NR548 FINAL EXAM ACTUAL 2026/2027 | Psychiatric
Assessment for PMHNP | Weeks 7-8 Covered | Questions &
Verified Answers | Chamberlain | Pass Guaranteed - A+
Graded
Section 1: Psychotic Disorders Assessment
Q1: A 22-year-old college student is brought to the emergency department by campus
security after being found wandering outside at 3 AM, claiming the FBI is monitoring his
thoughts through the campus Wi-Fi. He reports hearing a male voice commenting on his
actions for the past three months. His affect is flat, and he shows minimal response to
questions. Which phase of schizophrenia is he most likely experiencing?
A. Prodromal phase
B. Active phase [CORRECT]
C. Residual phase
D. Premorbid phase
Correct Answer: B
Rationale: That's the correct assessment approach because this patient is displaying
classic first-rank positive symptoms—auditory hallucinations (the commenting voice),
delusions of persecution (FBI monitoring), and flat affect—which define the active phase
of schizophrenia. For the final exam, Weeks 7-8 emphasize that the active phase is
when psychotic symptoms are fully present and cause significant functional
impairment; the prodromal phase (Option A) involves subtle decline in functioning
,without full psychosis, while residual phase (Option C) follows an active episode with
diminished but lingering symptoms.
Q2: A 35-year-old woman with a history of bipolar I disorder presents with grandiose
delusions that she is destined to solve world hunger, accompanied by pressured
speech, decreased need for sleep, and visual hallucinations of angels guiding her work.
Her mood is euphoric and expansive. Which diagnosis best fits this presentation?
A. Schizophrenia
B. Schizoaffective disorder, bipolar type
C. Bipolar I disorder with psychotic features [CORRECT]
D. Brief psychotic disorder
Correct Answer: C
Rationale: The key differential here is recognizing that mood-congruent psychotic
features (grandiose delusions and visual hallucinations matching the euphoric,
expansive mood) occurring exclusively during a manic episode point to bipolar I with
psychotic features rather than schizoaffective disorder. That's the correct assessment
approach because schizoaffective disorder requires a two-week period of psychosis
without mood symptoms, which isn't described here; the psychosis is entirely
embedded within the manic episode.
Q3: A PMHNP is assessing a 28-year-old man recently diagnosed with schizophrenia.
Which symptom would be classified as a negative symptom rather than a positive
symptom?
A. Auditory hallucinations
,B. Delusions of reference
C. Avolition and social withdrawal [CORRECT]
D. Disorganized speech
Correct Answer: C
Rationale: That's right because avolition (decreased motivation) and social withdrawal
are negative symptoms—reflecting an absence or diminution of normal
functions—whereas hallucinations, delusions, and disorganized speech are positive
symptoms representing excess or distortion. Remember for the final exam that negative
symptoms often respond less well to antipsychotic medication and are major
contributors to long-term disability in schizophrenia.
Q4: A 19-year-old woman presents with sudden onset of bizarre delusions that she is
pregnant with an alien baby, accompanied by disorganized behavior and inappropriate
laughter. Symptoms began two weeks ago following a stressful breakup and have
persisted daily. She has no prior psychiatric history. Which diagnosis is most
appropriate?
A. Schizophrenia
B. Schizoaffective disorder
C. Brief psychotic disorder [CORRECT]
D. Schizophreniform disorder
Correct Answer: C
, Rationale: The key differential here is the sudden onset and brief duration—symptoms
present for less than one month with eventual full return to premorbid functioning
defines brief psychotic disorder, often triggered by stress. That's the correct
assessment approach because schizophrenia requires six months of symptoms
including prodrome or residual phases; schizophreniform disorder (Option D) requires
one to six months, so this two-week presentation fits brief psychotic disorder perfectly.
Q5: A PMHNP administers the PANSS (Positive and Negative Syndrome Scale) to a
patient with schizophrenia. Which domain would assess symptoms such as
suspiciousness, hostility, and poor impulse control?
A. Positive scale
B. Negative scale
C. General psychopathology scale [CORRECT]
D. Cognitive scale
Correct Answer: C
Rationale: That's the correct assessment approach because the PANSS general
psychopathology scale captures symptoms like anxiety, guilt, tension, depression, and
active social avoidance—including the hostility and poor impulse control described. The
positive scale (Option A) covers hallucinations and delusions; negative scale (Option B)
covers blunted affect and withdrawal; the PANSS doesn't have a separate cognitive
scale (Option D), though cognitive symptoms are assessed within other domains.
