NR605 Diagnosis Management in Psychiatric Mental Health
/NR 605 Midterm and Final Examplify Online Proctored
/NR605 Week 4 Midterm Exam Newest Version And Correct
Answers. — 300 Questions
Section 1: Diagnostic Criteria and Classification (DSM-5) (Questions 1-30)
1 A patient presents with a two-week history of elevated mood, grandiosity, decreased need for sleep, and
pressured speech. The symptoms are severe enough to cause marked impairment in social and occupational
functioning. According to DSM-5-TR criteria, which specifier must be documented to justify a diagnosis of
bipolar I disorder, current episode manic?
A) With mixed features
B) With psychotic features
C) With anxious distress
D) With rapid cycling
Answer: B
Rationale: The DSM-5-TR requires that if psychotic features are present during a manic episode, they must be
specified. The case describes severe impairment and grandiosity, which often co-occur with psychosis. Mixed
features require simultaneous depressive symptoms; anxious distress and rapid cycling are specifiers but not
mandatory for this scenario.
2 A researcher is developing a screening tool for DSM-5-TR somatic symptom disorder. Which item would be
LEAST consistent with the core feature of this disorder?
A) Excessive time and energy devoted to health concerns
B) High level of health-related anxiety
C) Disproportionate and persistent thoughts about the seriousness of symptoms
D) A documented medical condition that fully explains the symptoms
Answer: D
Rationale: Somatic symptom disorder is characterized by disproportionate thoughts, feelings, and behaviors related
to somatic symptoms, regardless of whether a medical condition is present. Option D suggests a fully explained
medical condition, which would not meet the criterion of disproportionate response. The other options are core
features.
3 In the DSM-5-TR classification, which of the following changes from DSM-IV was made to the diagnostic
criteria for autism spectrum disorder?
A) Removal of the requirement for onset by age 3
B) Addition of a specifier for intellectual impairment
C) Separation of social communication and restricted interests into two domains
D) Inclusion of language impairment as a core criterion
Answer: A
Rationale: DSM-5 eliminated the specific age-at-onset criterion (by age 3) and replaced it with a requirement that
symptoms be present in early development. Option B is incorrect because intellectual impairment is a specifier, not
a criterion change. Option C is true (two domains merged from three), but not the removal of age criterion. Option
D is false; language impairment is not a core criterion.
,4 A patient meets criteria for major depressive disorder, recurrent episode, with a history of hypomanic episodes
lasting 2-3 days. According to DSM-5-TR, which diagnosis should be considered?
A) Bipolar I disorder
B) Bipolar II disorder
C) Cyclothymic disorder
D) Other specified bipolar and related disorder
Answer: D
Rationale: Bipolar II disorder requires hypomanic episodes lasting at least 4 consecutive days. Since the hypomanic
episodes here last only 2-3 days, criteria for bipolar II are not met. Cyclothymic disorder requires numerous periods
of hypomanic and depressive symptoms over 2 years. The most appropriate diagnosis is other specified bipolar and
related disorder (short-duration hypomania).
5 Which of the following best describes the DSM-5-TR's approach to the diagnosis of posttraumatic stress
disorder in children age 6 years and younger?
A) The same criteria as adults, but with lower symptom thresholds
B) A separate set of criteria that includes reenactment play and fewer verbal requirements
C) Diagnosis is deferred until age 6 because of developmental variability
D) Criteria focus primarily on dissociative symptoms
Answer: B
Rationale: DSM-5-TR includes a separate PTSD subtype for children 6 years and younger, with criteria adapted for
developmental level, such as play reenactment and less reliance on verbal expression of internal states. Option A is
incorrect because the criteria are distinct. Option C is false; diagnosis can be made before age 6. Option D is
incorrect; dissociation is not the primary focus.
6 A clinician is evaluating a patient with obsessive-compulsive disorder. The patient reports spending 3 hours per
day washing hands and checking locks. Which specifier should be applied according to DSM-5-TR?
A) With poor insight
B) With good or fair insight
C) With absent insight/delusional beliefs
D) With tic-related
Answer: B
Rationale: The specifier for insight is based on the individual's recognition that beliefs are definitely or probably
true. The scenario does not indicate delusional intensity. Option B is correct because the patient likely recognizes
the excessiveness of the behaviors (good/fair insight). Option A would be if the patient thinks beliefs are probably
true. Option D requires a current or past tic disorder.
