NRNP 6635 Final Exam (Latest-2024, 100 Q
and A) / NRNP6635 Final Exam: Walden
University
Section 1: Neurocognitive & Neurodevelopmental Disorders (Questions 1-10)
1. Select the mental function that is most affected in mild cognitive impairment.
A) Executive function
B) Recent memory
C) Language
D) Attention
Answer: B) Recent memory
Rationale: Mild cognitive impairment (MCI) primarily affects recent memory,
making it difficult to recall recent events or information. This is often the earliest
sign of cognitive decline and may be a precursor to dementia. Other cognitive
domains remain relatively intact in early MCI .
2. Select the most frequent cause of infant and childhood intellectual disability
that is attributed to a specific gene.
A) Fragile X syndrome
B) Fetal alcohol syndrome
C) Down syndrome
D) Autism spectrum disorder
Answer: C) Down syndrome
Rationale: Down syndrome (trisomy 21) is the most frequent genetic cause of
intellectual disability in children and infants. Unlike fetal alcohol syndrome, which
is environmental, Down syndrome is directly attributed to a specific chromosomal
abnormality .
3. Select the neurotransmitter that is most associated with the occurrence of
ADHD.
,A) Serotonin
B) Dopamine
C) Norepinephrine
D) GABA
Answer: B) Dopamine
Rationale: Dopamine dysregulation in the prefrontal cortex and striatum is most
strongly implicated in ADHD pathophysiology. Dopamine plays a key role in
attention regulation, motivation, and reward processing .
4. Which brain region shows the greatest anatomical abnormalities in
schizophrenic patients?
A) Prefrontal cortex
B) Temporal lobe
C) Basal ganglia
D) Cerebellum
Answer: C) Basal ganglia
Rationale: The basal ganglia, along with the cerebellum, are involved in
movement control. In schizophrenia, structural and functional abnormalities in
the basal ganglia are frequently observed, partly related to dopamine
dysregulation .
5. Select the neurodevelopmental disorder typically diagnosed in childhood.
A) Bipolar disorder
B) Schizophrenia
C) Intellectual disability
D) Panic disorder
Answer: C) Intellectual disability
Rationale: Intellectual disability is a neurodevelopmental disorder with onset
during the developmental period (typically childhood). It involves deficits in
intellectual and adaptive functioning. Bipolar disorder and schizophrenia typically
emerge in late adolescence or early adulthood .
,6. A 72-year-old man develops gradual memory loss over two years. He cannot
recall recent conversations, gets lost driving, and has trouble managing finances.
His Mini-Mental State Exam score is 20/30. What is the most likely diagnosis?
A) Major neurocognitive disorder (Alzheimer's type)
B) Delirium
C) Frontotemporal dementia
D) Mild neurocognitive disorder
Answer: A) Major neurocognitive disorder (Alzheimer's type)
Rationale: Gradual onset, progressive decline over two years, and impairments in
memory and executive function suggest major neurocognitive disorder due to
Alzheimer's disease. Delirium has acute onset and fluctuating course .
7. A 70-year-old man with hypertension becomes acutely confused, agitated,
and has visual hallucinations of bugs crawling on the walls. Symptoms started
two days after a urinary tract infection. What is the most likely diagnosis?
A) Major neurocognitive disorder with behavioral disturbance
B) Delirium
C) Substance/medication-induced psychotic disorder
D) Brief psychotic disorder
Answer: B) Delirium
Rationale: Delirium is characterized by acute onset, fluctuating course,
inattention, and altered consciousness, often due to a medical condition (UTI).
Hallucinations, particularly visual, can occur .
8. A 16-year-old boy has a 2-year history of difficulty sustaining attention,
frequent fidgeting, talking excessively, and interrupting others. Symptoms occur
at home, school, and with friends. What is the most likely diagnosis?
A) Oppositional defiant disorder
B) Specific learning disorder
C) ADHD, combined presentation
D) Autism spectrum disorder
, Answer: C) ADHD, combined presentation
Rationale: ADHD combined presentation requires both inattention (difficulty
sustaining attention) and hyperactivity-impulsivity (fidgeting, excessive talking,
interrupting) symptoms present before age 12 and across settings .
9. The neurotransmitter involved in OCD in children and adolescents, based on
the common comorbidity of tic disorder, is:
A) Serotonin
B) Dopamine
C) Norepinephrine
D) Acetylcholine
Answer: B) Dopamine
Rationale: The frequent comorbidity of OCD with tic disorders suggests
dopaminergic involvement, particularly in the cortico-striatal-thalamo-cortical
circuit. While serotonin is also involved, the tic disorder connection points to
dopamine .
10. The primary cause of reactive attachment disorder in children is:
A) Death of mother
B) Bullying by peers
C) Negligent parenting
D) Fetal alcohol syndrome
Answer: C) Negligent parenting
Rationale: Reactive attachment disorder results from severe neglect or pathogenic
care, including persistent lack of comfort, distress, and affection from caregivers. It
is a disorder of social relatedness directly linked to early caregiving experiences .
