NSG 526 | Wilkes
OBJECTIVE ASSESSMENT - EXAM
Clinical Modalities
Advanced Psych
NSG 526 Exam 3 | Wilkes
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Advanced Psychiatric Assessment Psychotic Disorders & Treatment
Psychotherapy Modalities & Techniques Ethical & Legal Issues in Psychiatry
Mood & Anxiety Disorder Management
COVER PAGE - 1
,SECTION 1 | Advanced Psychiatric Assessment | Q1-Q20 | NSG 526 Clinical Modalities Advanced Psych Exam 3 2026/2027
Q1 Question 1 of 100
A 28-year-old man is brought to the emergency department by police after he was found wandering a highway
median singing loudly. During the psychiatric-mental health nurse's mental status examination, the patient is
wearing three layered shirts, mismatched socks, and a winter coat despite an ambient temperature of 80
degrees Fahrenheit. His hair is matted and he smells of urine. Which MSE component is being documented with
these observations?
A. Appearance and behavior
B. Mood and affect
C. Thought process
D. Insight and judgment
Correct Answer: A
Rationale:
Appearance and behavior is the MSE domain that captures observable physical presentation including grooming, hygiene,
clothing appropriateness, and motor behavior. Mood and affect describe the patient's internal and expressed emotional state
rather than physical presentation, making it the top wrong answer because it does not address the documented grooming
and clothing findings.
Q2 Question 2 of 100
A 19-year-old female college student presents to the campus counseling center reporting increased
hopelessness after a recent relationship breakup. The psychiatric-mental health nurse needs a structured,
evidence-based tool to assess suicide risk. The patient denies prior attempts but reports recent passive ideation.
Which instrument is most appropriate to use?
A. SAD PERSONS scale
B. Columbia Suicide Severity Rating Scale (C-SSRS)
C. Beck Depression Inventory (BDI-II)
D. Hamilton Depression Rating Scale (HAM-D)
Correct Answer: B
Rationale:
The C-SSRS is a validated, structured suicide risk assessment that systematically evaluates ideation severity, intensity,
behavior, and lethality, and is widely used in clinical and research settings. The SAD PERSONS scale is an older predictor
tool with weaker psychometric properties and is not the current evidence-based standard, making it the top wrong answer.
NSG 526 Clinical Modalities Advanced Psych Exam 3 - 2026/2027 | Passing Score: 75% | Page 2 of 55
,Q3 Question 3 of 100
A 62-year-old man is admitted to the inpatient psychiatric unit after a suicide attempt by medication overdose.
The psychiatric-mental health nurse reviews factors that increase his suicide risk using the SAD PERSONS
scale framework. Which combination of factors carries the highest weighted risk for completed suicide in this
population?
A. Recent job loss and financial strain
B. History of moderate depression
C. Male sex with age over 60
D. Lack of social support network
Correct Answer: C
Rationale:
The SAD PERSONS scale assigns points for Sex (male), Age over 60, Depression, Previous attempt, Ethanol use, Rational
thinking loss, Social supports, Organized plan, No spouse, and Sickness; male sex and age over 60 are weighted factors
strongly associated with completed suicide. Job loss is a stressor but is not an explicitly scored SAD PERSONS item,
making option A the top wrong answer.
Q4 Question 4 of 100
A 45-year-old woman is evaluated in the emergency department after taking a deliberate overdose of
acetaminophen with intent to die. She reports she purchased two bottles and ingested approximately 30 grams.
The psychiatric-mental health nurse is conducting a lethality assessment. Which factor most strongly increases
the lethality risk of this attempt?
A. The patient's reported ambivalence about dying
B. The patient's concurrent anxiety symptoms
C. The patient's history of outpatient psychotherapy
D. The high dose ingested and availability of the means
Correct Answer: D
Rationale:
Lethality is determined by the medical dangerousness of the method, quantity ingested, and accessibility of means, with
high-dose acetaminophen carrying significant hepatotoxic risk. The patient's ambivalence about dying lowers intent but does
not decrease the medical lethality of the actual attempt, making option A the top wrong answer.
NSG 526 Clinical Modalities Advanced Psych Exam 3 - 2026/2027 | Passing Score: 75% | Page 3 of 55
, Q5 Question 5 of 100
A 51-year-old man with schizophrenia is interviewed on the inpatient psychiatric unit. When asked about his
sleep, he begins describing his childhood bedroom, then discusses his brother's job, then talks about weather
patterns, never returning to the original question about sleep. Which thought process abnormality is the nurse
documenting?
A. Tangentiality
B. Circumstantiality
C. Thought blocking
D. Perseveration
Correct Answer: A
Rationale:
Tangentiality is the thought process disorder in which the patient moves from one topic to another in an oblique manner and
never returns to the original point, characteristic of psychotic disorders. Circumstantiality includes excessive unnecessary
detail but eventually returns to the original point, making option B the top wrong answer.
Q6 Question 6 of 100
A 33-year-old woman with major depressive disorder is admitted to an outpatient partial hospitalization program.
The psychiatric-mental health nurse is completing a comprehensive psychosocial assessment. Which domain is
most essential to assess given its direct relationship to suicide risk and treatment outcomes?
A. Dietary preferences and caffeine intake
B. Social support network and interpersonal losses
C. Preferred leisure activities and hobbies
D. Childhood vaccination history
Correct Answer: B
Rationale:
Social support network and recent interpersonal losses are core psychosocial assessment domains directly linked to suicide
risk, treatment adherence, and prognosis in depression. Dietary preferences and caffeine intake, while relevant to overall
health, do not carry the same predictive weight for suicide risk or outcomes, making option A the top wrong answer.
