A+ VE RIFIE D
P S YC H I AT R I C M E N TA L H E A LT H N U R S I N G · OBJECTIV E A SSESSMENT
NR 605 Final Exam — Diagnosis & Management in Psychiatric
Mental Health Across the Lifespan I — Complete
Official Exam
6 0 Q UES T I O N S FUL L R AT I O N AL ES VER I FI ED AN S WER S
60
Q UES T IO NS
6
S ECT IO NS
100%
R AT I O N A L E S
W HAT THI S C OV E R S
01 Psychiatric Assessment & Diagnostic Reasoning
02 Mood Disorders: Depressive & Bipolar Spectrum
03 Anxiety, Trauma & Obsessive-Compulsive Disorders
04 Psychotic Spectrum & Neurocognitive Disorders
05 Child, Adolescent & Geriatric Mental Health
06 Psychopharmacology, Monitoring & Safety
A BO UT THI S A SSE SSM E N T
This assessment is an original study aid containing 60 newly written multiple-choice questions with complete
rationales for every answer choice. It is designed for self-paced review of core course concepts at the application
and analysis level.
It is independent review material: it is not affiliated with, endorsed by, or sourced from any school, publisher, or
certifying body, and it does not contain and does not claim to contain any actual, secured, or proctored
examination content. Use it alongside your own course materials to test your understanding.
PA S S I N G S C O R E LEVEL F O R M AT
75% (45 of 60) APPLICATION / ANALYSIS MULTIPLE CHOICE (A–D)
S T U V I A A C T U A L EX A M Page 1
, NR 605 Final Exam — Diagnosis & Management in Psychiatric Mental Health Across the Lifespan I —
Complete
60 multiple-choice questions · 6 sections · Full rationales included · Answer key appears at the end of this document
SECTION 01 · Psychiatric Assessment & Diagnostic Reasoning
Q1. A 47-year-old warehouse supervisor was laid off six weeks ago and is now being evaluated for
adjustment concerns. During the mental status examination he gives excessive, unnecessary detail about
every job task he ever performed, yet each digression eventually circles back to answer the question that
was asked. His speech is goal-directed overall and he denies any perceptual disturbances. This pattern of
disordered thought process is best documented as:
A. Tangentiality with loss of the goal
B. Circumstantiality with eventual return to the point
C. Flight of ideas with rapid topic shifts
D. Loosening of associations with illogical connections
Correct Answer: B
Rationale: Circumstantiality is characterized by excessive detail and digressions, but the patient ultimately
returns to the original question, which matches this presentation exactly. Tangentiality describes speech that drifts
permanently away from the goal without returning, and flight of ideas involves accelerated, pressured shifts
linked by words or sounds rather than detail.
Q2. A 28-year-old graduate student completes a PHQ-9 in the university counseling center and scores
18, indicating moderately severe depressive symptoms. On item 9 she reports that on several days she
has had thoughts that she would be better off dead. She denies a specific plan or intent and came in
voluntarily after her roommate expressed concern. What is the clinician's best next action?
A. Conduct a full structured suicide risk assessment before any treatment planning
B. Begin sertraline 50 mg daily and reassess mood in two weeks
C. Schedule routine follow-up in four weeks to monitor the score trend
D. Order thyroid function studies and a vitamin B12 level today
Correct Answer: A
Rationale: Any positive response on PHQ-9 item 9 requires immediate, structured risk assessment covering
ideation, plan, intent, means, and protective factors before treatment decisions are made. Starting an
antidepressant or delaying reassessment without this evaluation would leave an identifiable safety risk
unaddressed, and laboratory work does not take priority over safety.
STUVIA ACTUAL EXAM Page 2
, Q3. A 26-year-old administrative assistant reports six months of constant worry, heart palpitations,
tremulousness, and difficulty sleeping. She also notes a five-pound weight loss despite a good appetite,
heat intolerance, and her hair thinning. On examination her pulse is 108 and irregular, and she has a fine
tremor with warm, moist skin. Before confirming a diagnosis of generalized anxiety disorder, the
clinician should first:
A. Start low-dose buspirone and reassess in one month
B. Refer directly for cognitive behavioral therapy
C. Confirm the anxiety disorder and begin an SSRI
D. Obtain TSH and free T4 to evaluate thyrotoxicosis
Correct Answer: D
Rationale: Tachycardia, tremor, heat intolerance, weight loss, and irregular pulse strongly suggest
hyperthyroidism, a common medical mimic of generalized anxiety that must be excluded before a primary
psychiatric diagnosis is assigned. Treating the anxiety symptomatically without thyroid testing risks missing a
reversible endocrine cause and delaying definitive care.
Q4. A 41-year-old man presents for a routine visit and answers yes to two of the four CAGE questions,
admitting he has felt he should cut down and has drunk in the morning to steady his nerves. He last
drank heavily two days ago and reports morning shakiness and sweating that resolve with alcohol. He is
alert and hemodynamically stable today. What is the most appropriate next step?
A. Discharge with a printed pamphlet on local Alcoholics Anonymous meetings
B. Obtain a detailed substance use history and assess withdrawal risk with CIWA-Ar protocols
C. Prescribe disulfiram and instruct him to begin it tonight
D. Order a STAT head CT because morning drinking indicates Wernicke encephalopathy
Correct Answer: B
Rationale: A positive CAGE screen requires a focused confirmation of quantity, frequency, pattern, and
consequences, and his morning drinking signals physiological dependence with meaningful withdrawal risk best
quantified by the CIWA-Ar. Disulfiram is inappropriate in an actively drinking patient, and there are no
neurologic findings suggesting Wernicke encephalopathy at this time.
