NR 546 | Week 4
OBJECTIVE ASSESSMENT - EXAM
Midterm Exam
Week 4
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 Week 4
2026/2027
Q1 Question 1 of 100
A 34-year-old woman is admitted to the inpatient psychiatric unit after a suicide attempt.
During the initial mental status examination, she avoids eye contact, speaks softly, and her
affect appears congruent with a depressed mood. What is the most appropriate
documentation of her affect?
A. Affect is flat and inappropriate to the situation
B. Affect is labile with rapid shifts throughout the interview
C. Affect is constricted and congruent with depressed mood
D. Affect is blunted with no observable emotional expression
Correct Answer: A
Rationale:
A constricted affect describes a reduction in emotional expressiveness that remains appropriate to the
mood, which matches the patient's soft speech and congruent depressed presentation. Flat affect
indicates near absence of expression, while blunted affect is more severe than what is described; labile
affect involves rapid shifts not seen here.
Q2 Question 2 of 100
A 52-year-old man presents to the clinic reporting fatigue and hopelessness for the past
three weeks. The PMHNP plans to use a standardized screening tool. The Patient Health
Questionnaire-9 (PHQ-9) is selected. A score of 18 on this tool most strongly suggests
which severity of depression?
A. Mild depression with minimal functional impairment
B. Severe depression requiring prompt clinical intervention
C. Moderate depression manageable with brief therapy alone
D. No clinically significant depressive symptoms present
Correct Answer: C
Rationale:
A PHQ-9 score of 18 falls within the moderately severe to severe range (15-19 = moderately severe),
warranting prompt clinical intervention that often includes pharmacotherapy and psychotherapy. Mild
depression scores 5-9, moderate is 10-14, and scores below 5 indicate minimal symptoms.
NR 546 Midterm Exam Week 4 -- 2026/2027 | Passing Score: 80% | Page 2 of 52
,SECTION 1 | Psychiatric Assessment & Diagnosis | NR 546 Midterm Exam Week 4 2026/2027
Q3 Question 3 of 100
A 68-year-old retired teacher is brought by her daughter because of worsening memory
and confusion over six months. The PMHNP administers the Mini-Mental State
Examination (MMSE). She scores 19 out of 30. This score is most consistent with which
finding?
A. Normal cognitive function for her age and education
B. Mild cognitive impairment without functional decline
C. Significant cognitive impairment requiring further evaluation
D. Delirium requiring immediate neuroimaging only
Correct Answer: B
Rationale:
An MMSE score of 19 indicates moderate cognitive impairment and warrants further diagnostic workup
for reversible causes and neurocognitive disorders. A score of 24-30 is generally considered normal,
while scores below 24 suggest clinically significant impairment that requires evaluation rather than
watchful waiting alone.
Q4 Question 4 of 100
A 27-year-old veteran presents with nightmares, hypervigilance, and avoidance of crowds
since returning from deployment. The PMHNP uses the Columbia-Suicide Severity Rating
Scale. The patient reports passive thoughts of death but no plan or intent. How should this
be classified?
A. No suicidal ideation present at this time
B. Active ideation with a specific plan and intent
C. Passive ideation without plan, intent, or behavior
D. Suicidal behavior with interrupted attempt
Correct Answer: D
Rationale:
Passive thoughts of death without plan, intent, or behavior are classified as passive suicidal ideation and
require safety planning, increased monitoring, and outpatient follow-up. Active ideation with plan or any
suicidal behavior indicates higher risk requiring more intensive intervention.
NR 546 Midterm Exam Week 4 -- 2026/2027 | Passing Score: 80% | Page 3 of 52
, SECTION 1 | Psychiatric Assessment & Diagnosis | NR 546 Midterm Exam Week 4 2026/2027
Q5 Question 5 of 100
A 19-year-old college student is brought to the emergency department after being found
disheveled and talking to invisible people in her dorm. During the interview, she stops
mid-sentence and stares at the wall before saying her thoughts were taken out by an
outside force. What term best describes this experience?
A. Thought blocking with thought withdrawal
B. Thought insertion by an external entity
C. Flight of ideas with rapid speech patterns
D. Loose associations with derailment of thought
Correct Answer: A
Rationale:
Thought blocking is the abrupt interruption of thought flow, and thought withdrawal is the delusional
belief that thoughts have been removed by an outside force, both classic positive symptoms of
psychosis. Thought insertion involves beliefs that thoughts are placed into the mind, while flight of ideas
is seen in mania.
Q6 Question 6 of 100
A 45-year-old man with alcohol use disorder presents for an intake assessment. The
PMHNP uses the CAGE questionnaire. The patient answers yes to two of the four
questions. A score of two or more on the CAGE suggests which clinical finding?
A. No evidence of an alcohol use disorder
B. Clinically significant alcohol use disorder requiring further evaluation
C. Acute alcohol intoxication requiring immediate reversal
D. Alcohol withdrawal requiring inpatient detoxification
Correct Answer: D
Rationale:
A CAGE score of two or more indicates a high likelihood of alcohol use disorder and warrants further
assessment and intervention. A score of zero or one is considered negative, while acute intoxication or
withdrawal is determined by clinical exam and vital signs rather than the CAGE screening tool.
