NRNP 6665 Week 11 Final Exam with verified answers and rationales 2026/2027
version /instant pdf
1. A PMHNP begins evaluating a new patient with worsening depression. Which
action is the highest priority during the initial assessment?
A. Assess suicide risk
B. Obtain employment history
C. Discuss previous counseling experiences
D. Complete a family genogram
Answer: A
Rationale: Safety is always the first priority. Every patient presenting with depressive symptoms
should be assessed for suicidal ideation, intent, plan, means, previous attempts, and protective
factors before proceeding with other aspects of the evaluation.*
2. Which Mental Status Examination (MSE) component evaluates a patient's
awareness of person, place, time, and situation?
A. Orientation
B. Affect
C. Insight
D. Thought process
Answer: A
Rationale: Orientation assesses whether the patient correctly identifies person, place, time, and
situation. Disorientation may suggest delirium, dementia, intoxication, or other neurological
conditions.*
3. A patient states, "People on television are sending me secret messages." This
finding is best classified as:
A. Delusion of reference
B. Thought blocking
C. Flight of ideas
D. Obsession
Answer: A
,Rationale: A delusion of reference is the false belief that external events or media contain special
messages directed specifically at the individual.*
4. Which finding is most characteristic of flight of ideas?
A. Rapid shifting from one topic to another with understandable associations
B. Long pauses before answering questions
C. Repetition of another person's words
D. Inability to speak
Answer: A
Rationale: Flight of ideas is commonly seen in mania. Thoughts move rapidly but remain loosely
connected.*
5. During the MSE, a patient laughs while describing the recent death of a family
member. This finding is best documented as:
A. Incongruent affect
B. Restricted affect
C. Euthymic mood
D. Appropriate affect
Answer: A
Rationale: Incongruent affect occurs when emotional expression does not match the content
being discussed.*
6. Which screening tool is commonly used to assess depression severity in adults?
A. PHQ-9
B. MMSE
C. COWS
D. CIWA-Ar
Answer: A
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is widely used to screen for and monitor
depression severity.*
,7. Which assessment tool is commonly used to evaluate generalized anxiety
symptoms?
A. GAD-7
B. Braden Scale
C. Morse Fall Scale
D. APGAR Score
Answer: A
Rationale: The Generalized Anxiety Disorder-7 (GAD-7) is a validated screening instrument for
anxiety.*
8. A patient reports hearing voices commenting on their actions. This symptom is
best classified as:
A. Auditory hallucination
B. Illusion
C. Delusion
D. Obsession
Answer: A
Rationale: Hearing voices without an external stimulus is an auditory hallucination, a common
positive symptom of psychotic disorders.*
9. Which symptom is considered a negative symptom of schizophrenia?
A. Flat affect
B. Hallucinations
C. Delusions
D. Disorganized speech
Answer: A
Rationale: Negative symptoms include diminished emotional expression, avolition, alogia,
anhedonia, and asociality.*
, 10. Which question best assesses suicidal intent?
A. "Have you thought about how you would end your life?"
B. "Do you enjoy your job?"
C. "How many siblings do you have?"
D. "What is your favorite hobby?"
Answer: A
Rationale: Asking directly about suicidal thoughts, plans, intent, and access to means is
recommended and does not increase suicide risk.*
11. Which patient has the highest immediate suicide risk?
A. A patient with a specific suicide plan, available means, and stated intent
B. A patient who feels sad but denies suicidal thoughts
C. A patient experiencing mild anxiety before an examination
D. A patient reporting insomnia for one week
Answer: A
Rationale: A specific plan, intent, and access to means indicate a high level of acute suicide risk
requiring immediate intervention.*
12. A patient repeatedly washes their hands because they fear contamination
despite recognizing the behavior is excessive. This is most consistent with:
A. Obsessive-compulsive disorder (OCD)
B. Generalized anxiety disorder
C. Specific phobia
D. Bipolar disorder
Answer: A
Rationale: OCD is characterized by intrusive obsessions and/or compulsions performed to
reduce anxiety.*
13. Which symptom most strongly supports a diagnosis of mania?
version /instant pdf
1. A PMHNP begins evaluating a new patient with worsening depression. Which
action is the highest priority during the initial assessment?
