems and medication/substance history
DIAGNOSTIC EXAM
(CHAMBERLAIN)
NEWEST 2026/2027
ACTUAL EXAM
1. A patient reports depressed mood, anhedonia, fatigue, insomnia,
and guilt for 3 weeks. Which additional finding most strongly
supports a diagnosis of major depressive disorder?
A. Symptoms occur only after interpersonal conflict
B. Symptoms are present nearly every day and cause functional
impairment
C. Symptoms resolve within several hours
D. Symptoms occur exclusively during substance intoxication
Answer: B. Symptoms are present nearly every day and cause
functional impairment
Rationale: Major depressive disorder requires clinically significant
symptoms that persist for at least 2 weeks and cause distress or
impairment, after excluding alternative explanations.
,2. Which finding should be assessed first when evaluating a patient
with a new depressive episode?
A. Dietary preferences
B. Childhood academic performance
C. Suicidal ideation and intent
D. Preferred psychotherapy modality
Answer: C. Suicidal ideation and intent
Rationale: Safety assessment takes priority in patients with
depression because suicide risk may be present even when not
spontaneously disclosed.
3. A patient reports hearing a voice saying, “You are worthless.”
What is the most important initial clarification?
A. Whether the voice is male or female
B. Whether the patient recognizes the voice
C. Whether the voice commands the patient to harm self or others
D. Whether the voice occurs at night
Answer: C. Whether the voice commands the patient to harm self
or others
Rationale: Command hallucinations require immediate assessment of
safety, intent, ability to resist, and access to means.
4. Which feature most strongly suggests mania rather than
hypomania?
A. Increased energy
B. Decreased need for sleep
C. Significant functional impairment or hospitalization
D. Increased talkativeness
,Answer: C. Significant functional impairment or hospitalization
Rationale: Mania is more severe than hypomania and may cause
marked impairment, require hospitalization, or include psychotic
features.
5. A patient has excessive worry about several domains for 8 months.
Which diagnosis is most consistent with this presentation?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Adjustment disorder
Answer: B. Generalized anxiety disorder
Rationale: Generalized anxiety disorder involves excessive, difficult-
to-control worry across multiple areas for at least 6 months.
6. A patient repeatedly experiences unexpected episodes of intense
fear accompanied by palpitations, dyspnea, and trembling. Which
diagnosis should be considered?
A. Panic disorder
B. Somatic symptom disorder
C. OCD
D. Persistent depressive disorder
Answer: A. Panic disorder
Rationale: Recurrent unexpected panic attacks with associated
concern or behavioral change are characteristic of panic disorder.
7. Which symptom is particularly characteristic of obsessive-
compulsive disorder?
, A. Delusions
B. Intrusive unwanted thoughts followed by repetitive behaviors
C. Auditory hallucinations
D. Episodic elevated mood
Answer: B. Intrusive unwanted thoughts followed by repetitive
behaviors
Rationale: OCD is characterized by obsessions, compulsions, or both,
with the behaviors often performed to reduce anxiety associated with
intrusive thoughts.
8. A patient repeatedly checks the door 20 times before leaving
despite recognizing the behavior as excessive. This is most consistent
with:
A. Delusion
B. Compulsion
C. Hallucination
D. Confabulation
Answer: B. Compulsion
Rationale: A compulsion is a repetitive behavior performed in
response to an obsession or according to rigid rules.
9. Which assessment is particularly important before diagnosing a
primary psychiatric disorder?
A. Review of systems and medication/substance history
B. Family vacation history
C. Employment satisfaction alone
D. Preferred pharmacy
Answer: A. Review of systems and medication/substance history
