ORI GI NA L C ONTE NT
G R A D U AT E P S YC H I AT R I C NU R S I NG · STUDY QUESTION BANK
NR 605 Psychiatric Mental Health
Across the Lifespan I
Final Exam Review Study Guide · Edition · Questions with Full Answer Rationales
50 Questions Full Rationales Answer Key Included
50 5 100%
Q UES T IO NS S ECT IO NS R AT I O N A L E S
W H AT T H I S C OV E R S
01 Assessment, Diagnosis & Neurobiology Questions 1 - 10
02 Psychopharmacology & Side-Effect Management Questions 11 - 20
03 Depressive & Bipolar Disorders Questions 21 - 30
04 Anxiety, Trauma-Related & OCD Spectrum Disorders Questions 31 - 40
05 Schizophrenia Spectrum & Psychotic Disorders Questions 41 - 50
A B O U T T H I S S T U DY G U I D E
This study guide contains 50 original multiple-choice questions written to support independent review of the core concepts
covered in this course. Every item was authored specifically for this guide, mapped to high-yield course topics, and paired
with a detailed answer rationale that explains both the correct response and the strongest distractor. This publication is an
independent study aid: it is not the actual examination of any institution, and it is not affiliated with or endorsed by any school
or program. Use it alongside your course materials to test application-level understanding and master the reasoning behind
every answer.
M A S T E R Y TA R G E T LE VE L F O R M AT
80% (40 of 50) Graduate PDF · 50 Questions
S T U D Y Q U ES T IO N B A N K Pag e 1
, NR 605 Psychiatric Mental Health Across the Lifespan I
Final Exam Review Study Guide · Edition · 50 questions with full answer rationales
SECTION 1 · Assessment, Diagnosis & Neurobiology Questions 1 - 10
Q1. A 28-year-old graphic designer is brought in by her roommate, who reports that she has been stating the television
anchors are broadcasting coded warnings about her. During the interview, her speech is logical, coherent, and goal
directed from one topic to the next. When documenting the mental status examination, how should the PMHNP
characterize these findings?
A. Loose associations indicating disordered thought process
B. Organized thought process with delusional thought content
C. Tangential thought process with obsessional content
D. Circumstantial thought process with overvalued ideas
Correct Answer: B
Rationale: Thought process describes the form and flow of speech, which here is logical and goal directed, while thought
content describes the beliefs expressed, and the coded-warnings belief is a persecutory delusion. Option A mislabels an
organized stream of speech as a formal thought disorder. Options C and D invent distortions of process that are not present in
this interview.
Q2. A 34-year-old teacher screens positive for depression at a follow-up visit and completes the PHQ-9, scoring 15.
She endorses the self-harm item as not at all, and sertraline is prescribed today. What is the correct interpretation
of this score and the most appropriate follow-up interval?
A. Mild depression; repeat the PHQ-9 in 6 months
B. Severe depression; arrange same-day hospitalization
C. Moderately severe depression; repeat the PHQ-9 in 4 to 6 weeks
D. Mild-to-moderate depression; recheck the score in 12 weeks
Correct Answer: C
Rationale: PHQ-9 bands are 0 to 4 minimal, 5 to 9 mild, 10 to 14 moderate, 15 to 19 moderately severe, and 20 to 27 severe,
so a score of 15 falls in the moderately severe range. Response to treatment is reassessed 4 to 6 weeks after starting or
changing an antidepressant. Option B overstates severity because hospitalization is reserved for acute danger such as active
suicidal intent, which she denies.
Q3. During an intake visit, a 41-year-old emergency department nurse completes the GAD-7 and scores 12. She
describes worry she cannot control on more days than not for the past 7 months, along with restlessness and
muscle tension. What is the best interpretation of this result and the next step?
A. Moderate anxiety; complete a full diagnostic evaluation for generalized anxiety disorder
B. Subthreshold anxiety; defer any further assessment today
C. Diagnostic of panic disorder; start a benzodiazepine
D. Severe anxiety; refer immediately for cognitive processing therapy
Correct Answer: A
Rationale: GAD-7 scores of 10 to 14 indicate moderate anxiety and a positive screen, but the instrument is not diagnostic by
itself, so a structured evaluation against full criteria is the correct next step. Her 7-month duration of worry plus somatic
symptoms is consistent with generalized anxiety disorder rather than panic disorder. Option D names a trauma-focused
therapy that does not address this presentation.
STUDY QUESTION BANK Page 2
, Q4. A 52-year-old construction supervisor reports drinking several beers most nights of the week. His AUDIT-C
score is 7, and he answers yes to two CAGE questions, including morning drinking to steady his nerves. What is
the most appropriate interpretation and next step?
