NR548 EXAM 4
Psychiatric Assessment for PMHNP|
| Questions with Answers| Chamberlain| Score 100%
1. A client states, "I've been feeling so anxious I can't sleep." Where should
this statement be documented in the psychiatric history?
A. Past psychiatric history
B. Chief complaint, in the client's own words
C. Family history
D. Review of systems
Correct Answer: B
Rationale: The chief complaint captures, ideally in the client's own words, the
primary reason the client is presenting for care right now, making this direct
quote the appropriate content for that section.
2. A client reports that their current depressive symptoms started three weeks
ago after being laid off from work, and describes worsening sleep and appetite
since then. This information belongs in which section?
A. Social history
B. History of present illness (HPI)
C. Family psychiatric history
D. Medication history
Correct Answer: B
Rationale: The HPI documents the chronological development of the current
episode - onset, precipitants, symptom evolution, and severity - making the
timeline and trajectory of the current symptoms core HPI content.
3. A client mentions they were hospitalized for suicidal ideation five years ago
and were previously diagnosed with major depressive disorder, treated with
sertraline with partial response. Where is this documented?
A. History of present illness
B. Past psychiatric history
C. Chief complaint
D. Social history
Correct Answer: B
, Rationale: Past psychiatric history captures prior episodes, diagnoses,
hospitalizations, and treatment trials/responses that occurred before the current
presentation, distinct from the HPI, which focuses on the current episode.
4. A client reports a history of hypothyroidism, well-controlled on
levothyroxine, and a prior traumatic brain injury from a car accident ten
years ago. This information belongs in:
A. Past medical history
B. Family psychiatric history
C. Chief complaint
D. Mental status examination
Correct Answer: A
Rationale: Past medical history documents the client's general medical
conditions, surgeries, and relevant injuries, which is essential given the
bidirectional relationship between medical and psychiatric illness.
5. A client reports that their mother had bipolar disorder and a maternal
uncle died by suicide. This information is documented under:
A. Social history
B. Family psychiatric history
C. Past psychiatric history
D. Developmental history
Correct Answer: B
Rationale: Family psychiatric history captures psychiatric illness, suicide, and
substance use disorders among biological relatives, which is important given
the heritability of many psychiatric conditions and its relevance to risk
assessment.
6. A client describes growing up in a household with domestic violence, being
the youngest of four siblings, and struggling academically due to undiagnosed
ADHD as a child. This information is best documented in:
A. Chief complaint
B. Social/developmental history
C. Medication history
D. Review of systems
Correct Answer: B
, Rationale: Social and developmental history captures upbringing, family
structure, childhood experiences, trauma, and developmental
milestones/challenges, providing crucial psychosocial context for the current
presentation.
7. A client reports currently taking sertraline 100mg daily, occasional
ibuprofen for headaches, and a fish oil supplement, with no known drug
allergies. This belongs under:
A. Past psychiatric history
B. Medication history and allergies
C. Family history
D. Chief complaint
Correct Answer: B
Rationale: The medication and allergy history documents all current
prescribed medications, over-the-counter drugs, supplements, and known
allergic/adverse reactions, which is essential for safe prescribing and
identifying potential drug interactions.
8. A client reports drinking six beers nightly for the past two years and
smoking half a pack of cigarettes daily since age 16. This belongs under:
A. Substance use history
B. Family history
C. Chief complaint
D. Review of systems
Correct Answer: A
Rationale: Substance use history documents the type, amount, frequency, and
duration of use for all substances, including alcohol and tobacco, and is a
distinct, essential component of the comprehensive psychiatric database.
9. During the interview, a client denies current chest pain but endorses
occasional palpitations and reports no changes in bowel habits when asked a
broad screening question across body systems. This information is
documented under:
A. History of present illness
B. Review of systems (ROS)
C. Mental status examination
D. Social history
, Correct Answer: B
Rationale: The review of systems is a systematic screening of symptoms across
body systems (and, in psychiatry, across diagnostic symptom clusters) to
identify additional relevant findings beyond the chief complaint, distinct from
the focused narrative of the HPI.
10. A client reports currently being unemployed, living alone, having limited
social support, and expresses financial stress related to upcoming rent
payments. This belongs under:
A. Social history / current psychosocial stressors
B. Family psychiatric history
C. Past medical history
D. Medication history
Correct Answer: A
Rationale: Current living situation, employment status, social support, and
psychosocial stressors are documented within the social history, which provides
essential context for case formulation and treatment planning.
11. A client discloses they were arrested twice for DUI and are currently on
probation. Where should this information be documented?
A. Family history
B. Legal history, within the social history section
C. Chief complaint
D. Medication history
Correct Answer: B
Rationale: Legal history (arrests, incarceration, probation, pending litigation)
is typically documented within or alongside the social history, as it provides
relevant context regarding impulsivity, substance use, and psychosocial
stressors.
12. On mental status examination, the clinician observes that the client is
disheveled, avoids eye contact, and speaks in a monotone voice. Where is this
documented?
