NR605 FINAL EXAM PREP:
PSYCHIATRIC-MENTAL HEALTH
ACROSS THE LIFESPAN I (WEEKS 5-8)
QUESTIONS AND ANSWERS
1. A 32-year-old patient presents with symptoms of grandiosity, decreased need for sleep for
5 days, and pressured speech, but is able to maintain their job and social functions without
hospitalization. What is the most likely diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with Psychotic Features
Answer: A
Conceptual Explanation: Bipolar II is characterized by hypomanic episodes that last at
least 4 days and do not cause significant impairment in social or occupational functioning
or require hospitalization, unlike Bipolar I.
,2. Which lab value is most critical to monitor for a patient newly started on Clozapine
(Clozaril)?
A. Serum Potassium
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis;
therefore, strict monitoring of the ANC is required to ensure the patient’s immune system
is not compromised.
3. A 70-year-old patient exhibits acute confusion, fluctuating levels of consciousness, and
visual hallucinations following a hip surgery. What is the priority intervention?
A. Identifying and treating the underlying medical cause
B. Ordering a CT scan to rule out Alzheimer’s
C. Administering a high-dose benzodiazepine
D. Starting the patient on Donepezil
Answer: A
, Conceptual Explanation: Delirium is an acute, fluctuating change in mental status often
caused by underlying medical issues (infection, medication, or post-op complications).
Treatment focuses on the root cause.
4. Which medication is considered first-line treatment for a patient diagnosed with
Obsessive-Compulsive Disorder (OCD)?
A. Alprazolam
B. Bupropion
C. Fluoxetine
D. Quetiapine
Answer: C
Conceptual Explanation: SSRIs like Fluoxetine, usually at higher doses than used for
depression, are first-line pharmacological treatments for OCD.
5. A patient taking Lithium for Bipolar Disorder reports coarse hand tremors, diarrhea, and
confusion. The serum lithium level is 1.8 mEq/L. What is the appropriate next step?
A. Increase the dose as these are common side effects
B. Hold the medication and evaluate for toxicity
C. Continue the dose and recheck in one week
D. Add Propranolol to manage the tremors
Answer: B
PSYCHIATRIC-MENTAL HEALTH
ACROSS THE LIFESPAN I (WEEKS 5-8)
QUESTIONS AND ANSWERS
1. A 32-year-old patient presents with symptoms of grandiosity, decreased need for sleep for
5 days, and pressured speech, but is able to maintain their job and social functions without
hospitalization. What is the most likely diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Major Depressive Disorder with Psychotic Features
Answer: A
Conceptual Explanation: Bipolar II is characterized by hypomanic episodes that last at
least 4 days and do not cause significant impairment in social or occupational functioning
or require hospitalization, unlike Bipolar I.
,2. Which lab value is most critical to monitor for a patient newly started on Clozapine
(Clozaril)?
A. Serum Potassium
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis;
therefore, strict monitoring of the ANC is required to ensure the patient’s immune system
is not compromised.
3. A 70-year-old patient exhibits acute confusion, fluctuating levels of consciousness, and
visual hallucinations following a hip surgery. What is the priority intervention?
A. Identifying and treating the underlying medical cause
B. Ordering a CT scan to rule out Alzheimer’s
C. Administering a high-dose benzodiazepine
D. Starting the patient on Donepezil
Answer: A
, Conceptual Explanation: Delirium is an acute, fluctuating change in mental status often
caused by underlying medical issues (infection, medication, or post-op complications).
Treatment focuses on the root cause.
4. Which medication is considered first-line treatment for a patient diagnosed with
Obsessive-Compulsive Disorder (OCD)?
A. Alprazolam
B. Bupropion
C. Fluoxetine
D. Quetiapine
Answer: C
Conceptual Explanation: SSRIs like Fluoxetine, usually at higher doses than used for
depression, are first-line pharmacological treatments for OCD.
5. A patient taking Lithium for Bipolar Disorder reports coarse hand tremors, diarrhea, and
confusion. The serum lithium level is 1.8 mEq/L. What is the appropriate next step?
A. Increase the dose as these are common side effects
B. Hold the medication and evaluate for toxicity
C. Continue the dose and recheck in one week
D. Add Propranolol to manage the tremors
Answer: B