A. Assess suicide risk
B. Obtain employment history
C. Discuss previous counseling experiences
D. Complete a family genogram
Answer: A
Rationale: Safety is always the first priority. Every patient presenting with depressive symptoms
should be assessed for suicidal ideation, intent, plan, means, previous attempts, and protective
factors before proceeding with other aspects of the evaluation.*
2. Which Mental Status Examination (MSE) component evaluates a patient's
awareness of person, place, time, and situation?
A. Orientation
B. Affect
C. Insight
D. Thought process
Answer: A
Rationale: Orientation assesses whether the patient correctly identifies person, place, time, and
situation. Disorientation may suggest delirium, dementia, intoxication, or other neurological
conditions.*
3. A patient states, "People on television are sending me secret messages." This
finding is best classified as:
A. Delusion of reference
B. Thought blocking
C. Flight of ideas
D. Obsession
Answer: A
,Rationale: A delusion of reference is the false belief that external events or media contain special
messages directed specifically at the individual.*
4. Which finding is most characteristic of flight of ideas?
A. Rapid shifting from one topic to another with understandable associations
B. Long pauses before answering questions
C. Repetition of another person's words
D. Inability to speak
Answer: A
Rationale: Flight of ideas is commonly seen in mania. Thoughts move rapidly but remain loosely
connected.*
5. During the MSE, a patient laughs while describing the recent death of a family
member. This finding is best documented as:
A. Incongruent affect
B. Restricted affect
C. Euthymic mood
D. Appropriate affect
Answer: A
Rationale: Incongruent affect occurs when emotional expression does not match the content
being discussed.*
6. Which screening tool is commonly used to assess depression severity in adults?
A. PHQ-9
B. MMSE
C. COWS
D. CIWA-Ar
Answer: A
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is widely used to screen for and monitor
depression severity.*
,7. Which assessment tool is commonly used to evaluate generalized anxiety
symptoms?
A. GAD-7
B. Braden Scale
C. Morse Fall Scale
D. APGAR Score
Answer: A
Rationale: The Generalized Anxiety Disorder-7 (GAD-7) is a validated screening instrument for
anxiety.*
8. A patient reports hearing voices commenting on their actions. This symptom is
best classified as:
A. Auditory hallucination
B. Illusion
C. Delusion
D. Obsession
Answer: A
Rationale: Hearing voices without an external stimulus is an auditory hallucination, a common
positive symptom of psychotic disorders.*
9. Which symptom is considered a negative symptom of schizophrenia?
A. Flat affect
B. Hallucinations
C. Delusions
D. Disorganized speech
Answer: A
Rationale: Negative symptoms include diminished emotional expression, avolition, alogia,
anhedonia, and asociality.*
, 10. Which question best assesses suicidal intent?
A. "Have you thought about how you would end your life?"
B. "Do you enjoy your job?"
C. "How many siblings do you have?"
D. "What is your favorite hobby?"
Answer: A
Rationale: Asking directly about suicidal thoughts, plans, intent, and access to means is
recommended and does not increase suicide risk.*
11. Which patient has the highest immediate suicide risk?
A. A patient with a specific suicide plan, available means, and stated intent
B. A patient who feels sad but denies suicidal thoughts
C. A patient experiencing mild anxiety before an examination
D. A patient reporting insomnia for one week
Answer: A
Rationale: A specific plan, intent, and access to means indicate a high level of acute suicide risk
requiring immediate intervention.*
12. A patient repeatedly washes their hands because they fear contamination
despite recognizing the behavior is excessive. This is most consistent with:
A. Obsessive-compulsive disorder (OCD)
B. Generalized anxiety disorder
C. Specific phobia
D. Bipolar disorder
Answer: A
Rationale: OCD is characterized by intrusive obsessions and/or compulsions performed to
reduce anxiety.*
13. Which symptom most strongly supports a diagnosis of mania?
