NSG 527/NSG527 Psychopathology Final Exam With Complete Questions And Correct Answers | Graded A+ | Latest Updated 2026/2027 | Guaranteed Success.

NSG 527 Exam 1 /NSG 527 Final Exam Practice With Complete Questions And Correct Answers | Graded A+ | Latest Updated 2026/2027 | Guaranteed Success. She is admitted to the psychiatric unit. Her physical examination is unremarkable, and her blood alcohol is undetectable. Her urine toxicology results come back positive for cannabis, which she confirms she started smoking about 3 months ago. Which of the following would be the most appropriate provisional diagnosis? (A) Brief psychotic disorder (B) Schizophreniform disorder (C) Schizophrenia (D) Substance-induced mood disorder (E) Substance-induced psychotic disorder – Correct Answer :(E) While her history strongly suggests a primary psychotic disorder such as brief psychotic disorder (lasting 1 day-1 month), schizophreniform disorder (lasting 1-6 months), or schizophrenia, the presence of cannabis on her toxicology screen precludes such a diagnosis at this time, especially since the onset of her cannabis use predates the positive symptoms by a few weeks. Unless her symptoms persist after sobriety from cannabis is attained, given the prominence of her psychotic (rather than mood) symptoms, her most appropriate diagnosis at this time is a substance-induced (specifically cannabisinduced) psychotic disorder. Further, if her symptom severity remains out of proportion, she may eventually meet criteria for a comorbid primary psychotic disorder as well as a cannabis use disorder. A 42-year-old woman presents to a therapist with a history of dramatic mood swings since early adolescence, where she will quickly become deeply depressed for hours to days, usually in response to separation from a loved one. She also admits to "rage attacks," where she will break items, scream, or scratch herself superficially on her arms. She inter- mittently binge drinks and has frequently engaged in unprotected sexual intercourse with new partners. Others describe her as "reactive" and intense. Which of the follow- ing defense mechanisms does this patient most likely employ? (A) Altruism (B) Intellectualization (C) Splitting (D) Sublimation (E) Undoing – Correct Answer :(C) The patient meets the criteria for borderline personality disorder characterized by rapid mood swings, efforts to avoid abandonment, chronic feelings of emptiness, intense anger outbursts, impulsivity, fluctuations between idealization and devaluation, and recurrent self-mutilation or suicidality. People with this personality disorder commonly employ primitive defense mechanisms, such as denial, projective identification, and splitting. Splitting is dividing external objects (individuals) into "all good" or "all bad" categories. Altruism (living vicariously by helping others) and sublimation (gratifying urges in socially acceptable ways) are mature defenses, while intellectualization (using intellectual processes to avoid feelings) and undoing (acts performed to undo obsessional thoughts) are considered neurotic defenses. The family of a 26-year-old patient with schizophrenia brings him in for follow-up. He was initially diagnosed at age 25 after a psychotic break that, in retrospect, followed a protracted course of increasing isolation and amotivation. Despite difficulties, he was able to graduate from college and hold a full-time job by age 23. He reports intermittent halluci- nations, but has been able to maintain inde- pendent living and part-time employment. On examination, he is a disheveled man who articulates a multitude of delusional beliefs with a sophisticated vocabulary. Which of the following characteristics in this patient is most strongly associated with a better overall prognosis? (A) Age at presentation (B) Gender of patient (C) Insidious symptom onset (D) Predominantly positive symptoms (E) Premorbid functioning – Correct Answer :(E) Good premorbid functioning portends a better prognosis for this patient. Other features of schizophrenia that predict a better prognosis include later age at presentation, female gender, acute and rapid onset of symptoms (as opposed to insidious onset), and the presence of mood symptoms. While predominantly positive symptoms also predict a more favorable prognosis, this patient has significant negative symptoms, as evidenced by his isolation and amotivation. She was started on appropriate treatment. One year later this woman returns to your office with her mother for follow-up. Her symptoms remitted within a month. However, she has not done well in her freshman year and for the past several months has continued to experi- ence worsening social isolation and amotiva- tion. While she has not used any substances since she last saw you, she reluctantly admits to occasionally hearing the devil communicat- ing with her. She tries to ignore the communi- cation, and has taken to arranging her books in a certain manner to prevent his controlling her thoughts. On her mental status examina- tion she makes poor eye contact and her affect is blunted. Her mother reports that the patient now rarely calls home, though before she'd do so twice weekly. Which of the following is the most likely diagnosis? (A) Brief psychotic disorder (B) Schizophreniform disorder (C) Schizophrenia (D) Subs - Correct Answer :(C) The patient meets criteria A for schizophrenia: for at least 1 month she has exhibited hallucinations, delusions, and disorganized speech. Further her symptoms are occurring outside of an acute mood episode and are not due to another medical condition. They have persisted for over a year, despite sobriety from cannabis. Since her psychotic symptoms have lasted longer than 6 months, her most appropriate diagnosis is schizophrenia. Brief psychotic disorder is characterized by psychotic symptoms lasting 1 day to 1 month. Schizophreniform disorder refers to symptoms lasting more than 1 month but less than 6 in the absence of concurrent mood disorder, substance use, or another medical condition. A 36-year-old patient with no previous psychiatric history is brought to the emergency room by his family. For the past month he has not been eating regularly and has isolated himself in the apartment where he lives alone. Two months ago he stopped fishing, and reported feeling like a burden on his fiancée. On mental status examination, he displays psychomotor retardation and rarely blinks. He responds in the negative to any question asked. On physical examination, he appears in no acute distress, is afebrile, marginally hypotensive, and mildly tachycardic. He resists your motions with strength proportional to what you exert and crudely mimics your movements. His laboratory studies are unremarkable. Which of the following diagnoses is the most likely? (A) Catatonia associated with major depressive disorder (B) Catatonia associated with schizophrenia (C) Hypothyroidism (D) Neuroleptic malignant syndrome (E) Unspecifie - Correct Answer :(A) This patient is presenting with several catatonic features, including negativism, psychomotor slowing, and echopraxia, with slight vital sign fluctuations. Catatonia is often underdiagnosed. While catatonia was formerly considered a subtype of schizophrenia, it is found more frequently in affective disorders, especially major depressive disorder. This patient's history of isolation, anhedonia, psychomotor retardation, decreased appetite, and guilt (burden on fiancée) are more suggestive of major depressive disorder. While hypothyroidism should be ruled out, catatonia is not a common presentation. There is no evidence to suggest that he is faking symptoms for secondary gain, as in malingering. The lack of prior psychiatric history or psychosis makes a diagnosis of catatonia associated with schizophrenia unlikely. There is no evidence of exposure to antipsychotics nor significant autonomic instability, so neuroleptic malignant syndrome is unlikely.