NR548 Exam 3 Actual Exam Style V3 | NR
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. When assessing a patient for a potential diagnosis of Major Depressive Disorder (MDD),
which of the following is considered a core symptom required for diagnosis according to the
DSM-5?
A. Anhedonia or depressed mood
B. Psychomotor agitation or retardation
C. Feelings of worthlessness or guilt
D. Significant weight loss or gain
Answer: A
Rationale: According to the DSM-5, at least one of the core symptoms must be either
depressed mood or loss of interest or pleasure (anhedonia). These symptoms must be
present during the same 2-week period and represent a change from previous functioning.
Other symptoms like weight change or guilt are secondary criteria that contribute to the
diagnosis but are not the primary mandatory core symptoms.
2. During a Mental Status Examination (MSE), the PMHNP asks the patient to interpret the
proverb ‘A rolling stone gathers no moss.’ This is primarily testing which cognitive function?
A. Judgment
,B. Insight
C. Orientation
D. Abstract reasoning
Answer: D
Rationale: Abstract reasoning is the ability to understand concepts that are not directly
tied to physical objects or concrete experiences. Testing with proverbs allows the clinician
to see if the patient interprets the meaning figuratively rather than literally. Concrete
thinking is often associated with certain psychiatric conditions such as schizophrenia or
neurocognitive disorders.
3. Which standardized tool is most appropriate for a PMHNP to use when screening a patient
specifically for Generalized Anxiety Disorder (GAD)?
A. GAD-7
B. PHQ-9
C. CAGE-AID
D. AIMS
Answer: A
Rationale: The GAD-7 is a validated 7-item self-report scale designed to identify cases of
generalized anxiety disorder and assess symptom severity. It is widely used in clinical
practice due to its brevity and high sensitivity for anxiety symptoms. While the PHQ-9 is for
, depression, the GAD-7 remains the gold standard for initial anxiety screening in primary
and psychiatric care.
4. In the context of the Tarasoff ruling, what is the PMHNP’s legal and ethical obligation when
a patient expresses a credible threat of physical violence toward a specific, identifiable
individual?
A. Duty to warn and protect the intended victim
B. Encourage the patient to self-report the threat
C. Maintain patient-provider confidentiality at all costs
D. Request an immediate involuntary commitment without notification
Answer: A
Rationale: The Tarasoff case established the ‘duty to warn,’ meaning clinicians must take
reasonable steps to protect third parties from harm. This involves notifying the intended
victim and potentially the police when a serious threat is made. This legal precedent
overrides the standard rules of patient confidentiality to ensure public safety.
5. Which of the following symptoms distinguishes Bipolar I Disorder from Bipolar II Disorder?
A. The presence of hypomanic episodes
B. The occurrence of at least one manic episode
C. The presence of major depressive episodes
D. A history of rapid cycling
548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. When assessing a patient for a potential diagnosis of Major Depressive Disorder (MDD),
which of the following is considered a core symptom required for diagnosis according to the
DSM-5?
A. Anhedonia or depressed mood
B. Psychomotor agitation or retardation
C. Feelings of worthlessness or guilt
D. Significant weight loss or gain
Answer: A
Rationale: According to the DSM-5, at least one of the core symptoms must be either
depressed mood or loss of interest or pleasure (anhedonia). These symptoms must be
present during the same 2-week period and represent a change from previous functioning.
Other symptoms like weight change or guilt are secondary criteria that contribute to the
diagnosis but are not the primary mandatory core symptoms.
2. During a Mental Status Examination (MSE), the PMHNP asks the patient to interpret the
proverb ‘A rolling stone gathers no moss.’ This is primarily testing which cognitive function?
A. Judgment
,B. Insight
C. Orientation
D. Abstract reasoning
Answer: D
Rationale: Abstract reasoning is the ability to understand concepts that are not directly
tied to physical objects or concrete experiences. Testing with proverbs allows the clinician
to see if the patient interprets the meaning figuratively rather than literally. Concrete
thinking is often associated with certain psychiatric conditions such as schizophrenia or
neurocognitive disorders.
3. Which standardized tool is most appropriate for a PMHNP to use when screening a patient
specifically for Generalized Anxiety Disorder (GAD)?
A. GAD-7
B. PHQ-9
C. CAGE-AID
D. AIMS
Answer: A
Rationale: The GAD-7 is a validated 7-item self-report scale designed to identify cases of
generalized anxiety disorder and assess symptom severity. It is widely used in clinical
practice due to its brevity and high sensitivity for anxiety symptoms. While the PHQ-9 is for
, depression, the GAD-7 remains the gold standard for initial anxiety screening in primary
and psychiatric care.
4. In the context of the Tarasoff ruling, what is the PMHNP’s legal and ethical obligation when
a patient expresses a credible threat of physical violence toward a specific, identifiable
individual?
A. Duty to warn and protect the intended victim
B. Encourage the patient to self-report the threat
C. Maintain patient-provider confidentiality at all costs
D. Request an immediate involuntary commitment without notification
Answer: A
Rationale: The Tarasoff case established the ‘duty to warn,’ meaning clinicians must take
reasonable steps to protect third parties from harm. This involves notifying the intended
victim and potentially the police when a serious threat is made. This legal precedent
overrides the standard rules of patient confidentiality to ensure public safety.
5. Which of the following symptoms distinguishes Bipolar I Disorder from Bipolar II Disorder?
A. The presence of hypomanic episodes
B. The occurrence of at least one manic episode
C. The presence of major depressive episodes
D. A history of rapid cycling
