NR548 Exam 3 Actual Exam Style V1 | NR
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. A 7-year-old child is brought to the clinic by his mother, who reports he is often ‘in his own
world,’ fails to respond to his name, and has difficulty making eye contact. Which screening
tool is most appropriate for initial assessment of Autism Spectrum Disorder (ASD)?
A. PHQ-A
B. SCARED
C. Vanderbilt Assessment Scale
D. M-CHAT-R
Answer: D
Rationale: The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a
validated screening tool used to identify children at risk for social communication
disorders. While usually used for younger toddlers, its principles apply to early
developmental screening for ASD. The Vanderbilt scale is specifically for ADHD, while
SCARED assesses anxiety in children.
2. When assessing a patient for Post-Traumatic Stress Disorder (PTSD), the PMHNP recognizes
that ‘intrusion symptoms’ include which of the following?
A. Hypervigilance and exaggerated startle response
,B. Persistent inability to experience positive emotions
C. Recurrent, involuntary, and intrusive distressing memories
D. Efforts to avoid external reminders of the event
Answer: C
Rationale: Intrusion symptoms are characterized by the involuntary re-experiencing of the
traumatic event through memories or flashbacks. Hypervigilance is categorized under
arousal and reactivity symptoms rather than intrusion. Avoidance is a separate diagnostic
cluster in the DSM-5-TR criteria for PTSD.
3. The PMHNP is conducting a Mental Status Examination (MSE) on a new patient. The
patient reports feeling ‘sad and hopeless’ for the last month. How should the PMHNP
document this in the MSE?
A. The patient’s affect is depressed.
B. The patient’s mood is depressed.
C. The patient exhibits a flat affect.
D. The patient is experiencing dysphoria.
Answer: B
Rationale: Mood is the subjective emotional state reported by the patient in their own
words. Affect refers to the provider’s objective observation of the patient’s emotional
, expression during the interview. Since the patient is describing their own feelings, it is
documented as ‘mood.’
4. During a suicide risk assessment, which of the following is considered the most significant
‘red flag’ or immediate risk factor?
A. A family history of depression
B. Recent loss of employment
C. Expressing a specific plan and having access to lethal means
D. Chronic physical pain
Answer: C
Rationale: The presence of a specific plan combined with the means to carry it out
indicates high immediate lethality risk. While loss of employment and chronic pain are
significant stressors, they are distal risk factors compared to an active plan. Identifying
access to firearms or medication is a critical step in the safety assessment process.
5. An adolescent presents with symptoms of irritability, difficulty concentrating, and school
refusal. Which tool is specifically designed to screen for depression in this population?
A. PHQ-9
B. CRAFFT
C. PHQ-A
D. GAD-7
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. A 7-year-old child is brought to the clinic by his mother, who reports he is often ‘in his own
world,’ fails to respond to his name, and has difficulty making eye contact. Which screening
tool is most appropriate for initial assessment of Autism Spectrum Disorder (ASD)?
A. PHQ-A
B. SCARED
C. Vanderbilt Assessment Scale
D. M-CHAT-R
Answer: D
Rationale: The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a
validated screening tool used to identify children at risk for social communication
disorders. While usually used for younger toddlers, its principles apply to early
developmental screening for ASD. The Vanderbilt scale is specifically for ADHD, while
SCARED assesses anxiety in children.
2. When assessing a patient for Post-Traumatic Stress Disorder (PTSD), the PMHNP recognizes
that ‘intrusion symptoms’ include which of the following?
A. Hypervigilance and exaggerated startle response
,B. Persistent inability to experience positive emotions
C. Recurrent, involuntary, and intrusive distressing memories
D. Efforts to avoid external reminders of the event
Answer: C
Rationale: Intrusion symptoms are characterized by the involuntary re-experiencing of the
traumatic event through memories or flashbacks. Hypervigilance is categorized under
arousal and reactivity symptoms rather than intrusion. Avoidance is a separate diagnostic
cluster in the DSM-5-TR criteria for PTSD.
3. The PMHNP is conducting a Mental Status Examination (MSE) on a new patient. The
patient reports feeling ‘sad and hopeless’ for the last month. How should the PMHNP
document this in the MSE?
A. The patient’s affect is depressed.
B. The patient’s mood is depressed.
C. The patient exhibits a flat affect.
D. The patient is experiencing dysphoria.
Answer: B
Rationale: Mood is the subjective emotional state reported by the patient in their own
words. Affect refers to the provider’s objective observation of the patient’s emotional
, expression during the interview. Since the patient is describing their own feelings, it is
documented as ‘mood.’
4. During a suicide risk assessment, which of the following is considered the most significant
‘red flag’ or immediate risk factor?
A. A family history of depression
B. Recent loss of employment
C. Expressing a specific plan and having access to lethal means
D. Chronic physical pain
Answer: C
Rationale: The presence of a specific plan combined with the means to carry it out
indicates high immediate lethality risk. While loss of employment and chronic pain are
significant stressors, they are distal risk factors compared to an active plan. Identifying
access to firearms or medication is a critical step in the safety assessment process.
5. An adolescent presents with symptoms of irritability, difficulty concentrating, and school
refusal. Which tool is specifically designed to screen for depression in this population?
A. PHQ-9
B. CRAFFT
C. PHQ-A
D. GAD-7