Q6: A 42-year-old man has held the delusion for five years that his neighbor is poisoning
his water supply, despite multiple negative water tests and no evidence. He functions
Assessment for PMHNP | Weeks 7-8 Covered | Questions &
Verified Answers | Chamberlain | Pass Guaranteed - A+
Graded
Section 1: Psychotic Disorders Assessment
Q1: A 22-year-old college student is brought to the emergency department by campus
security after being found wandering outside at 3 AM, claiming the FBI is monitoring his
thoughts through the campus Wi-Fi. He reports hearing a male voice commenting on his
actions for the past three months. His affect is flat, and he shows minimal response to
questions. Which phase of schizophrenia is he most likely experiencing?
A. Prodromal phase
B. Active phase [CORRECT]
C. Residual phase
D. Premorbid phase
Correct Answer: B
Rationale: That's the correct assessment approach because this patient is displaying
classic first-rank positive symptoms—auditory hallucinations (the commenting voice),
delusions of persecution (FBI monitoring), and flat affect—which define the active phase
of schizophrenia. For the final exam, Weeks 7-8 emphasize that the active phase is
when psychotic symptoms are fully present and cause significant functional
impairment; the prodromal phase (Option A) involves subtle decline in functioning
,without full psychosis, while residual phase (Option C) follows an active episode with
diminished but lingering symptoms.
Q2: A 35-year-old woman with a history of bipolar I disorder presents with grandiose
delusions that she is destined to solve world hunger, accompanied by pressured
speech, decreased need for sleep, and visual hallucinations of angels guiding her work.
Her mood is euphoric and expansive. Which diagnosis best fits this presentation?
A. Schizophrenia
B. Schizoaffective disorder, bipolar type
C. Bipolar I disorder with psychotic features [CORRECT]
D. Brief psychotic disorder
Correct Answer: C
Rationale: The key differential here is recognizing that mood-congruent psychotic
features (grandiose delusions and visual hallucinations matching the euphoric,
expansive mood) occurring exclusively during a manic episode point to bipolar I with
psychotic features rather than schizoaffective disorder. That's the correct assessment
approach because schizoaffective disorder requires a two-week period of psychosis
without mood symptoms, which isn't described here; the psychosis is entirely
embedded within the manic episode.
Q3: A PMHNP is assessing a 28-year-old man recently diagnosed with schizophrenia.
Which symptom would be classified as a negative symptom rather than a positive
symptom?
A. Auditory hallucinations
,B. Delusions of reference
C. Avolition and social withdrawal [CORRECT]
D. Disorganized speech
Correct Answer: C
Rationale: That's right because avolition (decreased motivation) and social withdrawal
are negative symptoms—reflecting an absence or diminution of normal
functions—whereas hallucinations, delusions, and disorganized speech are positive
symptoms representing excess or distortion. Remember for the final exam that negative
symptoms often respond less well to antipsychotic medication and are major
contributors to long-term disability in schizophrenia.
Q4: A 19-year-old woman presents with sudden onset of bizarre delusions that she is
pregnant with an alien baby, accompanied by disorganized behavior and inappropriate
laughter. Symptoms began two weeks ago following a stressful breakup and have
persisted daily. She has no prior psychiatric history. Which diagnosis is most
appropriate?
A. Schizophrenia
B. Schizoaffective disorder
C. Brief psychotic disorder [CORRECT]
D. Schizophreniform disorder
Correct Answer: C
, Rationale: The key differential here is the sudden onset and brief duration—symptoms
present for less than one month with eventual full return to premorbid functioning
defines brief psychotic disorder, often triggered by stress. That's the correct
assessment approach because schizophrenia requires six months of symptoms
including prodrome or residual phases; schizophreniform disorder (Option D) requires
one to six months, so this two-week presentation fits brief psychotic disorder perfectly.
Q5: A PMHNP administers the PANSS (Positive and Negative Syndrome Scale) to a
patient with schizophrenia. Which domain would assess symptoms such as
suspiciousness, hostility, and poor impulse control?
A. Positive scale
B. Negative scale
C. General psychopathology scale [CORRECT]
D. Cognitive scale
Correct Answer: C
Rationale: That's the correct assessment approach because the PANSS general
psychopathology scale captures symptoms like anxiety, guilt, tension, depression, and
active social avoidance—including the hostility and poor impulse control described. The
positive scale (Option A) covers hallucinations and delusions; negative scale (Option B)
covers blunted affect and withdrawal; the PANSS doesn't have a separate cognitive
scale (Option D), though cognitive symptoms are assessed within other domains.
Q6: A 42-year-old man has held the delusion for five years that his neighbor is poisoning
his water supply, despite multiple negative water tests and no evidence. He functions
