NRNP 6635 Exam 4 V2 | NRNP 6635
Psychopathology and Diagnostic
Reasoning | Actual Q&A with Rationale
(NRNP6635 Exam 4) | Walden University
1. A 28-year-old female presents with a six-month history of excessive worry about various
life events, including work performance and health. She reports muscle tension, fatigue, and
difficulty concentrating. Which is the most appropriate DSM-5 diagnosis?
A. Panic Disorder
B. Social Anxiety Disorder
C. Adjustment Disorder with Anxiety
D. Generalized Anxiety Disorder (GAD)
Answer: D
Rationale: Generalized Anxiety Disorder is characterized by persistent and excessive
worry about several different things for at least six months. The patient must also
demonstrate physical symptoms such as restlessness or muscle tension. This diagnosis is
distinguished from other anxiety disorders by the lack of a specific focus for the anxiety.
,2. A 9-year-old male is brought to the clinic for severe temper outbursts that occur
approximately four times a week. Between these episodes, the child is described as being
‘irritable and angry’ by his parents and teachers. What is the most likely diagnosis?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder
C. Attention-Deficit/Hyperactivity Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Rationale: DMDD is characterized by chronic, severe persistent irritability and frequent
temper outbursts. To meet the criteria, the onset must be before age 10, and the symptoms
must occur in at least two settings. This diagnosis was created to differentiate from
pediatric bipolar disorder which typically presents with episodic rather than chronic
irritability.
3. When evaluating a patient for Schizoaffective Disorder, what is the primary requirement
regarding the duration of mood symptoms?
A. Mood symptoms must be present for the majority of the total duration of the illness.
B. Mood symptoms must only occur during the prodromal phase.
C. Mood symptoms must be present for at least two weeks in the absence of psychosis.
D. Mood symptoms must resolve immediately after the psychotic episode ends.
,Answer: A
Rationale: The DSM-5 specifies that for a diagnosis of Schizoaffective Disorder, the
symptoms of a major mood episode must be present for the majority of the total duration
of the active and residual portions of the illness. Additionally, there must be a period of at
least two weeks where delusions or hallucinations are present without major mood
symptoms. This criteria helps differentiate it from Major Depressive Disorder with
Psychotic Features.
4. A patient presents with a long-standing pattern of detachment from social relationships
and a restricted range of emotional expression in interpersonal settings. He prefers solitary
activities and lacks close friends. This most likely describes which personality disorder?
A. Avoidant Personality Disorder
B. Schizotypal Personality Disorder
C. Schizoid Personality Disorder
D. Antisocial Personality Disorder
Answer: C
Rationale: Schizoid Personality Disorder is defined by a pervasive pattern of detachment
from social relationships and a restricted range of expression of emotions. Unlike
Schizotypal, it does not involve cognitive or perceptual distortions. Unlike Avoidant, the
individual generally lacks the desire for intimacy rather than fearing rejection.
, 5. Which of the following is a core requirement for a diagnosis of Anorexia Nervosa?
A. Binge eating followed by purging at least once a week.
B. A Body Mass Index (BMI) within the normal range.
C. The presence of amenorrhea for at least three consecutive cycles.
D. Intense fear of gaining weight or becoming fat, even though underweight.
Answer: D
Rationale: Anorexia Nervosa involves the restriction of energy intake relative to
requirements leading to a significantly low body weight. It is accompanied by an intense
fear of weight gain and a disturbance in the way one’s body weight or shape is experienced.
The DSM-5 removed the requirement for amenorrhea, making weight-related fears and low
BMI the primary indicators.
