QUESTIONS, VERIFIED ANSWERS AND
DETAILED RATIONALES (LATEST UPDATE)
This premium study document features highly realistic multiple-
choice questions, verified answers, and detailed, bold-italicized
rationales tailored specifically for the NR547 Final Exam. It
comprehensively covers DSM-5-TR differential diagnosis criteria
across the lifespan, including neurocognitive disorders, personality
clusters, and substance withdrawal profiles. Optimized for student
success, this resource is perfect for boosting exam readiness and
achieving top grades.
1. A 74-year-old female presents with acute onset confusion, visual
hallucinations, and a fluctuating level of consciousness that worsens
in the evening. Her family notes she was completely normal two days
ago. What is the most likely diagnosis?
• A) Major Neurocognitive Disorder due to Alzheimer's Disease
• B) Delirium
• C) Major Depressive Disorder with Psychotic Features
• D) Schizophrenia, Late-Onset
• Answer: B
• Rationale: The hallmark features of delirium are an acute onset,
a fluctuating course of symptoms, inattention, and altered levels
of consciousness. Unlike neurocognitive disorders, delirium
, develops rapidly over hours to days and is typically secondary
to an underlying medical condition or substance toxicity.
2. When evaluating a patient for Bipolar I Disorder versus Bipolar II
Disorder, which clinical finding is strictly required to establish a
Bipolar I diagnosis?
• A) At least one hypomanic episode and one major depressive
episode
• B) A history of at least one full manic episode
• C) Rapid cycling of moods within a 48-hour period
• D) Cyclothymic mood swings lasting over two years
• Answer: B
• Rationale: DSM-5-TR criteria stipulate that a diagnosis of Bipolar
I Disorder requires the occurrence of at least one lifetime manic
episode. A major depressive episode is common but not strictly
required for Bipolar I, whereas Bipolar II requires both a
hypomanic episode and a major depressive episode, with no
history of a full manic episode.
3. A clinician asks a patient during a Mental Status Examination (MSE)
to recall what they ate for dinner the previous evening. Which
cognitive domain is the clinician primarily assessing?
• A) Immediate memory
• B) Remote memory
• C) Recent memory
• D) Executive functioning
• Answer: C
• Rationale: Recent memory refers to the ability to recall
information or events from the past few hours to days, such as
what was eaten for dinner or recent appointments. Immediate
, memory evaluates recall within seconds to minutes (e.g.,
repeating words), while remote memory looks at events from
years past.
4. A 29-year-old male exhibits a pervasive pattern of grandiosity, a
constant need for admiration, a deep lack of empathy, and an
entitlement that leads him to exploit others for personal gain. This
pattern has been present since early adulthood. Which personality
disorder is described?
• A) Borderline Personality Disorder
• B) Histrionic Personality Disorder
• C) Antisocial Personality Disorder
• D) Narcissistic Personality Disorder
• Answer: D
• Rationale: Narcissistic Personality Disorder is characterized by
a long-standing, pervasive pattern of grandiosity, an insatiable
need for admiration, entitlement, and a marked lack of empathy.
While Antisocial Personality Disorder also involves exploitation,
it focuses more on a disregard for laws, safety, and societal
norms.
5. Which pharmacological intervention is considered a first-line,
standard choice for managing the cognitive decline associated with
mild-to-moderate Alzheimer's disease by inhibiting
acetylcholinesterase?
• A) Memantine
• B) Donepezil
• C) Haloperidol
• D) Sertraline
• Answer: B
, • Rationale: Cholinesterase inhibitors like Donepezil,
Rivastigmine, and Galantamine are first-line treatments
indicated for mild-to-moderate Alzheimer's disease to
temporarily stabilize cognitive symptoms. Memantine is an
NMDA receptor antagonist typically added or used for moderate-
to-severe stages.
6. A 45-year-old patient reports a continuous, low-grade depressed
mood alongside periods of mild hypomanic symptoms for the past 2.5
years. The symptoms have never met the full criteria for a Major
Depressive Episode or a Manic Episode. What is the most
appropriate differential diagnosis?
• A) Persistent Depressive Disorder (Dysthymia)
• B) Cyclothymic Disorder
• C) Bipolar II Disorder
• D) Disruptive Mood Dysregulation Disorder
• Answer: B
• Rationale: Cyclothymic Disorder requires at least 2 years (1 year
in children/adolescents) of numerous periods with hypomanic
symptoms that do not meet criteria for a hypomanic episode and
numerous periods with depressive symptoms that do not meet
criteria for a major depressive episode.
7. A patient presents with progressive memory loss, severe spatial
disorientation, and difficulty finding words. A brain MRI reveals diffuse
cortical atrophy and prominent neurofibrillary tangles are suspected
pathologically. Which type of neurocognitive disorder does this align
with?
• A) Vascular Neurocognitive Disorder
• B) Frontotemporal Neurocognitive Disorder
• C) Neurocognitive Disorder due to Alzheimer's Disease