NRNP 6635 PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING
COMPREHENSIVE EXAM
1. A 24-year-old patient presents with symptoms of psychosis including auditory
hallucinations and paranoid delusions that have persisted for 4 months. There are no
prominent mood episodes. Which diagnosis is most appropriate based on the duration of
symptoms?
A. Schizophrenia
B. Brief Psychotic Disorder
C. Schizophreniform Disorder
D. Schizoaffective Disorder
Answer: C
Conceptual Explanation: Schizophreniform disorder is diagnosed when the symptoms of
schizophrenia are present for at least 1 month but less than 6 months. Schizophrenia
requires at least 6 months of continuous signs of the disturbance.
,2. Which neurotransmitter pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is thought to
mediate the positive symptoms of psychosis, while the mesocortical pathway is associated
with negative and cognitive symptoms.
3. A patient exhibits a pattern of instability in interpersonal relationships, self-image, and
affects, along with marked impulsivity beginning by early adulthood. She frequently engages
in self-harm and expresses intense fears of abandonment. What is the most likely diagnosis?
A. Histrionic Personality Disorder
B. Antisocial Personality Disorder
C. Borderline Personality Disorder
D. Schizoid Personality Disorder
Answer: C
, Conceptual Explanation: Borderline Personality Disorder (BPD) is characterized by a
pervasive pattern of instability in affect regulation, impulse control, interpersonal
relationships, and self-image.
4. In the DSM-5-TR, what is the primary difference between Bipolar I and Bipolar II Disorder?
A. Bipolar II requires a full manic episode.
B. Bipolar II requires at least one hypomanic episode and at least one major depressive
episode, with no history of a manic episode.
C. Bipolar I requires at least one hypomanic episode and one major depressive episode.
D. Bipolar I does not require a depressive episode for diagnosis.
Answer: B
Conceptual Explanation: Bipolar II is defined by the occurrence of at least one hypomanic
episode and at least one major depressive episode. If a full manic episode has ever
occurred, the diagnosis is Bipolar I.
5. Which brain region is most implicated in the pathophysiology of Obsessive-Compulsive
Disorder (OCD)?
A. Locus Coeruleus
B. Hippocampus and Amygdala
C. Cortico-striato-thalamo-cortical (CSTC) circuit
D. Occipital Lobe
DIAGNOSTIC REASONING
COMPREHENSIVE EXAM
1. A 24-year-old patient presents with symptoms of psychosis including auditory
hallucinations and paranoid delusions that have persisted for 4 months. There are no
prominent mood episodes. Which diagnosis is most appropriate based on the duration of
symptoms?
A. Schizophrenia
B. Brief Psychotic Disorder
C. Schizophreniform Disorder
D. Schizoaffective Disorder
Answer: C
Conceptual Explanation: Schizophreniform disorder is diagnosed when the symptoms of
schizophrenia are present for at least 1 month but less than 6 months. Schizophrenia
requires at least 6 months of continuous signs of the disturbance.
,2. Which neurotransmitter pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is thought to
mediate the positive symptoms of psychosis, while the mesocortical pathway is associated
with negative and cognitive symptoms.
3. A patient exhibits a pattern of instability in interpersonal relationships, self-image, and
affects, along with marked impulsivity beginning by early adulthood. She frequently engages
in self-harm and expresses intense fears of abandonment. What is the most likely diagnosis?
A. Histrionic Personality Disorder
B. Antisocial Personality Disorder
C. Borderline Personality Disorder
D. Schizoid Personality Disorder
Answer: C
, Conceptual Explanation: Borderline Personality Disorder (BPD) is characterized by a
pervasive pattern of instability in affect regulation, impulse control, interpersonal
relationships, and self-image.
4. In the DSM-5-TR, what is the primary difference between Bipolar I and Bipolar II Disorder?
A. Bipolar II requires a full manic episode.
B. Bipolar II requires at least one hypomanic episode and at least one major depressive
episode, with no history of a manic episode.
C. Bipolar I requires at least one hypomanic episode and one major depressive episode.
D. Bipolar I does not require a depressive episode for diagnosis.
Answer: B
Conceptual Explanation: Bipolar II is defined by the occurrence of at least one hypomanic
episode and at least one major depressive episode. If a full manic episode has ever
occurred, the diagnosis is Bipolar I.
5. Which brain region is most implicated in the pathophysiology of Obsessive-Compulsive
Disorder (OCD)?
A. Locus Coeruleus
B. Hippocampus and Amygdala
C. Cortico-striato-thalamo-cortical (CSTC) circuit
D. Occipital Lobe
