NR 605 Exam Study Guide 2026/2027 | DSM-5-TR Diagnosis,
Psychiatric Assessment & Differential Diagnosis | 300 Questions &
Answers
Psychiatric Assessment and DSM-5-TR Foundations
1. Which finding is most important when establishing a psychiatric
diagnosis?
A. The patient's occupation
B. Symptom pattern, duration, severity, and functional
impairment
C. The patient's preferred treatment
D. Family income
Answer: B
Rationale: Psychiatric diagnoses are based primarily on symptom
patterns, duration, severity, associated impairment, and exclusion of
alternative explanations.
2. What is the primary purpose of the DSM-5-TR?
A. To prescribe medications
B. To establish standardized criteria for mental disorders
C. To determine insurance premiums
D. To replace clinical judgment
Answer: B
Rationale: The DSM-5-TR provides standardized diagnostic criteria
and descriptions that support consistent clinical assessment.
3. Which component of the psychiatric interview focuses on why
the patient is seeking care now?
A. Family history
B. Chief complaint and history of present illness
C. Developmental history
D. Social history
Answer: B
,Rationale: The chief complaint and history of present illness clarify
the patient's current concerns, symptom onset, progression, and
reasons for seeking treatment.
4. A clinician asks, "When did you first notice these symptoms?"
This question primarily assesses:
A. Symptom chronology
B. Judgment
C. Insight
D. Thought content
Answer: A
Rationale: Determining onset and progression establishes the
temporal relationship among symptoms and helps distinguish
possible diagnoses.
5. Which finding is considered a mental status examination
observation?
A. Childhood vaccination history
B. Appearance and behavior
C. Family psychiatric history
D. Previous surgeries
Answer: B
Rationale: Appearance, behavior, speech, mood, affect, thought
process, thought content, cognition, insight, and judgment are
components of the MSE.
6. A patient's subjective description of emotional state is called:
A. Affect
B. Mood
C. Thought process
D. Cognition
Answer: B
Rationale: Mood is the patient's internally experienced emotional
state, whereas affect is the clinician's observation of emotional
expression.
, 7. A clinician documents that a patient's affect is "constricted."
What does this mean?
A. Affect changes rapidly
B. Emotional expression is reduced in range
C. The patient has no emotions
D. Affect is inappropriate to the situation
Answer: B
Rationale: Constricted affect describes a reduced range of emotional
expression.
8. Which term describes emotional expression that does not match
the situation or thought content?
A. Appropriate
B. Congruent
C. Incongruent
D. Euthymic
Answer: C
Rationale: Incongruent affect does not correspond appropriately to
the patient's reported mood, thoughts, or circumstances.
9. A patient reports sadness but smiles continuously while
discussing the death of a spouse. Which MSE finding may be
documented?
A. Congruent affect
B. Incongruent affect
C. Flat affect
D. Euthymia
Answer: B
Rationale: Smiling while discussing profound sadness may represent
affect incongruent with the reported emotional state.
10. Which question best assesses orientation?
A. "What do you think caused this problem?"
B. "Can you tell me your name, where you are, and today's
date?"
, C. "Do you hear voices?"
D. "How do you feel about your family?"
Answer: B
Rationale: Orientation assesses awareness of person, place, time,
and sometimes situation.
11. Which finding most directly indicates impaired attention?
A. Delusion
B. Inability to maintain focus during serial calculations
C. Auditory hallucination
D. Depressed mood
Answer: B
Rationale: Attention refers to the ability to focus and sustain mental
activity.
12. A patient's thought process is described as "loose
associations." This means:
A. Thoughts are organized and goal-directed
B. Ideas have weak or illogical connections
C. The patient repeats the same word
D. Speech is completely absent
Answer: B
Rationale: Loose associations involve shifts between ideas with
limited or unclear logical connections.
13. Which term describes rapid movement from one topic to
another with understandable but accelerated connections?
A. Flight of ideas
B. Thought blocking
C. Circumstantiality
D. Mutism
Answer: A
Rationale: Flight of ideas is commonly associated with mania and
involves rapid shifts between related ideas.
