NRNP 6675 Midterm Exam Psychiatric Mental Health NP Care Across
the Lifespan II Question Bank (Latest 2026/2027 Edition) – 100%
Correct Questions, Answers & Detailed Rationales
Walden University
Instructor: Dr. Mihaela Fletcher
Total Questions: 50
Time Allowed: 90 Minutes
Passing Score: 80%
Instructions: Select the BEST answer for each question based on DSM-5 criteria, NRNP
6675 course content, and current clinical guidelines.
SECTION 1: PSYCHIATRIC ASSESSMENT & DIAGNOSTIC REASONING
Questions 1–9
Question 1
A 34-year-old female presents for initial psychiatric evaluation reporting persistent
sadness, loss of interest in activities, and difficulty sleeping for the past three weeks.
She denies suicidal ideation. Her medical history includes hypothyroidism. Which action
should the PMHNP prioritize before assigning a psychiatric diagnosis?
A. Administer the PHQ-9 and initiate sertraline 50 mg daily
B. Order thyroid function tests and review current levothyroxine dosing
C. Proceed with DSM-5 criteria for major depressive disorder and begin psychotherapy
D. Prescribe a sleep aid and reassess in two weeks
,Correct Answer: B
Rationale: Hypothyroidism is a well-established medical cause of depressive symptoms;
the PMHNP must rule out organic etiologies before assigning a primary psychiatric
diagnosis per DSM-5 diagnostic guidelines. Option A prematurely initiates
pharmacotherapy without excluding medical causes. Option C assumes a psychiatric
etiology without appropriate medical workup. Option D delays necessary evaluation and
may mask an underlying endocrine disorder.
Question 2
A 72-year-old male is brought by his daughter for evaluation due to progressive memory
decline. He scores 18/30 on the MMSE. Which additional assessment strategy is MOST
essential for accurate diagnosis?
A. Obtain collateral history from family members regarding functional decline and
timeline of symptoms
B. Order immediate brain MRI and refer for neurosurgical consultation
C. Diagnose major neurocognitive disorder based on MMSE score alone
D. Initiate memantine and cholinesterase inhibitor combination therapy
Correct Answer: A
Rationale: Per DSM-5 criteria for major and mild neurocognitive disorders, collateral
history is essential to establish functional decline, differentiate delirium from dementia,
and identify reversible causes; the MMSE alone is insufficient for diagnosis. Option B is
premature without a comprehensive history. Option C violates DSM-5 criteria requiring
functional impairment in addition to cognitive testing. Option D is inappropriate without
establishing etiology and severity.
Question 3
,A 19-year-old college student reports feeling "on edge," difficulty concentrating, and
muscle tension for the past six months. She denies panic attacks. Which screening tool
is MOST appropriate to quantify symptom severity?
A. Columbia-Suicide Severity Rating Scale (C-SSRS)
B. Patient Health Questionnaire-9 (PHQ-9)
C. Generalized Anxiety Disorder-7 (GAD-7)
D. Mini-Mental State Examination (MMSE)
Correct Answer: C
Rationale: The GAD-7 is a validated, DSM-5-aligned screening tool specifically designed
to assess severity of generalized anxiety disorder symptoms including worry, tension,
and concentration difficulties. Option A assesses suicide risk, not anxiety severity.
Option B screens for depression, not anxiety. Option D assesses cognitive function, not
anxiety symptoms.
Question 4
During a mental status examination, a patient demonstrates poor eye contact, flat
affect, and minimal spontaneous speech but answers questions when prompted. Which
MSE domain is MOST affected?
A. Thought process
B. Mood and affect
C. Sensorium and cognition
D. Insight and judgment
Correct Answer: B
Rationale: Flat affect and poor eye contact are core components of the affective
presentation during MSE; affect refers to the external, observable expression of
emotional state, while mood reflects the subjective internal state. Option A refers to the
, form and flow of thinking. Option C refers to alertness, orientation, and cognitive
testing. Option D refers to the patient's awareness of illness and decision-making
capacity.
Question 5
A PMHNP is conducting a suicide risk assessment on a 28-year-old male who states, "I
don't see the point anymore." Which C-SSRS screening element is MOST critical to
determine immediate safety needs?
A. Frequency of depressed mood over the past two weeks
B. Presence of intent, plan, and access to means
C. History of childhood trauma and adverse experiences
D. Current GAD-7 score
Correct Answer: B
Rationale: The C-SSRS assesses suicidal ideation severity through progression from
wish to die → active ideation → intent → plan; intent, plan, and access to means
determine imminent risk and guide immediate safety interventions. Option A assesses
depression severity, not acute suicide risk. Option C is a distal risk factor but does not
determine imminent danger. Option D is irrelevant to suicide risk stratification.
Question 6
A 45-year-old transgender male (FTM) presents for psychiatric evaluation. He reports
distress related to gender identity and recent discrimination. Which approach reflects
culturally competent PMHNP practice?
