NRNP 6675 Midterm Exam Review 2026 |
200 Questions & Correct Answers with
Rationales | Psychiatric Mental Health NP
NGN Prep
Course: NRNP 6675 — Psychiatric Mental Health Nurse Practitioner Care Across the
Lifespan II (Walden University)
Exam Blueprint (based on course content and ANCC PMHNP certification
alignment):
Section Topic # Question
1 Psychiatric Assessment & Diagnosis (MSE, DSM-5-TR, Differential Dx) 30
2 Psychopharmacology & Neurobiology 30
3 Mood Disorders 25
4 Anxiety Disorders, OCD & Trauma-Related Disorders 25
5 Psychotic Disorders & Schizophrenia Spectrum 20
6 Special Populations (Geriatric, Pediatric, Perinatal) 20
,Section Topic # Question
7 Ethics, Legal & Professional Practice 20
8 Integrated Case Studies & NGN Scenarios 30
TOTAL 200
Each question includes four options, the correct answer, and a detailed rationale
explaining why the correct answer is best and why distractors are incorrect.
SECTION 1: PSYCHIATRIC ASSESSMENT & DIAGNOSTIC REASONING (Questions 1–
30)
Question 1
A patient presents with delusions, disorganized thoughts and speech, and poor self-
care, all of which have persisted for the past 7 months. The PMHNP concludes that
this presentation is most consistent with which of the following diagnoses?
A) Schizophreniform disorder
B) Schizophrenia
C) Brief psychotic disorder
D) Delusional disorder
Correct Answer: B
Rationale: Schizophrenia requires at least 6 months of symptoms, including at least 1
month of active-phase symptoms (delusions, hallucinations, disorganized speech).
Schizophreniform disorder has the same symptom profile but lasts less than 6
months. Brief psychotic disorder lasts less than 1 month. Delusional disorder is
primarily delusions with relatively preserved functioning and no prominent
disorganization.
Question 2
The diagnosis used to describe a syndrome characterized by specific signs and
,symptoms resulting from recent ingestion or exposure to a substance is which of the
following?
A) Substance intoxication
B) Substance withdrawal
C) Substance use disorder
D) Any of the above
Correct Answer: A
Rationale: "Substance intoxication" refers to the set of behavioral or physiological
changes that occur when a substance is recently taken in excess. "Substance
withdrawal" refers to the symptomatic reaction when reducing or discontinuing a
substance. "Substance use disorder" is a pattern of continued use despite significant
impairment. Only intoxication specifically describes the syndrome resulting from
recent ingestion.
Question 3
A 34-year-old female presents for initial psychiatric evaluation reporting persistent
sadness, loss of interest in activities, and difficulty sleeping for the past three weeks.
Her medical history includes hypothyroidism. Which action should the PMHNP
prioritize before assigning a psychiatric diagnosis?
A) Administer the PHQ-9 and initiate sertraline 50 mg daily
B) Order thyroid function tests and review current levothyroxine dosing
C) Proceed with DSM-5 criteria for major depressive disorder and begin
psychotherapy
D) Prescribe a sleep aid and reassess in two weeks
Correct Answer: B
Rationale: Hypothyroidism is a well-established medical cause of depressive
symptoms; the PMHNP must rule out organic etiologies before assigning a primary
psychiatric diagnosis per DSM-5 diagnostic guidelines. Option A prematurely initiates
pharmacotherapy without excluding medical causes. Option C assumes a psychiatric
etiology without appropriate medical workup. Option D delays appropriate diagnostic
evaluation.
, Question 4
The main psychological difference between fear and anxiety is best described by
which of the following statements?
A) Fear is insidious; anxiety is sudden
B) Anxiety is insidious; fear is sudden
C) There is no difference between fear and anxiety
D) Both anxiety and fear are alerting signals
Correct Answer: B
Rationale: Fear is an emotional response to a known, external, definite threat and is
typically sudden and acute. Anxiety is a vague, subjective sense of apprehension and
dread that is insidious in onset and often has no identifiable trigger. Both serve as
alerting signals, but the key distinction is the temporal onset and identified threat.
Question 5
A PMHNP is conducting a mental status examination. The patient's speech is slow,
soft, and monotone, with long pauses before answering. This finding is best
described as which MSE component?
A) Thought content
B) Psychomotor activity
C) Speech (rate, tone, volume)
D) Insight
Correct Answer: C
Rationale: Rate, tone, volume, and latency of speech are documented under the
"speech" domain of the MSE. Psychomotor activity refers to observable motor
behavior (agitation, retardation), not verbal output. Thought content refers to what the
patient is thinking (delusions, suicidal ideation). Insight refers to the patient's
awareness of their condition.
Question 6
During an MSE, a patient reports, "The television is sending me coded messages
meant only for me." This is an example of which finding?