A. History of present illness
B. Mental status examination - appearance, behavior, and speech
C. Past psychiatric history
D. Chief complaint
Psychiatric Assessment for PMHNP|
| Questions with Answers| Chamberlain| Score 100%
1. A client states, "I've been feeling so anxious I can't sleep." Where should
this statement be documented in the psychiatric history?
A. Past psychiatric history
B. Chief complaint, in the client's own words
C. Family history
D. Review of systems
Correct Answer: B
Rationale: The chief complaint captures, ideally in the client's own words, the
primary reason the client is presenting for care right now, making this direct
quote the appropriate content for that section.
2. A client reports that their current depressive symptoms started three weeks
ago after being laid off from work, and describes worsening sleep and appetite
since then. This information belongs in which section?
A. Social history
B. History of present illness (HPI)
C. Family psychiatric history
D. Medication history
Correct Answer: B
Rationale: The HPI documents the chronological development of the current
episode - onset, precipitants, symptom evolution, and severity - making the
timeline and trajectory of the current symptoms core HPI content.
3. A client mentions they were hospitalized for suicidal ideation five years ago
and were previously diagnosed with major depressive disorder, treated with
sertraline with partial response. Where is this documented?
A. History of present illness
B. Past psychiatric history
C. Chief complaint
D. Social history
Correct Answer: B
, Rationale: Past psychiatric history captures prior episodes, diagnoses,
hospitalizations, and treatment trials/responses that occurred before the current
presentation, distinct from the HPI, which focuses on the current episode.
4. A client reports a history of hypothyroidism, well-controlled on
levothyroxine, and a prior traumatic brain injury from a car accident ten
years ago. This information belongs in:
A. Past medical history
B. Family psychiatric history
C. Chief complaint
D. Mental status examination
Correct Answer: A
Rationale: Past medical history documents the client's general medical
conditions, surgeries, and relevant injuries, which is essential given the
bidirectional relationship between medical and psychiatric illness.
5. A client reports that their mother had bipolar disorder and a maternal
uncle died by suicide. This information is documented under:
A. Social history
B. Family psychiatric history
C. Past psychiatric history
D. Developmental history
Correct Answer: B
Rationale: Family psychiatric history captures psychiatric illness, suicide, and
substance use disorders among biological relatives, which is important given
the heritability of many psychiatric conditions and its relevance to risk
assessment.
6. A client describes growing up in a household with domestic violence, being
the youngest of four siblings, and struggling academically due to undiagnosed
ADHD as a child. This information is best documented in:
A. Chief complaint
B. Social/developmental history
C. Medication history
D. Review of systems
Correct Answer: B
, Rationale: Social and developmental history captures upbringing, family
structure, childhood experiences, trauma, and developmental
milestones/challenges, providing crucial psychosocial context for the current
presentation.
7. A client reports currently taking sertraline 100mg daily, occasional
ibuprofen for headaches, and a fish oil supplement, with no known drug
allergies. This belongs under:
A. Past psychiatric history
B. Medication history and allergies
C. Family history
D. Chief complaint
Correct Answer: B
Rationale: The medication and allergy history documents all current
prescribed medications, over-the-counter drugs, supplements, and known
allergic/adverse reactions, which is essential for safe prescribing and
identifying potential drug interactions.
8. A client reports drinking six beers nightly for the past two years and
smoking half a pack of cigarettes daily since age 16. This belongs under:
A. Substance use history
B. Family history
C. Chief complaint
D. Review of systems
Correct Answer: A
Rationale: Substance use history documents the type, amount, frequency, and
duration of use for all substances, including alcohol and tobacco, and is a
distinct, essential component of the comprehensive psychiatric database.
9. During the interview, a client denies current chest pain but endorses
occasional palpitations and reports no changes in bowel habits when asked a
broad screening question across body systems. This information is
documented under:
A. History of present illness
B. Review of systems (ROS)
C. Mental status examination
D. Social history
, Correct Answer: B
Rationale: The review of systems is a systematic screening of symptoms across
body systems (and, in psychiatry, across diagnostic symptom clusters) to
identify additional relevant findings beyond the chief complaint, distinct from
the focused narrative of the HPI.
10. A client reports currently being unemployed, living alone, having limited
social support, and expresses financial stress related to upcoming rent
payments. This belongs under:
A. Social history / current psychosocial stressors
B. Family psychiatric history
C. Past medical history
D. Medication history
Correct Answer: A
Rationale: Current living situation, employment status, social support, and
psychosocial stressors are documented within the social history, which provides
essential context for case formulation and treatment planning.
11. A client discloses they were arrested twice for DUI and are currently on
probation. Where should this information be documented?
A. Family history
B. Legal history, within the social history section
C. Chief complaint
D. Medication history
Correct Answer: B
Rationale: Legal history (arrests, incarceration, probation, pending litigation)
is typically documented within or alongside the social history, as it provides
relevant context regarding impulsivity, substance use, and psychosocial
stressors.
12. On mental status examination, the clinician observes that the client is
disheveled, avoids eye contact, and speaks in a monotone voice. Where is this
documented?
A. History of present illness
B. Mental status examination - appearance, behavior, and speech
C. Past psychiatric history
D. Chief complaint