NR 546 Midterm Exam Week 4 -- 2026/2027 | Passing Score: 80% | Page 4 of 52
OBJECTIVE ASSESSMENT - EXAM
Midterm Exam
Week 4
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 Week 4
2026/2027
Q1 Question 1 of 100
A 34-year-old woman is admitted to the inpatient psychiatric unit after a suicide attempt.
During the initial mental status examination, she avoids eye contact, speaks softly, and her
affect appears congruent with a depressed mood. What is the most appropriate
documentation of her affect?
A. Affect is flat and inappropriate to the situation
B. Affect is labile with rapid shifts throughout the interview
C. Affect is constricted and congruent with depressed mood
D. Affect is blunted with no observable emotional expression
Correct Answer: A
Rationale:
A constricted affect describes a reduction in emotional expressiveness that remains appropriate to the
mood, which matches the patient's soft speech and congruent depressed presentation. Flat affect
indicates near absence of expression, while blunted affect is more severe than what is described; labile
affect involves rapid shifts not seen here.
Q2 Question 2 of 100
A 52-year-old man presents to the clinic reporting fatigue and hopelessness for the past
three weeks. The PMHNP plans to use a standardized screening tool. The Patient Health
Questionnaire-9 (PHQ-9) is selected. A score of 18 on this tool most strongly suggests
which severity of depression?
A. Mild depression with minimal functional impairment
B. Severe depression requiring prompt clinical intervention
C. Moderate depression manageable with brief therapy alone
D. No clinically significant depressive symptoms present
Correct Answer: C
Rationale:
A PHQ-9 score of 18 falls within the moderately severe to severe range (15-19 = moderately severe),
warranting prompt clinical intervention that often includes pharmacotherapy and psychotherapy. Mild
depression scores 5-9, moderate is 10-14, and scores below 5 indicate minimal symptoms.
NR 546 Midterm Exam Week 4 -- 2026/2027 | Passing Score: 80% | Page 2 of 52
,SECTION 1 | Psychiatric Assessment & Diagnosis | NR 546 Midterm Exam Week 4 2026/2027
Q3 Question 3 of 100
A 68-year-old retired teacher is brought by her daughter because of worsening memory
and confusion over six months. The PMHNP administers the Mini-Mental State
Examination (MMSE). She scores 19 out of 30. This score is most consistent with which
finding?
A. Normal cognitive function for her age and education
B. Mild cognitive impairment without functional decline
C. Significant cognitive impairment requiring further evaluation
D. Delirium requiring immediate neuroimaging only
Correct Answer: B
Rationale:
An MMSE score of 19 indicates moderate cognitive impairment and warrants further diagnostic workup
for reversible causes and neurocognitive disorders. A score of 24-30 is generally considered normal,
while scores below 24 suggest clinically significant impairment that requires evaluation rather than
watchful waiting alone.
Q4 Question 4 of 100
A 27-year-old veteran presents with nightmares, hypervigilance, and avoidance of crowds
since returning from deployment. The PMHNP uses the Columbia-Suicide Severity Rating
Scale. The patient reports passive thoughts of death but no plan or intent. How should this
be classified?
A. No suicidal ideation present at this time
B. Active ideation with a specific plan and intent
C. Passive ideation without plan, intent, or behavior
D. Suicidal behavior with interrupted attempt
Correct Answer: D
Rationale:
Passive thoughts of death without plan, intent, or behavior are classified as passive suicidal ideation and
require safety planning, increased monitoring, and outpatient follow-up. Active ideation with plan or any
suicidal behavior indicates higher risk requiring more intensive intervention.
NR 546 Midterm Exam Week 4 -- 2026/2027 | Passing Score: 80% | Page 3 of 52
, SECTION 1 | Psychiatric Assessment & Diagnosis | NR 546 Midterm Exam Week 4 2026/2027
Q5 Question 5 of 100
A 19-year-old college student is brought to the emergency department after being found
disheveled and talking to invisible people in her dorm. During the interview, she stops
mid-sentence and stares at the wall before saying her thoughts were taken out by an
outside force. What term best describes this experience?
A. Thought blocking with thought withdrawal
B. Thought insertion by an external entity
C. Flight of ideas with rapid speech patterns
D. Loose associations with derailment of thought
Correct Answer: A
Rationale:
Thought blocking is the abrupt interruption of thought flow, and thought withdrawal is the delusional
belief that thoughts have been removed by an outside force, both classic positive symptoms of
psychosis. Thought insertion involves beliefs that thoughts are placed into the mind, while flight of ideas
is seen in mania.
Q6 Question 6 of 100
A 45-year-old man with alcohol use disorder presents for an intake assessment. The
PMHNP uses the CAGE questionnaire. The patient answers yes to two of the four
questions. A score of two or more on the CAGE suggests which clinical finding?
A. No evidence of an alcohol use disorder
B. Clinically significant alcohol use disorder requiring further evaluation
C. Acute alcohol intoxication requiring immediate reversal
D. Alcohol withdrawal requiring inpatient detoxification
Correct Answer: D
Rationale:
A CAGE score of two or more indicates a high likelihood of alcohol use disorder and warrants further
assessment and intervention. A score of zero or one is considered negative, while acute intoxication or
withdrawal is determined by clinical exam and vital signs rather than the CAGE screening tool.
NR 546 Midterm Exam Week 4 -- 2026/2027 | Passing Score: 80% | Page 4 of 52
