WGU D344 PMHNP Objective Assessment (OA) | Questions and
Answers | 2026 Update | 100% Correct.
🧠 WGU D344 – PMHNP MOCK OA (TIMED)
Time Limit: 2 hours 30 minutes
Questions: 70
Passing Target: ≥ 67%
Format: Single best answer (some scenario-heavy, some safety/priority)
SECTION 1: DIAGNOSTIC RECOGNITION (DSM-5-TR)
Q1.
A client reports persistent depressed mood, anhedonia, insomnia, guilt, and impaired concentration for
3 weeks. No history of mania or hypomania. Best diagnosis?
A. Persistent depressive disorder
B. Major depressive disorder
C. Adjustment disorder
D. Bipolar II disorder
✅ Answer: B
🧠 Rationale: ≥2 weeks with core symptoms and functional impairment = MDD.
Q2.
A client has elevated mood, decreased need for sleep, pressured speech, and grandiosity lasting 9 days
with hospitalization. Diagnosis?
A. Hypomanic episode
B. Cyclothymic disorder
C. Manic episode
D. Bipolar II disorder
✅ Answer: C
🧠 Rationale: ≥7 days or hospitalization = mania.
Q3.
A patient experiences intrusive memories, nightmares, hypervigilance, and avoidance for 2 months after
a violent assault.
,A. Acute stress disorder
B. PTSD
C. Adjustment disorder
D. Panic disorder
✅ Answer: B
🧠 Rationale: Symptoms >1 month = PTSD.
Q4.
A child shows persistent inattention, distractibility, and forgetfulness across home and school for 9
months.
A. ADHD
B. Autism spectrum disorder
C. Conduct disorder
D. Oppositional defiant disorder
✅ Answer: A
🧠 Rationale: Multi-setting, ≥6 months, inattentive symptoms.
Q5.
A client fears social situations due to embarrassment and avoids public speaking.
A. Panic disorder
B. Agoraphobia
C. Social anxiety disorder
D. GAD
✅ Answer: C
🧠 Rationale: Fear of scrutiny and embarrassment.
SECTION 2: PSYCHOPHARMACOLOGY
Q6.
First-line medication for major depressive disorder?
A. MAOI
B. TCA
C. SSRI
D. Benzodiazepine
,✅ Answer: C
🧠 Rationale: SSRIs are first-line due to safety and efficacy.
Q7.
Which medication requires regular blood level monitoring?
A. Fluoxetine
B. Lithium
C. Sertraline
D. Bupropion
✅ Answer: B
🧠 Rationale: Narrow therapeutic index.
Q8.
Which side effect is MOST concerning with clozapine?
A. Weight gain
B. Sedation
C. Agranulocytosis
D. Orthostatic hypotension
✅ Answer: C
🧠 Rationale: Life-threatening → REMS monitoring.
Q9.
Which antidepressant lowers seizure threshold?
A. Sertraline
B. Fluoxetine
C. Bupropion
D. Citalopram
✅ Answer: C
🧠 Rationale: Avoid in seizure disorders/eating disorders.
Q10.
A bipolar patient presents with acute mania. Best initial treatment?
, A. SSRI
B. Benzodiazepine only
C. Mood stabilizer + antipsychotic
D. Psychotherapy alone
✅ Answer: C
🧠 Rationale: Combination therapy for acute mania.
SECTION 3: THERAPEUTIC COMMUNICATION
Q11.
Client: “I feel like my life isn’t worth living.” Best response?
A. “You shouldn’t think like that.”
B. “Why do you feel this way?”
C. “Tell me more about those thoughts.”
D. “Things will get better.”
✅ Answer: C
🧠 Rationale: Open-ended, nonjudgmental.
Q12.
Client with delusions says, “The FBI is watching me.” Best response?
A. “That’s impossible.”
B. “Why would they do that?”
C. “I don’t see evidence of that.”
D. “Tell me more about how that makes you feel.”
✅ Answer: D
🧠 Rationale: Do not reinforce or challenge delusion.
SECTION 4: SAFETY & RISK PRIORITIZATION
Q13.
Which patient requires IMMEDIATE intervention?
