NR607 PRE-DIAGNOSTIC EXAM 2026: 300 VERIFIED QUESTIONS &
CORRECT ANSWERS WITH DETAILED RATIONALES |PSYCHIATRIC
MENTAL HEALTH NURSE PRACTITIONER ADVANCED DIFFERENTIAL
DIAGNOSIS, PSYCHOPHARMACOLOGY, NEUROBIOLOGY & EVIDENCE-
BASED TREATMENT EXAM| LATEST UPDATE
SECTION 1: ADVANCED DIFFERENTIAL DIAGNOSIS (Questions 1-75)
Q1. A 35-year-old woman presents with persistent sadness, fatigue, and loss of
interest in activities for the past 6 weeks. She denies suicidal ideation but notes
difficulty concentrating at work. The PMHNP begins the diagnostic process using
the DSM-5-TR classification system. What is the primary purpose of using a
multiaxial diagnostic approach in psychiatric assessment?
A. To assign a single label that captures all of the patient's symptoms
B. To provide a comprehensive biopsychosocial framework that captures multiple
dimensions of the patient's presentation
C. To ensure that all patients receive the same medication regimen
D. To eliminate the need for collateral information from family members
Correct Answer: B
Rationale: A rational diagnostic approach provides a comprehensive
biopsychosocial framework that captures multiple dimensions including
psychiatric diagnoses, medical conditions, psychosocial stressors, and functional
impairment. A single diagnostic label would fail to capture the complexity of most
psychiatric presentations.
Q2. A 42-year-old man is referred for psychiatric evaluation after his wife reports
he has been acting strangely for 3 months, talking to people who are not present
and expressing beliefs that the government is monitoring him. The PMHNP
performs a mental status examination. What component of the MSE specifically
assesses the patient's beliefs about being monitored?
A. Thought content evaluation for delusions and obsessions
B. Mood assessment for affective symptoms
C. Cognitive assessment for memory impairment
1
,D. Sensorium evaluation for level of consciousness
Correct Answer: A
Rationale: Thought content evaluation specifically assesses for delusions,
obsessions, phobias, and suicidal or homicidal ideation, which includes the
paranoid beliefs about government monitoring described in this patient. Mood
assessment evaluates emotional state rather than fixed false beliefs.
Q3. A 28-year-old woman with a history of childhood sexual abuse presents with
chronic feelings of emptiness, unstable relationships, and recurrent self-harm
behaviors. The PMHNP considers both borderline personality disorder and
complex PTSD in the differential diagnosis. What feature most strongly
distinguishes complex PTSD from borderline personality disorder?
A. Presence of self-injurious behaviors and impulsivity
B. Chronic emotional dysregulation and fear of abandonment
C. History of trauma with negative self-concept and relational disturbances
without pervasive identity instability
D. Preoccupation with fantasies of unlimited success
Correct Answer: C
Rationale: Complex PTSD is characterized by trauma-related negative self-concept
and relational disturbances, but unlike BPD, it lacks the pervasive identity
instability and frantic fear of abandonment that are core to BPD. The DSM-5-TR
emphasizes these distinguishing features.
Q4. A nurse practitioner is assessing a client with suspected borderline personality
disorder (BPD) who presents with intense fear of abandonment and recurrent
suicidal gestures. According to the DSM-5-TR (2022 update), what is the primary
diagnostic criterion for BPD?
A. Persistent depressed mood lasting at least two weeks
B. Frantic efforts to avoid real or imagined abandonment
2
,C. Excessive social withdrawal and anhedonia
D. Preoccupation with fantasies of unlimited success
Correct Answer: B
Rationale: The DSM-5-TR emphasizes frantic efforts to avoid real or imagined
abandonment as a core criterion for BPD. This fear drives many of the
interpersonal and behavioral symptoms seen in the disorder.