A. Negative screen; repeat the CAGE at the annual visit
B. Normal intake; provide brief written advice only
C. Confirmed dependence; admit for inpatient detoxification today
D. Positive screens; assess further for alcohol use disorder and withdrawal risk
Correct Answer: D
Rationale: An AUDIT-C of 7 exceeds the positive threshold of 4 for men, and a CAGE score of 2 or more is clinically
significant, so both results warrant a full assessment for alcohol use disorder, including consumption pattern and withdrawal
risk. Option C jumps to inpatient detoxification, which depends on withdrawal severity rather than the screening score alone.
Options A and B incorrectly treat clearly positive screens as negative.
Q5. The PMHNP evaluates a 19-year-old sophomore who admits to passive thoughts that she would be better off
asleep and never waking up. She denies any plan, intent, or preparatory behavior, although she keeps a bottle of
over-the-counter sleep aid in her dorm room. She is engaged with her campus counselor and close to her older
sister. Which action best reflects a structured suicide risk assessment?
A. Admit involuntarily because any reported ideation mandates hospitalization
B. Assess plan and intent, restrict access to lethal means, document protective factors, and arrange prompt outpatient
follow-up
C. Discharge with no follow-up because passive ideation carries no risk
D. Prescribe a benzodiazepine and reevaluate in 3 months
Correct Answer: B
Rationale: A C-SSRS style assessment stratifies ideation severity, plan, and intent, and passive ideation without plan or intent
generally supports a safety plan, means restriction, and rapid outpatient follow-up rather than automatic admission.
Documenting protective factors such as treatment engagement and social support is part of the formulation. Option A
overtreats a low-acuity presentation, while option C undertreats any acknowledged ideation.
Q6. A nurse practitioner student presents a seminar on the neurobiology of major depressive disorder to the PMHNP
class. Which statement should the instructor confirm as accurate?
A. Depression results solely from absolute serotonin deficiency
B. Cortisol is uniformly low and dexamethasone suppression is enhanced in depression
C. Monoamine alterations involving serotonin and norepinephrine are implicated, and many patients show HPA-axis
hyperactivity with elevated cortisol
D. Dopamine findings explain depression while the HPA axis remains unaffected
Correct Answer: C
Rationale: The monoamine hypothesis, supported by depletion and pharmacologic challenge studies, implicates serotonin
and norepinephrine in mood regulation, while a large subset of depressed patients demonstrates HPA-axis hyperactivity such
as elevated cortisol and nonsuppression on dexamethasone testing. Option A oversimplifies a model that current research
treats as partial. Options B and D reverse or ignore the HPA-axis findings.
STUDY QUESTION BANK Page 3
G R A D U AT E P S YC H I AT R I C NU R S I NG · STUDY QUESTION BANK
NR 605 Psychiatric Mental Health
Across the Lifespan I
Final Exam Review Study Guide · Edition · Questions with Full Answer Rationales
50 Questions Full Rationales Answer Key Included
50 5 100%
Q UES T IO NS S ECT IO NS R AT I O N A L E S
W H AT T H I S C OV E R S
01 Assessment, Diagnosis & Neurobiology Questions 1 - 10
02 Psychopharmacology & Side-Effect Management Questions 11 - 20
03 Depressive & Bipolar Disorders Questions 21 - 30
04 Anxiety, Trauma-Related & OCD Spectrum Disorders Questions 31 - 40
05 Schizophrenia Spectrum & Psychotic Disorders Questions 41 - 50
A B O U T T H I S S T U DY G U I D E
This study guide contains 50 original multiple-choice questions written to support independent review of the core concepts
covered in this course. Every item was authored specifically for this guide, mapped to high-yield course topics, and paired
with a detailed answer rationale that explains both the correct response and the strongest distractor. This publication is an
independent study aid: it is not the actual examination of any institution, and it is not affiliated with or endorsed by any school
or program. Use it alongside your course materials to test application-level understanding and master the reasoning behind
every answer.
M A S T E R Y TA R G E T LE VE L F O R M AT
80% (40 of 50) Graduate PDF · 50 Questions
S T U D Y Q U ES T IO N B A N K Pag e 1
, NR 605 Psychiatric Mental Health Across the Lifespan I
Final Exam Review Study Guide · Edition · 50 questions with full answer rationales
SECTION 1 · Assessment, Diagnosis & Neurobiology Questions 1 - 10
Q1. A 28-year-old graphic designer is brought in by her roommate, who reports that she has been stating the television
anchors are broadcasting coded warnings about her. During the interview, her speech is logical, coherent, and goal
directed from one topic to the next. When documenting the mental status examination, how should the PMHNP
characterize these findings?
A. Loose associations indicating disordered thought process
B. Organized thought process with delusional thought content
C. Tangential thought process with obsessional content
D. Circumstantial thought process with overvalued ideas
Correct Answer: B
Rationale: Thought process describes the form and flow of speech, which here is logical and goal directed, while thought
content describes the beliefs expressed, and the coded-warnings belief is a persecutory delusion. Option A mislabels an
organized stream of speech as a formal thought disorder. Options C and D invent distortions of process that are not present in
this interview.
