NRNP 6635 Midterm Exam | Psychopathology
and Diagnostic Reasoning | Latest Questions
and Correct Answers | Verified Solutions
Exam Structure:
Subject: Nursing / Psychiatric Mental Health, Psychopathology, Diagnostic
Reasoning
Source: NRNP 6635 MIDTERM
Format: Multiple-Choice Questions with Correct Answers and Rationales
Depression and Suicide
1. What is the most IMMEDIATE consideration in assessing depression
in adolescents?
Correct Answer: Safety
Rationale:
1. Safety is the priority in any psychiatric assessment, especially in
adolescents with depression.
2. Suicidal ideation, self-harm behaviors, and risk of harm to others
must be assessed immediately.
3. Establishing safety precedes all other diagnostic and treatment
considerations.
Schizophrenia
2. Select the neurotransmitter that is most involved in the
pathophysiology of schizophrenia.
Correct Answer: Dopamine
Rationale:
1. The dopamine hypothesis suggests that schizophrenia is related to
excess dopamine activity in the mesolimbic pathway.
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2. Antipsychotic medications work primarily by blocking dopamine D2
receptors.
3. Other neurotransmitters (glutamate, serotonin) are also implicated
but dopamine is central.
Patient-Provider Rapport
3. Select the most important component of the patient-provider
rapport.
Correct Answer: Respect
Rationale:
1. Respect is fundamental to building trust and therapeutic alliance.
2. Empathy, confidentiality, and privacy are important, but respect
underpins all aspects of the relationship.
3. Patients who feel respected are more likely to engage in treatment
and be honest.
Social Anxiety Disorder
4. Select the most effective treatment for social anxiety disorder in
children.
Correct Answer: Cognitive-behavioral therapy (CBT) and SSRI
antidepressants
Rationale:
1. Combination therapy (CBT plus SSRI) is more effective than either
alone.
2. CBT addresses maladaptive thoughts and behaviors; SSRIs reduce
anxiety symptoms.
3. Evidence supports this combination as first-line treatment for
pediatric social anxiety.
Speech and Language Assessment
5. All the following are key psychiatric findings when assessing speech
and language in children EXCEPT:
Correct Answer: Normal articulation
Rationale:
1. Key findings include delays, atypical patterns, or abnormalities in
speech and language development.
2. Normal articulation is not a psychiatric finding; it is expected.
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3. Abnormal findings may include echolalia, mutism, or idiosyncratic
language.
PTSD
6. Select the factor that is required to cause PTSD from a stressor.
Correct Answer: Intense horror
Rationale:
1. The DSM-5 criteria for PTSD require exposure to actual or threatened
death, serious injury, or sexual violation.
2. The individual's response must involve intense fear, helplessness, or
horror (in children, disorganized or agitated behavior).
3. Subjective experience of horror is a key component.
Coping Mechanisms
7. All the following are classes of coping mechanisms in the Model of
Mental Health as Resilience where humans overcome stressful
situations EXCEPT:
Correct Answer: Generativity versus Stagnation
Rationale:
1. Generativity versus stagnation is a stage in Erikson's psychosocial
development theory, not a coping mechanism.
2. Coping mechanisms include adaptive and involuntary strategies such
as defense mechanisms.
3. Resilience models focus on how individuals adapt to stress.
Neuroimaging in OCD
8. Anatomical and functional neuroimaging studies have associated a
decreased activation in what part of the brain with obsessive-
compulsive behaviors?
Correct Answer: Substantia nigra
Rationale:
1. The substantia nigra is part of the basal ganglia circuitry implicated
in OCD.
2. Dysfunction in cortico-striato-thalamo-cortical circuits is associated
with OCD symptoms.
3. Decreased activation in specific regions may correlate with symptom
severity.
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Anorexia Nervosa
9. Select the two complications in diagnosing patients with anorexia
nervosa.
Correct Answers: Denial of symptoms; Insisting weight loss has a medical
cause
Rationale:
1. Patients with anorexia often deny the seriousness of their low weight
and may attribute weight loss to medical causes.
2. This denial complicates diagnosis and treatment engagement.
3. Medical workup is needed to rule out organic causes.
10. Select the percent rate of mortality in anorexia nervosa patients.
Correct Answer: 5 to 10%
Rationale:
1. Anorexia nervosa has the highest mortality rate of any psychiatric
disorder.
2. Death may result from medical complications or suicide.
3. Long-term studies show mortality rates of approximately 5-10%.
Anxiety Disorders
11. Select the anxiety disorder that emerges in ages 9 to 18 months.
Correct Answer: Separation anxiety
Rationale:
1. Separation anxiety disorder typically emerges in infancy or early
childhood.
2. It is characterized by excessive fear or anxiety concerning separation
from attachment figures.
3. Onset can occur as early as 9 months, though diagnosis is usually
made later.
12. Select the two most common peripheral symptoms of anxiety.
Correct Answers: Dizziness; Tremors
Rationale:
1. Peripheral (somatic) symptoms of anxiety include palpitations,
sweating, trembling, shortness of breath, and dizziness.
2. These symptoms result from autonomic nervous system activation.
3. They are common across multiple anxiety disorders.