NR 546 | Midterm
OBJECTIVE ASSESSMENT - EXAM
Midterm
Exam
NR 546 | Tested Q&As
100 100%
QUESTIONS VERIFIED ANSWERS
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
A 34-year-old woman presents to the outpatient clinic reporting fatigue, low mood, and insomnia for the past 6 weeks. She
denies suicidal ideation but has lost interest in her usual hobbies. Which initial action by the psychiatric nurse practitioner
is most appropriate?
A. Conduct a comprehensive psychiatric interview and administer a standardized depression screening tool
such as the PHQ-9.
B. Prescribe a selective serotonin reuptake inhibitor immediately based on the reported symptoms.
C. Refer the patient to a social worker for counseling without further assessment.
D. Schedule a brain MRI to rule out an organic cause of depression.
Correct Answer: A
Rationale:
A comprehensive psychiatric interview plus a validated screening tool establishes the diagnostic foundation before any
intervention. Prescribing without a full assessment risks missing comorbid conditions, and imaging is not indicated without
focal neurological findings.
Q2 Question 2 of 100
A 52-year-old man with a history of alcohol use disorder is admitted for acute intoxication and agitation. On day 2, he
becomes tremulous, hypertensive, and reports visual hallucinations. Which assessment finding most strongly suggests
delirium tremens rather than primary psychosis?
A. Hallucinations with intact reality testing.
B. Clouded consciousness with autonomic hyperactivity and recent cessation of heavy alcohol use.
C. A family history of schizophrenia.
D. Chronic auditory hallucinations lasting months.
Correct Answer: B
Rationale:
Delirium tremens is characterized by clouded consciousness, autonomic instability, and onset within 48-72 hours of alcohol
cessation. Primary psychosis typically preserves orientation and lacks the marked autonomic signs seen here.
NR 546 Midterm Exam - 2026/2027 | Passing Score: 80% | Page 2
, Q3 Question 3 of 100
A 19-year-old college student is brought to the emergency department after telling roommates she hears voices telling her
to harm herself. She is alert and oriented but appears frightened. What is the priority nursing assessment?
A. Risk for suicide and homicide, including ideation, plan, intent, and access to means.
B. Detailed family psychiatric history going back three generations.
C. Her preference for inpatient versus outpatient treatment.
D. Her academic performance over the past semester.
Correct Answer: A
Rationale:
Safety is the highest priority in any psychiatric encounter involving command hallucinations or self-harm ideation. A thorough
risk assessment must occur before exploring history or treatment preferences.
Q4 Question 4 of 100
A 67-year-old man is evaluated for worsening memory and personality changes over 4 months. His wife reports he has
been disoriented in familiar places. Which feature most strongly differentiates neurocognitive disorder from delirium?
A. Acute onset with fluctuating attention.
B. Gradual onset with progressive cognitive decline and clear consciousness.
C. Visual hallucinations occurring only at night.
D. Rapid reversal with benzodiazepine administration.
Correct Answer: B
Rationale:
Major neurocognitive disorder features a gradual, progressive decline with preserved consciousness, whereas delirium has
acute onset and fluctuating attention. Hallucinations and benzodiazepine responsiveness do not reliably distinguish the two.
NR 546 Midterm Exam - 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 100
A 28-year-old woman describes a 2-year pattern of intense mood swings, fear of abandonment, and self-injurious cutting
when she feels rejected. Which diagnostic cluster best aligns with these findings?
A. Cluster A personality disorder.
B. Cluster B personality disorder.
C. Cluster C personality disorder.
D. Autism spectrum disorder.
Correct Answer: B
Rationale:
Cluster B personality disorders, which include borderline personality disorder, are marked by dramatic, emotional, and erratic
behavior with fear of abandonment and self-injury. Clusters A and C feature different core traits.
Q6 Question 6 of 100
A 45-year-old man reports intrusive memories of a motor vehicle accident 3 months ago, hypervigilance, and avoidance of
driving. He sleeps poorly and feels detached from family. Which diagnosis best fits this presentation?
A. Acute stress disorder, because symptoms began within one month of trauma.
B. Post-traumatic stress disorder, given symptoms lasting longer than one month after the trauma.
C. Generalized anxiety disorder, due to excessive worry.
D. Adjustment disorder with anxiety, related to the accident.
Correct Answer: B
Rationale:
PTSD requires symptom duration longer than one month following trauma, with intrusion, avoidance, negative cognitions, and
arousal. Acute stress disorder lasts 3 days to 1 month, while GAD and adjustment disorder do not require a specific traumatic
trigger.