7 Which of the following is a key difference between the DSM-5-TR diagnostic criteria for generalized anxiety
disorder (GAD) and the criteria for illness anxiety disorder?
A) GAD requires somatic symptoms, while illness anxiety disorder does not
B) Illness anxiety disorder is limited to fear of having a serious disease, while GAD involves worry about
multiple domains
C) GAD requires a duration of at least 6 months, while illness anxiety disorder requires 3 months
D) Illness anxiety disorder is diagnosed only if the patient has a known medical condition
Answer: B
Rationale: GAD involves excessive anxiety and worry about a number of events or activities (e.g., work, school,
health), while illness anxiety disorder focuses specifically on the fear of having or acquiring a serious illness.
Option A is false; GAD does not require somatic symptoms. Option C is false; both require at least 6 months.
,Option D is false; illness anxiety disorder can occur without a medical condition.
8 A patient reports a 1-year history of recurrent, unexpected panic attacks followed by persistent worry about
having more attacks. The patient avoids crowded places but does not avoid all situations. Which DSM-5-TR
diagnosis is most appropriate?
A) Panic disorder
B) Agoraphobia
C) Panic disorder with agoraphobia
D) Specific phobia, situational type
Answer: C
Rationale: The patient meets criteria for panic disorder (recurrent unexpected panic attacks with worry about
recurrence) and also avoids situations (crowds) due to fear of having a panic attack, which meets criteria for
agoraphobia. Option A is insufficient because agoraphobia is present. Option B is incorrect because the primary
issue is panic attacks. Option D is incorrect because the fear is not limited to a specific object.
9 In the DSM-5-TR, which of the following is a specifier for schizophrenia that indicates the presence of negative
symptoms?
A) With catatonia
B) With prominent negative symptoms
C) With mood symptoms
D) With early onset
Answer: B
Rationale: DSM-5-TR includes 'with prominent negative symptoms' as a specifier for schizophrenia, which requires
that negative symptoms (e.g., avolition, alogia) are present and severe. Option A is a separate specifier for
catatonia. Option C is not a specifier for schizophrenia; mood symptoms would suggest schizoaffective disorder.
Option D is not a specifier.
10 A patient has a history of recurrent depressive episodes and manic episodes that occur only during
antidepressant treatment. According to DSM-5-TR, which diagnosis is most appropriate?
A) Bipolar I disorder
B) Substance/medication-induced bipolar disorder
C) Bipolar II disorder
D) Cyclothymic disorder
Answer: B
Rationale: When manic symptoms arise solely as a physiological consequence of a medication (e.g., antidepressant),
the diagnosis is substance/medication-induced bipolar disorder, not a primary bipolar disorder. Option A is
incorrect because the manic episode is not independent of medication. Option C is incorrect for the same reason.
Option D requires chronic fluctuating symptoms over 2 years.
11 A patient presents with recurrent, unexpected panic attacks followed by at least one month of persistent worry
about having additional attacks and maladaptive changes in behavior. According to DSM-5, which additional
criterion must be met to distinguish Panic Disorder from Panic Attacks Specifier in other disorders?
A) The panic attacks must be triggered by a specific phobic stimulus.
B) The panic attacks must be exclusively cued by substances or medical conditions.
C) The presence of agoraphobia is required for the diagnosis.
D) The attacks must be unexpected and not better explained by another mental disorder.
Answer: D
, Rationale: DSM-5 requires that the panic attacks are unexpected and not attributable to the physiological effects of a
substance, another medical condition, or better explained by another mental disorder (e.g., social anxiety disorder,
specific phobia). Option A is incorrect because cued attacks are typical of specific phobia. Option B is incorrect
because substance/medical condition-induced attacks are exclusionary. Option C is incorrect because agoraphobia
is a separate diagnosis, not required for panic disorder.
12 Which of the following best describes the DSM-5 specifier 'with mixed features' for a major depressive
episode?
A) It requires at least three manic/hypomanic symptoms that do not meet full criteria for a manic episode.
B) It indicates the presence of both depressive and manic symptoms simultaneously for at least one week.
C) It is used exclusively for bipolar I disorder during a depressive episode.
D) It requires the presence of psychotic features in addition to depressive symptoms.
