NU 664 Exam 2 (2025/2026) – High-Yield Questions on
Anxiety, DSM-5, Schizophrenia, GAD & Cultural
Section 1: Foundational DSM-5 Concepts (Questions 1-15)
1. A clinician is using the DSM-5 to diagnose a patient. Which of the following represents a
key change from DSM-IV to DSM-5 regarding the organization of disorders?
A. Anxiety disorders are now listed after obsessive-compulsive disorders.
B. Mood disorders have been split into depressive disorders and bipolar disorders.
C. All childhood disorders are now in a single chapter.
D. Substance use disorders no longer include legal problems.
Answer: B. Rationale: DSM-5 separated mood disorders into distinct chapters: "Depressive
Disorders" and "Bipolar and Related Disorders" to reflect their differing pathophysiology and
treatment.
2. The DSM-5 uses a dimensional approach to diagnosis. This means:
A. Disorders are either present or absent.
B. Clinicians rate the severity of core symptoms.
C. Cultural factors are ignored.
D. Only biological markers are considered.
Answer: B. Rationale: Dimensional assessment (e.g., using severity scales like the PHQ-9)
complements categorical diagnosis, allowing tracking of symptom change over time.
3. A patient meets full criteria for major depressive disorder but also has significant anxiety.
Under the DSM-5, the clinician should:
A. Diagnose only MDD.
B. Add the specifier "with anxious distress."
C. Diagnose a separate anxiety disorder.
D. Diagnose MDD with psychotic features.
Answer: B. Rationale: The "with anxious distress" specifier was added to DSM-5 to capture
patients with MDD who have anxiety symptoms that do not meet full criteria for an anxiety
disorder.
4. Which of the following is NOT a specifier in DSM-5 for depressive disorders?
A. With peripartum onset
B. With melancholic features
C. With catastrophic features
D. With seasonal pattern
,Answer: C. Rationale: "Catastrophic features" is not a DSM-5 specifier. Melancholic, atypical,
peripartum, and seasonal are valid specifiers.
5. A patient presents with multiple somatic complaints, anxiety, and depression. The DSM-5
encourages clinicians to:
A. Use a hierarchical exclusion rule.
B. Diagnose a somatic symptom disorder instead of anxiety.
C. Diagnose both disorders if criteria are met.
D. Wait 6 months before diagnosing a mood disorder.
Answer: C. Rationale: DSM-5 removed the requirement that anxiety or mood disorders
cannot be diagnosed if they are "due to" a medical condition. Comorbid diagnoses are
encouraged.
6. The "CULTURE" mnemonic for cultural formulation includes all EXCEPT:
A. Cultural identity
B. Cultural conceptualizations of distress
C. Cultural elements of the patient-nurse relationship
D. Cultural neurobiology
Answer: D. Rationale: The Cultural Formulation Interview (CFI) components are: Cultural
identity, conceptualizations of distress, psychosocial stressors/vulnerability, and patient-
clinician relationship.
7. A patient from a culture that normalizes hearing the voice of a deceased relative would
receive a diagnosis of psychosis only if:
A. The patient is distressed by the voice.
B. The voice is derogatory.
C. The voice occurs daily.
D. The voice commands harm to others.
Answer: A. Rationale: DSM-5 emphasizes functional impairment and distress. Culturally
normative experiences (e.g., bereavement-related auditory experiences) are not
pathological unless they cause distress or dysfunction.
8. The DSM-5 Text Revision (DSM-5-TR) added a new diagnosis:
A. Complex somatic symptom disorder
B. Prolonged grief disorder
C. Emotional dysregulation disorder
D. Mixed anxiety-depression
Answer: B. Rationale: Prolonged Grief Disorder was added to DSM-5-TR (2022) to capture
persistent, disabling grief lasting >12 months in adults.
9. A clinician using the DSM-5 Cross-Cutting Symptom Measure would be assessing:
A. Only the primary diagnosis
B. Psychiatric symptoms across multiple domains
, C. Medical comorbidities
D. Childhood trauma history
Answer: B. Rationale: The DSM-5 Level 1 Cross-Cutting Symptom Measure screens for 13
psychiatric domains (e.g., depression, anxiety, psychosis, sleep) to identify possible
secondary diagnoses.
10. Which of the following is true about the DSM-5 approach to gender dysphoria?
A. It is classified as a sexual dysfunction.
B. It was removed entirely from DSM-5.
C. It is separated from paraphilic disorders.
D. It requires a paraphilia diagnosis.
Answer: C. Rationale: Gender dysphoria is in its own chapter, distinct from paraphilic
disorders and sexual dysfunctions, to reduce stigma while maintaining access to care.
11. A patient has panic attacks, avoidance, and worries about panic for 2 months. Under
DSM-5, the earliest time to diagnose panic disorder is:
A. 1 month
B. 3 months
C. 6 months
D. Immediately
Answer: A. Rationale: Panic disorder requires at least 1 month of persistent worry or
maladaptive change in behavior related to panic attacks.
12. The DSM-5 "with psychotic features" specifier for mood disorders requires that psychosis
occurs:
A. Only during manic episodes
B. Only during depressive episodes
C. Only in the absence of mood symptoms
D. Exclusively during mood episodes
Answer: D. Rationale: For mood disorders with psychotic features, delusions or
hallucinations must occur only during mood episodes (distinguishing from schizoaffective
disorder).
13. Which disorder was moved from "Anxiety Disorders" to "Obsessive-Compulsive and
Related Disorders" in DSM-5?
A. Social anxiety disorder
B. Panic disorder
C. Trichotillomania
D. Acute stress disorder
Answer: C. Rationale: Trichotillomania (hair-pulling disorder), hoarding disorder, and
excoriation disorder were moved to the new OCD and Related Disorders chapter.
