NR548 Exam 2 Actual Exam Style V3 | NR
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. Which component of the Mental Status Exam (MSE) describes a patient moving from one
topic to another without ever returning to the original point or reaching the goal of the
conversation?
A. Tangentiality
B. Circumstantiality
C. Flight of ideas
D. Loose associations
Answer: A
Rationale: Tangentiality is characterized by a person’s thoughts drifting off the main
subject without returning to it. Unlike circumstantiality, where the patient eventually
provides the answer after many details, a tangential patient never circles back. This is
frequently observed in individuals experiencing high levels of anxiety or psychosis.
2. When conducting a suicide risk assessment, which of the following is considered the
strongest predictor of a future suicide attempt?
A. A previous suicide attempt
,B. Current substance abuse
C. Family history of depression
D. Recent job loss
Answer: A
Rationale: A history of previous suicide attempts is the single most significant predictor of
future suicidal behavior. While other factors like substance use or job loss contribute to
risk, they do not carry the same statistical weight as past actions. Assessment must always
include a detailed history of any self-harming behaviors to accurately gauge current
lethality.
3. Using the CAGE questionnaire, how many ‘yes’ responses are typically required to suggest
a clinical suspicion of alcohol misuse?
A. Two
B. One
C. Three
D. Four
Answer: A
Rationale: The CAGE questionnaire is a validated screening tool for alcohol use disorder
where a score of two or more is considered clinically significant. One ‘yes’ may warrant
further discussion, but two is the standard threshold for identifying potential problems. It
, evaluates attempts to Cut down, Annoyance at criticism, Guilt, and the need for an Eye-
opener.
4. A patient describes their mood as ‘fine,’ but the PMHNP observes the patient crying
throughout the interview. How should the provider document the patient’s ‘affect’?
A. Euthymic
B. Incongruent
C. Congruent
D. Constricted
Answer: B
Rationale: Affect is considered incongruent when the patient’s outward emotional
expression does not match their reported internal mood state. Congruent affect would
mean the patient says they are sad while crying. Documenting this discrepancy is vital for
evaluating insight and the severity of the psychiatric condition.
5. Which screening tool is most appropriate for assessing the severity of depressive
symptoms and monitoring treatment response over time?
A. PHQ-9
B. GAD-7
C. MDQ
D. AUDIT
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. Which component of the Mental Status Exam (MSE) describes a patient moving from one
topic to another without ever returning to the original point or reaching the goal of the
conversation?
A. Tangentiality
B. Circumstantiality
C. Flight of ideas
D. Loose associations
Answer: A
Rationale: Tangentiality is characterized by a person’s thoughts drifting off the main
subject without returning to it. Unlike circumstantiality, where the patient eventually
provides the answer after many details, a tangential patient never circles back. This is
frequently observed in individuals experiencing high levels of anxiety or psychosis.
2. When conducting a suicide risk assessment, which of the following is considered the
strongest predictor of a future suicide attempt?
A. A previous suicide attempt
,B. Current substance abuse
C. Family history of depression
D. Recent job loss
Answer: A
Rationale: A history of previous suicide attempts is the single most significant predictor of
future suicidal behavior. While other factors like substance use or job loss contribute to
risk, they do not carry the same statistical weight as past actions. Assessment must always
include a detailed history of any self-harming behaviors to accurately gauge current
lethality.
3. Using the CAGE questionnaire, how many ‘yes’ responses are typically required to suggest
a clinical suspicion of alcohol misuse?
A. Two
B. One
C. Three
D. Four
Answer: A
Rationale: The CAGE questionnaire is a validated screening tool for alcohol use disorder
where a score of two or more is considered clinically significant. One ‘yes’ may warrant
further discussion, but two is the standard threshold for identifying potential problems. It
, evaluates attempts to Cut down, Annoyance at criticism, Guilt, and the need for an Eye-
opener.
4. A patient describes their mood as ‘fine,’ but the PMHNP observes the patient crying
throughout the interview. How should the provider document the patient’s ‘affect’?
A. Euthymic
B. Incongruent
C. Congruent
D. Constricted
Answer: B
Rationale: Affect is considered incongruent when the patient’s outward emotional
expression does not match their reported internal mood state. Congruent affect would
mean the patient says they are sad while crying. Documenting this discrepancy is vital for
evaluating insight and the severity of the psychiatric condition.
5. Which screening tool is most appropriate for assessing the severity of depressive
symptoms and monitoring treatment response over time?
A. PHQ-9
B. GAD-7
C. MDQ
D. AUDIT
