NR 605 FINAL EXAM LATEST 2026/2027 | Diagnosis
& Management Psychiatric-Mental Health Across
Lifespan I | Q&A Grade A 100% Correct |
Chamberlain | Pass Guaranteed - A+ Graded
Section 1: Foundational Concepts & Therapeutic Alliance
(Questions 1-10)
Question 1
A 24-year-old client states, "I feel like nobody understands what I'm going through."
The PMHNP responds, "It sounds like you're feeling very alone in your experience
right now." This response is an example of:
A. Giving advice
B. Restating
C. Confrontation
D. Interpretation
Correct Answer: B. Restating [CORRECT]
Rationale: Restating (or paraphrasing) reflects the client's stated content back in the
clinician's words, validating the client's experience and encouraging further
exploration. Giving advice (Option A) would direct the client toward a specific action.
Confrontation (Option C) would challenge discrepancies. Interpretation (Option D)
would offer deeper meaning beyond what the client explicitly stated. NR605
emphasizes that restating is a foundational therapeutic communication technique
that builds the therapeutic alliance through active listening and empathy.
Question 2
According to Bordin's conceptualization, the therapeutic alliance consists of three
components: bond, goals, and tasks. The "tasks" component refers to:
,A. The emotional connection between therapist and client
B. The specific activities and interventions both parties engage in to achieve
therapeutic goals
C. The mutual understanding of what the client wants to accomplish in therapy
D. The termination plan for ending the therapeutic relationship
Correct Answer: B. The specific activities and interventions both parties engage in
to achieve therapeutic goals [CORRECT]
Rationale: Bordin's tripartite model defines tasks as the specific therapeutic activities
and interventions that both client and therapist undertake to achieve mutually
agreed-upon goals. The bond (Option A) is the emotional connection. Goals (Option
C) are the desired outcomes. Termination planning (Option D) occurs in the final
stage. NR605 emphasizes that all three components must be present and
collaboratively negotiated for effective therapeutic engagement.
Question 3
A PMHNP is meeting a new client for the first time. During this initial session, the
PMHNP explains the limits of confidentiality, including mandatory reporting
requirements and duty to protect. This occurs during which stage of the therapeutic
relationship?
A. Pre-interaction
B. Orientation
C. Working
D. Termination
Correct Answer: B. Orientation [CORRECT]
Rationale: The orientation stage involves establishing the therapeutic relationship,
setting expectations, discussing confidentiality limits, and beginning assessment. Pre-
interaction (Option A) involves preparation before meeting the client. Working
(Option C) involves active intervention. Termination (Option D) involves ending the
relationship. NR605 emphasizes that informed consent and confidentiality limits
must be discussed during the orientation stage before therapeutic work begins.
,Question 4
A client discloses during session that they have been sexually abusing their 8-year-
old stepchild. The PMHNP's legal and ethical obligation is to:
A. Maintain absolute confidentiality to preserve the therapeutic alliance
B. Report the disclosure to child protective services as mandated by law
C. Confront the client and terminate the relationship immediately
D. Wait for the client to voluntarily report the abuse themselves
Correct Answer: B. Report the disclosure to child protective services as mandated
by law [CORRECT]
Rationale: Child abuse is a mandatory reporting exception to confidentiality in all
states. The PMHNP must report to child protective services regardless of the client's
wishes. Absolute confidentiality (Option A) does not apply to mandated reporting.
Immediate termination (Option C) may be necessary but reporting takes precedence.
Waiting (Option D) violates legal obligations and places the child at continued risk.
NR605 emphasizes that mandated reporting supersedes therapeutic confidentiality.
Question 5
A client with schizophrenia tells the PMHNP they plan to kill their neighbor because
the neighbor is "broadcasting evil thoughts into my brain." The PMHNP determines
the threat is serious, foreseeable, and the victim is identifiable. The PMHNP's
obligation under Tarasoff duty to protect includes:
A. Maintaining confidentiality because the threat is a symptom of psychosis
B. Warning the intended victim and notifying law enforcement
C. Increasing the client's antipsychotic medication dosage only
D. Referring the client to a different provider
Correct Answer: B. Warning the intended victim and notifying law enforcement
[CORRECT]
, Rationale: Tarasoff duty to protect requires warning identifiable victims of serious,
foreseeable harm and notifying law enforcement when necessary. Confidentiality
(Option A) does not override duty to protect. Medication adjustment alone (Option
C) is insufficient. Referral (Option D) does not discharge the duty. NR605 emphasizes
that Tarasoff obligations apply even when threats arise from psychotic symptoms,
requiring immediate safety intervention.
Question 6
A 78-year-old client with moderate dementia is being considered for
electroconvulsive therapy (ECT) for severe depression. The client appears to
understand the procedure, risks, and benefits but cannot consistently retain this
information. The determination of whether this client can provide informed consent
should focus on:
A. Global cognitive functioning as measured by the MMSE
B. The client's capacity to make this specific decision at this specific time
C. Whether the client has ever refused treatment in the past
D. The family's preference regardless of the client's wishes
Correct Answer: B. The client's capacity to make this specific decision at this
specific time [CORRECT]
Rationale: Capacity is decision-specific and time-specific, not global. The client may
have capacity for some decisions but not others. MMSE score (Option A) is
insufficient alone. Past refusals (Option C) are irrelevant to current capacity. Family
preference (Option D) is secondary to the client's own decision-making capacity.
NR605 emphasizes that capacity assessments evaluate understanding, appreciation,
reasoning, and expression of choice for the specific decision at hand.
