NR548 EXAM 2 ACTUAL 2026/2027 | Psychiatric Assessment
for PMHNP | Weeks 3-4 Covered | Questions & Verified
Answers 100% Correct | Chamberlain | Pass Guaranteed - A+
Graded
Section 1: Cognitive & Neuropsychological Assessment
Q1: A 72-year-old patient with memory concerns scores 22/30 on the MoCA. The
PMHNP notes particular difficulty on clock drawing, trail making, and delayed word
recall. Which cognitive domains are most likely impaired?
A. Language and semantic memory only
B. Visuospatial/executive function and episodic memory [CORRECT]
C. Attention and working memory exclusively
D. Procedural memory and implicit learning
Correct Answer: B
Rationale: For Exam 2, Weeks 3-4 focus on interpreting specific MoCA domain
impairments. The clock drawing and trail making tests specifically assess visuospatial
skills and executive function, while delayed recall targets episodic memory (the ability to
remember specific events and learned information). That's the pattern you see in early
neurocognitive disorders like mild cognitive impairment or Alzheimer's disease, where
these domains decline before language or procedural memory.
Q2: A patient repeats a string of 7 numbers forward but only 3 numbers backward. The
backward digit span primarily assesses:
,A. Auditory attention only
B. Working memory and executive control [CORRECT]
C. Long-term semantic memory storage
D. Implicit procedural learning
Correct Answer: B
Rationale: The difference between forward and backward digit span is crucial for your
assessment toolkit. Forward span is more about simple attention and short-term
storage, but backward span requires you to mentally manipulate information—holding it
in mind while reversing the order—which taps working memory and executive control.
That's why it's more sensitive to frontal lobe dysfunction and why patients with
executive deficits struggle even when forward span is intact.
Q3: A patient with depression performs poorly on word list learning but improves
dramatically with cueing and recognition. This pattern suggests:
A. Alzheimer's disease with encoding deficit
B. Depressive "pseudo-dementia" with retrieval deficit [CORRECT]
C. Amnestic syndrome with storage failure
D. Normal pressure hydrocephalus with inattention
Correct Answer: B
Rationale: Remember the difference between encoding/storage problems versus
retrieval problems. In depression, the information is actually stored in memory—patients
just can't access it voluntarily. When you give cues or multiple choice, they recognize the
material, which distinguishes this from true dementia where the memory trace was
never formed. That's why we call it "pseudo-dementia" and why cognitive testing
patterns matter so much in differential diagnosis.
,Q4: A patient takes 90 seconds to complete Trail Making Test A and 240 seconds for
Part B with 4 errors. The most significant finding is:
A. Slow processing speed only
B. Impaired set-shifting and cognitive flexibility [CORRECT]
C. Pure visuospatial neglect
D. Primary language comprehension deficit
Correct Answer: B
Rationale: Trail Making B is all about set-shifting—alternating between numbers and
letters, which requires cognitive flexibility and executive control. While Part A is mostly
processing speed, the dramatic increase in time and errors on Part B specifically points
to frontal lobe executive dysfunction. That's the pattern you see in traumatic brain injury,
frontal dementias, or executive dysfunction from various psychiatric conditions.
Q5: A patient cannot name objects but can describe their use and recognize them by
touch. This pattern indicates:
A. Wernicke's aphasia with comprehension deficit
B. Anomic aphasia with word-finding difficulty [CORRECT]
C. Broca's aphasia with non-fluent output
D. Global aphasia with all language impaired
Correct Answer: B
Rationale: Pure anomia is frustrating for patients—they know what things are and can
use them appropriately, but the word just won't come out. The fact that semantic
knowledge is preserved (they can describe function) and sensory recognition is intact
means the problem is at the word retrieval level, not comprehension or conceptual
understanding. That's anomic aphasia, often seen in early Alzheimer's or after left
temporal lesions.
, Q6: A patient draws a clock with all numbers on one side and hands that don't connect.
This pattern suggests:
A. Pure executive dysfunction only
B. Right hemisphere visuospatial neglect [CORRECT]
C. Primary motor impairment
D. Language comprehension deficit
Correct Answer: B
Rationale: The clock drawing test is incredibly informative. When numbers are crowded
on one side (typically right side, suggesting left neglect), that's classic visuospatial
neglect from right hemisphere injury—usually stroke. The patient isn't aware they're
missing half of space. Combined with planning errors, this tells you about both parietal
and frontal involvement. That's why we use clock drawing as a quick screen for multiple
cognitive domains.
Q7: A 68-year-old with mild cognitive impairment needs a screen that detects early
deficits better than MMSE. The best choice is:
A. MMSE for its widespread availability
B. MoCA with its executive function and attention domains [CORRECT]
C. GDS-15 for depression screening
D. CDT alone for comprehensive assessment
Correct Answer: B
Rationale: That's the correct cognitive screening tool because the MoCA was
specifically designed to be more sensitive than MMSE for mild cognitive impairment. It
includes executive function and attention tasks that MMSE misses, and it has less
ceiling effect in higher-functioning individuals. For Exam 2, remember that MMSE is
for PMHNP | Weeks 3-4 Covered | Questions & Verified
Answers 100% Correct | Chamberlain | Pass Guaranteed - A+
Graded
Section 1: Cognitive & Neuropsychological Assessment
Q1: A 72-year-old patient with memory concerns scores 22/30 on the MoCA. The
PMHNP notes particular difficulty on clock drawing, trail making, and delayed word
recall. Which cognitive domains are most likely impaired?