200 Questions & Correct Answers with
Rationales | Psychiatric Mental Health NP
NGN Prep
Course: NRNP 6675 — Psychiatric Mental Health Nurse Practitioner Care Across the
Lifespan II (Walden University)
Exam Blueprint (based on course content and ANCC PMHNP certification
alignment):
Section Topic # Question
1 Psychiatric Assessment & Diagnosis (MSE, DSM-5-TR, Differential Dx) 30
2 Psychopharmacology & Neurobiology 30
3 Mood Disorders 25
4 Anxiety Disorders, OCD & Trauma-Related Disorders 25
5 Psychotic Disorders & Schizophrenia Spectrum 20
6 Special Populations (Geriatric, Pediatric, Perinatal) 20
,Section Topic # Question
7 Ethics, Legal & Professional Practice 20
8 Integrated Case Studies & NGN Scenarios 30
TOTAL 200
Each question includes four options, the correct answer, and a detailed rationale
explaining why the correct answer is best and why distractors are incorrect.
SECTION 1: PSYCHIATRIC ASSESSMENT & DIAGNOSTIC REASONING (Questions 1–
30)
Question 1
A patient presents with delusions, disorganized thoughts and speech, and poor self-
care, all of which have persisted for the past 7 months. The PMHNP concludes that
this presentation is most consistent with which of the following diagnoses?
A) Schizophreniform disorder
B) Schizophrenia
C) Brief psychotic disorder
D) Delusional disorder
Correct Answer: B
Rationale: Schizophrenia requires at least 6 months of symptoms, including at least 1
month of active-phase symptoms (delusions, hallucinations, disorganized speech).
Schizophreniform disorder has the same symptom profile but lasts less than 6
months. Brief psychotic disorder lasts less than 1 month. Delusional disorder is
primarily delusions with relatively preserved functioning and no prominent
disorganization.
Question 2
The diagnosis used to describe a syndrome characterized by specific signs and
,symptoms resulting from recent ingestion or exposure to a substance is which of the
following?
A) Substance intoxication
B) Substance withdrawal
C) Substance use disorder
D) Any of the above
Correct Answer: A
Rationale: "Substance intoxication" refers to the set of behavioral or physiological
changes that occur when a substance is recently taken in excess. "Substance
withdrawal" refers to the symptomatic reaction when reducing or discontinuing a
substance. "Substance use disorder" is a pattern of continued use despite significant
impairment. Only intoxication specifically describes the syndrome resulting from
recent ingestion.
Question 3
A 34-year-old female presents for initial psychiatric evaluation reporting persistent
sadness, loss of interest in activities, and difficulty sleeping for the past three weeks.
Her medical history includes hypothyroidism. Which action should the PMHNP
prioritize before assigning a psychiatric diagnosis?
A) Administer the PHQ-9 and initiate sertraline 50 mg daily
B) Order thyroid function tests and review current levothyroxine dosing
C) Proceed with DSM-5 criteria for major depressive disorder and begin
psychotherapy
D) Prescribe a sleep aid and reassess in two weeks
Correct Answer: B
Rationale: Hypothyroidism is a well-established medical cause of depressive
symptoms; the PMHNP must rule out organic etiologies before assigning a primary
psychiatric diagnosis per DSM-5 diagnostic guidelines. Option A prematurely initiates
pharmacotherapy without excluding medical causes. Option C assumes a psychiatric
etiology without appropriate medical workup. Option D delays appropriate diagnostic
evaluation.
, Question 4
The main psychological difference between fear and anxiety is best described by
which of the following statements?
A) Fear is insidious; anxiety is sudden
B) Anxiety is insidious; fear is sudden
C) There is no difference between fear and anxiety
D) Both anxiety and fear are alerting signals
Correct Answer: B
Rationale: Fear is an emotional response to a known, external, definite threat and is
typically sudden and acute. Anxiety is a vague, subjective sense of apprehension and
dread that is insidious in onset and often has no identifiable trigger. Both serve as
alerting signals, but the key distinction is the temporal onset and identified threat.
Question 5
A PMHNP is conducting a mental status examination. The patient's speech is slow,
soft, and monotone, with long pauses before answering. This finding is best
described as which MSE component?
A) Thought content
B) Psychomotor activity
C) Speech (rate, tone, volume)
D) Insight
Correct Answer: C
Rationale: Rate, tone, volume, and latency of speech are documented under the
"speech" domain of the MSE. Psychomotor activity refers to observable motor
behavior (agitation, retardation), not verbal output. Thought content refers to what the
patient is thinking (delusions, suicidal ideation). Insight refers to the patient's
awareness of their condition.
Question 6
During an MSE, a patient reports, "The television is sending me coded messages
meant only for me." This is an example of which finding?
