NR548 EXAM 3 ACTUAL 2026/2027 | Psychiatric Assessment
for PMHNP | Weeks 5-6 Covered | Questions & Verified
Answers | Chamberlain | Pass Guaranteed - A+ Graded
Section 1: Mood Disorders Assessment
Q1: A 34-year-old patient presents with a 3-week history of depressed mood, loss of
interest in activities, insomnia, fatigue, difficulty concentrating, and feelings of
worthlessness. They deny any history of elevated or irritable mood. Which assessment
tool would you use first to quantify symptom severity?
A. Mood Disorder Questionnaire (MDQ)
B. Montgomery-Åsberg Depression Rating Scale (MADRS) or Patient Health
Questionnaire-9 (PHQ-9) [CORRECT]
C. Young Mania Rating Scale (YMRS)
D. Columbia Suicide Severity Rating Scale (C-SSRS)
Correct Answer: B
Rationale: For Exam 3, Weeks 5-6 focus on mood disorder assessment, and for unipolar
depression, the PHQ-9 or MADRS are your go-to tools for tracking severity and
treatment response. The MDQ screens for bipolar disorder, which this patient denies,
and the YMRS assesses mania, not present here.
Q2: A 28-year-old graduate student reports episodes lasting 4-5 days where they need
only 3 hours of sleep, feel unusually energetic, talk rapidly, and start multiple ambitious
projects, followed by crashes into depression. These episodes cause them to miss
classes but they deny hospitalization. Which diagnosis fits best?
,A. Bipolar I disorder
B. Bipolar II disorder [CORRECT]
C. Cyclothymic disorder
D. Major depressive disorder with mixed features
Correct Answer: B
Rationale: The key differentiator here is the duration and severity—4-5 days of
hypomanic symptoms (not severe enough for hospitalization) alternating with
depressive episodes meets criteria for Bipolar II. Bipolar I requires full mania (7+ days or
hospitalization), and cyclothymia involves subthreshold symptoms for 2+ years without
full episodes.
Q3: A 45-year-old patient has experienced depressed mood most of the day, more days
than not, for the past 2 years, with poor appetite, low energy, and low self-esteem, but
has never had a full major depressive episode. Which diagnosis is most appropriate?
A. Major depressive disorder, single episode
B. Persistent depressive disorder (dysthymia) [CORRECT]
C. Adjustment disorder with depressed mood
D. Bipolar II disorder
Correct Answer: B
Rationale: Remember the duration criteria for persistent depressive
disorder—depressed mood for at least 2 years in adults (1 year in children) with never
more than 2 months symptom-free, plus two or more associated symptoms. That's
exactly what this chronic, low-grade presentation describes, distinct from MDD's
discrete episodes.
,Q4: A 22-year-old patient scores 7 on the MDQ (positive screen) and describes periods
of "feeling amazing" with increased goal-directed activity, but these only last 3 days and
don't cause significant impairment. Which follow-up question is most important?
A. "Have you ever been hospitalized for these episodes?"
B. "Do these periods last at least 4 days, and do they represent a clear change from your
usual self?" [CORRECT]
C. "Do you hear voices during these periods?"
D. "Have you tried medication for this before?"
Correct Answer: B
Rationale: The key differentiator here is distinguishing true hypomania from normal
mood variations—the 4-day minimum duration and clear change in functioning separate
clinical episodes from "good days." Without meeting duration and change criteria, even a
positive MDQ doesn't confirm bipolarity.
Q5: A patient with bipolar I disorder has had four distinct mood episodes (manic,
depressed, manic, depressed) within the past 12 months. Which specifier applies?
A. With rapid cycling [CORRECT]
B. With mixed features
C. With melancholic features
D. With atypical features
Correct Answer: A
Rationale: For Exam 3, remember that rapid cycling in bipolar disorder is defined as four
or more mood episodes in 12 months—it's a course specifier that significantly impacts
treatment decisions and prognosis. Mixed features would require simultaneous manic
and depressive symptoms, not alternating episodes.
, Q6: A 52-year-old patient presents with depressed mood, anhedonia, insomnia, and
prominent psychomotor agitation. They describe "waking up at 4 AM every day" and
feeling worse in the morning. Which specifier is most appropriate?
A. With atypical features
B. With melancholic features [CORRECT]
C. With psychotic features
D. With catatonic features
Correct Answer: B
Rationale: The melancholic features specifier requires either loss of pleasure in almost
all activities or lack of reactivity to usually pleasurable stimuli, plus three or more of:
distinct quality of depressed mood, diurnal variation (worse in morning), early morning
awakening, psychomotor changes, anorexia/weight loss, or excessive guilt. That's the
pattern this patient shows.
Q7: A patient with major depression has been treated with antidepressants for 6 weeks
with partial response. They now report increased energy, decreased need for sleep, and
racing thoughts, but deny grandiosity or risky behavior. Which phenomenon should you
assess for?
