NR548 Exam 1 Actual Exam Style V1 | NR
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. A 45-year-old patient reports feeling ‘down’ for several weeks and exhibits a lack of
emotional expression during the interview. The PMHNP notes the patient’s face remains
immobile throughout the session. How should this be documented in the Mental Status Exam
(MSE)?
A. Flat affect
B. Labile affect
C. Blunted affect
D. Constricted affect
Answer: A
Rationale: Flat affect is defined by a complete or near-complete absence of emotional
expression, often seen in schizophrenia or severe depression. It is characterized by an
immobile facial expression and a monotonous voice. Accurate documentation of affect is
crucial for establishing a baseline and monitoring the patient’s response to psychiatric
interventions.
,2. During a psychiatric evaluation, the PMHNP uses the OARS technique from motivational
interviewing. Which of the following best represents the ‘A’ in OARS?
A. Action
B. Affirmation
C. Assessment
D. Advocacy
Answer: B
Rationale: The acronym OARS stands for Open-ended questions, Affirmations, Reflective
listening, and Summaries. Affirmations are used to acknowledge a patient’s strengths and
efforts during the therapeutic process. This technique helps build rapport and increases the
patient’s confidence in their ability to change.
3. A PMHNP is assessing a patient who believes the local news anchor is sending secret
messages specifically to them through the television. This is an example of:
A. Delusions of grandeur
B. Ideas of reference
C. Hallucinations
D. Thought broadcasting
Answer: B
, Rationale: Ideas of reference involve the false belief that irrelevant or innocuous events in
the world have direct personal significance. This differs from a fixed delusion because the
patient may still have some degree of insight or the belief may be less structured.
Identifying these thought content disturbances is a key component of the psychiatric
diagnostic process.
4. Which standardized tool is most appropriate for a PMHNP to use when screening a patient
specifically for the severity of depressive symptoms?
A. PHQ-9
B. GAD-7
C. CAGE
D. MMSE
Answer: A
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a validated 9-item tool used to
screen, diagnose, and monitor the severity of depression. Each item is based on the DSM-5
criteria for Major Depressive Disorder. Regular use of this tool helps the PMHNP
objectively track treatment progress over time.
5. A patient describes their thoughts as ‘racing’ and the PMHNP observes the patient jumping
from one topic to another with only minimal logical connections. This is documented as:
A. Circumstantiality
B. Tangentiality
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. A 45-year-old patient reports feeling ‘down’ for several weeks and exhibits a lack of
emotional expression during the interview. The PMHNP notes the patient’s face remains
immobile throughout the session. How should this be documented in the Mental Status Exam
(MSE)?
A. Flat affect
B. Labile affect
C. Blunted affect
D. Constricted affect
Answer: A
Rationale: Flat affect is defined by a complete or near-complete absence of emotional
expression, often seen in schizophrenia or severe depression. It is characterized by an
immobile facial expression and a monotonous voice. Accurate documentation of affect is
crucial for establishing a baseline and monitoring the patient’s response to psychiatric
interventions.
,2. During a psychiatric evaluation, the PMHNP uses the OARS technique from motivational
interviewing. Which of the following best represents the ‘A’ in OARS?
A. Action
B. Affirmation
C. Assessment
D. Advocacy
Answer: B
Rationale: The acronym OARS stands for Open-ended questions, Affirmations, Reflective
listening, and Summaries. Affirmations are used to acknowledge a patient’s strengths and
efforts during the therapeutic process. This technique helps build rapport and increases the
patient’s confidence in their ability to change.
3. A PMHNP is assessing a patient who believes the local news anchor is sending secret
messages specifically to them through the television. This is an example of:
A. Delusions of grandeur
B. Ideas of reference
C. Hallucinations
D. Thought broadcasting
Answer: B
, Rationale: Ideas of reference involve the false belief that irrelevant or innocuous events in
the world have direct personal significance. This differs from a fixed delusion because the
patient may still have some degree of insight or the belief may be less structured.
Identifying these thought content disturbances is a key component of the psychiatric
diagnostic process.
4. Which standardized tool is most appropriate for a PMHNP to use when screening a patient
specifically for the severity of depressive symptoms?
A. PHQ-9
B. GAD-7
C. CAGE
D. MMSE
Answer: A
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is a validated 9-item tool used to
screen, diagnose, and monitor the severity of depression. Each item is based on the DSM-5
criteria for Major Depressive Disorder. Regular use of this tool helps the PMHNP
objectively track treatment progress over time.
5. A patient describes their thoughts as ‘racing’ and the PMHNP observes the patient jumping
from one topic to another with only minimal logical connections. This is documented as:
A. Circumstantiality
B. Tangentiality
