NSG 527 | Wilkes
OBJECTIVE ASSESSMENT - EXAM
Final
Exam
NSG 527 | Verified Q&As + Rationales
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Advanced Psychiatric Assessment Psychotic Disorders & Treatment
Psychopharmacology & Management Ethical & Legal Issues in Psychiatry
Mood & Anxiety Disorders
COVER PAGE - 1
, SECTION 1 | Advanced Psychiatric Assessment | Q1-Q20 | NSG 527 Final Exam 2026/2027
Q1 Question 1 of 100
Q1. A 34-year-old woman presents to the psychiatric clinic reporting persistent sadness,
anhedonia, and difficulty concentrating for the past six weeks. She denies any suicidal ideation but
mentions she has been skipping meals and sleeping 10 to 12 hours per day. Her PHQ-9 score is
16. Based on these findings, what is the most appropriate initial assessment step?
A. Conduct a comprehensive biopsychosocial assessment including substance use
screening
B. Prescribe a selective serotonin reuptake inhibitor and reassess in four weeks
C. Initiate immediate inpatient hospitalization for safety
D. Refer the patient to a clinical psychologist for cognitive behavioral therapy only
Correct Answer: A
Rationale:
A comprehensive biopsychosocial assessment is the most appropriate initial step because it evaluates
biological, psychological, and social factors contributing to the presentation. While the PHQ-9 indicates
moderately severe depression, initiating treatment without a full assessment risks missing comorbid
substance use or medical conditions. Option A is premature because there is no imminent safety risk,
and option C bypasses essential diagnostic evaluation.
NSG 527 Final Exam -- 2026/2027 | Passing Score: 75% | Page 2 of 53
,Q2 Question 2 of 100
Q2. A 45-year-old male veteran is referred for psychiatric evaluation after his primary care provider
notes irritability, hypervigilance, and avoidance of crowded places. He reports experiencing
recurrent nightmares about combat events and avoids driving on highways because the noise
triggers intense anxiety. His PCL-5 score is 42. Which assessment tool is most appropriate for
confirming the suspected diagnosis?
A. Mini-Mental State Examination (MMSE)
B. Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
C. Hamilton Anxiety Rating Scale (HAM-A)
D. Abnormal Involuntary Movement Scale (AIMS)
Correct Answer: B
Rationale:
The CAPS-5 is the gold standard structured clinical interview for diagnosing PTSD and assessing
symptom severity according to DSM-5 criteria. The veteran's presentation of re-experiencing, avoidance,
and hyperarousal symptoms strongly suggests PTSD. The MMSE assesses cognition, the HAM-A
measures generalized anxiety severity, and the AIMS evaluates tardive dyskinesia, none of which target
PTSD-specific diagnostic criteria.
Q3 Question 3 of 100
Q3. A 28-year-old woman with a history of borderline personality disorder is admitted after a suicide
attempt by medication overdose. During the mental status examination, she displays labile affect,
describes feeling empty, and insists that no one understands her. She has superficial lacerations
on her forearms. Which finding on mental status examination most distinguishes this presentation
from major depressive disorder?
A. Psychomotor retardation and decreased energy
B. Auditory hallucinations commanding self-harm
C. Rapidly shifting affect and fear of abandonment
D. Persistent anhedonia lasting more than two weeks
Correct Answer: C
Rationale:
Rapidly shifting affect and fear of abandonment are hallmark features of borderline personality disorder
that distinguish it from major depressive disorder, which typically presents with sustained depressed
mood and anhedonia rather than affective lability. Auditory hallucinations suggest a psychotic disorder,
and psychomotor retardation is more characteristic of melancholic depression.
NSG 527 Final Exam -- 2026/2027 | Passing Score: 75% | Page 3 of 53
, Q4 Question 4 of 100
Q4. A 62-year-old man with no prior psychiatric history is brought to the emergency department by
his wife, who reports that over the past three days he has been speaking rapidly, sleeping only two
hours per night, and making grandiose plans to start a technology company despite having no
experience. His speech is pressured and he is easily distracted. What is the most likely diagnosis?
A. Major depressive disorder with psychotic features
B. Generalized anxiety disorder
C. Schizophreniform disorder
D. Bipolar I disorder, current episode manic
Correct Answer: D
Rationale:
The presentation of elevated mood, pressured speech, decreased need for sleep, grandiosity, and
distractibility lasting at least one week meets DSM-5 criteria for a manic episode, confirming bipolar I
disorder. Schizophreniform disorder requires psychotic symptoms without the mood component, major
depressive disorder involves depressed rather than elevated mood, and generalized anxiety disorder
does not feature grandiosity or decreased sleep need.
Q5 Question 5 of 100
Q5. During a psychiatric interview, a 19-year-old college student describes hearing voices that
comment on his behavior and tell him he is worthless. He appears guarded and reports that he
believes his roommate is spying on him through the electrical outlets. His thought process is
tangential, and his affect is blunted. Which component of the mental status examination best
captures the belief about his roommate?
A. Paranoid delusion
B. Idea of reference
C. Loose association
D. Perseveration
Correct Answer: A
Rationale:
The fixed, false belief that his roommate is spying on him through electrical outlets is a paranoid
delusion, which is a disturbance of thought content. An idea of reference involves the belief that neutral
events have personal significance, perseveration is the repetitive continuation of a response, and loose
association is a disorder of thought process rather than content.