6. A 45-year-old male reports a 2-month history of sudden, intense fear accompanied by
palpitations, sweating, and shortness of breath. He now worries constantly about having
another attack. This is consistent with:
A. Panic Disorder
B. Specific Phobia
C. Post-Traumatic Stress Disorder
D. Obsessive-Compulsive Disorder
Answer: A
Psychopathology and Diagnostic
Reasoning | Actual Q&A with Rationale
(NRNP6635 Exam 4) | Walden University
1. A 28-year-old female presents with a six-month history of excessive worry about various
life events, including work performance and health. She reports muscle tension, fatigue, and
difficulty concentrating. Which is the most appropriate DSM-5 diagnosis?
A. Panic Disorder
B. Social Anxiety Disorder
C. Adjustment Disorder with Anxiety
D. Generalized Anxiety Disorder (GAD)
Answer: D
Rationale: Generalized Anxiety Disorder is characterized by persistent and excessive
worry about several different things for at least six months. The patient must also
demonstrate physical symptoms such as restlessness or muscle tension. This diagnosis is
distinguished from other anxiety disorders by the lack of a specific focus for the anxiety.
,2. A 9-year-old male is brought to the clinic for severe temper outbursts that occur
approximately four times a week. Between these episodes, the child is described as being
‘irritable and angry’ by his parents and teachers. What is the most likely diagnosis?
A. Bipolar I Disorder
B. Oppositional Defiant Disorder
C. Attention-Deficit/Hyperactivity Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
Rationale: DMDD is characterized by chronic, severe persistent irritability and frequent
temper outbursts. To meet the criteria, the onset must be before age 10, and the symptoms
must occur in at least two settings. This diagnosis was created to differentiate from
pediatric bipolar disorder which typically presents with episodic rather than chronic
irritability.
3. When evaluating a patient for Schizoaffective Disorder, what is the primary requirement
regarding the duration of mood symptoms?
A. Mood symptoms must be present for the majority of the total duration of the illness.
B. Mood symptoms must only occur during the prodromal phase.
C. Mood symptoms must be present for at least two weeks in the absence of psychosis.
D. Mood symptoms must resolve immediately after the psychotic episode ends.
,Answer: A
Rationale: The DSM-5 specifies that for a diagnosis of Schizoaffective Disorder, the
symptoms of a major mood episode must be present for the majority of the total duration
of the active and residual portions of the illness. Additionally, there must be a period of at
least two weeks where delusions or hallucinations are present without major mood
symptoms. This criteria helps differentiate it from Major Depressive Disorder with
Psychotic Features.
4. A patient presents with a long-standing pattern of detachment from social relationships
and a restricted range of emotional expression in interpersonal settings. He prefers solitary
activities and lacks close friends. This most likely describes which personality disorder?
A. Avoidant Personality Disorder
B. Schizotypal Personality Disorder
C. Schizoid Personality Disorder
D. Antisocial Personality Disorder
Answer: C
Rationale: Schizoid Personality Disorder is defined by a pervasive pattern of detachment
from social relationships and a restricted range of expression of emotions. Unlike
Schizotypal, it does not involve cognitive or perceptual distortions. Unlike Avoidant, the
individual generally lacks the desire for intimacy rather than fearing rejection.
, 5. Which of the following is a core requirement for a diagnosis of Anorexia Nervosa?
A. Binge eating followed by purging at least once a week.
B. A Body Mass Index (BMI) within the normal range.
C. The presence of amenorrhea for at least three consecutive cycles.
D. Intense fear of gaining weight or becoming fat, even though underweight.
Answer: D
Rationale: Anorexia Nervosa involves the restriction of energy intake relative to
requirements leading to a significantly low body weight. It is accompanied by an intense
fear of weight gain and a disturbance in the way one’s body weight or shape is experienced.
The DSM-5 removed the requirement for amenorrhea, making weight-related fears and low
BMI the primary indicators.
6. A 45-year-old male reports a 2-month history of sudden, intense fear accompanied by
palpitations, sweating, and shortness of breath. He now worries constantly about having
another attack. This is consistent with:
A. Panic Disorder
B. Specific Phobia
C. Post-Traumatic Stress Disorder
D. Obsessive-Compulsive Disorder
Answer: A