A. Bipolar I disorder conversion
B. Antidepressant-induced mania/hypomania or emerging bipolar disorder [CORRECT]
C. Treatment-resistant depression
D. Schizoaffective disorder
Correct Answer: B
Rationale: In clinical practice, antidepressant-induced mood elevation is often the first
clue to underlying bipolar disorder—any patient presenting with depression who shows
for PMHNP | Weeks 5-6 Covered | Questions & Verified
Answers | Chamberlain | Pass Guaranteed - A+ Graded
Section 1: Mood Disorders Assessment
Q1: A 34-year-old patient presents with a 3-week history of depressed mood, loss of
interest in activities, insomnia, fatigue, difficulty concentrating, and feelings of
worthlessness. They deny any history of elevated or irritable mood. Which assessment
tool would you use first to quantify symptom severity?
A. Mood Disorder Questionnaire (MDQ)
B. Montgomery-Åsberg Depression Rating Scale (MADRS) or Patient Health
Questionnaire-9 (PHQ-9) [CORRECT]
C. Young Mania Rating Scale (YMRS)
D. Columbia Suicide Severity Rating Scale (C-SSRS)
Correct Answer: B
Rationale: For Exam 3, Weeks 5-6 focus on mood disorder assessment, and for unipolar
depression, the PHQ-9 or MADRS are your go-to tools for tracking severity and
treatment response. The MDQ screens for bipolar disorder, which this patient denies,
and the YMRS assesses mania, not present here.
Q2: A 28-year-old graduate student reports episodes lasting 4-5 days where they need
only 3 hours of sleep, feel unusually energetic, talk rapidly, and start multiple ambitious
projects, followed by crashes into depression. These episodes cause them to miss
classes but they deny hospitalization. Which diagnosis fits best?
,A. Bipolar I disorder
B. Bipolar II disorder [CORRECT]
C. Cyclothymic disorder
D. Major depressive disorder with mixed features
Correct Answer: B
Rationale: The key differentiator here is the duration and severity—4-5 days of
hypomanic symptoms (not severe enough for hospitalization) alternating with
depressive episodes meets criteria for Bipolar II. Bipolar I requires full mania (7+ days or
hospitalization), and cyclothymia involves subthreshold symptoms for 2+ years without
full episodes.
Q3: A 45-year-old patient has experienced depressed mood most of the day, more days
than not, for the past 2 years, with poor appetite, low energy, and low self-esteem, but
has never had a full major depressive episode. Which diagnosis is most appropriate?
A. Major depressive disorder, single episode
B. Persistent depressive disorder (dysthymia) [CORRECT]
C. Adjustment disorder with depressed mood
D. Bipolar II disorder
Correct Answer: B
Rationale: Remember the duration criteria for persistent depressive
disorder—depressed mood for at least 2 years in adults (1 year in children) with never
more than 2 months symptom-free, plus two or more associated symptoms. That's
exactly what this chronic, low-grade presentation describes, distinct from MDD's
discrete episodes.
,Q4: A 22-year-old patient scores 7 on the MDQ (positive screen) and describes periods
of "feeling amazing" with increased goal-directed activity, but these only last 3 days and
don't cause significant impairment. Which follow-up question is most important?
A. "Have you ever been hospitalized for these episodes?"
B. "Do these periods last at least 4 days, and do they represent a clear change from your
usual self?" [CORRECT]
C. "Do you hear voices during these periods?"
D. "Have you tried medication for this before?"
Correct Answer: B
Rationale: The key differentiator here is distinguishing true hypomania from normal
mood variations—the 4-day minimum duration and clear change in functioning separate
clinical episodes from "good days." Without meeting duration and change criteria, even a
positive MDQ doesn't confirm bipolarity.
Q5: A patient with bipolar I disorder has had four distinct mood episodes (manic,
depressed, manic, depressed) within the past 12 months. Which specifier applies?
A. With rapid cycling [CORRECT]
B. With mixed features
C. With melancholic features
D. With atypical features
Correct Answer: A
Rationale: For Exam 3, remember that rapid cycling in bipolar disorder is defined as four
or more mood episodes in 12 months—it's a course specifier that significantly impacts
treatment decisions and prognosis. Mixed features would require simultaneous manic
and depressive symptoms, not alternating episodes.
, Q6: A 52-year-old patient presents with depressed mood, anhedonia, insomnia, and
prominent psychomotor agitation. They describe "waking up at 4 AM every day" and
feeling worse in the morning. Which specifier is most appropriate?
A. With atypical features
B. With melancholic features [CORRECT]
C. With psychotic features
D. With catatonic features
Correct Answer: B
Rationale: The melancholic features specifier requires either loss of pleasure in almost
all activities or lack of reactivity to usually pleasurable stimuli, plus three or more of:
distinct quality of depressed mood, diurnal variation (worse in morning), early morning
awakening, psychomotor changes, anorexia/weight loss, or excessive guilt. That's the
pattern this patient shows.
Q7: A patient with major depression has been treated with antidepressants for 6 weeks
with partial response. They now report increased energy, decreased need for sleep, and
racing thoughts, but deny grandiosity or risky behavior. Which phenomenon should you
assess for?
A. Bipolar I disorder conversion
B. Antidepressant-induced mania/hypomania or emerging bipolar disorder [CORRECT]
C. Treatment-resistant depression
D. Schizoaffective disorder
Correct Answer: B
Rationale: In clinical practice, antidepressant-induced mood elevation is often the first
clue to underlying bipolar disorder—any patient presenting with depression who shows
