NR 606 Psychiatric-Mental Health II Midterm Exam 2026/2027 |80
Verified Questions & Answers | Chamberlain University PMHNP
Prep | 6 Core Domains | Instant Download .
INTRODUCTION
NR 606: Diagnosis & Management in Psychiatric-Mental Health II is an advanced course in the
Chamberlain University MSN Psychiatric-Mental Health Nurse Practitioner (PMHNP) program. This
course builds upon foundational psychiatric knowledge and focuses on the advanced assessment,
diagnosis, and management of complex psychiatric disorders across the lifespan.
The midterm examination evaluates the PMHNP candidate's ability to:
Apply DSM-5-TR diagnostic criteria to complex clinical presentations
Differentiate between overlapping psychiatric disorders
Develop evidence-based treatment plans including pharmacologic and non-pharmacologic
interventions
Consider cultural, developmental, and biological factors in diagnostic reasoning
Recognize psychiatric emergencies and initiate appropriate interventions
Domain Approximate Weight
Mood Disorders & Complex Differential Diagnosis 25%
Anxiety, OCD & Trauma-Related Disorders 25%
Psychotic Disorders & Schizophrenia Spectrum 25%
Neurodevelopmental, Neurocognitive & Personality Disorders 25%
,SECTION 1: MOOD DISORDERS & COMPLEX DIFFERENTIAL DIAGNOSIS
Question 1:
A 32-year-old patient presents with a 3-week history of depressed mood, anhedonia, insomnia,
fatigue, feelings of worthlessness, and difficulty concentrating. The patient denies any history of
manic or hypomanic episodes. What is the most likely diagnosis?
A) Major depressive disorder, single episode, moderate
B) Bipolar II disorder, current episode depressed
C) Persistent depressive disorder
D) Adjustment disorder with depressed mood
Correct Answer: A) Major depressive disorder, single episode, moderate
Rationale: The patient meets DSM-5-TR criteria for a major depressive episode: ≥5 symptoms for
≥2 weeks, including depressed mood and anhedonia. The absence of manic/hypomanic episodes
rules out bipolar disorder. The duration is <2 years, ruling out persistent depressive disorder.
Adjustment disorder requires a identifiable stressor and less severe symptoms.
Question 2:
A patient with a history of major depressive disorder reports decreased need for sleep, increased
energy, grandiosity, and excessive involvement in risky activities for the past 5 days. The patient's
functioning is significantly impaired. What is the most likely diagnosis?
A) Major depressive disorder with mixed features
B) Bipolar I disorder, current episode manic
C) Bipolar II disorder, current episode hypomanic
D) Cyclothymic disorder
Correct Answer: B) Bipolar I disorder, current episode manic
,Rationale: The presence of a manic episode (≥1 week of elevated mood, decreased need for sleep,
grandiosity, risky behavior with marked impairment) confirms Bipolar I disorder. The patient has a
history of major depression, which is common in Bipolar I but not required for diagnosis.
Question 3:
Which specifier is applied when a patient experiences four or more mood episodes within a 12-
month period?
A) Seasonal pattern
B) Rapid cycling
C) Mixed features
D) With psychotic features
Correct Answer: B) Rapid cycling
Rationale: Rapid cycling is defined as ≥4 mood episodes (mania, hypomania, or major depression)
during a 12-month period. This specifier can be applied to Bipolar I or Bipolar II disorder and has
prognostic and treatment implications.
Question 4:
A patient with recurrent depressive episodes reports that symptoms consistently begin in
November and remit in March each year for the past 3 years. Which specifier is most appropriate?
A) With peripartum onset
B) With seasonal pattern
C) With atypical features
D) With melancholic features
Correct Answer: B) With seasonal pattern
, Rationale: Seasonal pattern requires a regular temporal relationship between the onset of mood
episodes and a particular time of year for at least 2 years. Depressive episodes typically occur in
winter, with remission in spring/summer.
Question 5:
A patient presents with depressed mood, loss of interest, significant weight gain, hypersomnia, and
leaden paralysis. The patient reports that their mood brightens in response to positive events.
Which specifier best describes this presentation?
A) With melancholic features
B) With atypical features
C) With catatonia
D) With anxious distress
Correct Answer: B) With atypical features
Rationale: Atypical features include mood reactivity (mood brightens in response to positive
events), significant weight gain or increased appetite, hypersomnia, leaden paralysis, and a
longstanding pattern of interpersonal rejection sensitivity.
Question 6:
What is the minimum duration of symptoms required for a diagnosis of persistent depressive
disorder (dysthymia) in adults?