A. Mild anxiety
B. Passive death wish
C. Command hallucinations to kill self
D. Insomnia
Answers | 2026 Update | 100% Correct.
🧠 WGU D344 – PMHNP MOCK OA (TIMED)
Time Limit: 2 hours 30 minutes
Questions: 70
Passing Target: ≥ 67%
Format: Single best answer (some scenario-heavy, some safety/priority)
SECTION 1: DIAGNOSTIC RECOGNITION (DSM-5-TR)
Q1.
A client reports persistent depressed mood, anhedonia, insomnia, guilt, and impaired concentration for
3 weeks. No history of mania or hypomania. Best diagnosis?
A. Persistent depressive disorder
B. Major depressive disorder
C. Adjustment disorder
D. Bipolar II disorder
✅ Answer: B
🧠 Rationale: ≥2 weeks with core symptoms and functional impairment = MDD.
Q2.
A client has elevated mood, decreased need for sleep, pressured speech, and grandiosity lasting 9 days
with hospitalization. Diagnosis?
A. Hypomanic episode
B. Cyclothymic disorder
C. Manic episode
D. Bipolar II disorder
✅ Answer: C
🧠 Rationale: ≥7 days or hospitalization = mania.
Q3.
A patient experiences intrusive memories, nightmares, hypervigilance, and avoidance for 2 months after
a violent assault.
,A. Acute stress disorder
B. PTSD
C. Adjustment disorder
D. Panic disorder
✅ Answer: B
🧠 Rationale: Symptoms >1 month = PTSD.
Q4.
A child shows persistent inattention, distractibility, and forgetfulness across home and school for 9
months.
A. ADHD
B. Autism spectrum disorder
C. Conduct disorder
D. Oppositional defiant disorder
✅ Answer: A
🧠 Rationale: Multi-setting, ≥6 months, inattentive symptoms.
Q5.
A client fears social situations due to embarrassment and avoids public speaking.
A. Panic disorder
B. Agoraphobia
C. Social anxiety disorder
D. GAD
✅ Answer: C
🧠 Rationale: Fear of scrutiny and embarrassment.
SECTION 2: PSYCHOPHARMACOLOGY
Q6.
First-line medication for major depressive disorder?
A. MAOI
B. TCA
C. SSRI
D. Benzodiazepine
,✅ Answer: C
🧠 Rationale: SSRIs are first-line due to safety and efficacy.
Q7.
Which medication requires regular blood level monitoring?
A. Fluoxetine
B. Lithium
C. Sertraline
D. Bupropion
✅ Answer: B
🧠 Rationale: Narrow therapeutic index.
Q8.
Which side effect is MOST concerning with clozapine?
A. Weight gain
B. Sedation
C. Agranulocytosis
D. Orthostatic hypotension
✅ Answer: C
🧠 Rationale: Life-threatening → REMS monitoring.
Q9.
Which antidepressant lowers seizure threshold?
A. Sertraline
B. Fluoxetine
C. Bupropion
D. Citalopram
✅ Answer: C
🧠 Rationale: Avoid in seizure disorders/eating disorders.
Q10.
A bipolar patient presents with acute mania. Best initial treatment?
, A. SSRI
B. Benzodiazepine only
C. Mood stabilizer + antipsychotic
D. Psychotherapy alone
✅ Answer: C
🧠 Rationale: Combination therapy for acute mania.
SECTION 3: THERAPEUTIC COMMUNICATION
Q11.
Client: “I feel like my life isn’t worth living.” Best response?
A. “You shouldn’t think like that.”
B. “Why do you feel this way?”
C. “Tell me more about those thoughts.”
D. “Things will get better.”
✅ Answer: C
🧠 Rationale: Open-ended, nonjudgmental.
Q12.
Client with delusions says, “The FBI is watching me.” Best response?
A. “That’s impossible.”
B. “Why would they do that?”
C. “I don’t see evidence of that.”
D. “Tell me more about how that makes you feel.”
✅ Answer: D
🧠 Rationale: Do not reinforce or challenge delusion.
SECTION 4: SAFETY & RISK PRIORITIZATION
Q13.
Which patient requires IMMEDIATE intervention?
A. Mild anxiety
B. Passive death wish
C. Command hallucinations to kill self
D. Insomnia