Answer: A
Rationale: The 'with mixed features' specifier requires at least three manic/hypomanic symptoms (e.g., elevated
mood, grandiosity, decreased need for sleep) during a major depressive episode, but the criteria for a full
manic/hypomanic episode are not met. Option B is incorrect because mixed features do not need to be
simultaneous for a full week. Option C is incorrect because this specifier can also be used for major depressive
disorder. Option D is incorrect; psychotic features are a separate specifier.
13 A clinician is evaluating a patient with a history of recurrent, brief episodes of perceptual disturbances and
disorganized speech lasting less than one day, with full return to baseline. These episodes have occurred
multiple times over the past year but never met criteria for brief psychotic disorder because of the brief
duration. According to DSM-5, which diagnosis should be considered?
A) Schizophreniform disorder
B) Brief psychotic disorder
C) Other specified schizophrenia spectrum and other psychotic disorder
D) Psychotic disorder due to another medical condition
Answer: C
Rationale: The episodes are less than one day, which is shorter than the 1-day minimum for brief psychotic disorder
(which requires 1 day to 1 month). Since the symptoms do not meet full criteria for any specific psychotic disorder,
the appropriate DSM-5 diagnosis is 'Other specified schizophrenia spectrum and other psychotic disorder.'
Schizophreniform disorder requires 1-6 months of symptoms, and brief psychotic disorder requires at least 1 day.
14 According to DSM-5, which of the following is a key change from DSM-IV regarding the diagnosis of autism
spectrum disorder?
A) The addition of distinct subtypes such as Asperger's disorder and childhood disintegrative disorder.
B) The requirement that symptoms must be present in early childhood, even if not recognized until later.
C) The elimination of the social communication and social interaction domain.
D) The inclusion of a specifier for intellectual disability and language impairment.
Answer: B
Rationale: DSM-5 consolidated several subtypes into a single autism spectrum disorder and requires that symptoms
be present in early childhood (though they may not become fully manifest until social demands exceed capacity).
Option A is incorrect because subtypes were removed. Option C is incorrect because social communication is a
core domain. Option D is incorrect because intellectual disability and language impairment are coded as separate
conditions, not specifiers.
/NR 605 Midterm and Final Examplify Online Proctored
/NR605 Week 4 Midterm Exam Newest Version And Correct
Answers. — 300 Questions
Section 1: Diagnostic Criteria and Classification (DSM-5) (Questions 1-30)
1 A patient presents with a two-week history of elevated mood, grandiosity, decreased need for sleep, and
pressured speech. The symptoms are severe enough to cause marked impairment in social and occupational
functioning. According to DSM-5-TR criteria, which specifier must be documented to justify a diagnosis of
bipolar I disorder, current episode manic?
A) With mixed features
B) With psychotic features
C) With anxious distress
D) With rapid cycling
Answer: B
Rationale: The DSM-5-TR requires that if psychotic features are present during a manic episode, they must be
specified. The case describes severe impairment and grandiosity, which often co-occur with psychosis. Mixed
features require simultaneous depressive symptoms; anxious distress and rapid cycling are specifiers but not
mandatory for this scenario.
2 A researcher is developing a screening tool for DSM-5-TR somatic symptom disorder. Which item would be
LEAST consistent with the core feature of this disorder?
A) Excessive time and energy devoted to health concerns
B) High level of health-related anxiety
C) Disproportionate and persistent thoughts about the seriousness of symptoms
D) A documented medical condition that fully explains the symptoms
Answer: D
Rationale: Somatic symptom disorder is characterized by disproportionate thoughts, feelings, and behaviors related
to somatic symptoms, regardless of whether a medical condition is present. Option D suggests a fully explained
medical condition, which would not meet the criterion of disproportionate response. The other options are core
features.
3 In the DSM-5-TR classification, which of the following changes from DSM-IV was made to the diagnostic
criteria for autism spectrum disorder?
A) Removal of the requirement for onset by age 3
B) Addition of a specifier for intellectual impairment
C) Separation of social communication and restricted interests into two domains
D) Inclusion of language impairment as a core criterion
Answer: A
Rationale: DSM-5 eliminated the specific age-at-onset criterion (by age 3) and replaced it with a requirement that
symptoms be present in early development. Option B is incorrect because intellectual impairment is a specifier, not
a criterion change. Option C is true (two domains merged from three), but not the removal of age criterion. Option
D is false; language impairment is not a core criterion.
