Lifespan I ACTUAL FINAL EXAM PRACTICE
2026/2027 | Verified Questions and Answers | DSM-5-
TR & Evidence-Based Prescribing Focus | Grade A
SECTION 1: Assessment, Diagnosis, & Lifespan Considerations (25 Questions)
Q1: A 19-year-old college freshman presents to the university counseling center stating, "I feel
like I'm losing my mind. Last week I stayed up for three days straight cleaning my apartment and
spending $2,000 on art supplies because I had this incredible creative vision. Now I can't get out
of bed and I'm failing my classes." She reports no prior psychiatric history. Her mother has
bipolar disorder. Which diagnosis is most likely?
A. Major Depressive Disorder with psychotic features
B. Bipolar I Disorder, current episode depressed [CORRECT]
C. Cyclothymic Disorder
D. Borderline Personality Disorder
Correct Answer: B
Q2: A 67-year-old male is brought by his wife for evaluation. She reports, "He's not the same
person. He puts his shoes in the refrigerator and last night he tried to cook breakfast at 3 AM
because he said he saw children in the kitchen." He has fluctuating alertness, visual
hallucinations, and impaired attention. His medical history includes Parkinson's disease and a
recent urinary tract infection. Which assessment finding would be most critical to obtain first?
A. Comprehensive metabolic panel
B. Urinalysis and culture [CORRECT]
C. Brain MRI with contrast
D. Mini-Mental State Examination score
Correct Answer: B
Q3: During a psychiatric interview, a 34-year-old patient maintains unbroken eye contact, leans
forward intensely, and responds to questions with excessive detail that never quite answers the
question. His speech is loud and rapid. Which component of the Mental Status Examination is
being assessed?
,A. Thought process and form [CORRECT]
B. Mood and affect
C. Insight and judgment
D. Perceptual disturbances
Correct Answer: A
Q4: A 15-year-old is brought to the emergency department by parents after disclosing suicidal
ideation. When conducting a suicide risk assessment, which factor is most strongly associated
with imminent risk and requires immediate intervention?
A. History of previous suicide attempts
B. Presence of a specific plan with access to lethal means [CORRECT]
C. Family history of completed suicide
D. Recent romantic relationship breakup
Correct Answer: B
Q5: A 42-year-old female reports, "I can't stop washing my hands. I know it doesn't make sense,
but if I don't wash exactly 7 times, something terrible will happen to my children." She spends 4
hours daily on rituals and experiences significant distress. Which DSM-5-TR criteria are met?
A. Specific Phobia
B. Obsessive-Compulsive Disorder [CORRECT]
C. Generalized Anxiety Disorder
D. Body Dysmorphic Disorder
Correct Answer: B
Q6: A PMHNP is evaluating a 28-year-old veteran who states, "I can't sleep, I jump at every
sound, and I keep seeing the Humvee explosion whenever I close my eyes. I avoid driving
because it reminds me of Iraq." Symptoms have persisted for 14 months. Which diagnosis is
most appropriate?
A. Acute Stress Disorder
B. Post-Traumatic Stress Disorder [CORRECT]
C. Adjustment Disorder with Anxiety
D. Panic Disorder
Correct Answer: B
, Q7: During a medication review, a patient reveals, "I've been taking my son's Adderall because it
helps me focus at work. I know I shouldn't, but I can't seem to stop." She admits to crushing and
snorting the medication for faster effect. Which additional assessment is most critical before
prescribing any controlled substance?
A. Comprehensive psychological testing
B. Substance use disorder screening and urine drug screen [CORRECT]
C. Electrocardiogram
D. Thyroid function studies
Correct Answer: B
Q8: A 55-year-old male with schizophrenia reports, "The voices are telling me to hurt my
neighbor because he's poisoning my water." He has command hallucinations, poor insight, and
refuses medication. Which is the priority nursing/PMHNP intervention?
A. Immediate voluntary admission for safety [CORRECT]
B. Outpatient commitment to treatment
C. Family psychoeducation
D. Long-acting injectable antipsychotic discussion
Correct Answer: A
Q9: A 7-year-old boy is referred by his teacher for "constant motion, interrupting, and inability
to finish tasks." Parents report similar behaviors since age 4, affecting both school and home
functioning. Which diagnostic criterion differentiates ADHD from normal childhood behavior?
A. Onset before age 12 and impairment in two or more settings [CORRECT]
B. Presence of learning disability
C. Family history of ADHD
D. Response to stimulant medication
Correct Answer: A
Q10: A 73-year-old widow presents with 3-month history of sadness, anhedonia, 10-pound
weight loss, and insomnia. She states, "I'm ready to join my husband. I've given away my
jewelry and written letters to my children." Her PHQ-9 score is 18. Which assessment
component takes immediate priority?