A) 2 weeks
B) 1 month
C) 1 year
D) 2 years
Correct Answer: D) 2 years
Verified Questions & Answers | Chamberlain University PMHNP
Prep | 6 Core Domains | Instant Download .
INTRODUCTION
NR 606: Diagnosis & Management in Psychiatric-Mental Health II is an advanced course in the
Chamberlain University MSN Psychiatric-Mental Health Nurse Practitioner (PMHNP) program. This
course builds upon foundational psychiatric knowledge and focuses on the advanced assessment,
diagnosis, and management of complex psychiatric disorders across the lifespan.
The midterm examination evaluates the PMHNP candidate's ability to:
Apply DSM-5-TR diagnostic criteria to complex clinical presentations
Differentiate between overlapping psychiatric disorders
Develop evidence-based treatment plans including pharmacologic and non-pharmacologic
interventions
Consider cultural, developmental, and biological factors in diagnostic reasoning
Recognize psychiatric emergencies and initiate appropriate interventions
Domain Approximate Weight
Mood Disorders & Complex Differential Diagnosis 25%
Anxiety, OCD & Trauma-Related Disorders 25%
Psychotic Disorders & Schizophrenia Spectrum 25%
Neurodevelopmental, Neurocognitive & Personality Disorders 25%
,SECTION 1: MOOD DISORDERS & COMPLEX DIFFERENTIAL DIAGNOSIS
Question 1:
A 32-year-old patient presents with a 3-week history of depressed mood, anhedonia, insomnia,
fatigue, feelings of worthlessness, and difficulty concentrating. The patient denies any history of
manic or hypomanic episodes. What is the most likely diagnosis?
A) Major depressive disorder, single episode, moderate
B) Bipolar II disorder, current episode depressed
C) Persistent depressive disorder
D) Adjustment disorder with depressed mood
Correct Answer: A) Major depressive disorder, single episode, moderate
Rationale: The patient meets DSM-5-TR criteria for a major depressive episode: ≥5 symptoms for
≥2 weeks, including depressed mood and anhedonia. The absence of manic/hypomanic episodes
rules out bipolar disorder. The duration is <2 years, ruling out persistent depressive disorder.
Adjustment disorder requires a identifiable stressor and less severe symptoms.
Question 2:
A patient with a history of major depressive disorder reports decreased need for sleep, increased
energy, grandiosity, and excessive involvement in risky activities for the past 5 days. The patient's
functioning is significantly impaired. What is the most likely diagnosis?
A) Major depressive disorder with mixed features
B) Bipolar I disorder, current episode manic
C) Bipolar II disorder, current episode hypomanic
D) Cyclothymic disorder
Correct Answer: B) Bipolar I disorder, current episode manic
,Rationale: The presence of a manic episode (≥1 week of elevated mood, decreased need for sleep,
grandiosity, risky behavior with marked impairment) confirms Bipolar I disorder. The patient has a
history of major depression, which is common in Bipolar I but not required for diagnosis.
Question 3:
Which specifier is applied when a patient experiences four or more mood episodes within a 12-
month period?
A) Seasonal pattern
B) Rapid cycling
C) Mixed features
D) With psychotic features
Correct Answer: B) Rapid cycling
Rationale: Rapid cycling is defined as ≥4 mood episodes (mania, hypomania, or major depression)
during a 12-month period. This specifier can be applied to Bipolar I or Bipolar II disorder and has
prognostic and treatment implications.
Question 4:
A patient with recurrent depressive episodes reports that symptoms consistently begin in
November and remit in March each year for the past 3 years. Which specifier is most appropriate?
A) With peripartum onset
B) With seasonal pattern
C) With atypical features
D) With melancholic features
Correct Answer: B) With seasonal pattern
, Rationale: Seasonal pattern requires a regular temporal relationship between the onset of mood
episodes and a particular time of year for at least 2 years. Depressive episodes typically occur in
winter, with remission in spring/summer.
Question 5:
A patient presents with depressed mood, loss of interest, significant weight gain, hypersomnia, and
leaden paralysis. The patient reports that their mood brightens in response to positive events.
Which specifier best describes this presentation?
A) With melancholic features
B) With atypical features
C) With catatonia
D) With anxious distress
Correct Answer: B) With atypical features
Rationale: Atypical features include mood reactivity (mood brightens in response to positive
events), significant weight gain or increased appetite, hypersomnia, leaden paralysis, and a
longstanding pattern of interpersonal rejection sensitivity.
Question 6:
What is the minimum duration of symptoms required for a diagnosis of persistent depressive
disorder (dysthymia) in adults?
A) 2 weeks
B) 1 month
C) 1 year
D) 2 years
Correct Answer: D) 2 years
