Psychiatric-Mental Health Nurse Practitioner Exam Psychiatric Assessment and Diagnosis 2 — Questions and Answers
Question 1: Which criterion differentiates schizophrenia from schizoaffective disorder?
- Presence of hallucinations
- In schizoaffective disorder, mood episodes are present for the majority of the illness duration (Correct answer)
- Schizophrenia always includes negative symptoms
- Schizoaffective disorder has a shorter duration requirement
Correct answer: In schizoaffective disorder, mood episodes are present for the majority of the illness duration
Schizoaffective disorder requires that mood episodes (manic or depressive) are present for the majority of the total illness duration alongside psychotic symptoms.
Question 2: A PMHNP is assessing negative symptoms of schizophrenia. Which symptom cluster is classified as 'negative'?
- Hallucinations and delusions
- Alogia, anhedonia, avolition, and flat affect (Correct answer)
- Disorganized speech and behavior
- Thought insertion and broadcasting
Correct answer: Alogia, anhedonia, avolition, and flat affect
Negative symptoms represent a diminution of normal functions, including restricted speech (alogia), lack of pleasure (anhedonia), lack of motivation (avolition), and flattened affect.
Question 3: According to DSM-5, a major depressive episode requires at least how many symptoms persisting for a minimum of how many weeks?
- 3 symptoms for 1 week
- 5 symptoms for 2 weeks (Correct answer)
- 7 symptoms for 1 month
- 4 symptoms for 3 weeks
Correct answer: 5 symptoms for 2 weeks
DSM-5 requires at least 5 of 9 specified symptoms present for a minimum of 2 weeks, with at least one being depressed mood or anhedonia.
Question 4: A PMHNP documents 'loosening of associations' in a patient. This thought process abnormality means:
- The patient shifts topic in response to sound rather than meaning
- The patient's thinking shifts between topics with tenuous connections (Correct answer)
- The patient abruptly stops mid-sentence
- The patient repeats words or phrases involuntarily
Correct answer: The patient's thinking shifts between topics with tenuous connections
Loosening of associations describes fragmented, illogical thinking where ideas shift with weak or absent logical connections.
Question 5: Which structured clinical assessment instrument is considered the gold standard for diagnosing DSM-5 disorders in research settings?
- PHQ-9
- Hamilton Anxiety Rating Scale (HAM-A)
- Structured Clinical Interview for DSM Disorders (SCID) (Correct answer)
- Beck Depression Inventory (BDI)
Correct answer: Structured Clinical Interview for DSM Disorders (SCID)
The SCID is a semi-structured diagnostic interview conducted by trained clinicians and is considered the gold standard for establishing DSM diagnoses.
Question 6: A PMHNP suspects factitious disorder in a patient who fabricates symptoms. How does factitious disorder differ from malingering?
- Factitious disorder has external incentives; malingering does not
- Malingering has external incentives; factitious disorder is driven by psychological need to assume the sick role (Correct answer)
- They are the same disorder with different names
- Factitious disorder involves unconscious symptom production
Correct answer: Malingering has external incentives; factitious disorder is driven by psychological need to assume the sick role
In factitious disorder, symptom falsification is motivated by a psychological need to assume the sick role, with no external gains; malingering involves intentional feigning for external rewards.
Psychiatric-Mental Health Nurse Practitioner Exam Psychiatric Assessment and Diagnosis 2
Which criterion differentiates schizophrenia from schizoaffective disorder?