NR548 Exam 2 Actual Exam Style V1 | NR
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. During a Mental Status Exam (MSE), a patient provides excessive detail and unnecessary
information but eventually returns to the original point. This thought process is best
described as:
A. Tangentiality
B. Circumstantiality
C. Flight of ideas
D. Derailment
Answer: B
Rationale: Circumstantiality is a pattern of speech that is indirect and delayed in reaching
the goal because of excessive detail. Unlike tangentiality, the speaker does eventually
return to the point. Recognizing this distinction helps the PMHNP assess the efficiency and
organization of the patient’s thought process.
2. A 72-year-old patient presents with new-onset depressive symptoms. Which laboratory
test is most critical to rule out a common medical cause of depression in the elderly?
A. Blood Urea Nitrogen (BUN)
,B. Serum Creatinine
C. Thyroid Stimulating Hormone (TSH)
D. Alanine Aminotransferase (ALT)
Answer: C
Rationale: Hypothyroidism is a well-known medical cause of depressive symptoms,
particularly in geriatric populations. Screening with a TSH test ensures that a metabolic or
endocrine issue is not masquerading as a primary psychiatric disorder. This is a
fundamental step in the comprehensive psychiatric assessment process.
3. Which screening tool is specifically designed to assess for the presence and severity of
symptoms of Mania or Hypomania to help differentiate Bipolar Disorder from Unipolar
Depression?
A. PHQ-9
B. GAD-7
C. HAM-D
D. Mood Disorder Questionnaire (MDQ)
Answer: D
Rationale: The Mood Disorder Questionnaire (MDQ) is a validated tool for identifying
symptoms associated with bipolar spectrum disorders. It focuses on historical symptoms of
mania and hypomania which patients often fail to report during a depressive episode.
, Proper use of the MDQ can prevent the misdiagnosis of bipolar disorder as major
depressive disorder.
4. When assessing a pediatric patient, which of the following is considered the gold standard
for gathering information about the child’s behavior in different environments?
A. Asking the child to fill out a self-report
B. Observing the child in the waiting room
C. Obtaining collateral information from parents and teachers
D. Performing a physical examination
Answer: C
Rationale: Collateral information is essential in pediatric assessments because children
may not have the insight to describe their own behaviors. Parents and teachers provide
different perspectives on the child’s functioning in home versus school settings. This multi-
informant approach is necessary for an accurate DSM-5-TR diagnosis in children.
5. A patient reports feeling ‘empty’ and ‘on edge’ but displays a wide range of emotions
during the interview, including laughing and crying. The PMHNP should document the
patient’s affect as:
A. Labile
B. Blunted
C. Flat
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. During a Mental Status Exam (MSE), a patient provides excessive detail and unnecessary
information but eventually returns to the original point. This thought process is best
described as:
A. Tangentiality
B. Circumstantiality
C. Flight of ideas
D. Derailment
Answer: B
Rationale: Circumstantiality is a pattern of speech that is indirect and delayed in reaching
the goal because of excessive detail. Unlike tangentiality, the speaker does eventually
return to the point. Recognizing this distinction helps the PMHNP assess the efficiency and
organization of the patient’s thought process.
2. A 72-year-old patient presents with new-onset depressive symptoms. Which laboratory
test is most critical to rule out a common medical cause of depression in the elderly?
A. Blood Urea Nitrogen (BUN)
,B. Serum Creatinine
C. Thyroid Stimulating Hormone (TSH)
D. Alanine Aminotransferase (ALT)
Answer: C
Rationale: Hypothyroidism is a well-known medical cause of depressive symptoms,
particularly in geriatric populations. Screening with a TSH test ensures that a metabolic or
endocrine issue is not masquerading as a primary psychiatric disorder. This is a
fundamental step in the comprehensive psychiatric assessment process.
3. Which screening tool is specifically designed to assess for the presence and severity of
symptoms of Mania or Hypomania to help differentiate Bipolar Disorder from Unipolar
Depression?
A. PHQ-9
B. GAD-7
C. HAM-D
D. Mood Disorder Questionnaire (MDQ)
Answer: D
Rationale: The Mood Disorder Questionnaire (MDQ) is a validated tool for identifying
symptoms associated with bipolar spectrum disorders. It focuses on historical symptoms of
mania and hypomania which patients often fail to report during a depressive episode.
, Proper use of the MDQ can prevent the misdiagnosis of bipolar disorder as major
depressive disorder.
4. When assessing a pediatric patient, which of the following is considered the gold standard
for gathering information about the child’s behavior in different environments?
A. Asking the child to fill out a self-report
B. Observing the child in the waiting room
C. Obtaining collateral information from parents and teachers
D. Performing a physical examination
Answer: C
Rationale: Collateral information is essential in pediatric assessments because children
may not have the insight to describe their own behaviors. Parents and teachers provide
different perspectives on the child’s functioning in home versus school settings. This multi-
informant approach is necessary for an accurate DSM-5-TR diagnosis in children.
5. A patient reports feeling ‘empty’ and ‘on edge’ but displays a wide range of emotions
during the interview, including laughing and crying. The PMHNP should document the
patient’s affect as:
A. Labile
B. Blunted
C. Flat
