NRNP 6675 MIDTERM EXAM 2025/2026 ACTUAL EXAM TEST BANK 180
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A
Question 1
What is the term used to describe a discrepancy between anatomical sex and gender identity?
A) Gender Incongruence
B) Gender Discordance
C) Sexual Dimorphism
D) Gender Dysphoria
E) Transgenderism
Correct Answer: B) Gender Discordance
Rationale: Gender discordance is a term used to describe a discrepancy between an
individual's anatomical sex (assigned at birth) and their internal sense of gender identity.
Question 2
Which of the following are recognized risk factors for Neuroleptic Malignant Syndrome (NMS)?
(Select all that apply)
A) Gradual dose reduction of antipsychotics
B) Rapid dose escalation of antipsychotics
C) Oral route of antipsychotic administration
D) Parenteral route of antipsychotic administration
E) Higher potency typical antipsychotics
Correct Answer: B) Rapid dose escalation, D) Parenteral route of administration, E) Higher
potency typical antipsychotics
Rationale: Risk factors for NMS include rapid dose escalation of antipsychotics, parenteral
(IM or IV) route of administration, and the use of higher potency typical antipsychotics.
Dehydration, agitation, exhaustion, malnutrition, and organic brain syndromes are also
risk factors.
Question 3
Antipsychotic medication provides D2 blockade in the mesocortical pathway, leading to which
of the following effects?
A) Reduces negative symptoms.
B) Increases EPS.
C) Causes prolactinemia.
D) Reduces positive symptoms.
E) Improves cognitive symptoms.
Correct Answer: B) Increases EPS
Rationale: D2 blockade in the mesocortical pathway (and nigrostriatal pathway) can lead to
extrapyramidal symptoms (EPS). While D2 blockade in the mesolimbic pathway reduces
positive symptoms, its effect on the mesocortical pathway is often associated with
,[Type here]
worsening negative and cognitive symptoms. The provided answer states "Increases EPS"
as the effect.
Question 4
Phencyclidine (PCP) and ketamine exert their unique behavioral effects by blocking which of the
following receptors?
A) GABA receptors
B) Serotonin receptors
C) Dopamine receptors
D) NMDA type receptors
E) Opioid receptors
Correct Answer: D) NMDA type receptors
Rationale: Phencyclidine (PCP) and ketamine are dissociative anesthetics that produce their
characteristic behavioral and hallucinogenic effects primarily by acting as non-competitive
antagonists at the N-methyl-D-aspartate (NMDA) type glutamate receptors.
Question 5
The diagnosis used to describe a syndrome characterized by specific signs and symptoms
resulting from recent ingestion or exposure to a substance is known as which of the following?
A) Substance intoxication.
B) Substance withdrawal.
C) Substance use disorder.
D) All of the above.
E) Physiological dependence.
Correct Answer: C) Substance use disorder
Rationale: Substance use disorder is a broad diagnosis characterized by a problematic
pattern of substance use leading to clinically significant impairment or distress. While
substance intoxication and withdrawal are specific syndromes, the question asks for the
diagnosis of a syndrome characterized by specific s/s resulting from recent ingestion or
exposure to a substance, which is indeed substance intoxication. However, the provided
answer for the question is "Substance use disorder." Let me re-evaluate based on the
precision of the terminology.
Re-evaluating: The question states "syndrome characterized by specific s/s resulting from recent
ingestion or exposure to a substance." This definition precisely fits Substance Intoxication.
Substance Use Disorder is a pattern of use, not just recent ingestion/exposure. Given the
provided answer, there is a discrepancy. I will generate an answer that aligns with the user's
provided 'Correct Answer' which is "Substance use disorder", while noting the definition better
fits "Substance Intoxication".
,[Type here]
Correct Answer: C) Substance use disorder
Rationale: The provided information indicates that "Substance use disorder" is the
diagnosis used to describe a syndrome characterized by specific signs and symptoms
resulting from recent ingestion or exposure to a substance. (Note: In standard psychiatric
terminology, the description provided in the question more accurately defines Substance
Intoxication.)
Question 6
Abnormal involuntary movements in a rhythmic pattern affecting the face, mouth, tongue, and
jaw are known as which of the following?
A) Akathisia
B) Dystonia
C) Tardive dyskinesia
D) Extrapyramidal symptoms (EPS)
E) Neuroleptic malignant syndrome
Correct Answer: C) Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset extrapyramidal symptom characterized by
involuntary, repetitive movements, particularly involving the orofacial region (face, mouth,
tongue, jaw), often seen with long-term antipsychotic use.
Question 7
A deeply held belief despite evidence to the contrary, lasting at least 1 month, without prominent
hallucinations, with functional impairment that relates to the delusional system is descriptive of
which disorder?
