NR605 Exam 4 Actual Exam Style V2 | NR 605
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. A 75-year-old patient presents with acute onset of confusion, fluctuating levels of
consciousness, and visual hallucinations following a hip surgery. Which of the
following is the most likely diagnosis?
A. Delirium
B. Alzheimer’s Disease
C. Vascular Dementia
D. Major Depressive Disorder with Psychotic Features
Correct Answer: A
Expert Explanation: The acute onset and fluctuating consciousness are hallmark
signs of delirium, often triggered by medical stressors like surgery. Alzheimer’s and
vascular dementia typically involve a slow, progressive decline rather than sudden
changes. The Confusion Assessment Method (CAM) is the gold standard for
identifying these symptoms in clinical settings.
2. Which neurotransmitter system is primarily targeted by Memantine (Namenda) in
the treatment of moderate to severe Alzheimer’s disease?
A. Glutamate
,B. Serotonin
C. Dopamine
D. GABA
Correct Answer: A
Expert Explanation: Memantine acts as an NMDA receptor antagonist, which
modulates the activity of glutamate in the brain. Excessive glutamate activity is
thought to lead to neurotoxicity in patients with Alzheimer’s disease. By regulating
this pathway, the medication helps slow the symptomatic progression of cognitive
decline.
3. A patient exhibits a pervasive pattern of instability in interpersonal relationships,
self-image, and affects, along with marked impulsivity. Which personality disorder
does this describe?
A. Antisocial Personality Disorder
B. Histrionic Personality Disorder
C. Avoidant Personality Disorder
D. Borderline Personality Disorder
Correct Answer: D
,Expert Explanation: Borderline Personality Disorder is characterized by emotional
dysregulation and intense, unstable relationships. Individuals often experience fear
of abandonment and engage in self-destructive behaviors. This diagnosis falls under
Cluster B of the DSM-5 personality disorders.
4. What is the primary pharmacological treatment for a patient experiencing acute
alcohol withdrawal symptoms, such as tremors and tachycardia?
A. Haloperidol
B. Naltrexone
C. Disulfiram
D. Benzodiazepines
Correct Answer: D
Expert Explanation: Benzodiazepines like Diazepam or Lorazepam are the
standard of care for preventing seizures and delirium tremens during alcohol
withdrawal. They work by enhancing GABAergic activity to counteract the
hyperexcitability of the central nervous system. Other options like Naltrexone are
used for maintenance and relapse prevention rather than acute withdrawal.
5. Which of the following is a key clinical feature that distinguishes Lewy Body
Dementia from Alzheimer’s Disease?
A. Spontaneous parkinsonism and visual hallucinations
, B. Memory loss as the very first symptom
C. Gradual decline over 20 years
D. Preserved executive function
Correct Answer: A
Expert Explanation: Lewy Body Dementia (LBD) often presents with early visual
hallucinations and motor symptoms similar to Parkinson’s disease. In contrast,
Alzheimer’s typically begins with significant episodic memory deficits before motor
issues arise. Understanding these distinctions is vital for appropriate
pharmacological management as LBD patients are highly sensitive to antipsychotics.
6. A patient reports difficulty falling asleep and staying asleep for at least three nights
a week for the past three months. Which sleep disorder is most likely?
A. Narcolepsy
B. Sleep Apnea
C. Circadian Rhythm Disorder
D. Insomnia Disorder
Correct Answer: D
Expert Explanation: Insomnia Disorder is defined by dissatisfaction with sleep
quantity or quality associated with difficulty initiating or maintaining sleep. The ‘3-
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. A 75-year-old patient presents with acute onset of confusion, fluctuating levels of
consciousness, and visual hallucinations following a hip surgery. Which of the
following is the most likely diagnosis?
A. Delirium
B. Alzheimer’s Disease
C. Vascular Dementia
D. Major Depressive Disorder with Psychotic Features
Correct Answer: A
Expert Explanation: The acute onset and fluctuating consciousness are hallmark
signs of delirium, often triggered by medical stressors like surgery. Alzheimer’s and
vascular dementia typically involve a slow, progressive decline rather than sudden
changes. The Confusion Assessment Method (CAM) is the gold standard for
identifying these symptoms in clinical settings.
2. Which neurotransmitter system is primarily targeted by Memantine (Namenda) in
the treatment of moderate to severe Alzheimer’s disease?
A. Glutamate
,B. Serotonin
C. Dopamine
D. GABA
Correct Answer: A
Expert Explanation: Memantine acts as an NMDA receptor antagonist, which
modulates the activity of glutamate in the brain. Excessive glutamate activity is
thought to lead to neurotoxicity in patients with Alzheimer’s disease. By regulating
this pathway, the medication helps slow the symptomatic progression of cognitive
decline.
3. A patient exhibits a pervasive pattern of instability in interpersonal relationships,
self-image, and affects, along with marked impulsivity. Which personality disorder
does this describe?
A. Antisocial Personality Disorder
B. Histrionic Personality Disorder
C. Avoidant Personality Disorder
D. Borderline Personality Disorder
Correct Answer: D
,Expert Explanation: Borderline Personality Disorder is characterized by emotional
dysregulation and intense, unstable relationships. Individuals often experience fear
of abandonment and engage in self-destructive behaviors. This diagnosis falls under
Cluster B of the DSM-5 personality disorders.
4. What is the primary pharmacological treatment for a patient experiencing acute
alcohol withdrawal symptoms, such as tremors and tachycardia?
A. Haloperidol
B. Naltrexone
C. Disulfiram
D. Benzodiazepines
Correct Answer: D
Expert Explanation: Benzodiazepines like Diazepam or Lorazepam are the
standard of care for preventing seizures and delirium tremens during alcohol
withdrawal. They work by enhancing GABAergic activity to counteract the
hyperexcitability of the central nervous system. Other options like Naltrexone are
used for maintenance and relapse prevention rather than acute withdrawal.
5. Which of the following is a key clinical feature that distinguishes Lewy Body
Dementia from Alzheimer’s Disease?
A. Spontaneous parkinsonism and visual hallucinations
, B. Memory loss as the very first symptom
C. Gradual decline over 20 years
D. Preserved executive function
Correct Answer: A
Expert Explanation: Lewy Body Dementia (LBD) often presents with early visual
hallucinations and motor symptoms similar to Parkinson’s disease. In contrast,
Alzheimer’s typically begins with significant episodic memory deficits before motor
issues arise. Understanding these distinctions is vital for appropriate
pharmacological management as LBD patients are highly sensitive to antipsychotics.
6. A patient reports difficulty falling asleep and staying asleep for at least three nights
a week for the past three months. Which sleep disorder is most likely?
A. Narcolepsy
B. Sleep Apnea
C. Circadian Rhythm Disorder
D. Insomnia Disorder
Correct Answer: D
Expert Explanation: Insomnia Disorder is defined by dissatisfaction with sleep
quantity or quality associated with difficulty initiating or maintaining sleep. The ‘3-
