NR605 Final Exam Actual Exam Style V2 | NR 605
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. A 15-year-old male presents with irritability, decreased need for sleep, and
excessive talkativeness for the past 5 days. He has no history of substance use. Which
of the following is the most likely diagnosis?
A. Bipolar II Disorder, Hypomanic Episode
B. Bipolar I Disorder, Manic Episode
C. Cyclothymic Disorder
D. Disruptive Mood Dysregulation Disorder
Correct Answer: A
Expert Explanation: Hypomania is defined by a distinct period of abnormally and
persistently elevated or irritable mood lasting at least 4 consecutive days. Unlike
mania, it does not cause marked impairment in social or occupational functioning
and does not require hospitalization. Bipolar II requires at least one hypomanic
episode and one major depressive episode.
2. Which neurotransmitter is primarily implicated in the reward system and is the
main target for most addictive substances?
A. Serotonin
,B. GABA
C. Dopamine
D. Norepinephrine
Correct Answer: C
Expert Explanation: Dopamine is the primary neurotransmitter involved in the
mesolimbic pathway, often referred to as the reward circuit. Most drugs of abuse
increase dopamine levels in the nucleus accumbens, reinforcing the behavior of
drug seeking. Understanding this pathway is essential for treating substance use
disorders in clinical practice.
3. A 32-year-old female patient on Lithium for Bipolar Disorder presents with coarse
tremors, ataxia, and confusion. What is the most likely cause?
A. Therapeutic Lithium levels
B. Neuroleptic Malignant Syndrome
C. Serotonin Syndrome
D. Lithium toxicity
Correct Answer: D
Expert Explanation: Lithium has a narrow therapeutic index, and levels above 1.5
mEq/L are typically associated with toxicity. Symptoms such as coarse tremors,
,ataxia, and mental status changes are classic signs of moderate to severe toxicity.
Immediate medical intervention and serum level checks are necessary to prevent
permanent damage or death.
4. Which of the following is a core symptom requirement for a diagnosis of Major
Depressive Disorder (MDD) according to DSM-5-TR?
A. Psychomotor agitation
B. Suicidal ideation
C. Anhedonia or depressed mood
D. Feelings of worthlessness
Correct Answer: C
Expert Explanation: To meet the criteria for MDD, a patient must experience at
least five symptoms during the same 2-week period, with at least one being
depressed mood or loss of interest/pleasure (anhedonia). While the other options
are potential symptoms, they are not mandatory for the diagnosis. This distinction
ensures that the primary mood disturbance is the focus of clinical assessment.
5. A 28-year-old veteran complains of intrusive memories, nightmares, and
hypervigilance following a combat deployment. Which medication is FDA-approved
for the treatment of PTSD?
A. Lorazepam (Ativan)
, B. Quetiapine (Seroquel)
C. Sertraline (Zoloft)
D. Bupropion (Wellbutrin)
Correct Answer: C
Expert Explanation: Sertraline and Paroxetine are the only two SSRIs currently
FDA-approved for the treatment of Post-Traumatic Stress Disorder. These
medications help address the core symptoms of re-experiencing, avoidance, and
hyperarousal. While other medications like Prazosin may be used off-label for
nightmares, SSRIs remain first-line pharmacotherapy.
6. In children, the ‘Black Box Warning’ for SSRIs specifically highlights an increased risk
of:
A. Liver failure
B. Suicidal ideation and behavior
C. Serotonin syndrome
D. Growth retardation
Correct Answer: B
Expert Explanation: The FDA issued a black box warning for all antidepressants
regarding the increased risk of suicidal thinking and behavior in children,
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. A 15-year-old male presents with irritability, decreased need for sleep, and
excessive talkativeness for the past 5 days. He has no history of substance use. Which
of the following is the most likely diagnosis?
A. Bipolar II Disorder, Hypomanic Episode
B. Bipolar I Disorder, Manic Episode
C. Cyclothymic Disorder
D. Disruptive Mood Dysregulation Disorder
Correct Answer: A
Expert Explanation: Hypomania is defined by a distinct period of abnormally and
persistently elevated or irritable mood lasting at least 4 consecutive days. Unlike
mania, it does not cause marked impairment in social or occupational functioning
and does not require hospitalization. Bipolar II requires at least one hypomanic
episode and one major depressive episode.
2. Which neurotransmitter is primarily implicated in the reward system and is the
main target for most addictive substances?
A. Serotonin
,B. GABA
C. Dopamine
D. Norepinephrine
Correct Answer: C
Expert Explanation: Dopamine is the primary neurotransmitter involved in the
mesolimbic pathway, often referred to as the reward circuit. Most drugs of abuse
increase dopamine levels in the nucleus accumbens, reinforcing the behavior of
drug seeking. Understanding this pathway is essential for treating substance use
disorders in clinical practice.
3. A 32-year-old female patient on Lithium for Bipolar Disorder presents with coarse
tremors, ataxia, and confusion. What is the most likely cause?
A. Therapeutic Lithium levels
B. Neuroleptic Malignant Syndrome
C. Serotonin Syndrome
D. Lithium toxicity
Correct Answer: D
Expert Explanation: Lithium has a narrow therapeutic index, and levels above 1.5
mEq/L are typically associated with toxicity. Symptoms such as coarse tremors,
,ataxia, and mental status changes are classic signs of moderate to severe toxicity.
Immediate medical intervention and serum level checks are necessary to prevent
permanent damage or death.
4. Which of the following is a core symptom requirement for a diagnosis of Major
Depressive Disorder (MDD) according to DSM-5-TR?
A. Psychomotor agitation
B. Suicidal ideation
C. Anhedonia or depressed mood
D. Feelings of worthlessness
Correct Answer: C
Expert Explanation: To meet the criteria for MDD, a patient must experience at
least five symptoms during the same 2-week period, with at least one being
depressed mood or loss of interest/pleasure (anhedonia). While the other options
are potential symptoms, they are not mandatory for the diagnosis. This distinction
ensures that the primary mood disturbance is the focus of clinical assessment.
5. A 28-year-old veteran complains of intrusive memories, nightmares, and
hypervigilance following a combat deployment. Which medication is FDA-approved
for the treatment of PTSD?
A. Lorazepam (Ativan)
, B. Quetiapine (Seroquel)
C. Sertraline (Zoloft)
D. Bupropion (Wellbutrin)
Correct Answer: C
Expert Explanation: Sertraline and Paroxetine are the only two SSRIs currently
FDA-approved for the treatment of Post-Traumatic Stress Disorder. These
medications help address the core symptoms of re-experiencing, avoidance, and
hyperarousal. While other medications like Prazosin may be used off-label for
nightmares, SSRIs remain first-line pharmacotherapy.
6. In children, the ‘Black Box Warning’ for SSRIs specifically highlights an increased risk
of:
A. Liver failure
B. Suicidal ideation and behavior
C. Serotonin syndrome
D. Growth retardation
Correct Answer: B
Expert Explanation: The FDA issued a black box warning for all antidepressants
regarding the increased risk of suicidal thinking and behavior in children,