,4 A patient meets criteria for major depressive disorder, recurrent episode, with a history of hypomanic episodes
lasting 2-3 days. According to DSM-5-TR, which diagnosis should be considered?
A) Bipolar I disorder
B) Bipolar II disorder
C) Cyclothymic disorder
D) Other specified bipolar and related disorder
Answer: D
Rationale: Bipolar II disorder requires hypomanic episodes lasting at least 4 consecutive days. Since the hypomanic
episodes here last only 2-3 days, criteria for bipolar II are not met. Cyclothymic disorder requires numerous periods
of hypomanic and depressive symptoms over 2 years. The most appropriate diagnosis is other specified bipolar and
related disorder (short-duration hypomania).
5 Which of the following best describes the DSM-5-TR's approach to the diagnosis of posttraumatic stress
disorder in children age 6 years and younger?
A) The same criteria as adults, but with lower symptom thresholds
B) A separate set of criteria that includes reenactment play and fewer verbal requirements
C) Diagnosis is deferred until age 6 because of developmental variability
D) Criteria focus primarily on dissociative symptoms
Answer: B
Rationale: DSM-5-TR includes a separate PTSD subtype for children 6 years and younger, with criteria adapted for
developmental level, such as play reenactment and less reliance on verbal expression of internal states. Option A is
incorrect because the criteria are distinct. Option C is false; diagnosis can be made before age 6. Option D is
incorrect; dissociation is not the primary focus.
6 A clinician is evaluating a patient with obsessive-compulsive disorder. The patient reports spending 3 hours per
day washing hands and checking locks. Which specifier should be applied according to DSM-5-TR?
A) With poor insight
B) With good or fair insight
C) With absent insight/delusional beliefs
D) With tic-related
Answer: B
Rationale: The specifier for insight is based on the individual's recognition that beliefs are definitely or probably
true. The scenario does not indicate delusional intensity. Option B is correct because the patient likely recognizes
the excessiveness of the behaviors (good/fair insight). Option A would be if the patient thinks beliefs are probably
true. Option D requires a current or past tic disorder.
7 Which of the following is a key difference between the DSM-5-TR diagnostic criteria for generalized anxiety
disorder (GAD) and the criteria for illness anxiety disorder?
A) GAD requires somatic symptoms, while illness anxiety disorder does not
B) Illness anxiety disorder is limited to fear of having a serious disease, while GAD involves worry about
multiple domains
C) GAD requires a duration of at least 6 months, while illness anxiety disorder requires 3 months
D) Illness anxiety disorder is diagnosed only if the patient has a known medical condition
Answer: B
Rationale: GAD involves excessive anxiety and worry about a number of events or activities (e.g., work, school,
health), while illness anxiety disorder focuses specifically on the fear of having or acquiring a serious illness.
Option A is false; GAD does not require somatic symptoms. Option C is false; both require at least 6 months.
,Option D is false; illness anxiety disorder can occur without a medical condition.
8 A patient reports a 1-year history of recurrent, unexpected panic attacks followed by persistent worry about
having more attacks. The patient avoids crowded places but does not avoid all situations. Which DSM-5-TR
diagnosis is most appropriate?
A) Panic disorder
B) Agoraphobia
C) Panic disorder with agoraphobia
D) Specific phobia, situational type
Answer: C
Rationale: The patient meets criteria for panic disorder (recurrent unexpected panic attacks with worry about
recurrence) and also avoids situations (crowds) due to fear of having a panic attack, which meets criteria for
agoraphobia. Option A is insufficient because agoraphobia is present. Option B is incorrect because the primary
issue is panic attacks. Option D is incorrect because the fear is not limited to a specific object.
9 In the DSM-5-TR, which of the following is a specifier for schizophrenia that indicates the presence of negative
symptoms?
A) With catatonia
B) With prominent negative symptoms
C) With mood symptoms
D) With early onset
Answer: B
Rationale: DSM-5-TR includes 'with prominent negative symptoms' as a specifier for schizophrenia, which requires
that negative symptoms (e.g., avolition, alogia) are present and severe. Option A is a separate specifier for
catatonia. Option C is not a specifier for schizophrenia; mood symptoms would suggest schizoaffective disorder.
