WALDEN UNIVERSITY NURS 6635 MIDTERM-
PMHNP Newly Updated Exam Elaborations
Questions with Answers EXPLANATIONS
Question 1
A 28-year-old woman presents with persistent sadness, low energy, poor
concentration, and insomnia for the past 3 weeks following job loss. She denies
suicidal ideation. Which diagnosis is most appropriate?
A. Major Depressive Disorder
B. Adjustment Disorder with Depressed Mood
C. Persistent Depressive Disorder
D. Generalized Anxiety Disorder
Correct Answer: B. Adjustment Disorder with Depressed Mood
Rationale: Symptoms began after a clear stressor and have lasted less than 1
month. Major Depressive Disorder requires at least 2 weeks but must meet full
criteria including functional impairment beyond expected response.
Question 2
A patient reports excessive worry about finances, health, and relationships
occurring most days for 8 months. They experience muscle tension, fatigue, and
irritability. What is the most likely diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Acute Stress Disorder
Correct Answer: B. Generalized Anxiety Disorder
Rationale: GAD requires excessive anxiety and worry occurring more days than
not for at least 6 months, with associated physical symptoms.
,Question 3
A 35-year-old man reports recurrent intrusive thoughts about contamination and
spends hours washing his hands daily. He recognizes the thoughts are irrational.
Which disorder is indicated?
A. Delusional Disorder
B. Obsessive-Compulsive Disorder
C. Illness Anxiety Disorder
D. Body Dysmorphic Disorder
Correct Answer: B. Obsessive-Compulsive Disorder
Rationale: Presence of obsessions (intrusive thoughts) and compulsions (repetitive
behaviors) with insight supports OCD.
Question 4
A client experiences sudden episodes of intense fear with palpitations, sweating,
and a sense of impending doom lasting 10 minutes. Episodes occur unpredictably.
What is the diagnosis?
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Specific Phobia
D. Post-Traumatic Stress Disorder
Correct Answer: B. Panic Disorder
Rationale: Recurrent unexpected panic attacks characterize panic disorder.
Question 5
A patient presents with elevated mood, decreased need for sleep, increased goal-
directed activity, and risky behaviors lasting 5 days without significant
impairment. Diagnosis?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder
,Correct Answer: B. Bipolar II Disorder
Rationale: Hypomanic episode lasts at least 4 days without severe impairment;
Bipolar I requires full mania.
Question 6
A patient reports hearing voices commenting on their behavior for 2 months, along
with social withdrawal and disorganized speech. What is the most likely diagnosis?
A. Schizophreniform Disorder
B. Schizophrenia
C. Brief Psychotic Disorder
D. Schizoaffective Disorder
Correct Answer: A. Schizophreniform Disorder
Rationale: Symptoms lasting 1–6 months indicate schizophreniform disorder.
Question 7
A patient has experienced depressive symptoms for over 2 years without symptom-
free periods longer than 2 months. Diagnosis?
A. Major Depressive Disorder
B. Persistent Depressive Disorder
C. Adjustment Disorder
D. Cyclothymia
Correct Answer: B. Persistent Depressive Disorder
Rationale: Chronic depressive symptoms lasting at least 2 years define persistent
depressive disorder.
Question 8
Which neurotransmitter is most associated with the positive symptoms of
schizophrenia?
A. Serotonin
B. Dopamine
, C. GABA
D. Acetylcholine
Correct Answer: B. Dopamine
Rationale: Excess dopamine activity, especially in the mesolimbic pathway, is
linked to positive symptoms.
Question 9
A patient reports a persistent fear of public speaking due to embarrassment.
Diagnosis?
A. Panic Disorder
B. Social Anxiety Disorder
C. Specific Phobia
D. Agoraphobia
Correct Answer: B. Social Anxiety Disorder
Rationale: Fear of social situations involving possible scrutiny is characteristic of
social anxiety disorder.
Question 10
A trauma survivor experiences flashbacks, nightmares, and hypervigilance for 4
months. Diagnosis?
A. Acute Stress Disorder
B. PTSD
C. Adjustment Disorder
D. Generalized Anxiety Disorder
Correct Answer: B. PTSD
Rationale: Symptoms lasting more than 1 month following trauma indicate PTSD.
