WGU D344 PMHNP Objective Assessment
(OA) | Questions and Answers | 2026 Update |
100% Correct.
Course
D344
1. A PMHNP is beginning an initial psychiatric evaluation. What is the PRIMARY purpose of
the interview?
A. Establish a medication regimen immediately
B. Develop a comprehensive understanding of the patient's symptoms, functioning, history, and
safety
C. Obtain only the patient's chief complaint
D. Determine the patient's insurance coverage
Correct Answer: B
Rationale: The initial psychiatric evaluation should establish a comprehensive biopsychosocial
understanding of the patient, including presenting symptoms, psychiatric and medical history,
functioning, substance use, psychosocial factors, and safety risks.
2. During the mental status examination, the patient demonstrates rapid speech with
frequent shifts from one topic to another while maintaining understandable connections
between ideas. Which finding is MOST consistent with this presentation?
A. Flight of ideas
B. Thought blocking
C. Neologism
D. Clang associations
Correct Answer: A
Rationale: Flight of ideas involves rapid shifting from one topic to another with understandable
associations, commonly seen during manic episodes.
3. A patient says, “The government has implanted a device in my brain to monitor my
thoughts.” Which mental-status finding does this represent?
,A. Obsession
B. Delusion
C. Illusion
D. Depersonalization
Correct Answer: B
Rationale: A delusion is a fixed false belief that persists despite evidence to the contrary. The
statement represents a persecutory/bizarre delusional belief.
4. A patient reports hearing a voice when no external speaker is present. This is best
documented as:
A. Illusion
B. Auditory hallucination
C. Derealization
D. Obsession
Correct Answer: B
Rationale: A hallucination is a perception occurring without an external stimulus. Hearing a
voice without an external source is an auditory hallucination.
5. A patient repeatedly checks whether the front door is locked because of intrusive fears that
someone will break in. The patient recognizes that the behavior is excessive. Which finding is
MOST consistent with this presentation?
A. Delusion
B. Obsession with compulsion
C. Hallucination
D. Confabulation
Correct Answer: B
Rationale: Obsessions are intrusive, recurrent thoughts or urges. Compulsions are repetitive
behaviors performed in response to those thoughts. Preserved insight can occur in OCD.
6. A patient with depression reports loss of interest in activities that were previously
enjoyable. Which symptom is this?
,A. Anhedonia
B. Echolalia
C. Akathisia
D. Alexithymia
Correct Answer: A
Rationale: Anhedonia is diminished interest or pleasure in activities. It is a core symptom of
major depressive episodes.
7. A patient reports depressed mood, anhedonia, fatigue, impaired concentration, guilt, and
insomnia for 3 weeks. There is no history of mania or hypomania. Which diagnosis is MOST
appropriate?
A. Bipolar I disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Adjustment disorder
Correct Answer: B
Rationale: A depressive episode lasting at least 2 weeks with sufficient symptoms and clinically
significant distress or impairment can meet criteria for major depressive disorder when bipolar
disorder and other causes are excluded.
8. A patient reports recurrent periods of elevated mood, decreased need for sleep,
grandiosity, pressured speech, and impulsive behavior that resulted in hospitalization. Which
diagnosis should the PMHNP consider most strongly?
A. Bipolar I disorder
B. Persistent depressive disorder
C. Generalized anxiety disorder
D. Adjustment disorder
Correct Answer: A
Rationale: A manic episode that causes marked impairment, requires hospitalization, or
includes psychotic features supports Bipolar I disorder.
9. Which finding BEST distinguishes mania from hypomania?
, A. Both require psychotic features
B. Mania causes marked impairment, hospitalization, or psychosis
C. Hypomania always lasts longer than mania
D. Mania never affects functioning
Correct Answer: B
Rationale: Mania is more severe and may result in marked functional impairment,
hospitalization, or psychotic features. Hypomania is a less severe episode without marked
impairment or psychosis.
10. A patient presents with excessive anxiety and worry occurring more days than not for
approximately 8 months. The patient reports restlessness, fatigue, muscle tension, and
difficulty concentrating. Which diagnosis is MOST consistent?
A. Panic disorder
B. Generalized anxiety disorder
C. Specific phobia
D. Acute stress disorder
Correct Answer: B
Rationale: Generalized anxiety disorder involves excessive anxiety and worry about multiple
areas of life occurring more days than not for at least 6 months, accompanied by associated
symptoms.
11. A patient experiences recurrent unexpected episodes of intense fear accompanied by
palpitations, sweating, trembling, and shortness of breath. The patient worries persistently
about having another episode. Which diagnosis is most likely?
A. Panic disorder
B. Social anxiety disorder
C. OCD
D. Somatic symptom disorder
Correct Answer: A
Rationale: Recurrent unexpected panic attacks followed by persistent concern or maladaptive
behavioral changes are characteristic of panic disorder.