NR 546 Midterm Exam - 2026/2027 | Passing Score: 80% | Page 4
OBJECTIVE ASSESSMENT - EXAM
Midterm
Exam
NR 546 | Tested Q&As
100 100%
QUESTIONS VERIFIED ANSWERS
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
A 34-year-old woman presents to the outpatient clinic reporting fatigue, low mood, and insomnia for the past 6 weeks. She
denies suicidal ideation but has lost interest in her usual hobbies. Which initial action by the psychiatric nurse practitioner
is most appropriate?
A. Conduct a comprehensive psychiatric interview and administer a standardized depression screening tool
such as the PHQ-9.
B. Prescribe a selective serotonin reuptake inhibitor immediately based on the reported symptoms.
C. Refer the patient to a social worker for counseling without further assessment.
D. Schedule a brain MRI to rule out an organic cause of depression.
Correct Answer: A
Rationale:
A comprehensive psychiatric interview plus a validated screening tool establishes the diagnostic foundation before any
intervention. Prescribing without a full assessment risks missing comorbid conditions, and imaging is not indicated without
focal neurological findings.
Q2 Question 2 of 100
A 52-year-old man with a history of alcohol use disorder is admitted for acute intoxication and agitation. On day 2, he
becomes tremulous, hypertensive, and reports visual hallucinations. Which assessment finding most strongly suggests
delirium tremens rather than primary psychosis?
A. Hallucinations with intact reality testing.
B. Clouded consciousness with autonomic hyperactivity and recent cessation of heavy alcohol use.
C. A family history of schizophrenia.
D. Chronic auditory hallucinations lasting months.
Correct Answer: B
Rationale:
Delirium tremens is characterized by clouded consciousness, autonomic instability, and onset within 48-72 hours of alcohol
cessation. Primary psychosis typically preserves orientation and lacks the marked autonomic signs seen here.
NR 546 Midterm Exam - 2026/2027 | Passing Score: 80% | Page 2
, Q3 Question 3 of 100
A 19-year-old college student is brought to the emergency department after telling roommates she hears voices telling her
to harm herself. She is alert and oriented but appears frightened. What is the priority nursing assessment?
A. Risk for suicide and homicide, including ideation, plan, intent, and access to means.
B. Detailed family psychiatric history going back three generations.
C. Her preference for inpatient versus outpatient treatment.
D. Her academic performance over the past semester.
Correct Answer: A
Rationale:
Safety is the highest priority in any psychiatric encounter involving command hallucinations or self-harm ideation. A thorough
risk assessment must occur before exploring history or treatment preferences.
Q4 Question 4 of 100
A 67-year-old man is evaluated for worsening memory and personality changes over 4 months. His wife reports he has
been disoriented in familiar places. Which feature most strongly differentiates neurocognitive disorder from delirium?
A. Acute onset with fluctuating attention.
B. Gradual onset with progressive cognitive decline and clear consciousness.
C. Visual hallucinations occurring only at night.
D. Rapid reversal with benzodiazepine administration.
Correct Answer: B
Rationale:
Major neurocognitive disorder features a gradual, progressive decline with preserved consciousness, whereas delirium has
acute onset and fluctuating attention. Hallucinations and benzodiazepine responsiveness do not reliably distinguish the two.
NR 546 Midterm Exam - 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 100
A 28-year-old woman describes a 2-year pattern of intense mood swings, fear of abandonment, and self-injurious cutting
when she feels rejected. Which diagnostic cluster best aligns with these findings?
A. Cluster A personality disorder.
B. Cluster B personality disorder.
C. Cluster C personality disorder.
D. Autism spectrum disorder.
Correct Answer: B
Rationale:
Cluster B personality disorders, which include borderline personality disorder, are marked by dramatic, emotional, and erratic
behavior with fear of abandonment and self-injury. Clusters A and C feature different core traits.
Q6 Question 6 of 100
A 45-year-old man reports intrusive memories of a motor vehicle accident 3 months ago, hypervigilance, and avoidance of
driving. He sleeps poorly and feels detached from family. Which diagnosis best fits this presentation?
A. Acute stress disorder, because symptoms began within one month of trauma.
B. Post-traumatic stress disorder, given symptoms lasting longer than one month after the trauma.
C. Generalized anxiety disorder, due to excessive worry.
D. Adjustment disorder with anxiety, related to the accident.
Correct Answer: B
Rationale:
PTSD requires symptom duration longer than one month following trauma, with intrusion, avoidance, negative cognitions, and
arousal. Acute stress disorder lasts 3 days to 1 month, while GAD and adjustment disorder do not require a specific traumatic
trigger.
NR 546 Midterm Exam - 2026/2027 | Passing Score: 80% | Page 4
