NR 605 Comprehensive Exam Prep 2026/2027 | Diagnosis &
Management Across the Lifespan | 500 Practice Questions, Answers
& Rationales
Psychiatric Assessment, Diagnosis & Clinical Reasoning (1–50)
Which component of the mental status examination assesses a
patient's ability to identify who, where, and when they are?
A. Insight
B. Orientation
C. Judgment
D. Abstraction
Answer: B
Rationale: Orientation evaluates awareness of person, place, time,
and sometimes situation.
A patient reports hearing voices when no one is present. Which
symptom is this?
A. Delusion
B. Illusion
C. Hallucination
D. Obsession
Answer: C
Rationale: A hallucination is a perception occurring without an
external stimulus. Auditory hallucinations are particularly common
in psychotic disorders.
Which finding most strongly suggests mania?
A. Anhedonia
B. Decreased need for sleep with increased energy
C. Psychomotor retardation
D. Social withdrawal
Answer: B
Rationale: Decreased need for sleep, increased energy, pressured
speech, grandiosity, and increased goal-directed activity are
characteristic manic symptoms.
,Which condition requires ruling out a medical or substance-induced
cause before diagnosing a primary psychiatric disorder?
A. All new-onset psychiatric presentations
B. Only anxiety disorders
C. Only depressive disorders
D. Only personality disorders
Answer: A
Rationale: New psychiatric symptoms can result from medications,
substances, endocrine disorders, neurologic disease, infections, or
other medical conditions.
Which question is most appropriate when assessing suicidal ideation?
A. “You aren't thinking about suicide, are you?”
B. “Do you have thoughts of killing yourself?”
C. “You wouldn't actually hurt yourself, would you?”
D. “Why would you want to die?”
Answer: B
Rationale: Direct, nonjudgmental questioning about suicidal
thoughts is appropriate and does not cause suicidal behavior.
Which finding indicates the greatest immediate suicide risk?
A. Passive thoughts of death without intent
B. Remote history of depression
C. Current plan, intent, and access to lethal means
D. Mild insomnia
Answer: C
Rationale: Current intent, a specific plan, and access to lethal means
substantially increase acute suicide risk.
Which feature differentiates a delusion from an overvalued idea?
A. Delusions are always bizarre.
B. Delusions are fixed false beliefs not consistent with available
evidence.
C. Overvalued ideas always involve hallucinations.
D. Delusions occur only in schizophrenia.
,Answer: B
Rationale: A delusion is a fixed belief maintained despite contrary
evidence. Delusions may be bizarre or nonbizarre.
Which assessment is most important before initiating many
psychotropic medications?
A. Favorite food
B. Medication and substance-use history
C. Childhood grades
D. Preferred television program
Answer: B
Rationale: Current medications, previous medication responses,
allergies, substances, and supplements are essential for safe
treatment planning.
A patient believes neighbors are secretly monitoring them despite no
evidence. This is most consistent with:
A. Persecutory delusion
B. Flight of ideas
C. Thought blocking
D. Echolalia
Answer: A
Rationale: A persecutory delusion involves the belief that others
intend to harm, monitor, follow, or otherwise target the patient.
Which term describes rapidly shifting from one topic to another with
understandable connections?
A. Loose associations
B. Flight of ideas
C. Thought blocking
D. Clang associations
Answer: B
Rationale: Flight of ideas involves rapid speech and shifting topics
with discernible connections, often seen during mania.
, Which symptom is considered a negative symptom of schizophrenia?
A. Hallucination
B. Delusion
C. Avolition
D. Agitation
Answer: C
Rationale: Negative symptoms include diminished motivation,
emotional expression, speech, pleasure, and social engagement.
Which diagnosis requires symptoms of psychosis for at least one
month but less than six months?
A. Schizophrenia
B. Schizophreniform disorder
C. Brief psychotic disorder
D. Delusional disorder
Answer: B
Rationale: Schizophreniform disorder has a duration of at least one
month but less than six months.
Psychotic symptoms lasting less than one month with eventual return
to baseline are most consistent with:
A. Schizophrenia
B. Schizophreniform disorder
C. Brief psychotic disorder
D. Schizoaffective disorder
Answer: C
Rationale: Brief psychotic disorder involves psychosis lasting less
than one month followed by return toward premorbid functioning.
Which diagnosis requires both a major mood episode and a period of
psychosis without prominent mood symptoms?