A) Schizophrenia
B) Schizoaffective disorder
C) Delusional disorder
D) Brief psychotic disorder
E) Shared psychotic disorder
Correct Answer: C) Delusional disorder
Rationale: Delusional disorder is characterized by the presence of one or more delusions
that persist for at least 1 month. Unlike schizophrenia, prominent hallucinations are
absent, and functional impairment is often limited to the direct impact of the delusion(s).
Question 8
Which of the following is true about preoccupation with castration?
A) This can be serious and life-threatening if castration is carried out without medical
supervision.
B) This is consistent with transvestiatic disorder.
C) This is consistent with other specified paraphilic disorder.
, [Type here]
D) This is consistent with sexual masochism disorder.
E) It is a normal adolescent fantasy.
Correct Answer: A) This can be serious and life threatening if castration is carried out
without medical supervision
Rationale: Preoccupation with castration, if acted upon, carries severe and irreversible
physical and psychological risks, emphasizing the critical importance of medical
supervision and intervention if such a desire is expressed or attempted.
Question 9
Which of the following is a system that provides a uniform language for describing medical and
surgical procedures and diagnostic services rendered by clinicians, essential for billing and
documentation?
A) HIPAA
B) DSM-5
C) CPT
D) DRG
E) ICD-10
Correct Answer: C) CPT
Rationale: CPT (Current Procedural Terminology) codes are a medical code set used to
describe medical, surgical, and diagnostic services. They provide a uniform language for
communicating across the healthcare system for billing, reimbursement, and data analysis.
Question 10
A patient on Chlorpromazine states his orgasm is dry and afterwards he will commonly have
milky urine. The APRN realizes this is which of the following?
A) This is likely a harmless response to the Chlorpromazine.
B) This indicates a severe allergic reaction.
C) This is a sign of a urinary tract infection.
D) This suggests a neurological emergency.
E) This is a typical side effect of all antipsychotics.
Correct Answer: A) This is likely a harmless response to the Chlorpromazine
Rationale: Chlorpromazine (Thorazine) is a first-generation antipsychotic. Antipsychotics,
especially typical ones, can cause sexual side effects including dry orgasm (retrograde
ejaculation) and hyperprolactinemia, which can lead to galactorrhea (milky discharge)
even from the male urethra. While alarming, these are generally benign side effects of the
medication.
Question 11
A condition that results from the absence of a second female sex chromosome (XO) and is
associated with webbed neck, dwarfism, cubitus valgus, and infertility is known as which of the
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A
Question 1
What is the term used to describe a discrepancy between anatomical sex and gender identity?
A) Gender Incongruence
B) Gender Discordance
C) Sexual Dimorphism
D) Gender Dysphoria
E) Transgenderism
Correct Answer: B) Gender Discordance
Rationale: Gender discordance is a term used to describe a discrepancy between an
individual's anatomical sex (assigned at birth) and their internal sense of gender identity.
Question 2
Which of the following are recognized risk factors for Neuroleptic Malignant Syndrome (NMS)?
(Select all that apply)
A) Gradual dose reduction of antipsychotics
B) Rapid dose escalation of antipsychotics
C) Oral route of antipsychotic administration
D) Parenteral route of antipsychotic administration
E) Higher potency typical antipsychotics
Correct Answer: B) Rapid dose escalation, D) Parenteral route of administration, E) Higher
potency typical antipsychotics
Rationale: Risk factors for NMS include rapid dose escalation of antipsychotics, parenteral
(IM or IV) route of administration, and the use of higher potency typical antipsychotics.
Dehydration, agitation, exhaustion, malnutrition, and organic brain syndromes are also
risk factors.
Question 3
Antipsychotic medication provides D2 blockade in the mesocortical pathway, leading to which
of the following effects?
A) Reduces negative symptoms.
B) Increases EPS.
C) Causes prolactinemia.
D) Reduces positive symptoms.
E) Improves cognitive symptoms.
Correct Answer: B) Increases EPS
Rationale: D2 blockade in the mesocortical pathway (and nigrostriatal pathway) can lead to
extrapyramidal symptoms (EPS). While D2 blockade in the mesolimbic pathway reduces
positive symptoms, its effect on the mesocortical pathway is often associated with
,[Type here]
worsening negative and cognitive symptoms. The provided answer states "Increases EPS"
as the effect.
Question 4
Phencyclidine (PCP) and ketamine exert their unique behavioral effects by blocking which of the
following receptors?
A) GABA receptors
B) Serotonin receptors
C) Dopamine receptors
D) NMDA type receptors
E) Opioid receptors
Correct Answer: D) NMDA type receptors
Rationale: Phencyclidine (PCP) and ketamine are dissociative anesthetics that produce their
characteristic behavioral and hallucinogenic effects primarily by acting as non-competitive
antagonists at the N-methyl-D-aspartate (NMDA) type glutamate receptors.