A. Focus exclusively on mood symptoms and avoid discussing gender to prevent
discomfort
B. Use the patient's affirmed name and pronouns, assess for gender dysphoria per
DSM-5 criteria, and evaluate for minority stress effects
C. Refer the patient to endocrinology before addressing any mental health concerns
the Lifespan II Question Bank (Latest 2026/2027 Edition) – 100%
Correct Questions, Answers & Detailed Rationales
Walden University
Instructor: Dr. Mihaela Fletcher
Total Questions: 50
Time Allowed: 90 Minutes
Passing Score: 80%
Instructions: Select the BEST answer for each question based on DSM-5 criteria, NRNP
6675 course content, and current clinical guidelines.
SECTION 1: PSYCHIATRIC ASSESSMENT & DIAGNOSTIC REASONING
Questions 1–9
Question 1
A 34-year-old female presents for initial psychiatric evaluation reporting persistent
sadness, loss of interest in activities, and difficulty sleeping for the past three weeks.
She denies suicidal ideation. Her medical history includes hypothyroidism. Which action
should the PMHNP prioritize before assigning a psychiatric diagnosis?
A. Administer the PHQ-9 and initiate sertraline 50 mg daily
B. Order thyroid function tests and review current levothyroxine dosing
C. Proceed with DSM-5 criteria for major depressive disorder and begin psychotherapy
D. Prescribe a sleep aid and reassess in two weeks
,Correct Answer: B
Rationale: Hypothyroidism is a well-established medical cause of depressive symptoms;
the PMHNP must rule out organic etiologies before assigning a primary psychiatric
diagnosis per DSM-5 diagnostic guidelines. Option A prematurely initiates
pharmacotherapy without excluding medical causes. Option C assumes a psychiatric
etiology without appropriate medical workup. Option D delays necessary evaluation and
may mask an underlying endocrine disorder.
Question 2
A 72-year-old male is brought by his daughter for evaluation due to progressive memory
decline. He scores 18/30 on the MMSE. Which additional assessment strategy is MOST
essential for accurate diagnosis?
A. Obtain collateral history from family members regarding functional decline and
timeline of symptoms
B. Order immediate brain MRI and refer for neurosurgical consultation
C. Diagnose major neurocognitive disorder based on MMSE score alone
D. Initiate memantine and cholinesterase inhibitor combination therapy
Correct Answer: A
Rationale: Per DSM-5 criteria for major and mild neurocognitive disorders, collateral
history is essential to establish functional decline, differentiate delirium from dementia,
and identify reversible causes; the MMSE alone is insufficient for diagnosis. Option B is
premature without a comprehensive history. Option C violates DSM-5 criteria requiring
functional impairment in addition to cognitive testing. Option D is inappropriate without
establishing etiology and severity.
Question 3
,A 19-year-old college student reports feeling "on edge," difficulty concentrating, and
muscle tension for the past six months. She denies panic attacks. Which screening tool
is MOST appropriate to quantify symptom severity?
A. Columbia-Suicide Severity Rating Scale (C-SSRS)
B. Patient Health Questionnaire-9 (PHQ-9)
C. Generalized Anxiety Disorder-7 (GAD-7)
D. Mini-Mental State Examination (MMSE)
Correct Answer: C
Rationale: The GAD-7 is a validated, DSM-5-aligned screening tool specifically designed
to assess severity of generalized anxiety disorder symptoms including worry, tension,
and concentration difficulties. Option A assesses suicide risk, not anxiety severity.
Option B screens for depression, not anxiety. Option D assesses cognitive function, not
anxiety symptoms.
Question 4
During a mental status examination, a patient demonstrates poor eye contact, flat
affect, and minimal spontaneous speech but answers questions when prompted. Which
MSE domain is MOST affected?
A. Thought process
B. Mood and affect
C. Sensorium and cognition
D. Insight and judgment
Correct Answer: B
Rationale: Flat affect and poor eye contact are core components of the affective
presentation during MSE; affect refers to the external, observable expression of
emotional state, while mood reflects the subjective internal state. Option A refers to the
, form and flow of thinking. Option C refers to alertness, orientation, and cognitive
testing. Option D refers to the patient's awareness of illness and decision-making
capacity.
Question 5
A PMHNP is conducting a suicide risk assessment on a 28-year-old male who states, "I
don't see the point anymore." Which C-SSRS screening element is MOST critical to
determine immediate safety needs?
A. Frequency of depressed mood over the past two weeks
B. Presence of intent, plan, and access to means
C. History of childhood trauma and adverse experiences
D. Current GAD-7 score
Correct Answer: B
Rationale: The C-SSRS assesses suicidal ideation severity through progression from
wish to die → active ideation → intent → plan; intent, plan, and access to means
determine imminent risk and guide immediate safety interventions. Option A assesses
depression severity, not acute suicide risk. Option C is a distal risk factor but does not
determine imminent danger. Option D is irrelevant to suicide risk stratification.
Question 6
A 45-year-old transgender male (FTM) presents for psychiatric evaluation. He reports
distress related to gender identity and recent discrimination. Which approach reflects
culturally competent PMHNP practice?
A. Focus exclusively on mood symptoms and avoid discussing gender to prevent
discomfort
B. Use the patient's affirmed name and pronouns, assess for gender dysphoria per
DSM-5 criteria, and evaluate for minority stress effects
C. Refer the patient to endocrinology before addressing any mental health concerns
