NR605 Exam 2 Actual Exam Style V2 | NR 605
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake
Inhibitors (SSRIs) to treat Major Depressive Disorder?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. GABA
Correct Answer: C
Expert Explanation: SSRIs work by inhibiting the reuptake of serotonin at the
presynaptic cleft, thereby increasing the availability of serotonin in the synapse.
This mechanism is the standard first-line pharmacological intervention for
depression and various anxiety disorders. The increased serotonin levels eventually
lead to downstream effects that improve mood and emotional regulation over
several weeks.
2. A patient taking Clozapine must have regular blood monitoring for which life-
threatening side effect?
A. Hypothyroidism
,B. Agranulocytosis
C. Hepatotoxicity
D. Nephrotoxicity
Correct Answer: B
Expert Explanation: Clozapine carries a boxed warning for agranulocytosis, which
is a severe and dangerous decrease in the white blood cell count. Regular
monitoring of the Absolute Neutrophil Count (ANC) is required by the FDA to ensure
patient safety while on this medication. This monitoring protocol is essential
because a drop in ANC can leave the patient highly susceptible to life-threatening
infections.
3. What is the primary diagnostic difference between Bipolar I and Bipolar II disorder?
A. The presence of depressive episodes
B. The duration of the hypomanic episodes
C. The severity of the anxiety symptoms
D. The presence of at least one manic episode
Correct Answer: D
Expert Explanation: Bipolar I disorder requires the presence of at least one manic
episode, which often necessitates hospitalization and causes significant impairment.
,Bipolar II disorder is characterized by at least one hypomanic episode and at least
one major depressive episode, but never a full manic episode. Understanding this
distinction is critical for accurate diagnosis and determining the appropriate level of
care for the patient.
4. Which of the following is considered a therapeutic serum lithium level for the
maintenance phase of Bipolar Disorder?
A. 0.2 - 0.5 mEq/L
B. 2.5 - 3.0 mEq/L
C. 1.5 - 2.0 mEq/L
D. 0.6 - 1.2 mEq/L
Correct Answer: D
Expert Explanation: The standard therapeutic range for lithium in maintenance
therapy is generally 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L are considered toxic
and can lead to symptoms such as tremors, ataxia, and confusion. Continuous
monitoring of serum levels is necessary to ensure the medication remains effective
without reaching dangerous concentrations in the bloodstream.
5. A patient presents with high fever, muscle rigidity, and autonomic instability after
starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
, B. Neuroleptic Malignant Syndrome (NMS)
C. Anticholinergic Toxicity
D. Acute Dystonia
Correct Answer: B
Expert Explanation: Neuroleptic Malignant Syndrome is a rare but life-threatening
reaction to antipsychotic medications like Haloperidol. It is characterized by the
‘lead pipe’ muscle rigidity, hyperthermia, and mental status changes. Unlike
Serotonin Syndrome, which often features hyperreflexia, NMS is marked by severe
rigidity and elevated creatine kinase levels.
6. Valproic acid (Depakote) is contraindicated in pregnancy primarily due to the risk of
which fetal abnormality?
A. Cardiac defects
B. Limb malformations
C. Neural tube defects
D. Cleft palate
Correct Answer: C
Expert Explanation: Valproic acid is associated with a significantly increased risk
of neural tube defects, such as spina bifida, when taken during the first trimester. It
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake
Inhibitors (SSRIs) to treat Major Depressive Disorder?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. GABA
Correct Answer: C
Expert Explanation: SSRIs work by inhibiting the reuptake of serotonin at the
presynaptic cleft, thereby increasing the availability of serotonin in the synapse.
This mechanism is the standard first-line pharmacological intervention for
depression and various anxiety disorders. The increased serotonin levels eventually
lead to downstream effects that improve mood and emotional regulation over
several weeks.
2. A patient taking Clozapine must have regular blood monitoring for which life-
threatening side effect?
A. Hypothyroidism
,B. Agranulocytosis
C. Hepatotoxicity
D. Nephrotoxicity
Correct Answer: B
Expert Explanation: Clozapine carries a boxed warning for agranulocytosis, which
is a severe and dangerous decrease in the white blood cell count. Regular
monitoring of the Absolute Neutrophil Count (ANC) is required by the FDA to ensure
patient safety while on this medication. This monitoring protocol is essential
because a drop in ANC can leave the patient highly susceptible to life-threatening
infections.
3. What is the primary diagnostic difference between Bipolar I and Bipolar II disorder?
A. The presence of depressive episodes
B. The duration of the hypomanic episodes
C. The severity of the anxiety symptoms
D. The presence of at least one manic episode
Correct Answer: D
Expert Explanation: Bipolar I disorder requires the presence of at least one manic
episode, which often necessitates hospitalization and causes significant impairment.
,Bipolar II disorder is characterized by at least one hypomanic episode and at least
one major depressive episode, but never a full manic episode. Understanding this
distinction is critical for accurate diagnosis and determining the appropriate level of
care for the patient.
4. Which of the following is considered a therapeutic serum lithium level for the
maintenance phase of Bipolar Disorder?
A. 0.2 - 0.5 mEq/L
B. 2.5 - 3.0 mEq/L
C. 1.5 - 2.0 mEq/L
D. 0.6 - 1.2 mEq/L
Correct Answer: D
Expert Explanation: The standard therapeutic range for lithium in maintenance
therapy is generally 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L are considered toxic
and can lead to symptoms such as tremors, ataxia, and confusion. Continuous
monitoring of serum levels is necessary to ensure the medication remains effective
without reaching dangerous concentrations in the bloodstream.
5. A patient presents with high fever, muscle rigidity, and autonomic instability after
starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
, B. Neuroleptic Malignant Syndrome (NMS)
C. Anticholinergic Toxicity
D. Acute Dystonia
Correct Answer: B
Expert Explanation: Neuroleptic Malignant Syndrome is a rare but life-threatening
reaction to antipsychotic medications like Haloperidol. It is characterized by the
‘lead pipe’ muscle rigidity, hyperthermia, and mental status changes. Unlike
Serotonin Syndrome, which often features hyperreflexia, NMS is marked by severe
rigidity and elevated creatine kinase levels.
6. Valproic acid (Depakote) is contraindicated in pregnancy primarily due to the risk of
which fetal abnormality?
A. Cardiac defects
B. Limb malformations
C. Neural tube defects
D. Cleft palate
Correct Answer: C
Expert Explanation: Valproic acid is associated with a significantly increased risk
of neural tube defects, such as spina bifida, when taken during the first trimester. It
