NRNP6675 PMHNP Care Across Lifespan I MIDTERM
EXAM PRACTICE - 2026-2027 Academic Year | 60
Items | DSM-5-TR & 2026 APA/NICE/AACAP Aligned |
100% Evidence-Verified Answers
DOMAIN 1 – PSYCHIATRIC ASSESSMENT & DIAGNOSTIC EVALUATION (20 Qs)
Q1. A 38-year-old presents with depressed mood, anhedonia, and insomnia. During the
interview he makes poor eye contact, speaks in a slow low monotone, and is dressed in
wrinkled clothes. Which MSE component is primarily described?
A. Thought content
B. Mood and affect
C. Speech
D. Appearance & behavior
Verified Answer: D
Rationale: Observable dress, grooming, eye contact, and psychomotor activity are
catalogued under Appearance & Behavior. Speech rate/tone are noted separately; mood
is subjective report.
Q2. (SATA) A 29-year-old woman reports two weeks of low mood and fatigue. Which
actions are required at the initial visit? (Select ALL that apply.)
,A. Administer PHQ-9
B. Order serum TSH
C. Prescribe sertraline 50 mg
D. Conduct structured suicide inquiry
E. Document substance-use history
Verified Answers: A, B, D, E
Rationale: APA 2026 adult-depression guideline mandates standardized rating scale (A),
medical rule-outs (B), safety assessment (D), and substance screen (E) before initiating
treatment (C is premature).
Q3. Which question best assesses perseveration during cognitive testing?
A. “What would you do if you found a stamped addressed envelope on the sidewalk?”
B. “Can you name as many animals as possible in one minute?”
C. “I’ll say three numbers; repeat them backward.”
D. “What does ‘a stitch in time saves nine’ mean?”
Verified Answer: B
Rationale: Perseveration = repeated, stereotyped verbal output; animal-naming test (B)
directly measures this. Others assess executive/abstract (A,D) or working memory (C).
Q4. A patient endorses “I feel like I’m a burden and wish I wouldn’t wake up.” The
PMHNP’s next action is:
,A. Complete Columbia-Suicide Severity Rating Scale (C-SSRS)
B. Call 911 immediately
C. Obtain written safety contract
D. Ask about firearms access
Verified Answer: A
Rationale: Passive suicidal ideation requires systematic risk stratification; C-SSRS is
validated. 911 (B) unnecessary without active plan/means; contract (C) and means
assessment (D) follow structured scale.
Q5. (SATA) Which findings on cognitive screen suggest delirium rather than major
neurocognitive disorder? (Select ALL.)
A. Acute onset over 24 h
B. Fluctuating course
C. Inattention on digit-span
D. Sleep-wake cycle disturbance
E. Progressive decline >12 months
Verified Answers: A, B, C, D
Rationale: DSM-5-TR: acute/fluctuant (A,B), inattention (C), altered arousal (D) define
delirium. Gradual year-long decline (E) typifies major NCD.
Q6. PHQ-9 total score is 17. Interpretation:
, A. Minimal depression
B. Mild depression
C. Moderate depression
D. Severe depression
Verified Answer: C
Rationale: PHQ-9: 10–14 moderate-mild; 15–19 moderate; ≥20 severe. 17 = moderate
severity.
Q7. A patient scores 18 on AUDIT. Appropriate next step per WHO protocol:
A. Brief intervention + referral to specialist
B. Prescribe naltrexone immediately
C. Repeat AUDIT in 6 months
D. Order liver ultrasound
Verified Answer: A
Rationale: AUDIT ≥16 indicates high-risk use; Level 3 care = brief intervention + referral.
Pharmacotherapy (B) considered after full assessment.
Q8. Which MSE finding indicates formal thought disorder?
A. “I’m guilty, sinful, evil.”
B. Patient invents new word “splorkful”
EXAM PRACTICE - 2026-2027 Academic Year | 60
Items | DSM-5-TR & 2026 APA/NICE/AACAP Aligned |
100% Evidence-Verified Answers
DOMAIN 1 – PSYCHIATRIC ASSESSMENT & DIAGNOSTIC EVALUATION (20 Qs)
Q1. A 38-year-old presents with depressed mood, anhedonia, and insomnia. During the
interview he makes poor eye contact, speaks in a slow low monotone, and is dressed in
wrinkled clothes. Which MSE component is primarily described?
A. Thought content
B. Mood and affect
C. Speech
D. Appearance & behavior
Verified Answer: D
Rationale: Observable dress, grooming, eye contact, and psychomotor activity are
catalogued under Appearance & Behavior. Speech rate/tone are noted separately; mood
is subjective report.
Q2. (SATA) A 29-year-old woman reports two weeks of low mood and fatigue. Which
actions are required at the initial visit? (Select ALL that apply.)
,A. Administer PHQ-9
B. Order serum TSH
C. Prescribe sertraline 50 mg
D. Conduct structured suicide inquiry
E. Document substance-use history
Verified Answers: A, B, D, E
Rationale: APA 2026 adult-depression guideline mandates standardized rating scale (A),
medical rule-outs (B), safety assessment (D), and substance screen (E) before initiating
treatment (C is premature).
Q3. Which question best assesses perseveration during cognitive testing?
A. “What would you do if you found a stamped addressed envelope on the sidewalk?”
B. “Can you name as many animals as possible in one minute?”
C. “I’ll say three numbers; repeat them backward.”
D. “What does ‘a stitch in time saves nine’ mean?”
Verified Answer: B
Rationale: Perseveration = repeated, stereotyped verbal output; animal-naming test (B)
directly measures this. Others assess executive/abstract (A,D) or working memory (C).
Q4. A patient endorses “I feel like I’m a burden and wish I wouldn’t wake up.” The
PMHNP’s next action is:
,A. Complete Columbia-Suicide Severity Rating Scale (C-SSRS)
B. Call 911 immediately
C. Obtain written safety contract
D. Ask about firearms access
Verified Answer: A
Rationale: Passive suicidal ideation requires systematic risk stratification; C-SSRS is
validated. 911 (B) unnecessary without active plan/means; contract (C) and means
assessment (D) follow structured scale.
Q5. (SATA) Which findings on cognitive screen suggest delirium rather than major
neurocognitive disorder? (Select ALL.)
A. Acute onset over 24 h
B. Fluctuating course
C. Inattention on digit-span
D. Sleep-wake cycle disturbance
E. Progressive decline >12 months
Verified Answers: A, B, C, D
Rationale: DSM-5-TR: acute/fluctuant (A,B), inattention (C), altered arousal (D) define
delirium. Gradual year-long decline (E) typifies major NCD.
Q6. PHQ-9 total score is 17. Interpretation:
, A. Minimal depression
B. Mild depression
C. Moderate depression
D. Severe depression
Verified Answer: C
Rationale: PHQ-9: 10–14 moderate-mild; 15–19 moderate; ≥20 severe. 17 = moderate
severity.
Q7. A patient scores 18 on AUDIT. Appropriate next step per WHO protocol:
A. Brief intervention + referral to specialist
B. Prescribe naltrexone immediately
C. Repeat AUDIT in 6 months
D. Order liver ultrasound
Verified Answer: A
Rationale: AUDIT ≥16 indicates high-risk use; Level 3 care = brief intervention + referral.
Pharmacotherapy (B) considered after full assessment.
Q8. Which MSE finding indicates formal thought disorder?
A. “I’m guilty, sinful, evil.”
B. Patient invents new word “splorkful”