A. Schizophrenia
B. Schizoaffective disorder
C. Delusional disorder
D. Cyclothymic disorder
Management Across the Lifespan | 500 Practice Questions, Answers
& Rationales
Psychiatric Assessment, Diagnosis & Clinical Reasoning (1–50)
Which component of the mental status examination assesses a
patient's ability to identify who, where, and when they are?
A. Insight
B. Orientation
C. Judgment
D. Abstraction
Answer: B
Rationale: Orientation evaluates awareness of person, place, time,
and sometimes situation.
A patient reports hearing voices when no one is present. Which
symptom is this?
A. Delusion
B. Illusion
C. Hallucination
D. Obsession
Answer: C
Rationale: A hallucination is a perception occurring without an
external stimulus. Auditory hallucinations are particularly common
in psychotic disorders.
Which finding most strongly suggests mania?
A. Anhedonia
B. Decreased need for sleep with increased energy
C. Psychomotor retardation
D. Social withdrawal
Answer: B
Rationale: Decreased need for sleep, increased energy, pressured
speech, grandiosity, and increased goal-directed activity are
characteristic manic symptoms.
,Which condition requires ruling out a medical or substance-induced
cause before diagnosing a primary psychiatric disorder?
A. All new-onset psychiatric presentations
B. Only anxiety disorders
C. Only depressive disorders
D. Only personality disorders
Answer: A
Rationale: New psychiatric symptoms can result from medications,
substances, endocrine disorders, neurologic disease, infections, or
other medical conditions.
Which question is most appropriate when assessing suicidal ideation?
A. “You aren't thinking about suicide, are you?”
B. “Do you have thoughts of killing yourself?”
C. “You wouldn't actually hurt yourself, would you?”
D. “Why would you want to die?”
Answer: B
Rationale: Direct, nonjudgmental questioning about suicidal
thoughts is appropriate and does not cause suicidal behavior.
Which finding indicates the greatest immediate suicide risk?
A. Passive thoughts of death without intent
B. Remote history of depression
C. Current plan, intent, and access to lethal means
D. Mild insomnia
Answer: C
Rationale: Current intent, a specific plan, and access to lethal means
substantially increase acute suicide risk.
Which feature differentiates a delusion from an overvalued idea?
A. Delusions are always bizarre.
B. Delusions are fixed false beliefs not consistent with available
evidence.
C. Overvalued ideas always involve hallucinations.
D. Delusions occur only in schizophrenia.
,Answer: B
Rationale: A delusion is a fixed belief maintained despite contrary
evidence. Delusions may be bizarre or nonbizarre.
Which assessment is most important before initiating many
psychotropic medications?
A. Favorite food
B. Medication and substance-use history
C. Childhood grades
D. Preferred television program
Answer: B
Rationale: Current medications, previous medication responses,
allergies, substances, and supplements are essential for safe
treatment planning.
A patient believes neighbors are secretly monitoring them despite no
evidence. This is most consistent with:
A. Persecutory delusion
B. Flight of ideas
C. Thought blocking
D. Echolalia
Answer: A
Rationale: A persecutory delusion involves the belief that others
intend to harm, monitor, follow, or otherwise target the patient.
Which term describes rapidly shifting from one topic to another with
understandable connections?
A. Loose associations
B. Flight of ideas
C. Thought blocking
D. Clang associations
Answer: B
Rationale: Flight of ideas involves rapid speech and shifting topics
with discernible connections, often seen during mania.
, Which symptom is considered a negative symptom of schizophrenia?
A. Hallucination
B. Delusion
C. Avolition
D. Agitation
Answer: C
Rationale: Negative symptoms include diminished motivation,
emotional expression, speech, pleasure, and social engagement.
Which diagnosis requires symptoms of psychosis for at least one
month but less than six months?
A. Schizophrenia
B. Schizophreniform disorder
C. Brief psychotic disorder
D. Delusional disorder
Answer: B
Rationale: Schizophreniform disorder has a duration of at least one
month but less than six months.
Psychotic symptoms lasting less than one month with eventual return
to baseline are most consistent with:
A. Schizophrenia
B. Schizophreniform disorder
C. Brief psychotic disorder
D. Schizoaffective disorder
Answer: C
Rationale: Brief psychotic disorder involves psychosis lasting less
than one month followed by return toward premorbid functioning.
Which diagnosis requires both a major mood episode and a period of
psychosis without prominent mood symptoms?
A. Schizophrenia
B. Schizoaffective disorder
C. Delusional disorder
D. Cyclothymic disorder