Option D is not a specifier.
10 A patient has a history of recurrent depressive episodes and manic episodes that occur only during
antidepressant treatment. According to DSM-5-TR, which diagnosis is most appropriate?
A) Bipolar I disorder
B) Substance/medication-induced bipolar disorder
C) Bipolar II disorder
D) Cyclothymic disorder
Answer: B
Rationale: When manic symptoms arise solely as a physiological consequence of a medication (e.g., antidepressant),
the diagnosis is substance/medication-induced bipolar disorder, not a primary bipolar disorder. Option A is
incorrect because the manic episode is not independent of medication. Option C is incorrect for the same reason.
Option D requires chronic fluctuating symptoms over 2 years.
11 A patient presents with recurrent, unexpected panic attacks followed by at least one month of persistent worry
about having additional attacks and maladaptive changes in behavior. According to DSM-5, which additional
criterion must be met to distinguish Panic Disorder from Panic Attacks Specifier in other disorders?
A) The panic attacks must be triggered by a specific phobic stimulus.
B) The panic attacks must be exclusively cued by substances or medical conditions.
C) The presence of agoraphobia is required for the diagnosis.
D) The attacks must be unexpected and not better explained by another mental disorder.
Answer: D
, Rationale: DSM-5 requires that the panic attacks are unexpected and not attributable to the physiological effects of a
substance, another medical condition, or better explained by another mental disorder (e.g., social anxiety disorder,
specific phobia). Option A is incorrect because cued attacks are typical of specific phobia. Option B is incorrect
because substance/medical condition-induced attacks are exclusionary. Option C is incorrect because agoraphobia
is a separate diagnosis, not required for panic disorder.
12 Which of the following best describes the DSM-5 specifier 'with mixed features' for a major depressive
episode?
A) It requires at least three manic/hypomanic symptoms that do not meet full criteria for a manic episode.
B) It indicates the presence of both depressive and manic symptoms simultaneously for at least one week.
C) It is used exclusively for bipolar I disorder during a depressive episode.
D) It requires the presence of psychotic features in addition to depressive symptoms.
Answer: A
Rationale: The 'with mixed features' specifier requires at least three manic/hypomanic symptoms (e.g., elevated
mood, grandiosity, decreased need for sleep) during a major depressive episode, but the criteria for a full
manic/hypomanic episode are not met. Option B is incorrect because mixed features do not need to be
simultaneous for a full week. Option C is incorrect because this specifier can also be used for major depressive
disorder. Option D is incorrect; psychotic features are a separate specifier.
13 A clinician is evaluating a patient with a history of recurrent, brief episodes of perceptual disturbances and
disorganized speech lasting less than one day, with full return to baseline. These episodes have occurred
multiple times over the past year but never met criteria for brief psychotic disorder because of the brief
duration. According to DSM-5, which diagnosis should be considered?
A) Schizophreniform disorder
B) Brief psychotic disorder
C) Other specified schizophrenia spectrum and other psychotic disorder
D) Psychotic disorder due to another medical condition
Answer: C
Rationale: The episodes are less than one day, which is shorter than the 1-day minimum for brief psychotic disorder
(which requires 1 day to 1 month). Since the symptoms do not meet full criteria for any specific psychotic disorder,
the appropriate DSM-5 diagnosis is 'Other specified schizophrenia spectrum and other psychotic disorder.'
Schizophreniform disorder requires 1-6 months of symptoms, and brief psychotic disorder requires at least 1 day.
14 According to DSM-5, which of the following is a key change from DSM-IV regarding the diagnosis of autism
spectrum disorder?
A) The addition of distinct subtypes such as Asperger's disorder and childhood disintegrative disorder.
B) The requirement that symptoms must be present in early childhood, even if not recognized until later.
C) The elimination of the social communication and social interaction domain.
D) The inclusion of a specifier for intellectual disability and language impairment.
Answer: B
Rationale: DSM-5 consolidated several subtypes into a single autism spectrum disorder and requires that symptoms
be present in early childhood (though they may not become fully manifest until social demands exceed capacity).
Option A is incorrect because subtypes were removed. Option C is incorrect because social communication is a
core domain. Option D is incorrect because intellectual disability and language impairment are coded as separate
conditions, not specifiers.
