NR548 Final Exam Actual Exam Style V3 |
NR 548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. When assessing a patient’s mental status, how should the PMHNP distinguish between
mood and affect?
A. Mood is the patient’s internal emotional state, while affect is the external expression.
B. Mood is the clinician’s observation, while affect is the patient’s report.
C. Mood is always congruent with the patient’s current thought content.
D. Affect refers to long-term emotional patterns, while mood is transient.
Correct Answer: A
Expert Explanation: Mood is defined as the subjective emotional state reported by the
patient over time. Affect is the objective, observable expression of emotion during the
clinical interview. Distinguishing these helps the clinician identify incongruencies that may
suggest specific psychiatric pathologies.
2. A patient exhibits a thought process where they provide excessive detail and many
unnecessary ‘side trips’ before finally answering the original question. This is documented as:
A. Tangentiality
B. Flight of ideas
C. Derailment
,D. Circumstantiality
Correct Answer: D
Expert Explanation: Circumstantiality involves excessive detail but the patient eventually
returns to the original point. This differs from tangentiality, where the patient never
reaches the answer. Identifying these patterns is crucial for assessing executive function
and thought organization.
3. During a suicide risk assessment, which of the following is considered a ‘static’ risk factor?
A. Current suicidal ideation
B. Active substance intoxication
C. Access to firearms
D. History of a previous suicide attempt
Correct Answer: D
Expert Explanation: Static risk factors are historical variables that cannot be changed,
such as a previous attempt or family history of suicide. Dynamic factors are those that
fluctuate, such as current ideation or substance use. Understanding both types allows for a
comprehensive risk stratification.
4. Which screening tool is most appropriate for specifically assessing the severity of
depressive symptoms in an adult patient?
A. GAD-7
, B. CAGE-AID
C. AIMS
D. PHQ-9
Correct Answer: D
Expert Explanation: The Patient Health Questionnaire-9 (PHQ-9) is the gold standard for
assessing the severity of major depressive disorder. It maps directly to DSM-5 criteria for
MDD. Clinicians use it to monitor treatment progress and determine the level of care
required.
5. A patient scores a 12 on the Montreal Cognitive Assessment (MoCA). What does this score
typically indicate?
A. Normal cognitive function
B. Significant cognitive impairment/Dementia
C. Mild Cognitive Impairment
D. Borderline intellectual functioning
Correct Answer: B
Expert Explanation: The MoCA has a maximum score of 30, with a score of 26 or higher
considered normal. A score of 12 is significantly below the threshold and suggests
moderate to severe cognitive impairment. This requires further diagnostic workup to
differentiate between types of dementia or other organic causes.
NR 548 Psychiatric Assessment for
Psychiatric-Mental Health Nurse
Practitioner Chamberlain
1. When assessing a patient’s mental status, how should the PMHNP distinguish between
mood and affect?
A. Mood is the patient’s internal emotional state, while affect is the external expression.
B. Mood is the clinician’s observation, while affect is the patient’s report.
C. Mood is always congruent with the patient’s current thought content.
D. Affect refers to long-term emotional patterns, while mood is transient.
Correct Answer: A
Expert Explanation: Mood is defined as the subjective emotional state reported by the
patient over time. Affect is the objective, observable expression of emotion during the
clinical interview. Distinguishing these helps the clinician identify incongruencies that may
suggest specific psychiatric pathologies.
2. A patient exhibits a thought process where they provide excessive detail and many
unnecessary ‘side trips’ before finally answering the original question. This is documented as:
A. Tangentiality
B. Flight of ideas
C. Derailment
,D. Circumstantiality
Correct Answer: D
Expert Explanation: Circumstantiality involves excessive detail but the patient eventually
returns to the original point. This differs from tangentiality, where the patient never
reaches the answer. Identifying these patterns is crucial for assessing executive function
and thought organization.
3. During a suicide risk assessment, which of the following is considered a ‘static’ risk factor?
A. Current suicidal ideation
B. Active substance intoxication
C. Access to firearms
D. History of a previous suicide attempt
Correct Answer: D
Expert Explanation: Static risk factors are historical variables that cannot be changed,
such as a previous attempt or family history of suicide. Dynamic factors are those that
fluctuate, such as current ideation or substance use. Understanding both types allows for a
comprehensive risk stratification.
4. Which screening tool is most appropriate for specifically assessing the severity of
depressive symptoms in an adult patient?
A. GAD-7
, B. CAGE-AID
C. AIMS
D. PHQ-9
Correct Answer: D
Expert Explanation: The Patient Health Questionnaire-9 (PHQ-9) is the gold standard for
assessing the severity of major depressive disorder. It maps directly to DSM-5 criteria for
MDD. Clinicians use it to monitor treatment progress and determine the level of care
required.
5. A patient scores a 12 on the Montreal Cognitive Assessment (MoCA). What does this score
typically indicate?
A. Normal cognitive function
B. Significant cognitive impairment/Dementia
C. Mild Cognitive Impairment
D. Borderline intellectual functioning
Correct Answer: B
Expert Explanation: The MoCA has a maximum score of 30, with a score of 26 or higher
considered normal. A score of 12 is significantly below the threshold and suggests
moderate to severe cognitive impairment. This requires further diagnostic workup to
differentiate between types of dementia or other organic causes.