(OA) | Questions and Answers | 2026 Update |
100% Correct.
Course
D344
1. A PMHNP is beginning an initial psychiatric evaluation. What is the PRIMARY purpose of
the interview?
A. Establish a medication regimen immediately
B. Develop a comprehensive understanding of the patient's symptoms, functioning, history, and
safety
C. Obtain only the patient's chief complaint
D. Determine the patient's insurance coverage
Correct Answer: B
Rationale: The initial psychiatric evaluation should establish a comprehensive biopsychosocial
understanding of the patient, including presenting symptoms, psychiatric and medical history,
functioning, substance use, psychosocial factors, and safety risks.
2. During the mental status examination, the patient demonstrates rapid speech with
frequent shifts from one topic to another while maintaining understandable connections
between ideas. Which finding is MOST consistent with this presentation?
A. Flight of ideas
B. Thought blocking
C. Neologism
D. Clang associations
Correct Answer: A
Rationale: Flight of ideas involves rapid shifting from one topic to another with understandable
associations, commonly seen during manic episodes.
3. A patient says, “The government has implanted a device in my brain to monitor my
thoughts.” Which mental-status finding does this represent?
,A. Obsession
B. Delusion
C. Illusion
D. Depersonalization
Correct Answer: B
Rationale: A delusion is a fixed false belief that persists despite evidence to the contrary. The
statement represents a persecutory/bizarre delusional belief.
4. A patient reports hearing a voice when no external speaker is present. This is best
documented as:
A. Illusion
B. Auditory hallucination
C. Derealization
D. Obsession
Correct Answer: B
Rationale: A hallucination is a perception occurring without an external stimulus. Hearing a
voice without an external source is an auditory hallucination.
5. A patient repeatedly checks whether the front door is locked because of intrusive fears that
someone will break in. The patient recognizes that the behavior is excessive. Which finding is
MOST consistent with this presentation?
A. Delusion
B. Obsession with compulsion
C. Hallucination
D. Confabulation
Correct Answer: B
Rationale: Obsessions are intrusive, recurrent thoughts or urges. Compulsions are repetitive
behaviors performed in response to those thoughts. Preserved insight can occur in OCD.
6. A patient with depression reports loss of interest in activities that were previously
enjoyable. Which symptom is this?
,A. Anhedonia
B. Echolalia
C. Akathisia
D. Alexithymia
Correct Answer: A
Rationale: Anhedonia is diminished interest or pleasure in activities. It is a core symptom of
major depressive episodes.
7. A patient reports depressed mood, anhedonia, fatigue, impaired concentration, guilt, and
insomnia for 3 weeks. There is no history of mania or hypomania. Which diagnosis is MOST
appropriate?
A. Bipolar I disorder
B. Major depressive disorder
C. Cyclothymic disorder
D. Adjustment disorder
Correct Answer: B
Rationale: A depressive episode lasting at least 2 weeks with sufficient symptoms and clinically
significant distress or impairment can meet criteria for major depressive disorder when bipolar
disorder and other causes are excluded.
8. A patient reports recurrent periods of elevated mood, decreased need for sleep,
grandiosity, pressured speech, and impulsive behavior that resulted in hospitalization. Which
diagnosis should the PMHNP consider most strongly?
A. Bipolar I disorder
B. Persistent depressive disorder
C. Generalized anxiety disorder
D. Adjustment disorder
Correct Answer: A
Rationale: A manic episode that causes marked impairment, requires hospitalization, or
includes psychotic features supports Bipolar I disorder.
9. Which finding BEST distinguishes mania from hypomania?
, A. Both require psychotic features
B. Mania causes marked impairment, hospitalization, or psychosis
C. Hypomania always lasts longer than mania
D. Mania never affects functioning
Correct Answer: B
Rationale: Mania is more severe and may result in marked functional impairment,
hospitalization, or psychotic features. Hypomania is a less severe episode without marked
impairment or psychosis.
10. A patient presents with excessive anxiety and worry occurring more days than not for
approximately 8 months. The patient reports restlessness, fatigue, muscle tension, and
difficulty concentrating. Which diagnosis is MOST consistent?
A. Panic disorder
B. Generalized anxiety disorder
C. Specific phobia
D. Acute stress disorder
Correct Answer: B
Rationale: Generalized anxiety disorder involves excessive anxiety and worry about multiple
areas of life occurring more days than not for at least 6 months, accompanied by associated
symptoms.
11. A patient experiences recurrent unexpected episodes of intense fear accompanied by
palpitations, sweating, trembling, and shortness of breath. The patient worries persistently
about having another episode. Which diagnosis is most likely?
A. Panic disorder
B. Social anxiety disorder
C. OCD
D. Somatic symptom disorder
Correct Answer: A
Rationale: Recurrent unexpected panic attacks followed by persistent concern or maladaptive
behavioral changes are characteristic of panic disorder.
