Western Governors University
CCN: NURS 6810
Course Number: D117
Course Title: Advanced Health Assessment for the Advanced
Practice Nurse Systems
Credit Hours:4.0
Exam: Final Assessment
Date:2026
A 32-year-old patient presents with depressed mood, fatigue, and weight gain. Before diagnosing
major depressive disorder, the PMHNP orders a TSH level to rule out:
A. Cushing syndrome
B. Hypothyroidism
C. Hyperparathyroidism
D. Addison disease
Answer: B
Rationale: Hypothyroidism can mimic depressive symptoms; thyroid screening is essential in
psychiatric assessment.
True or False: A comprehensive psychiatric assessment should always include a review of systems
and physical health screening.
Answer: True
Rationale: Medical conditions frequently present with psychiatric manifestations; integrated
assessment is required.
A patient presents with acute confusion and fluctuating levels of consciousness. The most
important initial assessment is:
A. PHQ-9
B. Mini-Cog
1
,C. CAM (Confusion Assessment Method)
D. GAD-7
Answer: C
Rationale: The CAM is validated for detecting delirium, a medical emergency.
Fill in the blank: Rapid, pressured speech with flight of ideas is commonly observed in patients
experiencing a __________ episode.
Answer: Manic
Rationale: Pressured speech and flight of ideas are classic findings in mania.
During a mental status exam, a patient describes hearing voices commenting on their behavior.
This perceptual disturbance is classified as:
A. Illusion
B. Delusion
C. Hallucination
D. Obsession
Answer: C
Rationale: Auditory hallucinations occur without external stimuli.
True or False: Orthostatic vital signs are irrelevant in psychiatric evaluations.
Answer: False
Rationale: Many psychotropic medications cause orthostatic hypotension; baseline assessment is
essential.
A patient presents with anxiety, palpitations, and diaphoresis. Which assessment finding would
suggest hyperthyroidism rather than generalized anxiety disorder?
A. Excessive worry
B. Tremor and heat intolerance
C. Restlessness
D. Sleep disturbance
Answer: B
Rationale: Tremor and heat intolerance suggest endocrine etiology.
Fill in the blank: The structured suicide assessment tool commonly used in clinical settings is the
__________ Suicide Severity Rating Scale.
2
, Answer: Columbia
Rationale: The Columbia-Suicide Severity Rating Scale (C-SSRS) standardizes suicide risk
evaluation.
A 70-year-old with memory complaints struggles with executive tasks. Which screening tool best
evaluates cognitive impairment?
A. HAM-D
B. MoCA
C. YMRS
D. CAPS-5
Answer: B
Rationale: The Montreal Cognitive Assessment (MoCA) screens for mild cognitive impairment.
True or False: A fixed, false belief not shared by cultural peers is defined as a delusion.
Answer: True
Rationale: Cultural context is essential when identifying delusions.
A patient with chronic alcohol use presents with confusion and ataxia. The PMHNP suspects
Wernicke encephalopathy caused by deficiency of:
A. Vitamin B12
B. Folate
C. Thiamine
D. Niacin
Answer: C
Rationale: Thiamine deficiency leads to Wernicke’s encephalopathy.
Fill in the blank: The extrapyramidal symptom characterized by inner restlessness is called
__________.
Answer: Akathisia
Rationale: Akathisia is a common adverse effect of antipsychotics.
A patient reports intrusive thoughts recognized as irrational and distressing. These are best
described as:
A. Delusions
B. Obsessions
3
CCN: NURS 6810
Course Number: D117
Course Title: Advanced Health Assessment for the Advanced
Practice Nurse Systems
Credit Hours:4.0
Exam: Final Assessment
Date:2026
A 32-year-old patient presents with depressed mood, fatigue, and weight gain. Before diagnosing
major depressive disorder, the PMHNP orders a TSH level to rule out:
A. Cushing syndrome
B. Hypothyroidism
C. Hyperparathyroidism
D. Addison disease
Answer: B
Rationale: Hypothyroidism can mimic depressive symptoms; thyroid screening is essential in
psychiatric assessment.
True or False: A comprehensive psychiatric assessment should always include a review of systems
and physical health screening.
Answer: True
Rationale: Medical conditions frequently present with psychiatric manifestations; integrated
assessment is required.
A patient presents with acute confusion and fluctuating levels of consciousness. The most
important initial assessment is:
A. PHQ-9
B. Mini-Cog
1
,C. CAM (Confusion Assessment Method)
D. GAD-7
Answer: C
Rationale: The CAM is validated for detecting delirium, a medical emergency.
Fill in the blank: Rapid, pressured speech with flight of ideas is commonly observed in patients
experiencing a __________ episode.
Answer: Manic
Rationale: Pressured speech and flight of ideas are classic findings in mania.
During a mental status exam, a patient describes hearing voices commenting on their behavior.
This perceptual disturbance is classified as:
A. Illusion
B. Delusion
C. Hallucination
D. Obsession
Answer: C
Rationale: Auditory hallucinations occur without external stimuli.
True or False: Orthostatic vital signs are irrelevant in psychiatric evaluations.
Answer: False
Rationale: Many psychotropic medications cause orthostatic hypotension; baseline assessment is
essential.
A patient presents with anxiety, palpitations, and diaphoresis. Which assessment finding would
suggest hyperthyroidism rather than generalized anxiety disorder?
A. Excessive worry
B. Tremor and heat intolerance
C. Restlessness
D. Sleep disturbance
Answer: B
Rationale: Tremor and heat intolerance suggest endocrine etiology.
Fill in the blank: The structured suicide assessment tool commonly used in clinical settings is the
__________ Suicide Severity Rating Scale.
2
, Answer: Columbia
Rationale: The Columbia-Suicide Severity Rating Scale (C-SSRS) standardizes suicide risk
evaluation.
A 70-year-old with memory complaints struggles with executive tasks. Which screening tool best
evaluates cognitive impairment?
A. HAM-D
B. MoCA
C. YMRS
D. CAPS-5
Answer: B
Rationale: The Montreal Cognitive Assessment (MoCA) screens for mild cognitive impairment.
True or False: A fixed, false belief not shared by cultural peers is defined as a delusion.
Answer: True
Rationale: Cultural context is essential when identifying delusions.
A patient with chronic alcohol use presents with confusion and ataxia. The PMHNP suspects
Wernicke encephalopathy caused by deficiency of:
A. Vitamin B12
B. Folate
C. Thiamine
D. Niacin
Answer: C
Rationale: Thiamine deficiency leads to Wernicke’s encephalopathy.
Fill in the blank: The extrapyramidal symptom characterized by inner restlessness is called
__________.
Answer: Akathisia
Rationale: Akathisia is a common adverse effect of antipsychotics.
A patient reports intrusive thoughts recognized as irrational and distressing. These are best
described as:
A. Delusions
B. Obsessions
3