Section 2: Mood Disorders (Questions 11-20)
11. A 24-year-old woman presents with a one-week history of elevated mood,
grandiosity, decreased need for sleep, rapid speech, and agitation. She has been
spending large sums of money. This is her first episode with no psychosis. What
is the most likely diagnosis?
and A) / NRNP6635 Final Exam: Walden
University
Section 1: Neurocognitive & Neurodevelopmental Disorders (Questions 1-10)
1. Select the mental function that is most affected in mild cognitive impairment.
A) Executive function
B) Recent memory
C) Language
D) Attention
Answer: B) Recent memory
Rationale: Mild cognitive impairment (MCI) primarily affects recent memory,
making it difficult to recall recent events or information. This is often the earliest
sign of cognitive decline and may be a precursor to dementia. Other cognitive
domains remain relatively intact in early MCI .
2. Select the most frequent cause of infant and childhood intellectual disability
that is attributed to a specific gene.
A) Fragile X syndrome
B) Fetal alcohol syndrome
C) Down syndrome
D) Autism spectrum disorder
Answer: C) Down syndrome
Rationale: Down syndrome (trisomy 21) is the most frequent genetic cause of
intellectual disability in children and infants. Unlike fetal alcohol syndrome, which
is environmental, Down syndrome is directly attributed to a specific chromosomal
abnormality .
3. Select the neurotransmitter that is most associated with the occurrence of
ADHD.
,A) Serotonin
B) Dopamine
C) Norepinephrine
D) GABA
Answer: B) Dopamine
Rationale: Dopamine dysregulation in the prefrontal cortex and striatum is most
strongly implicated in ADHD pathophysiology. Dopamine plays a key role in
attention regulation, motivation, and reward processing .
4. Which brain region shows the greatest anatomical abnormalities in
schizophrenic patients?
A) Prefrontal cortex
B) Temporal lobe
C) Basal ganglia
D) Cerebellum
Answer: C) Basal ganglia
Rationale: The basal ganglia, along with the cerebellum, are involved in
movement control. In schizophrenia, structural and functional abnormalities in
the basal ganglia are frequently observed, partly related to dopamine
dysregulation .
5. Select the neurodevelopmental disorder typically diagnosed in childhood.
A) Bipolar disorder
B) Schizophrenia
C) Intellectual disability
D) Panic disorder
Answer: C) Intellectual disability
Rationale: Intellectual disability is a neurodevelopmental disorder with onset
during the developmental period (typically childhood). It involves deficits in
intellectual and adaptive functioning. Bipolar disorder and schizophrenia typically
emerge in late adolescence or early adulthood .
,6. A 72-year-old man develops gradual memory loss over two years. He cannot
recall recent conversations, gets lost driving, and has trouble managing finances.
His Mini-Mental State Exam score is 20/30. What is the most likely diagnosis?
A) Major neurocognitive disorder (Alzheimer's type)
B) Delirium
C) Frontotemporal dementia
D) Mild neurocognitive disorder
Answer: A) Major neurocognitive disorder (Alzheimer's type)
Rationale: Gradual onset, progressive decline over two years, and impairments in
memory and executive function suggest major neurocognitive disorder due to
Alzheimer's disease. Delirium has acute onset and fluctuating course .
7. A 70-year-old man with hypertension becomes acutely confused, agitated,
and has visual hallucinations of bugs crawling on the walls. Symptoms started
two days after a urinary tract infection. What is the most likely diagnosis?
A) Major neurocognitive disorder with behavioral disturbance
B) Delirium
C) Substance/medication-induced psychotic disorder
D) Brief psychotic disorder
Answer: B) Delirium
Rationale: Delirium is characterized by acute onset, fluctuating course,
inattention, and altered consciousness, often due to a medical condition (UTI).
Hallucinations, particularly visual, can occur .
8. A 16-year-old boy has a 2-year history of difficulty sustaining attention,
frequent fidgeting, talking excessively, and interrupting others. Symptoms occur
at home, school, and with friends. What is the most likely diagnosis?
A) Oppositional defiant disorder
B) Specific learning disorder
C) ADHD, combined presentation
D) Autism spectrum disorder
, Answer: C) ADHD, combined presentation
Rationale: ADHD combined presentation requires both inattention (difficulty
sustaining attention) and hyperactivity-impulsivity (fidgeting, excessive talking,
interrupting) symptoms present before age 12 and across settings .
9. The neurotransmitter involved in OCD in children and adolescents, based on
the common comorbidity of tic disorder, is:
A) Serotonin
B) Dopamine
C) Norepinephrine
D) Acetylcholine
Answer: B) Dopamine
Rationale: The frequent comorbidity of OCD with tic disorders suggests
dopaminergic involvement, particularly in the cortico-striatal-thalamo-cortical
circuit. While serotonin is also involved, the tic disorder connection points to
dopamine .
10. The primary cause of reactive attachment disorder in children is:
A) Death of mother
B) Bullying by peers
C) Negligent parenting
D) Fetal alcohol syndrome
Answer: C) Negligent parenting
Rationale: Reactive attachment disorder results from severe neglect or pathogenic
care, including persistent lack of comfort, distress, and affection from caregivers. It
is a disorder of social relatedness directly linked to early caregiving experiences .
Section 2: Mood Disorders (Questions 11-20)
11. A 24-year-old woman presents with a one-week history of elevated mood,
grandiosity, decreased need for sleep, rapid speech, and agitation. She has been
spending large sums of money. This is her first episode with no psychosis. What
is the most likely diagnosis?
