Psychiatric-Mental Health Nurse Practitioner Exam Psychiatric Assessment and Diagnosis 1 — Questions and Answers
Question 1: Which DSM-5 specifier distinguishes a manic episode with flight of ideas, decreased need for sleep, and grandiosity lasting 4 days without hospitalization?
- Manic episode
- Hypomanic episode (Correct answer)
- Mixed features specifier
- Cyclothymic disorder
Correct answer: Hypomanic episode
Hypomanic episodes last at least 4 days, are not severe enough to require hospitalization, and do not cause marked functional impairment.
Question 2: The Mini-Mental State Examination (MMSE) is used primarily to assess which domain?
- Personality pathology
- Psychotic symptom severity
- Cognitive functioning (Correct answer)
- Depressive symptom severity
Correct answer: Cognitive functioning
The MMSE screens for cognitive impairment across orientation, memory, attention, language, and visuospatial domains.
Question 3: A PMHNP is conducting a Mental Status Examination (MSE). 'Affect' refers to:
- The patient's reported subjective emotional experience
- The observed external expression of emotion (Correct answer)
- The patient's ability to think abstractly
- The patient's insight into their illness
Correct answer: The observed external expression of emotion
Affect is the clinician-observed emotional expression, while mood is the patient's subjective report of their internal emotional state.
Question 4: Which axis of the former DSM-IV multiaxial system was designated for personality disorders and intellectual disabilities?
- Axis I
- Axis II (Correct answer)
- Axis III
- Axis IV
Correct answer: Axis II
DSM-IV Axis II was designated for personality disorders and intellectual developmental disorders, distinguishing them from Axis I clinical syndromes.
Question 5: A patient reports hearing voices that tell them they are worthless. This auditory hallucination is best characterized as:
- Command hallucinations
- Commentary hallucinations
- Derogatory hallucinations (Correct answer)
- Referential hallucinations
Correct answer: Derogatory hallucinations
Derogatory hallucinations involve voices that insult or demean the patient, often worsening self-esteem and depression.
Question 6: The Montreal Cognitive Assessment (MoCA) differs from the MMSE in that it:
- Assesses psychotic symptoms
- Is more sensitive to mild cognitive impairment (MCI) (Correct answer)
- Takes longer to administer
- Focuses exclusively on memory
Correct answer: Is more sensitive to mild cognitive impairment (MCI)
The MoCA has greater sensitivity than the MMSE for detecting mild cognitive impairment, particularly in executive functioning and attention.
Psychiatric-Mental Health Nurse Practitioner Exam Psychiatric Assessment and Diagnosis 1
Which DSM-5 specifier distinguishes a manic episode with flight of ideas, decreased need for sleep, and grandiosity lasting 4 days without hospitalization?