Anxiety, DSM-5, Schizophrenia, GAD & Cultural
Section 1: Foundational DSM-5 Concepts (Questions 1-15)
1. A clinician is using the DSM-5 to diagnose a patient. Which of the following represents a
key change from DSM-IV to DSM-5 regarding the organization of disorders?
A. Anxiety disorders are now listed after obsessive-compulsive disorders.
B. Mood disorders have been split into depressive disorders and bipolar disorders.
C. All childhood disorders are now in a single chapter.
D. Substance use disorders no longer include legal problems.
Answer: B. Rationale: DSM-5 separated mood disorders into distinct chapters: "Depressive
Disorders" and "Bipolar and Related Disorders" to reflect their differing pathophysiology and
treatment.
2. The DSM-5 uses a dimensional approach to diagnosis. This means:
A. Disorders are either present or absent.
B. Clinicians rate the severity of core symptoms.
C. Cultural factors are ignored.
D. Only biological markers are considered.
Answer: B. Rationale: Dimensional assessment (e.g., using severity scales like the PHQ-9)
complements categorical diagnosis, allowing tracking of symptom change over time.
3. A patient meets full criteria for major depressive disorder but also has significant anxiety.
Under the DSM-5, the clinician should:
A. Diagnose only MDD.
B. Add the specifier "with anxious distress."
C. Diagnose a separate anxiety disorder.
D. Diagnose MDD with psychotic features.
Answer: B. Rationale: The "with anxious distress" specifier was added to DSM-5 to capture
patients with MDD who have anxiety symptoms that do not meet full criteria for an anxiety
disorder.
4. Which of the following is NOT a specifier in DSM-5 for depressive disorders?
A. With peripartum onset
B. With melancholic features
C. With catastrophic features
D. With seasonal pattern
,Answer: C. Rationale: "Catastrophic features" is not a DSM-5 specifier. Melancholic, atypical,
peripartum, and seasonal are valid specifiers.
5. A patient presents with multiple somatic complaints, anxiety, and depression. The DSM-5
encourages clinicians to:
A. Use a hierarchical exclusion rule.
B. Diagnose a somatic symptom disorder instead of anxiety.
C. Diagnose both disorders if criteria are met.
D. Wait 6 months before diagnosing a mood disorder.
Answer: C. Rationale: DSM-5 removed the requirement that anxiety or mood disorders
cannot be diagnosed if they are "due to" a medical condition. Comorbid diagnoses are
encouraged.
6. The "CULTURE" mnemonic for cultural formulation includes all EXCEPT:
A. Cultural identity
B. Cultural conceptualizations of distress
C. Cultural elements of the patient-nurse relationship
D. Cultural neurobiology
Answer: D. Rationale: The Cultural Formulation Interview (CFI) components are: Cultural
identity, conceptualizations of distress, psychosocial stressors/vulnerability, and patient-
clinician relationship.
7. A patient from a culture that normalizes hearing the voice of a deceased relative would
receive a diagnosis of psychosis only if:
A. The patient is distressed by the voice.
B. The voice is derogatory.
C. The voice occurs daily.
D. The voice commands harm to others.
Answer: A. Rationale: DSM-5 emphasizes functional impairment and distress. Culturally
normative experiences (e.g., bereavement-related auditory experiences) are not
pathological unless they cause distress or dysfunction.
8. The DSM-5 Text Revision (DSM-5-TR) added a new diagnosis:
A. Complex somatic symptom disorder
B. Prolonged grief disorder
C. Emotional dysregulation disorder
D. Mixed anxiety-depression
Answer: B. Rationale: Prolonged Grief Disorder was added to DSM-5-TR (2022) to capture
persistent, disabling grief lasting >12 months in adults.
9. A clinician using the DSM-5 Cross-Cutting Symptom Measure would be assessing:
A. Only the primary diagnosis
B. Psychiatric symptoms across multiple domains
, C. Medical comorbidities
D. Childhood trauma history
Answer: B. Rationale: The DSM-5 Level 1 Cross-Cutting Symptom Measure screens for 13
psychiatric domains (e.g., depression, anxiety, psychosis, sleep) to identify possible
secondary diagnoses.
10. Which of the following is true about the DSM-5 approach to gender dysphoria?
A. It is classified as a sexual dysfunction.
B. It was removed entirely from DSM-5.
C. It is separated from paraphilic disorders.
D. It requires a paraphilia diagnosis.
Answer: C. Rationale: Gender dysphoria is in its own chapter, distinct from paraphilic
disorders and sexual dysfunctions, to reduce stigma while maintaining access to care.
11. A patient has panic attacks, avoidance, and worries about panic for 2 months. Under
DSM-5, the earliest time to diagnose panic disorder is:
A. 1 month
B. 3 months
C. 6 months
D. Immediately
Answer: A. Rationale: Panic disorder requires at least 1 month of persistent worry or
maladaptive change in behavior related to panic attacks.
12. The DSM-5 "with psychotic features" specifier for mood disorders requires that psychosis
occurs:
A. Only during manic episodes
B. Only during depressive episodes
C. Only in the absence of mood symptoms
D. Exclusively during mood episodes
Answer: D. Rationale: For mood disorders with psychotic features, delusions or
hallucinations must occur only during mood episodes (distinguishing from schizoaffective
disorder).
13. Which disorder was moved from "Anxiety Disorders" to "Obsessive-Compulsive and
Related Disorders" in DSM-5?
A. Social anxiety disorder
B. Panic disorder
C. Trichotillomania
D. Acute stress disorder
Answer: C. Rationale: Trichotillomania (hair-pulling disorder), hoarding disorder, and
excoriation disorder were moved to the new OCD and Related Disorders chapter.