Q5. A 55-year-old man presents with a 2-year history of pervasive worry about
multiple areas of his life, including finances, health, and his children's safety. He
reports muscle tension, irritability, and sleep disturbance. He does not experience
panic attacks. What is the most likely diagnosis?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
Correct Answer: B
Rationale: Generalized anxiety disorder is characterized by excessive anxiety and
worry about multiple events or activities, occurring more days than not for at
least 6 months, accompanied by symptoms such as muscle tension, irritability,
and sleep disturbance. The absence of panic attacks and the chronic, pervasive
nature of the worry point to GAD.
Q6. A 22-year-old college student presents with a 6-month history of recurrent
unexpected panic attacks, fear of having another attack, and avoidance of places
where escape might be difficult. She has no history of trauma. What is the most
likely diagnosis?
A. Panic disorder with agoraphobia
B. Social anxiety disorder
C. Generalized anxiety disorder
3
, D. Specific phobia
Correct Answer: A
Rationale: Panic disorder with agoraphobia is characterized by recurrent
unexpected panic attacks, persistent concern about additional attacks, and
avoidance of situations where escape might be difficult or help unavailable. This
patient meets all criteria.
Q7. A 30-year-old woman presents with a 1-year history of excessive fear of social
situations, fearing she will be judged or embarrassed. She avoids parties, work
meetings, and eating in public. What is the most likely diagnosis?
A. Panic disorder
B. Social anxiety disorder
C. Generalized anxiety disorder
D. Agoraphobia
Correct Answer: B
Rationale: Social anxiety disorder is characterized by marked fear or anxiety about
one or more social situations in which the person is exposed to possible scrutiny
by others. The fear is out of proportion to the actual threat and leads to
avoidance.
Q8. A 45-year-old man presents with intrusive, unwanted thoughts of
contamination and repetitive handwashing that he feels compelled to perform.
He recognizes these thoughts and behaviors are excessive but cannot control
them. What is the most likely diagnosis?
A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Body dysmorphic disorder
D. Hoarding disorder
4
CORRECT ANSWERS WITH DETAILED RATIONALES |PSYCHIATRIC
MENTAL HEALTH NURSE PRACTITIONER ADVANCED DIFFERENTIAL
DIAGNOSIS, PSYCHOPHARMACOLOGY, NEUROBIOLOGY & EVIDENCE-
BASED TREATMENT EXAM| LATEST UPDATE
SECTION 1: ADVANCED DIFFERENTIAL DIAGNOSIS (Questions 1-75)
Q1. A 35-year-old woman presents with persistent sadness, fatigue, and loss of
interest in activities for the past 6 weeks. She denies suicidal ideation but notes
difficulty concentrating at work. The PMHNP begins the diagnostic process using
the DSM-5-TR classification system. What is the primary purpose of using a
multiaxial diagnostic approach in psychiatric assessment?
A. To assign a single label that captures all of the patient's symptoms
B. To provide a comprehensive biopsychosocial framework that captures multiple
dimensions of the patient's presentation
C. To ensure that all patients receive the same medication regimen
D. To eliminate the need for collateral information from family members
Correct Answer: B
Rationale: A rational diagnostic approach provides a comprehensive
biopsychosocial framework that captures multiple dimensions including
psychiatric diagnoses, medical conditions, psychosocial stressors, and functional
impairment. A single diagnostic label would fail to capture the complexity of most
psychiatric presentations.
Q2. A 42-year-old man is referred for psychiatric evaluation after his wife reports
he has been acting strangely for 3 months, talking to people who are not present
and expressing beliefs that the government is monitoring him. The PMHNP
performs a mental status examination. What component of the MSE specifically
assesses the patient's beliefs about being monitored?
A. Thought content evaluation for delusions and obsessions
B. Mood assessment for affective symptoms
C. Cognitive assessment for memory impairment
1
,D. Sensorium evaluation for level of consciousness
Correct Answer: A
Rationale: Thought content evaluation specifically assesses for delusions,
obsessions, phobias, and suicidal or homicidal ideation, which includes the
paranoid beliefs about government monitoring described in this patient. Mood
assessment evaluates emotional state rather than fixed false beliefs.
