NRNP 6635: PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING
COMPREHENSIVE EXAM
1. A 28-year-old patient presents with auditory hallucinations and delusions that have
persisted for 7 months. However, the patient also experienced a major depressive episode
lasting 2 months during this period. What is the most likely diagnosis?
A. Schizoaffective Disorder
B. Schizophrenia
C. Bipolar I Disorder with Psychotic Features
D. Major Depressive Disorder with Psychotic Features
Answer: A
Conceptual Explanation: Schizoaffective disorder requires a period of at least 2 weeks of
psychotic symptoms in the absence of a major mood episode, while the mood symptoms
are present for the majority of the total duration of the illness.
,2. In differentiating Bipolar I from Bipolar II, which of the following is the defining
characteristic of Bipolar II?
A. The presence of at least one hypomanic episode and one major depressive episode,
without a manic episode
B. The absence of any major depressive episodes
C. The presence of at least one manic episode
D. The presence of psychotic features during hypomania
Answer: A
Conceptual Explanation: Bipolar II requires at least one hypomanic episode and one
major depressive episode. If a manic episode occurs, the diagnosis changes to Bipolar I.
Psychotic features automatically qualify an episode as manic.
3. A patient exhibits a pervasive pattern of detachment from social relationships and a
restricted range of expression of emotions in interpersonal settings. They neither desire nor
enjoy close relationships. Which personality disorder is most likely?
A. Avoidant Personality Disorder
B. Schizotypal Personality Disorder
C. Schizoid Personality Disorder
D. Antisocial Personality Disorder
Answer: C
, Conceptual Explanation: Schizoid personality disorder is characterized by social
detachment and limited emotional expression. Unlike Avoidant PD, there is no desire for
social interaction.
4. According to the DSM-5, what is the minimum duration of symptoms required for a
diagnosis of Generalized Anxiety Disorder (GAD) in adults?
A. 6 months
B. 3 months
C. 1 month
D. 12 months
Answer: A
Conceptual Explanation: DSM-5 criteria for GAD require excessive anxiety and worry
occurring more days than not for at least 6 months.
5. Which neurotransmitter pathway is primarily associated with the ‘negative’ symptoms of
Schizophrenia (e.g., apathy, withdrawal)?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
DIAGNOSTIC REASONING
COMPREHENSIVE EXAM
1. A 28-year-old patient presents with auditory hallucinations and delusions that have
persisted for 7 months. However, the patient also experienced a major depressive episode
lasting 2 months during this period. What is the most likely diagnosis?
A. Schizoaffective Disorder
B. Schizophrenia
C. Bipolar I Disorder with Psychotic Features
D. Major Depressive Disorder with Psychotic Features
Answer: A
Conceptual Explanation: Schizoaffective disorder requires a period of at least 2 weeks of
psychotic symptoms in the absence of a major mood episode, while the mood symptoms
are present for the majority of the total duration of the illness.
,2. In differentiating Bipolar I from Bipolar II, which of the following is the defining
characteristic of Bipolar II?
A. The presence of at least one hypomanic episode and one major depressive episode,
without a manic episode
B. The absence of any major depressive episodes
C. The presence of at least one manic episode
D. The presence of psychotic features during hypomania
Answer: A
Conceptual Explanation: Bipolar II requires at least one hypomanic episode and one
major depressive episode. If a manic episode occurs, the diagnosis changes to Bipolar I.
Psychotic features automatically qualify an episode as manic.
3. A patient exhibits a pervasive pattern of detachment from social relationships and a
restricted range of expression of emotions in interpersonal settings. They neither desire nor
enjoy close relationships. Which personality disorder is most likely?
A. Avoidant Personality Disorder
B. Schizotypal Personality Disorder
C. Schizoid Personality Disorder
D. Antisocial Personality Disorder
Answer: C
, Conceptual Explanation: Schizoid personality disorder is characterized by social
detachment and limited emotional expression. Unlike Avoidant PD, there is no desire for
social interaction.
4. According to the DSM-5, what is the minimum duration of symptoms required for a
diagnosis of Generalized Anxiety Disorder (GAD) in adults?
A. 6 months
B. 3 months
C. 1 month
D. 12 months
Answer: A
Conceptual Explanation: DSM-5 criteria for GAD require excessive anxiety and worry
occurring more days than not for at least 6 months.
5. Which neurotransmitter pathway is primarily associated with the ‘negative’ symptoms of
Schizophrenia (e.g., apathy, withdrawal)?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