A. Language and semantic memory only
B. Visuospatial/executive function and episodic memory [CORRECT]
C. Attention and working memory exclusively
D. Procedural memory and implicit learning
Correct Answer: B
Rationale: For Exam 2, Weeks 3-4 focus on interpreting specific MoCA domain
impairments. The clock drawing and trail making tests specifically assess visuospatial
skills and executive function, while delayed recall targets episodic memory (the ability to
remember specific events and learned information). That's the pattern you see in early
neurocognitive disorders like mild cognitive impairment or Alzheimer's disease, where
these domains decline before language or procedural memory.
Q2: A patient repeats a string of 7 numbers forward but only 3 numbers backward. The
backward digit span primarily assesses:
,A. Auditory attention only
B. Working memory and executive control [CORRECT]
C. Long-term semantic memory storage
D. Implicit procedural learning
Correct Answer: B
Rationale: The difference between forward and backward digit span is crucial for your
assessment toolkit. Forward span is more about simple attention and short-term
storage, but backward span requires you to mentally manipulate information—holding it
in mind while reversing the order—which taps working memory and executive control.
That's why it's more sensitive to frontal lobe dysfunction and why patients with
executive deficits struggle even when forward span is intact.
Q3: A patient with depression performs poorly on word list learning but improves
dramatically with cueing and recognition. This pattern suggests:
A. Alzheimer's disease with encoding deficit
B. Depressive "pseudo-dementia" with retrieval deficit [CORRECT]
C. Amnestic syndrome with storage failure
D. Normal pressure hydrocephalus with inattention
Correct Answer: B
Rationale: Remember the difference between encoding/storage problems versus
retrieval problems. In depression, the information is actually stored in memory—patients
just can't access it voluntarily. When you give cues or multiple choice, they recognize the
material, which distinguishes this from true dementia where the memory trace was
never formed. That's why we call it "pseudo-dementia" and why cognitive testing
patterns matter so much in differential diagnosis.
,Q4: A patient takes 90 seconds to complete Trail Making Test A and 240 seconds for
Part B with 4 errors. The most significant finding is:
A. Slow processing speed only
B. Impaired set-shifting and cognitive flexibility [CORRECT]
C. Pure visuospatial neglect
D. Primary language comprehension deficit
Correct Answer: B
Rationale: Trail Making B is all about set-shifting—alternating between numbers and
letters, which requires cognitive flexibility and executive control. While Part A is mostly
processing speed, the dramatic increase in time and errors on Part B specifically points
to frontal lobe executive dysfunction. That's the pattern you see in traumatic brain injury,
frontal dementias, or executive dysfunction from various psychiatric conditions.
Q5: A patient cannot name objects but can describe their use and recognize them by
touch. This pattern indicates:
A. Wernicke's aphasia with comprehension deficit
B. Anomic aphasia with word-finding difficulty [CORRECT]
C. Broca's aphasia with non-fluent output
D. Global aphasia with all language impaired
Correct Answer: B
Rationale: Pure anomia is frustrating for patients—they know what things are and can
use them appropriately, but the word just won't come out. The fact that semantic
knowledge is preserved (they can describe function) and sensory recognition is intact
means the problem is at the word retrieval level, not comprehension or conceptual
understanding. That's anomic aphasia, often seen in early Alzheimer's or after left
temporal lesions.
, Q6: A patient draws a clock with all numbers on one side and hands that don't connect.
This pattern suggests:
A. Pure executive dysfunction only
B. Right hemisphere visuospatial neglect [CORRECT]
C. Primary motor impairment
D. Language comprehension deficit
Correct Answer: B
Rationale: The clock drawing test is incredibly informative. When numbers are crowded
on one side (typically right side, suggesting left neglect), that's classic visuospatial
neglect from right hemisphere injury—usually stroke. The patient isn't aware they're
missing half of space. Combined with planning errors, this tells you about both parietal
and frontal involvement. That's why we use clock drawing as a quick screen for multiple
cognitive domains.
Q7: A 68-year-old with mild cognitive impairment needs a screen that detects early
deficits better than MMSE. The best choice is:
A. MMSE for its widespread availability
B. MoCA with its executive function and attention domains [CORRECT]
C. GDS-15 for depression screening
D. CDT alone for comprehensive assessment
Correct Answer: B
Rationale: That's the correct cognitive screening tool because the MoCA was
specifically designed to be more sensitive than MMSE for mild cognitive impairment. It
includes executive function and attention tasks that MMSE misses, and it has less
ceiling effect in higher-functioning individuals. For Exam 2, remember that MMSE is
