NR548 Exam 2 Practice Question Bank: Psychiatric Assessment for the PMHNP — Mood Disorders, MDD & Bipolar Assessment (250 Questions with Verified Answers)

NR548 Exam 2 Practice Question Bank: Psychiatric Assessment for the PMHNP — Mood Disorders, MDD & Bipolar Assessment (250 Questions with Verified Answers) 1. A 42-year-old female presents with depressed mood, anhedonia, fatigue, sleep disturbance, feelings of worthlessness, difficulty concentrating, and psychomotor retardation. Symptoms began 3 weeks ago and have occurred nearly every day. She denies any history of elevated mood, decreased need for sleep, or increased energy. Her PHQ-9 score is 18. What is the MOST likely diagnosis? A. Adjustment disorder with depressed mood B. Major depressive disorder, single episode, moderate C. Persistent depressive disorder (dysthymia) D. Bipolar II disorder Answer: B. Major depressive disorder, single episode, moderate 2. A 28-year-old male is evaluated for depression. He reports depressed mood, anhedonia, insomnia, poor concentration, and significant weight loss over the past month. During the assessment, he mentions a period 2 years ago when he felt "unstoppable," slept only 2 hours nightly for 2 weeks, talked rapidly, and engaged in risky sexual behavior. He was not hospitalized and denies psychosis. What is the CRITICAL next step in diagnostic formulation? A. Diagnose major depressive disorder and initiate SSRI therapy B. Screen for bipolar disorder using the Mood Disorder Questionnaire (MDQ) C. Diagnose persistent depressive disorder with anxious distress D. Prescribe a mood stabilizer immediately without further assessment Answer: B. Screen for bipolar disorder using the Mood Disorder Questionnaire (MDQ) 3. A 35-year-old woman presents with major depressive disorder. She reports that her depression worsens every fall and winter, improves in spring, and has occurred for the past 4 years. She experiences hypersomnia, carbohydrate craving, and weight gain during these episodes. Which DSM-5-TR specifier applies? A. With melancholic features B. With atypical features C. With seasonal pattern D. With peripartum onset Answer: C. With seasonal pattern 4. A 52-year-old male with no prior psychiatric history presents with depressed mood, fatigue, constipation, cold intolerance, and dry skin. Laboratory studies reveal elevated TSH and low free T4. His PHQ-9 score is 12. What is the FIRST priority in the PMHNP's differential diagnosis hierarchy? A. Initiate SSRI therapy for moderate depression B. Refer for cognitive behavioral therapy as first-line treatment C. Rule out medical etiology and treat hypothyroidism D. Diagnose persistent depressive disorder and begin psychotherapy Answer: C. Rule out medical etiology and treat hypothyroidism 5. A 19-year-old college student presents with a 2-week history of elevated mood, decreased need for sleep (2 hours nightly), grandiose beliefs about becoming a famous musician, pressured speech, flight of ideas, and excessive spending on musical equipment. His roommate reports he is "impossible to reason with" and campus security was called twice for disruptive behavior. He has no prior psychiatric history. Which diagnosis is MOST appropriate? A. Bipolar II disorder B. Cyclothymic disorder C. Bipolar I disorder, current episode manic D. Brief psychotic disorder Answer: C. Bipolar I disorder, current episode manic 6. A 31-year-old female presents 3 weeks postpartum with depressed mood, anhedonia, severe anxiety about harming her baby, insomnia even when the baby sleeps, and guilt about being a "bad mother." She had a similar episode after her first pregnancy 3 years ago. What is the MOST appropriate DSM-5-TR specifier for her major depressive episode? A. With psychotic features B. With peripartum onset C. With anxious distress D. With mixed features Answer: B. With peripartum onset 7. A 45-year-old male presents with a 3-year history of chronic low-grade depressed mood occurring more days than not, along with poor appetite, low energy, low self-esteem, and hopelessness. He has never met criteria for a major depressive episode. What is the MOST likely diagnosis? A. Major depressive disorder, recurrent B. Persistent depressive disorder C. Cyclothymic disorder D. Adjustment disorder with depressed mood Answer: B. Persistent depressive disorder 8. A 27-year-old female with major depressive disorder reports that her mood brightens temporarily when good things happen, she oversleeps, overeats, and has heavy feelings in her arms and legs. Which DSM-5-TR specifier is MOST consistent with these features? A. With melancholic features B. With atypical features C. With catatonic features D. With psychotic features Answer: B. With atypical features 9. A 60-year-old male with major depressive disorder presents with profound anhedonia, early morning awakening, psychomotor agitation, significant weight loss, and excessive guilt. Which DSM-5-TR specifier is MOST consistent with this presentation? A. With atypical features B. With melancholic features C. With seasonal pattern D. With peripartum onset Answer: B. With melancholic features 10. A 24-year-old female presents with depressed mood and reports hearing voices telling her she is worthless. She also believes her neighbors are plotting against her. Which DSM-5-TR specifier for major depressive disorder is MOST appropriate? A. With anxious distress B. With mixed features C. With