Psychiatric Assessment & Differential Diagnosis | 300 Questions &
Answers
Psychiatric Assessment and DSM-5-TR Foundations
1. Which finding is most important when establishing a psychiatric
diagnosis?
A. The patient's occupation
B. Symptom pattern, duration, severity, and functional
impairment
C. The patient's preferred treatment
D. Family income
Answer: B
Rationale: Psychiatric diagnoses are based primarily on symptom
patterns, duration, severity, associated impairment, and exclusion of
alternative explanations.
2. What is the primary purpose of the DSM-5-TR?
A. To prescribe medications
B. To establish standardized criteria for mental disorders
C. To determine insurance premiums
D. To replace clinical judgment
Answer: B
Rationale: The DSM-5-TR provides standardized diagnostic criteria
and descriptions that support consistent clinical assessment.
3. Which component of the psychiatric interview focuses on why
the patient is seeking care now?
A. Family history
B. Chief complaint and history of present illness
C. Developmental history
D. Social history
Answer: B
,Rationale: The chief complaint and history of present illness clarify
the patient's current concerns, symptom onset, progression, and
reasons for seeking treatment.
4. A clinician asks, "When did you first notice these symptoms?"
This question primarily assesses:
A. Symptom chronology
B. Judgment
C. Insight
D. Thought content
Answer: A
Rationale: Determining onset and progression establishes the
temporal relationship among symptoms and helps distinguish
possible diagnoses.
5. Which finding is considered a mental status examination
observation?
A. Childhood vaccination history
B. Appearance and behavior
C. Family psychiatric history
D. Previous surgeries
Answer: B
Rationale: Appearance, behavior, speech, mood, affect, thought
process, thought content, cognition, insight, and judgment are
components of the MSE.
6. A patient's subjective description of emotional state is called:
A. Affect
B. Mood
C. Thought process
D. Cognition
Answer: B
Rationale: Mood is the patient's internally experienced emotional
state, whereas affect is the clinician's observation of emotional
expression.
, 7. A clinician documents that a patient's affect is "constricted."
What does this mean?
A. Affect changes rapidly
B. Emotional expression is reduced in range
C. The patient has no emotions
D. Affect is inappropriate to the situation
Answer: B
Rationale: Constricted affect describes a reduced range of emotional
expression.
8. Which term describes emotional expression that does not match
the situation or thought content?
A. Appropriate
B. Congruent
C. Incongruent
D. Euthymic
Answer: C
Rationale: Incongruent affect does not correspond appropriately to
the patient's reported mood, thoughts, or circumstances.
9. A patient reports sadness but smiles continuously while
discussing the death of a spouse. Which MSE finding may be
documented?
A. Congruent affect
B. Incongruent affect
C. Flat affect
D. Euthymia
Answer: B
Rationale: Smiling while discussing profound sadness may represent
affect incongruent with the reported emotional state.
10. Which question best assesses orientation?
A. "What do you think caused this problem?"
B. "Can you tell me your name, where you are, and today's
date?"
, C. "Do you hear voices?"
D. "How do you feel about your family?"
Answer: B
Rationale: Orientation assesses awareness of person, place, time,
and sometimes situation.
11. Which finding most directly indicates impaired attention?
A. Delusion
B. Inability to maintain focus during serial calculations
C. Auditory hallucination
D. Depressed mood
Answer: B
Rationale: Attention refers to the ability to focus and sustain mental
activity.
12. A patient's thought process is described as "loose
associations." This means:
A. Thoughts are organized and goal-directed
B. Ideas have weak or illogical connections
C. The patient repeats the same word
D. Speech is completely absent
Answer: B
Rationale: Loose associations involve shifts between ideas with
limited or unclear logical connections.
13. Which term describes rapid movement from one topic to
another with understandable but accelerated connections?
A. Flight of ideas
B. Thought blocking
C. Circumstantiality
D. Mutism
Answer: A
Rationale: Flight of ideas is commonly associated with mania and
involves rapid shifts between related ideas.