Q2. A 34-year-old teacher screens positive for depression at a follow-up visit and completes the PHQ-9, scoring 15.
She endorses the self-harm item as not at all, and sertraline is prescribed today. What is the correct interpretation
of this score and the most appropriate follow-up interval?
A. Mild depression; repeat the PHQ-9 in 6 months
B. Severe depression; arrange same-day hospitalization
C. Moderately severe depression; repeat the PHQ-9 in 4 to 6 weeks
D. Mild-to-moderate depression; recheck the score in 12 weeks
Correct Answer: C
Rationale: PHQ-9 bands are 0 to 4 minimal, 5 to 9 mild, 10 to 14 moderate, 15 to 19 moderately severe, and 20 to 27 severe,
so a score of 15 falls in the moderately severe range. Response to treatment is reassessed 4 to 6 weeks after starting or
changing an antidepressant. Option B overstates severity because hospitalization is reserved for acute danger such as active
suicidal intent, which she denies.
Q3. During an intake visit, a 41-year-old emergency department nurse completes the GAD-7 and scores 12. She
describes worry she cannot control on more days than not for the past 7 months, along with restlessness and
muscle tension. What is the best interpretation of this result and the next step?
A. Moderate anxiety; complete a full diagnostic evaluation for generalized anxiety disorder
B. Subthreshold anxiety; defer any further assessment today
C. Diagnostic of panic disorder; start a benzodiazepine
D. Severe anxiety; refer immediately for cognitive processing therapy
Correct Answer: A
Rationale: GAD-7 scores of 10 to 14 indicate moderate anxiety and a positive screen, but the instrument is not diagnostic by
itself, so a structured evaluation against full criteria is the correct next step. Her 7-month duration of worry plus somatic
symptoms is consistent with generalized anxiety disorder rather than panic disorder. Option D names a trauma-focused
therapy that does not address this presentation.
STUDY QUESTION BANK Page 2
, Q4. A 52-year-old construction supervisor reports drinking several beers most nights of the week. His AUDIT-C
score is 7, and he answers yes to two CAGE questions, including morning drinking to steady his nerves. What is
the most appropriate interpretation and next step?
A. Negative screen; repeat the CAGE at the annual visit
B. Normal intake; provide brief written advice only
C. Confirmed dependence; admit for inpatient detoxification today
D. Positive screens; assess further for alcohol use disorder and withdrawal risk
Correct Answer: D
Rationale: An AUDIT-C of 7 exceeds the positive threshold of 4 for men, and a CAGE score of 2 or more is clinically
significant, so both results warrant a full assessment for alcohol use disorder, including consumption pattern and withdrawal
risk. Option C jumps to inpatient detoxification, which depends on withdrawal severity rather than the screening score alone.
Options A and B incorrectly treat clearly positive screens as negative.
Q5. The PMHNP evaluates a 19-year-old sophomore who admits to passive thoughts that she would be better off
asleep and never waking up. She denies any plan, intent, or preparatory behavior, although she keeps a bottle of
over-the-counter sleep aid in her dorm room. She is engaged with her campus counselor and close to her older
sister. Which action best reflects a structured suicide risk assessment?
A. Admit involuntarily because any reported ideation mandates hospitalization
B. Assess plan and intent, restrict access to lethal means, document protective factors, and arrange prompt outpatient
follow-up
C. Discharge with no follow-up because passive ideation carries no risk
D. Prescribe a benzodiazepine and reevaluate in 3 months
Correct Answer: B
Rationale: A C-SSRS style assessment stratifies ideation severity, plan, and intent, and passive ideation without plan or intent
generally supports a safety plan, means restriction, and rapid outpatient follow-up rather than automatic admission.
Documenting protective factors such as treatment engagement and social support is part of the formulation. Option A
overtreats a low-acuity presentation, while option C undertreats any acknowledged ideation.
Q6. A nurse practitioner student presents a seminar on the neurobiology of major depressive disorder to the PMHNP
class. Which statement should the instructor confirm as accurate?
A. Depression results solely from absolute serotonin deficiency
B. Cortisol is uniformly low and dexamethasone suppression is enhanced in depression
C. Monoamine alterations involving serotonin and norepinephrine are implicated, and many patients show HPA-axis
hyperactivity with elevated cortisol
D. Dopamine findings explain depression while the HPA axis remains unaffected
Correct Answer: C
Rationale: The monoamine hypothesis, supported by depletion and pharmacologic challenge studies, implicates serotonin
and norepinephrine in mood regulation, while a large subset of depressed patients demonstrates HPA-axis hyperactivity such
as elevated cortisol and nonsuppression on dexamethasone testing. Option A oversimplifies a model that current research
treats as partial. Options B and D reverse or ignore the HPA-axis findings.
STUDY QUESTION BANK Page 3