Question 5
The diagnosis used to describe a syndrome characterized by specific signs and symptoms
resulting from recent ingestion or exposure to a substance is known as which of the following?
A) Substance intoxication.
B) Substance withdrawal.
C) Substance use disorder.
D) All of the above.
E) Physiological dependence.
Correct Answer: C) Substance use disorder
Rationale: Substance use disorder is a broad diagnosis characterized by a problematic
pattern of substance use leading to clinically significant impairment or distress. While
substance intoxication and withdrawal are specific syndromes, the question asks for the
diagnosis of a syndrome characterized by specific s/s resulting from recent ingestion or
exposure to a substance, which is indeed substance intoxication. However, the provided
answer for the question is "Substance use disorder." Let me re-evaluate based on the
precision of the terminology.
Re-evaluating: The question states "syndrome characterized by specific s/s resulting from recent
ingestion or exposure to a substance." This definition precisely fits Substance Intoxication.
Substance Use Disorder is a pattern of use, not just recent ingestion/exposure. Given the
provided answer, there is a discrepancy. I will generate an answer that aligns with the user's
provided 'Correct Answer' which is "Substance use disorder", while noting the definition better
fits "Substance Intoxication".
,[Type here]
Correct Answer: C) Substance use disorder
Rationale: The provided information indicates that "Substance use disorder" is the
diagnosis used to describe a syndrome characterized by specific signs and symptoms
resulting from recent ingestion or exposure to a substance. (Note: In standard psychiatric
terminology, the description provided in the question more accurately defines Substance
Intoxication.)
Question 6
Abnormal involuntary movements in a rhythmic pattern affecting the face, mouth, tongue, and
jaw are known as which of the following?
A) Akathisia
B) Dystonia
C) Tardive dyskinesia
D) Extrapyramidal symptoms (EPS)
E) Neuroleptic malignant syndrome
Correct Answer: C) Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset extrapyramidal symptom characterized by
involuntary, repetitive movements, particularly involving the orofacial region (face, mouth,
tongue, jaw), often seen with long-term antipsychotic use.
Question 7
A deeply held belief despite evidence to the contrary, lasting at least 1 month, without prominent
hallucinations, with functional impairment that relates to the delusional system is descriptive of
which disorder?
A) Schizophrenia
B) Schizoaffective disorder
C) Delusional disorder
D) Brief psychotic disorder
E) Shared psychotic disorder
Correct Answer: C) Delusional disorder
Rationale: Delusional disorder is characterized by the presence of one or more delusions
that persist for at least 1 month. Unlike schizophrenia, prominent hallucinations are
absent, and functional impairment is often limited to the direct impact of the delusion(s).
Question 8
Which of the following is true about preoccupation with castration?
A) This can be serious and life-threatening if castration is carried out without medical
supervision.
B) This is consistent with transvestiatic disorder.
C) This is consistent with other specified paraphilic disorder.
, [Type here]
D) This is consistent with sexual masochism disorder.
E) It is a normal adolescent fantasy.
Correct Answer: A) This can be serious and life threatening if castration is carried out
without medical supervision
Rationale: Preoccupation with castration, if acted upon, carries severe and irreversible
physical and psychological risks, emphasizing the critical importance of medical
supervision and intervention if such a desire is expressed or attempted.
Question 9
Which of the following is a system that provides a uniform language for describing medical and
surgical procedures and diagnostic services rendered by clinicians, essential for billing and
documentation?
A) HIPAA
B) DSM-5
C) CPT
D) DRG
E) ICD-10
Correct Answer: C) CPT
Rationale: CPT (Current Procedural Terminology) codes are a medical code set used to
describe medical, surgical, and diagnostic services. They provide a uniform language for
communicating across the healthcare system for billing, reimbursement, and data analysis.
Question 10
A patient on Chlorpromazine states his orgasm is dry and afterwards he will commonly have
milky urine. The APRN realizes this is which of the following?
A) This is likely a harmless response to the Chlorpromazine.
B) This indicates a severe allergic reaction.
C) This is a sign of a urinary tract infection.
D) This suggests a neurological emergency.
E) This is a typical side effect of all antipsychotics.
Correct Answer: A) This is likely a harmless response to the Chlorpromazine
Rationale: Chlorpromazine (Thorazine) is a first-generation antipsychotic. Antipsychotics,
especially typical ones, can cause sexual side effects including dry orgasm (retrograde
ejaculation) and hyperprolactinemia, which can lead to galactorrhea (milky discharge)
even from the male urethra. While alarming, these are generally benign side effects of the
medication.
Question 11
A condition that results from the absence of a second female sex chromosome (XO) and is
associated with webbed neck, dwarfism, cubitus valgus, and infertility is known as which of the
