1|Page
EXAM 3: NR548/ NR 548/2026/2027 PSYCHIATRIC
ASSESSMENT FOR THE PSYCHIATRIC-MENTAL HEALTH
NURSE PRACTITIONER REVIEW |WEEKS 5-6 COVERED
WITH VERIFIED SOLUTIONS GRADED A+
individual who presents with an extremely rapid and pressured speech with
constant interruptions may be experiencing __________ or __________
......ANSWER......hypomania or mania
An absence of speech is seen with some diagnoses such as ___________
......ANSWER......dementia
non-sensical speech is often associated with _______________
......ANSWER......psychotic disorders
MSE: Mood and Affect ......ANSWER......Mood
-client's state of mind or prevalent emotional state
-subjective
-typically self-reported
-Stable: mood is appropriate to their current situation
-other: bright, happy, angry, agitated, irritable, labile, anxious, depressed, or
euphoric
Affect
-physical manifestation of the client's emotional state as observed by the
provider
pg. 1
,2|Page
-normal, blunted, flat, bizarre, dysphoric, or euphoric
-Qualities of affect
• stability (stable or labile)
• appropriateness
• range (does it change with diff. situations)
• intensity
MSE: Thought Process ......ANSWER......-rate of thoughts and how they flow and
are connected
-coherent vs. incoherent
-Normal: linear & goal-directed
-Other: loose, circumstantial, or tangential
-Clients may experience flight of ideas with little connection between thoughts
or words
-Assessment: questioning client, listening to responses
MSE: Suicidal and Homicidal Ideation ......ANSWER......-Direct terms should be
used to assess suicide preoccupation and planning
-assess for homicidal ideation, intent, attempts, and plans
-critical to determine whether a plan exists
• access to the resources needed to execute the plan
• more detailed and thorough the plan, the higher the risk
• assess if plan is composed of fleeting thoughts rather than action steps
• assess whether the client is angry and lashing out or intending to bring actual
harm
pg. 2
, 3|Page
-SCREENING FOR SUICIDAL AND HOMICIDAL IDEATIONS IS AN ETHICAL
OBLIGATION OF THE PMHNP & IS ESSENTIAL FOR PROTECTING ONESELF, THE
CLIENT, & THE PUBLIC
MSE: Cognitive Assessment ......ANSWER......-evaluation of a client's level of
awareness, attention, concentration, and memory
-Awareness: observation with emphasis on the client's eyes and speech
-alertness or wakefulness provides information about cognitive function
• help rule out potential substance use or intoxication
-levels of awareness: alert and oriented, somnolent, drowsy, or even comatose
-Attention and concentration: observation of responses during the interview
• can they stay on topic?
• able to focus and respond to Q's?
• can use standardized tools such as the Mini-Mental State Exam (MMSE), digit
span test and the SSST
-Memory assessment: immediate recall, short-term, and long-term memory
• particularly important when ruling out dementia or Alzheimer's disease
• Stress, anxiety, and depression can also impact memory
• orientation, three-object recall
-Mini-Cog exam is commonly used to help rule out significant cognitive issues
Two attention and concentration assessments ......ANSWER......digit span test
-patient is given 5-7 numbers & asked to repeat them forward and backward
SSST
pg. 3
EXAM 3: NR548/ NR 548/2026/2027 PSYCHIATRIC
ASSESSMENT FOR THE PSYCHIATRIC-MENTAL HEALTH
NURSE PRACTITIONER REVIEW |WEEKS 5-6 COVERED
WITH VERIFIED SOLUTIONS GRADED A+
individual who presents with an extremely rapid and pressured speech with
constant interruptions may be experiencing __________ or __________
......ANSWER......hypomania or mania
An absence of speech is seen with some diagnoses such as ___________
......ANSWER......dementia
non-sensical speech is often associated with _______________
......ANSWER......psychotic disorders
MSE: Mood and Affect ......ANSWER......Mood
-client's state of mind or prevalent emotional state
-subjective
-typically self-reported
-Stable: mood is appropriate to their current situation
-other: bright, happy, angry, agitated, irritable, labile, anxious, depressed, or
euphoric
Affect
-physical manifestation of the client's emotional state as observed by the
provider
pg. 1
,2|Page
-normal, blunted, flat, bizarre, dysphoric, or euphoric
-Qualities of affect
• stability (stable or labile)
• appropriateness
• range (does it change with diff. situations)
• intensity
MSE: Thought Process ......ANSWER......-rate of thoughts and how they flow and
are connected
-coherent vs. incoherent
-Normal: linear & goal-directed
-Other: loose, circumstantial, or tangential
-Clients may experience flight of ideas with little connection between thoughts
or words
-Assessment: questioning client, listening to responses
MSE: Suicidal and Homicidal Ideation ......ANSWER......-Direct terms should be
used to assess suicide preoccupation and planning
-assess for homicidal ideation, intent, attempts, and plans
-critical to determine whether a plan exists
• access to the resources needed to execute the plan
• more detailed and thorough the plan, the higher the risk
• assess if plan is composed of fleeting thoughts rather than action steps
• assess whether the client is angry and lashing out or intending to bring actual
harm
pg. 2
, 3|Page
-SCREENING FOR SUICIDAL AND HOMICIDAL IDEATIONS IS AN ETHICAL
OBLIGATION OF THE PMHNP & IS ESSENTIAL FOR PROTECTING ONESELF, THE
CLIENT, & THE PUBLIC
MSE: Cognitive Assessment ......ANSWER......-evaluation of a client's level of
awareness, attention, concentration, and memory
-Awareness: observation with emphasis on the client's eyes and speech
-alertness or wakefulness provides information about cognitive function
• help rule out potential substance use or intoxication
-levels of awareness: alert and oriented, somnolent, drowsy, or even comatose
-Attention and concentration: observation of responses during the interview
• can they stay on topic?
• able to focus and respond to Q's?
• can use standardized tools such as the Mini-Mental State Exam (MMSE), digit
span test and the SSST
-Memory assessment: immediate recall, short-term, and long-term memory
• particularly important when ruling out dementia or Alzheimer's disease
• Stress, anxiety, and depression can also impact memory
• orientation, three-object recall
-Mini-Cog exam is commonly used to help rule out significant cognitive issues
Two attention and concentration assessments ......ANSWER......digit span test
-patient is given 5-7 numbers & asked to repeat them forward and backward
SSST
pg. 3
