NR 546 | Midterm
OBJECTIVE ASSESSMENT - EXAM
Midterm
Exam
NR 546 | Tested Q&As
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Psychiatric Assessment & Diagnosis Psychotic Disorders & Treatment
Psychopharmacology Principles Ethical & Legal Issues in Psychiatry
Mood & Anxiety Disorders
COVER PAGE - 1
, SECTION 1 | Psychiatric Assessment & Diagnosis | Q1-Q20 | NR 546 Midterm Exam 2026/2027
Q1 Question 1 of 100
Q1. A 34-year-old woman presents to the psychiatric clinic reporting persistent sadness, insomnia,
and loss of interest in activities for the past six weeks. She denies any psychotic symptoms or
suicidal ideation. The PMHNP is conducting an initial psychiatric evaluation. Which assessment
tool is most appropriate for screening the severity of her depressive symptoms?
A. Hamilton Depression Rating Scale
B. Mini-Mental State Examination
C. Yale-Brown Obsessive Compulsive Scale
D. Abnormal Involuntary Movement Scale
Correct Answer: A
Rationale:
The Hamilton Depression Rating Scale (HAM-D) is specifically designed to assess the severity of depressive
symptoms in patients already diagnosed with depression. The MMSE screens for cognitive impairment, the
Y-BOCS measures OCD severity, and the AIMS evaluates medication-induced movement disorders, none of
which are relevant to this depressive presentation.
Q2 Question 2 of 100
Q2. A 45-year-old man is brought to the emergency department by police after being found
wandering in traffic. He appears disheveled, mutters to himself, and is unable to provide coherent
personal history. The PMHNP must determine his capacity to refuse treatment. Which element is
most essential in assessing this patient's decision-making capacity?
A. Ability to understand the risks and benefits of treatment
B. Presence of a diagnosed mental illness
C. Agreement with the treatment team's recommendation
D. History of prior psychiatric hospitalizations
Correct Answer: A
Rationale:
Decision-making capacity requires the patient to understand relevant information, appreciate how it applies to
their situation, reason about the choices, and communicate a decision. A diagnosed mental illness alone does not
negate capacity, and agreeing with the treatment team or having prior hospitalizations does not determine
capacity.
NR 546 Midterm Exam -- 2026/2027 | Passing Score: 80% | Page 2 of 53
,SECTION 1 | Psychiatric Assessment & Diagnosis | Q1-Q20 | NR 546 Midterm Exam 2026/2027
Q3 Question 3 of 100
Q3. A 28-year-old graduate student reports a three-month history of excessive worry about
academic performance, social interactions, and health. She describes muscle tension, difficulty
concentrating, and irritability that occur most days. The PMHNP suspects generalized anxiety
disorder. Which diagnostic criterion distinguishes GAD from normal worry?
A. The worry is difficult to control and is associated with at least three additional symptoms
B. The worry is limited to a specific situation or object
C. The worry is accompanied by panic attacks
D. The worry resolves with reassurance from others
Correct Answer: A
Rationale:
GAD is characterized by excessive, difficult-to-control worry occurring more days than not for at least six months,
accompanied by at least three somatic or cognitive symptoms. Worry limited to a specific situation suggests a
specific phobia, panic attacks suggest panic disorder, and worry that resolves with reassurance is more typical of
normal anxiety.
Q4 Question 4 of 100
Q4. A 52-year-old man with a history of alcohol use disorder presents for a psychiatric
assessment. His family reports progressive memory difficulties and confabulation over the past
two months. Physical examination reveals nystagmus and ataxic gait. The PMHNP recognizes this
presentation is most consistent with which condition?
A. Wernicke-Korsakoff syndrome
B. Alcoholic hallucinosis
C. Delirium tremens
D. Substance-induced psychotic disorder
Correct Answer: A
Rationale:
Wernicke-Korsakoff syndrome results from thiamine deficiency commonly seen in chronic alcohol use, presenting
with the triad of confusion, ataxia, and ophthalmoplegia (including nystagmus), with Korsakoff features of memory
impairment and confabulation. Alcoholic hallucinosis involves hallucinations without the neurological triad, delirium
tremens is an acute withdrawal state, and substance-induced psychotic disorder does not feature the specific
neurological deficits described.
