NR548 Exam 4 Actual Exam Style V1 | NR
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. When assessing a geriatric patient for cognitive decline, which tool is specifically designed
to detect delirium rather than dementia?
A. CAM (Confusion Assessment Method)
B. MMSE (Mini-Mental State Examination)
C. MoCA (Montreal Cognitive Assessment)
D. GDS (Geriatric Depression Scale)
Answer: A
Rationale: The Confusion Assessment Method (CAM) is specifically designed to help
clinicians identify delirium quickly and accurately. Unlike the MMSE or MoCA, which focus
on general cognitive impairment and dementia, the CAM focuses on the fluctuating nature
of symptoms. It assesses acute onset, inattention, disorganized thinking, and altered levels
of consciousness.
2. In a pediatric psychiatric assessment using the HEADSS framework, what does the ‘E’ stand
for?
A. Education and Employment
,B. Exercise and Eating
C. Environment and Emotion
D. Experience and Expectations
Answer: A
Rationale: The HEADSS assessment is a systematic approach used to interview
adolescents regarding their psychosocial environment. The ‘E’ specifically targets
Education and Employment to determine how the youth is functioning in school or work
settings. This tool helps the PMHNP identify risk factors and protective factors in a
structured manner.
3. Which of the following is considered a ‘negative symptom’ of schizophrenia that should be
noted during a psychiatric evaluation?
A. Auditory hallucinations
B. Avolition
C. Delusions of grandeur
D. Disorganized speech
Answer: B
Rationale: Negative symptoms refer to the absence or reduction of normal functions such
as emotion, speech, or motivation. Avolition is a common negative symptom characterized
, by a lack of drive or ability to pursue meaningful goals. Recognizing these is crucial because
they often persist after positive symptoms like hallucinations have been treated.
4. During a mental status exam (MSE), the PMHNP observes the patient moving from one
topic to another rapidly, with some logical connection between themes. This is documented
as:
A. Looseness of association
B. Word salad
C. Circumstantiality
D. Flight of ideas
Answer: D
Rationale: Flight of ideas involves a rapid succession of thoughts where the patient jumps
between ideas that are loosely connected. While the connections may be understandable,
the speed and frequency of shifts are indicative of mania or severe anxiety. It differs from
looseness of association where there is no logical connection between ideas at all.
5. A patient presents with a score of 18 on the PHQ-9. How should the PMHNP interpret this
result?
A. Moderately severe depression
B. Moderate depression
C. Mild depression
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. When assessing a geriatric patient for cognitive decline, which tool is specifically designed
to detect delirium rather than dementia?
A. CAM (Confusion Assessment Method)
B. MMSE (Mini-Mental State Examination)
C. MoCA (Montreal Cognitive Assessment)
D. GDS (Geriatric Depression Scale)
Answer: A
Rationale: The Confusion Assessment Method (CAM) is specifically designed to help
clinicians identify delirium quickly and accurately. Unlike the MMSE or MoCA, which focus
on general cognitive impairment and dementia, the CAM focuses on the fluctuating nature
of symptoms. It assesses acute onset, inattention, disorganized thinking, and altered levels
of consciousness.
2. In a pediatric psychiatric assessment using the HEADSS framework, what does the ‘E’ stand
for?
A. Education and Employment
,B. Exercise and Eating
C. Environment and Emotion
D. Experience and Expectations
Answer: A
Rationale: The HEADSS assessment is a systematic approach used to interview
adolescents regarding their psychosocial environment. The ‘E’ specifically targets
Education and Employment to determine how the youth is functioning in school or work
settings. This tool helps the PMHNP identify risk factors and protective factors in a
structured manner.
3. Which of the following is considered a ‘negative symptom’ of schizophrenia that should be
noted during a psychiatric evaluation?
A. Auditory hallucinations
B. Avolition
C. Delusions of grandeur
D. Disorganized speech
Answer: B
Rationale: Negative symptoms refer to the absence or reduction of normal functions such
as emotion, speech, or motivation. Avolition is a common negative symptom characterized
, by a lack of drive or ability to pursue meaningful goals. Recognizing these is crucial because
they often persist after positive symptoms like hallucinations have been treated.
4. During a mental status exam (MSE), the PMHNP observes the patient moving from one
topic to another rapidly, with some logical connection between themes. This is documented
as:
A. Looseness of association
B. Word salad
C. Circumstantiality
D. Flight of ideas
Answer: D
Rationale: Flight of ideas involves a rapid succession of thoughts where the patient jumps
between ideas that are loosely connected. While the connections may be understandable,
the speed and frequency of shifts are indicative of mania or severe anxiety. It differs from
looseness of association where there is no logical connection between ideas at all.
5. A patient presents with a score of 18 on the PHQ-9. How should the PMHNP interpret this
result?
A. Moderately severe depression
B. Moderate depression
C. Mild depression
