NR548 FINAL EXAM LATEST 2026/2027 | Psychiatric
Assessment for PMHNP | Weeks 7-8 Covered | Questions &
Verified Answers | Chamberlain | Pass Guaranteed - A+
Graded
[Section 1: Mood Disorders – MDD & Bipolar Assessment (Questions
1-12)]
Question 1
A 28-year-old female presents with depressed mood, anhedonia, insomnia, fatigue, poor
concentration, feelings of worthlessness, and psychomotor agitation for the past 3
weeks. She denies any history of elevated or irritable mood. Her PHQ-9 score is 18.
What is the MOST likely diagnosis?
A. Bipolar II Disorder
B. Major Depressive Disorder, moderate severity
C. Persistent Depressive Disorder (Dysthymia)
D. Adjustment Disorder with Depressed Mood
Correct Answer: B. Major Depressive Disorder, moderate severity [CORRECT]
,Rationale: This patient meets DSM-5-TR criteria for MDD: ≥5 symptoms in the same
2-week period including depressed mood and anhedonia, causing clinically significant
distress. PHQ-9 score 18 indicates moderately severe depression (15-19 range). Option
A is incorrect because there is no history of mania or hypomania (MDQ should be
administered to rule out bipolar). Option C requires symptoms for ≥2 years. Option D
requires symptoms within 3 months of an identifiable stressor and does not meet full
MDD criteria. Per NR548 Week 7 competency, ruling out bipolar disorder before
diagnosing MDD is critical due to treatment implications.
Question 2
A patient with MDD reports that their depression consistently begins in October and
remits by April each year. Which specifier BEST describes this pattern?
A. Peripartum onset
B. Seasonal pattern
C. Atypical features
D. Melancholic features
Correct Answer: B. Seasonal pattern [CORRECT]
Rationale: Seasonal pattern specifier applies when there is a regular temporal
relationship between onset of major depressive episodes and a particular time of year
(typically fall/winter), with full remissions at a characteristic time (spring/summer).
Option A occurs during pregnancy or within 4 weeks postpartum. Option C requires
mood reactivity, hypersomnia, hyperphagia, leaden paralysis, and rejection sensitivity.
,Option D requires anhedonia, worse morning mood, early awakening, psychomotor
changes, weight loss, and excessive guilt. Per NR548 and DSM-5-TR, seasonal pattern
has implications for light therapy and preventive antidepressant use.
Question 3
A patient with MDD has mood reactivity, hypersomnia, hyperphagia, leaden paralysis,
and long-standing interpersonal rejection sensitivity. Which specifier is indicated?
A. Melancholic features
B. Atypical features
C. Anxious distress
D. Mixed features
Correct Answer: B. Atypical features [CORRECT]
Rationale: Atypical features specifier requires mood reactivity (mood brightens in
response to positive events) plus two or more of: hypersomnia, hyperphagia/weight
gain, leaden paralysis (heavy feelings in limbs), and interpersonal rejection sensitivity.
Option A (melancholic) shows opposite features: anhedonia, early morning awakening,
weight loss. Option C requires ≥2 anxiety symptoms. Option D requires subthreshold
manic/hypomanic symptoms. Per NR548, atypical depression often responds better to
MAOIs and SSRIs than TCAs.
, Question 4
A patient presents with depressed mood, anhedonia, insomnia, fatigue, poor
concentration, and psychomotor retardation. They report excessive guilt, worse mood in
the morning, and early morning awakening at 3:00 AM. Which specifier applies?
A. Atypical features
B. Melancholic features
C. Anxious distress
D. Catatonic features
Correct Answer: B. Melancholic features [CORRECT]
Rationale: Melancholic features require either anhedonia or lack of mood reactivity
PLUS three or more of: distinct quality of depressed mood (different from grief/loss),
depression worse in morning, early morning awakening, psychomotor changes, weight
loss/excessive anorexia, and excessive/inappropriate guilt. Option A requires mood
reactivity and reversed neurovegetative symptoms. Option C requires prominent anxiety.
Option D requires catatonia signs. Per NR548, melancholic features may predict better
response to biological treatments (ECT, TCAs, SSRIs).