Q3. A 28-year-old woman with a history of childhood sexual abuse presents with
chronic feelings of emptiness, unstable relationships, and recurrent self-harm
behaviors. The PMHNP considers both borderline personality disorder and
complex PTSD in the differential diagnosis. What feature most strongly
distinguishes complex PTSD from borderline personality disorder?
A. Presence of self-injurious behaviors and impulsivity
B. Chronic emotional dysregulation and fear of abandonment
C. History of trauma with negative self-concept and relational disturbances
without pervasive identity instability
D. Preoccupation with fantasies of unlimited success
Correct Answer: C
Rationale: Complex PTSD is characterized by trauma-related negative self-concept
and relational disturbances, but unlike BPD, it lacks the pervasive identity
instability and frantic fear of abandonment that are core to BPD. The DSM-5-TR
emphasizes these distinguishing features.
Q4. A nurse practitioner is assessing a client with suspected borderline personality
disorder (BPD) who presents with intense fear of abandonment and recurrent
suicidal gestures. According to the DSM-5-TR (2022 update), what is the primary
diagnostic criterion for BPD?
A. Persistent depressed mood lasting at least two weeks
B. Frantic efforts to avoid real or imagined abandonment
2
,C. Excessive social withdrawal and anhedonia
D. Preoccupation with fantasies of unlimited success
Correct Answer: B
Rationale: The DSM-5-TR emphasizes frantic efforts to avoid real or imagined
abandonment as a core criterion for BPD. This fear drives many of the
interpersonal and behavioral symptoms seen in the disorder.
Q5. A 55-year-old man presents with a 2-year history of pervasive worry about
multiple areas of his life, including finances, health, and his children's safety. He
reports muscle tension, irritability, and sleep disturbance. He does not experience
panic attacks. What is the most likely diagnosis?
A. Panic disorder
B. Generalized anxiety disorder
C. Social anxiety disorder
D. Obsessive-compulsive disorder
Correct Answer: B
Rationale: Generalized anxiety disorder is characterized by excessive anxiety and
worry about multiple events or activities, occurring more days than not for at
least 6 months, accompanied by symptoms such as muscle tension, irritability,
and sleep disturbance. The absence of panic attacks and the chronic, pervasive
nature of the worry point to GAD.
Q6. A 22-year-old college student presents with a 6-month history of recurrent
unexpected panic attacks, fear of having another attack, and avoidance of places
where escape might be difficult. She has no history of trauma. What is the most
likely diagnosis?
A. Panic disorder with agoraphobia
B. Social anxiety disorder
C. Generalized anxiety disorder
3
, D. Specific phobia
Correct Answer: A
Rationale: Panic disorder with agoraphobia is characterized by recurrent
unexpected panic attacks, persistent concern about additional attacks, and
avoidance of situations where escape might be difficult or help unavailable. This
patient meets all criteria.
Q7. A 30-year-old woman presents with a 1-year history of excessive fear of social
situations, fearing she will be judged or embarrassed. She avoids parties, work
meetings, and eating in public. What is the most likely diagnosis?
A. Panic disorder
B. Social anxiety disorder
C. Generalized anxiety disorder
D. Agoraphobia
Correct Answer: B
Rationale: Social anxiety disorder is characterized by marked fear or anxiety about
one or more social situations in which the person is exposed to possible scrutiny
by others. The fear is out of proportion to the actual threat and leads to
avoidance.
Q8. A 45-year-old man presents with intrusive, unwanted thoughts of
contamination and repetitive handwashing that he feels compelled to perform.
He recognizes these thoughts and behaviors are excessive but cannot control
them. What is the most likely diagnosis?
A. Generalized anxiety disorder
B. Obsessive-compulsive disorder
C. Body dysmorphic disorder
D. Hoarding disorder
4