NSG 526 Clinical Modalities Advanced Psych Exam 3 - 2026/2027 | Passing Score: 75% | Page 4 of 55
OBJECTIVE ASSESSMENT - EXAM
Clinical Modalities
Advanced Psych
NSG 526 Exam 3 | Wilkes
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Advanced Psychiatric Assessment Psychotic Disorders & Treatment
Psychotherapy Modalities & Techniques Ethical & Legal Issues in Psychiatry
Mood & Anxiety Disorder Management
COVER PAGE - 1
,SECTION 1 | Advanced Psychiatric Assessment | Q1-Q20 | NSG 526 Clinical Modalities Advanced Psych Exam 3 2026/2027
Q1 Question 1 of 100
A 28-year-old man is brought to the emergency department by police after he was found wandering a highway
median singing loudly. During the psychiatric-mental health nurse's mental status examination, the patient is
wearing three layered shirts, mismatched socks, and a winter coat despite an ambient temperature of 80
degrees Fahrenheit. His hair is matted and he smells of urine. Which MSE component is being documented with
these observations?
A. Appearance and behavior
B. Mood and affect
C. Thought process
D. Insight and judgment
Correct Answer: A
Rationale:
Appearance and behavior is the MSE domain that captures observable physical presentation including grooming, hygiene,
clothing appropriateness, and motor behavior. Mood and affect describe the patient's internal and expressed emotional state
rather than physical presentation, making it the top wrong answer because it does not address the documented grooming
and clothing findings.
Q2 Question 2 of 100
A 19-year-old female college student presents to the campus counseling center reporting increased
hopelessness after a recent relationship breakup. The psychiatric-mental health nurse needs a structured,
evidence-based tool to assess suicide risk. The patient denies prior attempts but reports recent passive ideation.
Which instrument is most appropriate to use?
A. SAD PERSONS scale
B. Columbia Suicide Severity Rating Scale (C-SSRS)
C. Beck Depression Inventory (BDI-II)
D. Hamilton Depression Rating Scale (HAM-D)
Correct Answer: B
Rationale:
The C-SSRS is a validated, structured suicide risk assessment that systematically evaluates ideation severity, intensity,
behavior, and lethality, and is widely used in clinical and research settings. The SAD PERSONS scale is an older predictor
tool with weaker psychometric properties and is not the current evidence-based standard, making it the top wrong answer.
NSG 526 Clinical Modalities Advanced Psych Exam 3 - 2026/2027 | Passing Score: 75% | Page 2 of 55
,Q3 Question 3 of 100
A 62-year-old man is admitted to the inpatient psychiatric unit after a suicide attempt by medication overdose.
The psychiatric-mental health nurse reviews factors that increase his suicide risk using the SAD PERSONS
scale framework. Which combination of factors carries the highest weighted risk for completed suicide in this
population?
A. Recent job loss and financial strain
B. History of moderate depression
C. Male sex with age over 60
D. Lack of social support network
Correct Answer: C
Rationale:
The SAD PERSONS scale assigns points for Sex (male), Age over 60, Depression, Previous attempt, Ethanol use, Rational
thinking loss, Social supports, Organized plan, No spouse, and Sickness; male sex and age over 60 are weighted factors
strongly associated with completed suicide. Job loss is a stressor but is not an explicitly scored SAD PERSONS item,
making option A the top wrong answer.
Q4 Question 4 of 100
A 45-year-old woman is evaluated in the emergency department after taking a deliberate overdose of
acetaminophen with intent to die. She reports she purchased two bottles and ingested approximately 30 grams.
The psychiatric-mental health nurse is conducting a lethality assessment. Which factor most strongly increases
the lethality risk of this attempt?
A. The patient's reported ambivalence about dying
B. The patient's concurrent anxiety symptoms
C. The patient's history of outpatient psychotherapy
D. The high dose ingested and availability of the means
Correct Answer: D
Rationale:
Lethality is determined by the medical dangerousness of the method, quantity ingested, and accessibility of means, with
high-dose acetaminophen carrying significant hepatotoxic risk. The patient's ambivalence about dying lowers intent but does
not decrease the medical lethality of the actual attempt, making option A the top wrong answer.
NSG 526 Clinical Modalities Advanced Psych Exam 3 - 2026/2027 | Passing Score: 75% | Page 3 of 55
, Q5 Question 5 of 100
A 51-year-old man with schizophrenia is interviewed on the inpatient psychiatric unit. When asked about his
sleep, he begins describing his childhood bedroom, then discusses his brother's job, then talks about weather
patterns, never returning to the original question about sleep. Which thought process abnormality is the nurse
documenting?
A. Tangentiality
B. Circumstantiality
C. Thought blocking
D. Perseveration
Correct Answer: A
Rationale:
Tangentiality is the thought process disorder in which the patient moves from one topic to another in an oblique manner and
never returns to the original point, characteristic of psychotic disorders. Circumstantiality includes excessive unnecessary
detail but eventually returns to the original point, making option B the top wrong answer.
Q6 Question 6 of 100
A 33-year-old woman with major depressive disorder is admitted to an outpatient partial hospitalization program.
The psychiatric-mental health nurse is completing a comprehensive psychosocial assessment. Which domain is
most essential to assess given its direct relationship to suicide risk and treatment outcomes?
A. Dietary preferences and caffeine intake
B. Social support network and interpersonal losses
C. Preferred leisure activities and hobbies
D. Childhood vaccination history
Correct Answer: B
Rationale:
Social support network and recent interpersonal losses are core psychosocial assessment domains directly linked to suicide
risk, treatment adherence, and prognosis in depression. Dietary preferences and caffeine intake, while relevant to overall
health, do not carry the same predictive weight for suicide risk or outcomes, making option A the top wrong answer.
NSG 526 Clinical Modalities Advanced Psych Exam 3 - 2026/2027 | Passing Score: 75% | Page 4 of 55