PMHNP Newly Updated Exam Elaborations
Questions with Answers EXPLANATIONS
Question 1
A 28-year-old woman presents with persistent sadness, low energy, poor
concentration, and insomnia for the past 3 weeks following job loss. She denies
suicidal ideation. Which diagnosis is most appropriate?
A. Major Depressive Disorder
B. Adjustment Disorder with Depressed Mood
C. Persistent Depressive Disorder
D. Generalized Anxiety Disorder
Correct Answer: B. Adjustment Disorder with Depressed Mood
Rationale: Symptoms began after a clear stressor and have lasted less than 1
month. Major Depressive Disorder requires at least 2 weeks but must meet full
criteria including functional impairment beyond expected response.
Question 2
A patient reports excessive worry about finances, health, and relationships
occurring most days for 8 months. They experience muscle tension, fatigue, and
irritability. What is the most likely diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Social Anxiety Disorder
D. Acute Stress Disorder
Correct Answer: B. Generalized Anxiety Disorder
Rationale: GAD requires excessive anxiety and worry occurring more days than
not for at least 6 months, with associated physical symptoms.
,Question 3
A 35-year-old man reports recurrent intrusive thoughts about contamination and
spends hours washing his hands daily. He recognizes the thoughts are irrational.
Which disorder is indicated?
A. Delusional Disorder
B. Obsessive-Compulsive Disorder
C. Illness Anxiety Disorder
D. Body Dysmorphic Disorder
Correct Answer: B. Obsessive-Compulsive Disorder
Rationale: Presence of obsessions (intrusive thoughts) and compulsions (repetitive
behaviors) with insight supports OCD.
Question 4
A client experiences sudden episodes of intense fear with palpitations, sweating,
and a sense of impending doom lasting 10 minutes. Episodes occur unpredictably.
What is the diagnosis?
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Specific Phobia
D. Post-Traumatic Stress Disorder
Correct Answer: B. Panic Disorder
Rationale: Recurrent unexpected panic attacks characterize panic disorder.
Question 5
A patient presents with elevated mood, decreased need for sleep, increased goal-
directed activity, and risky behaviors lasting 5 days without significant
impairment. Diagnosis?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder
,Correct Answer: B. Bipolar II Disorder
Rationale: Hypomanic episode lasts at least 4 days without severe impairment;
Bipolar I requires full mania.
Question 6
A patient reports hearing voices commenting on their behavior for 2 months, along
with social withdrawal and disorganized speech. What is the most likely diagnosis?
A. Schizophreniform Disorder
B. Schizophrenia
C. Brief Psychotic Disorder
D. Schizoaffective Disorder
Correct Answer: A. Schizophreniform Disorder
Rationale: Symptoms lasting 1–6 months indicate schizophreniform disorder.
Question 7
A patient has experienced depressive symptoms for over 2 years without symptom-
free periods longer than 2 months. Diagnosis?
A. Major Depressive Disorder
B. Persistent Depressive Disorder
C. Adjustment Disorder
D. Cyclothymia
Correct Answer: B. Persistent Depressive Disorder
Rationale: Chronic depressive symptoms lasting at least 2 years define persistent
depressive disorder.
Question 8
Which neurotransmitter is most associated with the positive symptoms of
schizophrenia?
A. Serotonin
B. Dopamine
, C. GABA
D. Acetylcholine
Correct Answer: B. Dopamine
Rationale: Excess dopamine activity, especially in the mesolimbic pathway, is
linked to positive symptoms.
Question 9
A patient reports a persistent fear of public speaking due to embarrassment.
Diagnosis?
A. Panic Disorder
B. Social Anxiety Disorder
C. Specific Phobia
D. Agoraphobia
Correct Answer: B. Social Anxiety Disorder
Rationale: Fear of social situations involving possible scrutiny is characteristic of
social anxiety disorder.
Question 10
A trauma survivor experiences flashbacks, nightmares, and hypervigilance for 4
months. Diagnosis?
A. Acute Stress Disorder
B. PTSD
C. Adjustment Disorder
D. Generalized Anxiety Disorder
Correct Answer: B. PTSD
Rationale: Symptoms lasting more than 1 month following trauma indicate PTSD.