NR 546 Midterm Exam -- 2026/2027 | Passing Score: 80% | Page 3 of 53
, SECTION 1 | Psychiatric Assessment & Diagnosis | Q1-Q20 | NR 546 Midterm Exam 2026/2027
Q5 Question 5 of 100
Q5. A 19-year-old college freshman is referred by student health after his roommate found him
talking to someone who was not there. The patient appears guarded and states that a government
agency is monitoring his thoughts through his laptop camera. His affect is flat and his speech is
sparse. The PMHNP suspects a psychotic disorder. Which feature most strongly suggests
schizophrenia rather than a brief psychotic disorder?
A. Duration of symptoms exceeding six months
B. Presence of visual hallucinations
C. History of substance use
D. Acute onset of symptoms
Correct Answer: A
Rationale:
Schizophrenia requires symptoms persisting for at least six months, including at least one month of active-phase
symptoms. Brief psychotic disorder by definition lasts less than one month. Visual hallucinations, substance use
history, and acute onset do not differentiate between the two disorders.
Q6 Question 6 of 100
Q6. A 37-year-old woman presents for an initial psychiatric evaluation. She describes a pattern of
unstable interpersonal relationships, impulsivity, and chronic feelings of emptiness. She reports a
history of self-harm and fear of abandonment. The PMHNP identifies features consistent with
borderline personality disorder. Which neurobiological finding has been most consistently
associated with this disorder?
A. Prefrontal cortex and amygdala dysregulation
B. Elevated dopamine in the mesolimbic pathway
C. Degeneration of the substantia nigra
D. Increased serotonin reuptake in the raphe nuclei
Correct Answer: A
Rationale:
Neuroimaging studies consistently demonstrate prefrontal cortex and amygdala dysregulation in borderline
personality disorder, leading to impaired emotional regulation and impulsivity. Elevated mesolimbic dopamine is
associated with psychotic disorders, substantia nigra degeneration with Parkinson disease, and increased
serotonin reuptake is not a recognized neurobiological finding in BPD.
NR 546 Midterm Exam -- 2026/2027 | Passing Score: 80% | Page 4 of 53
OBJECTIVE ASSESSMENT - EXAM
Midterm
Exam
NR 546 | Tested Q&As
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Psychiatric Assessment & Diagnosis Psychotic Disorders & Treatment
Psychopharmacology Principles Ethical & Legal Issues in Psychiatry
Mood & Anxiety Disorders
COVER PAGE - 1
, SECTION 1 | Psychiatric Assessment & Diagnosis | Q1-Q20 | NR 546 Midterm Exam 2026/2027
Q1 Question 1 of 100
Q1. A 34-year-old woman presents to the psychiatric clinic reporting persistent sadness, insomnia,
and loss of interest in activities for the past six weeks. She denies any psychotic symptoms or
suicidal ideation. The PMHNP is conducting an initial psychiatric evaluation. Which assessment
tool is most appropriate for screening the severity of her depressive symptoms?
A. Hamilton Depression Rating Scale
B. Mini-Mental State Examination
C. Yale-Brown Obsessive Compulsive Scale
D. Abnormal Involuntary Movement Scale
Correct Answer: A
Rationale:
The Hamilton Depression Rating Scale (HAM-D) is specifically designed to assess the severity of depressive
symptoms in patients already diagnosed with depression. The MMSE screens for cognitive impairment, the
Y-BOCS measures OCD severity, and the AIMS evaluates medication-induced movement disorders, none of
which are relevant to this depressive presentation.
Q2 Question 2 of 100
Q2. A 45-year-old man is brought to the emergency department by police after being found
wandering in traffic. He appears disheveled, mutters to himself, and is unable to provide coherent
personal history. The PMHNP must determine his capacity to refuse treatment. Which element is
most essential in assessing this patient's decision-making capacity?
A. Ability to understand the risks and benefits of treatment
B. Presence of a diagnosed mental illness
C. Agreement with the treatment team's recommendation
D. History of prior psychiatric hospitalizations
Correct Answer: A
Rationale:
Decision-making capacity requires the patient to understand relevant information, appreciate how it applies to
their situation, reason about the choices, and communicate a decision. A diagnosed mental illness alone does not
negate capacity, and agreeing with the treatment team or having prior hospitalizations does not determine
capacity.