Question 5
A 30-year-old male presents with 7 days of elevated mood, decreased need for sleep
(2-3 hours nightly), pressured speech, flight of ideas, increased goal-directed activity,
Assessment for PMHNP | Weeks 7-8 Covered | Questions &
Verified Answers | Chamberlain | Pass Guaranteed - A+
Graded
[Section 1: Mood Disorders – MDD & Bipolar Assessment (Questions
1-12)]
Question 1
A 28-year-old female presents with depressed mood, anhedonia, insomnia, fatigue, poor
concentration, feelings of worthlessness, and psychomotor agitation for the past 3
weeks. She denies any history of elevated or irritable mood. Her PHQ-9 score is 18.
What is the MOST likely diagnosis?
A. Bipolar II Disorder
B. Major Depressive Disorder, moderate severity
C. Persistent Depressive Disorder (Dysthymia)
D. Adjustment Disorder with Depressed Mood
Correct Answer: B. Major Depressive Disorder, moderate severity [CORRECT]
,Rationale: This patient meets DSM-5-TR criteria for MDD: ≥5 symptoms in the same
2-week period including depressed mood and anhedonia, causing clinically significant
distress. PHQ-9 score 18 indicates moderately severe depression (15-19 range). Option
A is incorrect because there is no history of mania or hypomania (MDQ should be
administered to rule out bipolar). Option C requires symptoms for ≥2 years. Option D
requires symptoms within 3 months of an identifiable stressor and does not meet full
MDD criteria. Per NR548 Week 7 competency, ruling out bipolar disorder before
diagnosing MDD is critical due to treatment implications.
Question 2
A patient with MDD reports that their depression consistently begins in October and
remits by April each year. Which specifier BEST describes this pattern?
A. Peripartum onset
B. Seasonal pattern
C. Atypical features
D. Melancholic features
Correct Answer: B. Seasonal pattern [CORRECT]
Rationale: Seasonal pattern specifier applies when there is a regular temporal
relationship between onset of major depressive episodes and a particular time of year
(typically fall/winter), with full remissions at a characteristic time (spring/summer).
Option A occurs during pregnancy or within 4 weeks postpartum. Option C requires
mood reactivity, hypersomnia, hyperphagia, leaden paralysis, and rejection sensitivity.
,Option D requires anhedonia, worse morning mood, early awakening, psychomotor
changes, weight loss, and excessive guilt. Per NR548 and DSM-5-TR, seasonal pattern
has implications for light therapy and preventive antidepressant use.
Question 3
A patient with MDD has mood reactivity, hypersomnia, hyperphagia, leaden paralysis,
and long-standing interpersonal rejection sensitivity. Which specifier is indicated?
A. Melancholic features
B. Atypical features
C. Anxious distress
D. Mixed features
Correct Answer: B. Atypical features [CORRECT]
Rationale: Atypical features specifier requires mood reactivity (mood brightens in
response to positive events) plus two or more of: hypersomnia, hyperphagia/weight
gain, leaden paralysis (heavy feelings in limbs), and interpersonal rejection sensitivity.
Option A (melancholic) shows opposite features: anhedonia, early morning awakening,
weight loss. Option C requires ≥2 anxiety symptoms. Option D requires subthreshold
manic/hypomanic symptoms. Per NR548, atypical depression often responds better to
MAOIs and SSRIs than TCAs.
, Question 4
A patient presents with depressed mood, anhedonia, insomnia, fatigue, poor
concentration, and psychomotor retardation. They report excessive guilt, worse mood in
the morning, and early morning awakening at 3:00 AM. Which specifier applies?
A. Atypical features
B. Melancholic features
C. Anxious distress
D. Catatonic features
Correct Answer: B. Melancholic features [CORRECT]
Rationale: Melancholic features require either anhedonia or lack of mood reactivity
PLUS three or more of: distinct quality of depressed mood (different from grief/loss),
depression worse in morning, early morning awakening, psychomotor changes, weight
loss/excessive anorexia, and excessive/inappropriate guilt. Option A requires mood
reactivity and reversed neurovegetative symptoms. Option C requires prominent anxiety.
Option D requires catatonia signs. Per NR548, melancholic features may predict better
response to biological treatments (ECT, TCAs, SSRIs).
Question 5
A 30-year-old male presents with 7 days of elevated mood, decreased need for sleep
(2-3 hours nightly), pressured speech, flight of ideas, increased goal-directed activity,