STUVIA ACTUAL EXAM Page 3
P S YC H I AT R I C M E N TA L H E A LT H N U R S I N G · OBJECTIV E A SSESSMENT
NR 605 Final Exam — Diagnosis & Management in Psychiatric
Mental Health Across the Lifespan I — Complete
Official Exam
6 0 Q UES T I O N S FUL L R AT I O N AL ES VER I FI ED AN S WER S
60
Q UES T IO NS
6
S ECT IO NS
100%
R AT I O N A L E S
W HAT THI S C OV E R S
01 Psychiatric Assessment & Diagnostic Reasoning
02 Mood Disorders: Depressive & Bipolar Spectrum
03 Anxiety, Trauma & Obsessive-Compulsive Disorders
04 Psychotic Spectrum & Neurocognitive Disorders
05 Child, Adolescent & Geriatric Mental Health
06 Psychopharmacology, Monitoring & Safety
A BO UT THI S A SSE SSM E N T
This assessment is an original study aid containing 60 newly written multiple-choice questions with complete
rationales for every answer choice. It is designed for self-paced review of core course concepts at the application
and analysis level.
It is independent review material: it is not affiliated with, endorsed by, or sourced from any school, publisher, or
certifying body, and it does not contain and does not claim to contain any actual, secured, or proctored
examination content. Use it alongside your own course materials to test your understanding.
PA S S I N G S C O R E LEVEL F O R M AT
75% (45 of 60) APPLICATION / ANALYSIS MULTIPLE CHOICE (A–D)
S T U V I A A C T U A L EX A M Page 1
, NR 605 Final Exam — Diagnosis & Management in Psychiatric Mental Health Across the Lifespan I —
Complete
60 multiple-choice questions · 6 sections · Full rationales included · Answer key appears at the end of this document
SECTION 01 · Psychiatric Assessment & Diagnostic Reasoning
Q1. A 47-year-old warehouse supervisor was laid off six weeks ago and is now being evaluated for
adjustment concerns. During the mental status examination he gives excessive, unnecessary detail about
every job task he ever performed, yet each digression eventually circles back to answer the question that
was asked. His speech is goal-directed overall and he denies any perceptual disturbances. This pattern of
disordered thought process is best documented as:
A. Tangentiality with loss of the goal
B. Circumstantiality with eventual return to the point
C. Flight of ideas with rapid topic shifts
D. Loosening of associations with illogical connections
Correct Answer: B
Rationale: Circumstantiality is characterized by excessive detail and digressions, but the patient ultimately
returns to the original question, which matches this presentation exactly. Tangentiality describes speech that drifts
permanently away from the goal without returning, and flight of ideas involves accelerated, pressured shifts
linked by words or sounds rather than detail.
Q2. A 28-year-old graduate student completes a PHQ-9 in the university counseling center and scores
18, indicating moderately severe depressive symptoms. On item 9 she reports that on several days she
has had thoughts that she would be better off dead. She denies a specific plan or intent and came in
voluntarily after her roommate expressed concern. What is the clinician's best next action?
A. Conduct a full structured suicide risk assessment before any treatment planning
B. Begin sertraline 50 mg daily and reassess mood in two weeks
C. Schedule routine follow-up in four weeks to monitor the score trend
D. Order thyroid function studies and a vitamin B12 level today
Correct Answer: A
Rationale: Any positive response on PHQ-9 item 9 requires immediate, structured risk assessment covering
ideation, plan, intent, means, and protective factors before treatment decisions are made. Starting an
antidepressant or delaying reassessment without this evaluation would leave an identifiable safety risk
unaddressed, and laboratory work does not take priority over safety.
STUVIA ACTUAL EXAM Page 2
, Q3. A 26-year-old administrative assistant reports six months of constant worry, heart palpitations,
tremulousness, and difficulty sleeping. She also notes a five-pound weight loss despite a good appetite,
heat intolerance, and her hair thinning. On examination her pulse is 108 and irregular, and she has a fine
tremor with warm, moist skin. Before confirming a diagnosis of generalized anxiety disorder, the
clinician should first:
A. Start low-dose buspirone and reassess in one month
B. Refer directly for cognitive behavioral therapy
C. Confirm the anxiety disorder and begin an SSRI
D. Obtain TSH and free T4 to evaluate thyrotoxicosis
Correct Answer: D
Rationale: Tachycardia, tremor, heat intolerance, weight loss, and irregular pulse strongly suggest
hyperthyroidism, a common medical mimic of generalized anxiety that must be excluded before a primary
psychiatric diagnosis is assigned. Treating the anxiety symptomatically without thyroid testing risks missing a
reversible endocrine cause and delaying definitive care.
Q4. A 41-year-old man presents for a routine visit and answers yes to two of the four CAGE questions,
admitting he has felt he should cut down and has drunk in the morning to steady his nerves. He last
drank heavily two days ago and reports morning shakiness and sweating that resolve with alcohol. He is
alert and hemodynamically stable today. What is the most appropriate next step?
A. Discharge with a printed pamphlet on local Alcoholics Anonymous meetings
B. Obtain a detailed substance use history and assess withdrawal risk with CIWA-Ar protocols
C. Prescribe disulfiram and instruct him to begin it tonight
D. Order a STAT head CT because morning drinking indicates Wernicke encephalopathy
Correct Answer: B
Rationale: A positive CAGE screen requires a focused confirmation of quantity, frequency, pattern, and
consequences, and his morning drinking signals physiological dependence with meaningful withdrawal risk best
quantified by the CIWA-Ar. Disulfiram is inappropriate in an actively drinking patient, and there are no
neurologic findings suggesting Wernicke encephalopathy at this time.
STUVIA ACTUAL EXAM Page 3