NR 546 Midterm Exam -- 2026/2027 | Passing Score: 80% | Page 2 of 53
,SECTION 1 | Psychiatric Assessment & Diagnosis | Q1-Q20 | NR 546 Midterm Exam 2026/2027
Q3 Question 3 of 100
Q3. A 28-year-old graduate student reports a three-month history of excessive worry about
academic performance, social interactions, and health. She describes muscle tension, difficulty
concentrating, and irritability that occur most days. The PMHNP suspects generalized anxiety
disorder. Which diagnostic criterion distinguishes GAD from normal worry?
A. The worry is difficult to control and is associated with at least three additional symptoms
B. The worry is limited to a specific situation or object
C. The worry is accompanied by panic attacks
D. The worry resolves with reassurance from others
Correct Answer: A
Rationale:
GAD is characterized by excessive, difficult-to-control worry occurring more days than not for at least six months,
accompanied by at least three somatic or cognitive symptoms. Worry limited to a specific situation suggests a
specific phobia, panic attacks suggest panic disorder, and worry that resolves with reassurance is more typical of
normal anxiety.
Q4 Question 4 of 100
Q4. A 52-year-old man with a history of alcohol use disorder presents for a psychiatric
assessment. His family reports progressive memory difficulties and confabulation over the past
two months. Physical examination reveals nystagmus and ataxic gait. The PMHNP recognizes this
presentation is most consistent with which condition?
A. Wernicke-Korsakoff syndrome
B. Alcoholic hallucinosis
C. Delirium tremens
D. Substance-induced psychotic disorder
Correct Answer: A
Rationale:
Wernicke-Korsakoff syndrome results from thiamine deficiency commonly seen in chronic alcohol use, presenting
with the triad of confusion, ataxia, and ophthalmoplegia (including nystagmus), with Korsakoff features of memory
impairment and confabulation. Alcoholic hallucinosis involves hallucinations without the neurological triad, delirium
tremens is an acute withdrawal state, and substance-induced psychotic disorder does not feature the specific
neurological deficits described.
NR 546 Midterm Exam -- 2026/2027 | Passing Score: 80% | Page 3 of 53
, SECTION 1 | Psychiatric Assessment & Diagnosis | Q1-Q20 | NR 546 Midterm Exam 2026/2027
Q5 Question 5 of 100
Q5. A 19-year-old college freshman is referred by student health after his roommate found him
talking to someone who was not there. The patient appears guarded and states that a government
agency is monitoring his thoughts through his laptop camera. His affect is flat and his speech is
sparse. The PMHNP suspects a psychotic disorder. Which feature most strongly suggests
schizophrenia rather than a brief psychotic disorder?
A. Duration of symptoms exceeding six months
B. Presence of visual hallucinations
C. History of substance use
D. Acute onset of symptoms
Correct Answer: A
Rationale:
Schizophrenia requires symptoms persisting for at least six months, including at least one month of active-phase
symptoms. Brief psychotic disorder by definition lasts less than one month. Visual hallucinations, substance use
history, and acute onset do not differentiate between the two disorders.
Q6 Question 6 of 100
Q6. A 37-year-old woman presents for an initial psychiatric evaluation. She describes a pattern of
unstable interpersonal relationships, impulsivity, and chronic feelings of emptiness. She reports a
history of self-harm and fear of abandonment. The PMHNP identifies features consistent with
borderline personality disorder. Which neurobiological finding has been most consistently
associated with this disorder?
A. Prefrontal cortex and amygdala dysregulation
B. Elevated dopamine in the mesolimbic pathway
C. Degeneration of the substantia nigra
D. Increased serotonin reuptake in the raphe nuclei
Correct Answer: A
Rationale:
Neuroimaging studies consistently demonstrate prefrontal cortex and amygdala dysregulation in borderline
personality disorder, leading to impaired emotional regulation and impulsivity. Elevated mesolimbic dopamine is
associated with psychotic disorders, substantia nigra degeneration with Parkinson disease, and increased
serotonin reuptake is not a recognized neurobiological finding in BPD.
NR 546 Midterm Exam -- 2026/2027 | Passing Score: 80% | Page 4 of 53