NSG 527 Final Exam -- 2026/2027 | Passing Score: 75% | Page 4 of 53
OBJECTIVE ASSESSMENT - EXAM
Final
Exam
NSG 527 | Verified Q&As + Rationales
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Advanced Psychiatric Assessment Psychotic Disorders & Treatment
Psychopharmacology & Management Ethical & Legal Issues in Psychiatry
Mood & Anxiety Disorders
COVER PAGE - 1
, SECTION 1 | Advanced Psychiatric Assessment | Q1-Q20 | NSG 527 Final Exam 2026/2027
Q1 Question 1 of 100
Q1. A 34-year-old woman presents to the psychiatric clinic reporting persistent sadness,
anhedonia, and difficulty concentrating for the past six weeks. She denies any suicidal ideation but
mentions she has been skipping meals and sleeping 10 to 12 hours per day. Her PHQ-9 score is
16. Based on these findings, what is the most appropriate initial assessment step?
A. Conduct a comprehensive biopsychosocial assessment including substance use
screening
B. Prescribe a selective serotonin reuptake inhibitor and reassess in four weeks
C. Initiate immediate inpatient hospitalization for safety
D. Refer the patient to a clinical psychologist for cognitive behavioral therapy only
Correct Answer: A
Rationale:
A comprehensive biopsychosocial assessment is the most appropriate initial step because it evaluates
biological, psychological, and social factors contributing to the presentation. While the PHQ-9 indicates
moderately severe depression, initiating treatment without a full assessment risks missing comorbid
substance use or medical conditions. Option A is premature because there is no imminent safety risk,
and option C bypasses essential diagnostic evaluation.
NSG 527 Final Exam -- 2026/2027 | Passing Score: 75% | Page 2 of 53
,Q2 Question 2 of 100
Q2. A 45-year-old male veteran is referred for psychiatric evaluation after his primary care provider
notes irritability, hypervigilance, and avoidance of crowded places. He reports experiencing
recurrent nightmares about combat events and avoids driving on highways because the noise
triggers intense anxiety. His PCL-5 score is 42. Which assessment tool is most appropriate for
confirming the suspected diagnosis?
A. Mini-Mental State Examination (MMSE)
B. Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
C. Hamilton Anxiety Rating Scale (HAM-A)
D. Abnormal Involuntary Movement Scale (AIMS)
Correct Answer: B
Rationale:
The CAPS-5 is the gold standard structured clinical interview for diagnosing PTSD and assessing
symptom severity according to DSM-5 criteria. The veteran's presentation of re-experiencing, avoidance,
and hyperarousal symptoms strongly suggests PTSD. The MMSE assesses cognition, the HAM-A
measures generalized anxiety severity, and the AIMS evaluates tardive dyskinesia, none of which target
PTSD-specific diagnostic criteria.
Q3 Question 3 of 100
Q3. A 28-year-old woman with a history of borderline personality disorder is admitted after a suicide
attempt by medication overdose. During the mental status examination, she displays labile affect,
describes feeling empty, and insists that no one understands her. She has superficial lacerations
on her forearms. Which finding on mental status examination most distinguishes this presentation
from major depressive disorder?
A. Psychomotor retardation and decreased energy
B. Auditory hallucinations commanding self-harm
C. Rapidly shifting affect and fear of abandonment
D. Persistent anhedonia lasting more than two weeks
Correct Answer: C
Rationale:
Rapidly shifting affect and fear of abandonment are hallmark features of borderline personality disorder
that distinguish it from major depressive disorder, which typically presents with sustained depressed
mood and anhedonia rather than affective lability. Auditory hallucinations suggest a psychotic disorder,
and psychomotor retardation is more characteristic of melancholic depression.
NSG 527 Final Exam -- 2026/2027 | Passing Score: 75% | Page 3 of 53
, Q4 Question 4 of 100
Q4. A 62-year-old man with no prior psychiatric history is brought to the emergency department by
his wife, who reports that over the past three days he has been speaking rapidly, sleeping only two
hours per night, and making grandiose plans to start a technology company despite having no
experience. His speech is pressured and he is easily distracted. What is the most likely diagnosis?
A. Major depressive disorder with psychotic features
B. Generalized anxiety disorder
C. Schizophreniform disorder
D. Bipolar I disorder, current episode manic
Correct Answer: D
Rationale:
The presentation of elevated mood, pressured speech, decreased need for sleep, grandiosity, and
distractibility lasting at least one week meets DSM-5 criteria for a manic episode, confirming bipolar I
disorder. Schizophreniform disorder requires psychotic symptoms without the mood component, major
depressive disorder involves depressed rather than elevated mood, and generalized anxiety disorder
does not feature grandiosity or decreased sleep need.
Q5 Question 5 of 100
Q5. During a psychiatric interview, a 19-year-old college student describes hearing voices that
comment on his behavior and tell him he is worthless. He appears guarded and reports that he
believes his roommate is spying on him through the electrical outlets. His thought process is
tangential, and his affect is blunted. Which component of the mental status examination best
captures the belief about his roommate?
A. Paranoid delusion
B. Idea of reference
C. Loose association
D. Perseveration
Correct Answer: A
Rationale:
The fixed, false belief that his roommate is spying on him through electrical outlets is a paranoid
delusion, which is a disturbance of thought content. An idea of reference involves the belief that neutral
events have personal significance, perseveration is the repetitive continuation of a response, and loose
association is a disorder of thought process rather than content.
NSG 527 Final Exam -- 2026/2027 | Passing Score: 75% | Page 4 of 53