Question 7
& Management Psychiatric-Mental Health Across
Lifespan I | Q&A Grade A 100% Correct |
Chamberlain | Pass Guaranteed - A+ Graded
Section 1: Foundational Concepts & Therapeutic Alliance
(Questions 1-10)
Question 1
A 24-year-old client states, "I feel like nobody understands what I'm going through."
The PMHNP responds, "It sounds like you're feeling very alone in your experience
right now." This response is an example of:
A. Giving advice
B. Restating
C. Confrontation
D. Interpretation
Correct Answer: B. Restating [CORRECT]
Rationale: Restating (or paraphrasing) reflects the client's stated content back in the
clinician's words, validating the client's experience and encouraging further
exploration. Giving advice (Option A) would direct the client toward a specific action.
Confrontation (Option C) would challenge discrepancies. Interpretation (Option D)
would offer deeper meaning beyond what the client explicitly stated. NR605
emphasizes that restating is a foundational therapeutic communication technique
that builds the therapeutic alliance through active listening and empathy.
Question 2
According to Bordin's conceptualization, the therapeutic alliance consists of three
components: bond, goals, and tasks. The "tasks" component refers to:
,A. The emotional connection between therapist and client
B. The specific activities and interventions both parties engage in to achieve
therapeutic goals
C. The mutual understanding of what the client wants to accomplish in therapy
D. The termination plan for ending the therapeutic relationship
Correct Answer: B. The specific activities and interventions both parties engage in
to achieve therapeutic goals [CORRECT]
Rationale: Bordin's tripartite model defines tasks as the specific therapeutic activities
and interventions that both client and therapist undertake to achieve mutually
agreed-upon goals. The bond (Option A) is the emotional connection. Goals (Option
C) are the desired outcomes. Termination planning (Option D) occurs in the final
stage. NR605 emphasizes that all three components must be present and
collaboratively negotiated for effective therapeutic engagement.
Question 3
A PMHNP is meeting a new client for the first time. During this initial session, the
PMHNP explains the limits of confidentiality, including mandatory reporting
requirements and duty to protect. This occurs during which stage of the therapeutic
relationship?
A. Pre-interaction
B. Orientation
C. Working
D. Termination
Correct Answer: B. Orientation [CORRECT]
Rationale: The orientation stage involves establishing the therapeutic relationship,
setting expectations, discussing confidentiality limits, and beginning assessment. Pre-
interaction (Option A) involves preparation before meeting the client. Working
(Option C) involves active intervention. Termination (Option D) involves ending the
relationship. NR605 emphasizes that informed consent and confidentiality limits
must be discussed during the orientation stage before therapeutic work begins.
,Question 4
A client discloses during session that they have been sexually abusing their 8-year-
old stepchild. The PMHNP's legal and ethical obligation is to:
A. Maintain absolute confidentiality to preserve the therapeutic alliance
B. Report the disclosure to child protective services as mandated by law
C. Confront the client and terminate the relationship immediately
D. Wait for the client to voluntarily report the abuse themselves
Correct Answer: B. Report the disclosure to child protective services as mandated
by law [CORRECT]
Rationale: Child abuse is a mandatory reporting exception to confidentiality in all
states. The PMHNP must report to child protective services regardless of the client's
wishes. Absolute confidentiality (Option A) does not apply to mandated reporting.
Immediate termination (Option C) may be necessary but reporting takes precedence.
Waiting (Option D) violates legal obligations and places the child at continued risk.
NR605 emphasizes that mandated reporting supersedes therapeutic confidentiality.
Question 5
A client with schizophrenia tells the PMHNP they plan to kill their neighbor because
the neighbor is "broadcasting evil thoughts into my brain." The PMHNP determines
the threat is serious, foreseeable, and the victim is identifiable. The PMHNP's
obligation under Tarasoff duty to protect includes:
A. Maintaining confidentiality because the threat is a symptom of psychosis
B. Warning the intended victim and notifying law enforcement
C. Increasing the client's antipsychotic medication dosage only
D. Referring the client to a different provider
Correct Answer: B. Warning the intended victim and notifying law enforcement
[CORRECT]
, Rationale: Tarasoff duty to protect requires warning identifiable victims of serious,
foreseeable harm and notifying law enforcement when necessary. Confidentiality
(Option A) does not override duty to protect. Medication adjustment alone (Option
C) is insufficient. Referral (Option D) does not discharge the duty. NR605 emphasizes
that Tarasoff obligations apply even when threats arise from psychotic symptoms,
requiring immediate safety intervention.
Question 6
A 78-year-old client with moderate dementia is being considered for
electroconvulsive therapy (ECT) for severe depression. The client appears to
understand the procedure, risks, and benefits but cannot consistently retain this
information. The determination of whether this client can provide informed consent
should focus on:
A. Global cognitive functioning as measured by the MMSE
B. The client's capacity to make this specific decision at this specific time
C. Whether the client has ever refused treatment in the past
D. The family's preference regardless of the client's wishes
Correct Answer: B. The client's capacity to make this specific decision at this
specific time [CORRECT]
Rationale: Capacity is decision-specific and time-specific, not global. The client may
have capacity for some decisions but not others. MMSE score (Option A) is
insufficient alone. Past refusals (Option C) are irrelevant to current capacity. Family
preference (Option D) is secondary to the client's own decision-making capacity.
NR605 emphasizes that capacity assessments evaluate understanding, appreciation,
reasoning, and expression of choice for the specific decision at hand.
Question 7