psychotic features D. With catatonic features Answer: C. With psychotic features 1. A 42-year-old female presents with depressed mood, anhedonia, fatigue, sleep disturbanNR548 Exam 2 Practice Question Bank: Psychiatric Assessment for the PMHNP — Mood Disorders, MDD & Bipolar Assessment (250 Questions with Verified Answers)ce, feelings of worthlessness, difficulty concentrating, and psychomotor retardation. Symptoms began 3 weeks ago and have occurred nearly every day. She denies any history of elevated mood, decreased need for sleep, or increased energy. Her PHQ-9 score is 18. What is the MOST likely diagnosis? A. Adjustment disorder with depressed mood B. Major depressive disorder, single episode, moderate C. Persistent depressive disorder (dysthymia) D. Bipolar II disorder Answer: B. Major depressive disorder, single episode, moderate 2. A 28-year-old male is evaluated for depression. He reports depressed mood, anhedonia, insomnia, poor concentration, and significant weight loss over the past month. During the assessment, he mentions a period 2 years ago when he felt "unstoppable," slept only 2 hours nightly for 2 weeks, talked rapidly, and engaged in risky sexual behavior. He was not hospitalized and denies psychosis. What is the CRITICAL next step in diagnostic formulation? A. Diagnose major depressive disorder and initiate SSRI therapy B. Screen for bipolar disorder using the Mood Disorder Questionnaire (MDQ) C. Diagnose persistent depressive disorder with anxious distress D. Prescribe a mood stabilizer immediately without further assessment Answer: B. Screen for bipolar disorder using the Mood Disorder Questionnaire (MDQ) 3. A 35-year-old woman presents with major depressive disorder. She reports that her depression worsens every fall and winter, improves in spring, and has occurred for the past 4 years. She experiences hypersomnia, carbohydrate craving, and weight gain during these episodes. Which DSM-5-TR specifier applies? A. With melancholic features B. With atypical features C. With seasonal pattern D. With peripartum onset Answer: C. With seasonal pattern 4. A 52-year-old male with no prior psychiatric history presents with depressed mood, fatigue, constipation, cold intolerance, and dry skin. Laboratory studies reveal elevated TSH and low free T4. His PHQ-9 score is 12. What is the FIRST priority in the PMHNP's differential diagnosis hierarchy? A. Initiate SSRI therapy for moderate depression B. Refer for cognitive behavioral therapy as first-line treatment C. Rule out medical etiology and treat hypothyroidism D. Diagnose persistent depressive disorder and begin psychotherapy Answer: C. Rule out medical etiology and treat hypothyroidism 5. A 19-year-old college student presents with a 2-week history of elevated mood, decreased need for sleep (2 hours nightly), grandiose beliefs about becoming a famous musician, pressured speech, flight of ideas, and excessive spending on musical equipment. His roommate reports he is "impossible to reason with" and campus security was called twice for disruptive behavior. He has no prior psychiatric history. Which diagnosis is MOST appropriate? A. Bipolar II disorder B. Cyclothymic disorder C. Bipolar I disorder, current episode manic D. Brief psychotic disorder Answer: C. Bipolar I disorder, current episode manic 6. A 31-year-old female presents 3 weeks postpartum with depressed mood, anhedonia, severe anxiety about harming her baby, insomnia even when the baby sleeps, and guilt about being a "bad mother." She had a similar episode after her first pregnancy 3 years ago. What is the MOST appropriate DSM-5-TR specifier for her major depressive episode? A. With psychotic features B. With peripartum onset C. With anxious distress D. With mixed features Answer: B. With peripartum onset 7. A 45-year-old male presents with a 3-year history of chronic low-grade depressed mood occurring more days than not, along with poor appetite, low energy, low self-esteem, and hopelessness. He has never met criteria for a major depressive episode. What is the MOST likely diagnosis? A. Major depressive disorder, recurrent B. Persistent depressive disorder C. Cyclothymic disorder D. Adjustment disorder with depressed mood Answer: B. Persistent depressive disorder 8. A 27-year-old female with major depressive disorder reports that her mood brightens temporarily when good things happen, she oversleeps, overeats, and has heavy feelings in her arms and legs. Which DSM-5-TR specifier is MOST consistent with these features? A. With melancholic features B. With atypical features C. With catatonic features D. With psychotic features Answer: B. With atypical features 9. A 60-year-old male with major depressive disorder presents with profound anhedonia, early morning awakening, psychomotor agitation, significant weight loss, and excessive guilt. Which DSM-5-TR specifier is MOST consistent with this presentation? A. With atypical features B. With melancholic features C. With seasonal pattern D. With peripartum onset Answer: B. With melancholic features 10. A 24-year-old female presents with depressed mood and reports hearing voices telling her she is worthless. She also believes her neighbors are plotting against her. Which DSM-5-TR specifier for major depressive disorder is MOST appropriate? A. With anxious distress B. With mixed features C. With psychotic features D. With catatonic features Answer: C. With psychotic features