NR605 Final Exam Actual Exam Style V1 | NR 605
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. A 25-year-old patient reports feeling depressed for the last 3 weeks, loss of
appetite, and difficulty sleeping. According to the DSM-5-TR, what is the minimum
duration of symptoms required for a diagnosis of Major Depressive Disorder?
A. 2 weeks
B. 1 week
C. 1 month
D. 6 months
Correct Answer: A
Expert Explanation: The correct answer is B because Major Depressive Disorder
requires symptoms to be present for at least a two-week period. This timeframe is
essential to distinguish acute distress from a clinical depressive episode.
Practitioners must ensure that at least five diagnostic symptoms are met during this
interval.
2. Which of the following medications is considered a first-line treatment for a
pediatric patient diagnosed with Major Depressive Disorder?
A. Sertraline
,B. Amitriptyline
C. Venlafaxine
D. Fluoxetine
Correct Answer: D
Expert Explanation: Fluoxetine is the correct answer as it is FDA-approved for the
treatment of depression in children and adolescents. It has the most robust evidence
base for safety and efficacy in this specific population. Clinical guidelines
recommend monitoring closely for increased suicidal ideation when starting SSRIs
in youth.
3. A patient with Bipolar I Disorder is being started on Lithium. Which of the following
is the therapeutic serum level range for maintenance therapy?
A. 0.2 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.0 mEq/L
Correct Answer: B
Expert Explanation: The therapeutic range for Lithium maintenance is typically 0.6
to 1.2 mEq/L to balance efficacy and toxicity risk. Levels above 1.5 mEq/L are
,generally considered toxic and require immediate medical intervention. Regular
blood monitoring is mandatory to ensure the patient remains within this narrow
therapeutic window.
4. A PMHNP is treating a patient with Schizophrenia who has not responded to two
different antipsychotic trials. What is the most appropriate next step in
pharmacological management?
A. Start a third-generation antipsychotic
B. Augment with an antidepressant
C. Switch to a typical antipsychotic
D. Trial Clozapine
Correct Answer: D
Expert Explanation: Clozapine is the gold standard for treatment-resistant
schizophrenia after two failed trials of other antipsychotics. It is uniquely effective
but requires intensive monitoring of the Absolute Neutrophil Count (ANC) due to
the risk of agranulocytosis. This medication should be considered early in the
treatment algorithm for refractory cases.
5. When prescribing Lamotrigine for Bipolar II Disorder, which life-threatening side
effect must the patient be educated about?
A. Stevens-Johnson Syndrome
, B. Agranulocytosis
C. Hepatic failure
D. Pancreatitis
Correct Answer: A
Expert Explanation: Stevens-Johnson Syndrome is a rare but life-threatening rash
associated with the use of Lamotrigine. To minimize this risk, the medication must
be titrated very slowly according to a specific schedule. Patients should be
instructed to seek immediate medical attention if any skin changes or mucosal
lesions occur.
6. A patient presents with sudden muscle rigidity, high fever, and autonomic
instability after starting Haloperidol. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome
C. Acute Dystonia
D. Tardive Dyskinesia
Correct Answer: A
Expert Explanation: Neuroleptic Malignant Syndrome is characterized by the ‘lead-
pipe’ rigidity and hyperthermia seen in this patient. It is a medical emergency
Diagnosis & Management in Psychiatric-Mental
Health across the Lifespan | Chamberlain
1. A 25-year-old patient reports feeling depressed for the last 3 weeks, loss of
appetite, and difficulty sleeping. According to the DSM-5-TR, what is the minimum
duration of symptoms required for a diagnosis of Major Depressive Disorder?
A. 2 weeks
B. 1 week
C. 1 month
D. 6 months
Correct Answer: A
Expert Explanation: The correct answer is B because Major Depressive Disorder
requires symptoms to be present for at least a two-week period. This timeframe is
essential to distinguish acute distress from a clinical depressive episode.
Practitioners must ensure that at least five diagnostic symptoms are met during this
interval.
2. Which of the following medications is considered a first-line treatment for a
pediatric patient diagnosed with Major Depressive Disorder?
A. Sertraline
,B. Amitriptyline
C. Venlafaxine
D. Fluoxetine
Correct Answer: D
Expert Explanation: Fluoxetine is the correct answer as it is FDA-approved for the
treatment of depression in children and adolescents. It has the most robust evidence
base for safety and efficacy in this specific population. Clinical guidelines
recommend monitoring closely for increased suicidal ideation when starting SSRIs
in youth.
3. A patient with Bipolar I Disorder is being started on Lithium. Which of the following
is the therapeutic serum level range for maintenance therapy?
A. 0.2 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.0 mEq/L
Correct Answer: B
Expert Explanation: The therapeutic range for Lithium maintenance is typically 0.6
to 1.2 mEq/L to balance efficacy and toxicity risk. Levels above 1.5 mEq/L are
,generally considered toxic and require immediate medical intervention. Regular
blood monitoring is mandatory to ensure the patient remains within this narrow
therapeutic window.
4. A PMHNP is treating a patient with Schizophrenia who has not responded to two
different antipsychotic trials. What is the most appropriate next step in
pharmacological management?
A. Start a third-generation antipsychotic
B. Augment with an antidepressant
C. Switch to a typical antipsychotic
D. Trial Clozapine
Correct Answer: D
Expert Explanation: Clozapine is the gold standard for treatment-resistant
schizophrenia after two failed trials of other antipsychotics. It is uniquely effective
but requires intensive monitoring of the Absolute Neutrophil Count (ANC) due to
the risk of agranulocytosis. This medication should be considered early in the
treatment algorithm for refractory cases.
5. When prescribing Lamotrigine for Bipolar II Disorder, which life-threatening side
effect must the patient be educated about?
A. Stevens-Johnson Syndrome
, B. Agranulocytosis
C. Hepatic failure
D. Pancreatitis
Correct Answer: A
Expert Explanation: Stevens-Johnson Syndrome is a rare but life-threatening rash
associated with the use of Lamotrigine. To minimize this risk, the medication must
be titrated very slowly according to a specific schedule. Patients should be
instructed to seek immediate medical attention if any skin changes or mucosal
lesions occur.
6. A patient presents with sudden muscle rigidity, high fever, and autonomic
instability after starting Haloperidol. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome
C. Acute Dystonia
D. Tardive Dyskinesia
Correct Answer: A
Expert Explanation: Neuroleptic Malignant Syndrome is characterized by the ‘lead-
pipe’ rigidity and hyperthermia seen in this patient. It is a medical emergency
