NR605 DIAGNOSIS & MANAGEMENT IN
PSYCHIATRIC-MENTAL HEALTH
REVIEW QUESTIONS AND ANSWERS
1. A patient taking Phenelzine (an MAOI) presents to the emergency department with a
severe headache, palpitations, and a blood pressure of 210/120 mmHg. Which dietary
indiscretion most likely caused this?
A. A slice of pepperoni pizza
B. A bowl of fresh strawberries
C. Grilled salmon with lemon
D. Scrambled eggs with spinach
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Consumption of tyramine-rich foods like
aged meats (pepperoni), aged cheeses, and fermented products can lead to a hypertensive
crisis due to the inhibition of tyramine breakdown.
,2. In the treatment of Schizophrenia, which dopamine pathway is primarily responsible for
the development of extrapyramidal symptoms (EPS) when blocked by first-generation
antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS, including dystonia and parkinsonism.
3. A 24-year-old female reports at least two years of hypomanic symptoms and periods of
depressive symptoms that do not meet the full criteria for a Major Depressive Episode. What
is the most likely diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Persistent Depressive Disorder
D. Cyclothymic Disorder
Answer: D
, Conceptual Explanation: Cyclothymic disorder is characterized by at least 2 years (1 year
in children) of numerous periods with hypomanic symptoms that do not meet criteria for a
hypomanic episode and numerous periods with depressive symptoms that do not meet
criteria for a major depressive episode.
4. Which of the following laboratory findings is most characteristic of Neuroleptic Malignant
Syndrome (NMS)?
A. Decreased White Blood Cell count
B. Elevated Creatine Phosphokinase (CPK)
C. Low serum potassium
D. Decreased liver enzymes
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics. A key
diagnostic marker is significantly elevated CPK due to intense muscle rigidity and
rhabdomyolysis.
5. A PMHNP is considering starting a patient on Clozapine. What is the absolute neutrophil
count (ANC) threshold required to initiate treatment?
A. Greater than or equal to 500/uL
B. Greater than or equal to 1000/uL
C. Greater than or equal to 1500/uL
PSYCHIATRIC-MENTAL HEALTH
REVIEW QUESTIONS AND ANSWERS
1. A patient taking Phenelzine (an MAOI) presents to the emergency department with a
severe headache, palpitations, and a blood pressure of 210/120 mmHg. Which dietary
indiscretion most likely caused this?
A. A slice of pepperoni pizza
B. A bowl of fresh strawberries
C. Grilled salmon with lemon
D. Scrambled eggs with spinach
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Consumption of tyramine-rich foods like
aged meats (pepperoni), aged cheeses, and fermented products can lead to a hypertensive
crisis due to the inhibition of tyramine breakdown.
,2. In the treatment of Schizophrenia, which dopamine pathway is primarily responsible for
the development of extrapyramidal symptoms (EPS) when blocked by first-generation
antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS, including dystonia and parkinsonism.
3. A 24-year-old female reports at least two years of hypomanic symptoms and periods of
depressive symptoms that do not meet the full criteria for a Major Depressive Episode. What
is the most likely diagnosis?
A. Bipolar II Disorder
B. Bipolar I Disorder
C. Persistent Depressive Disorder
D. Cyclothymic Disorder
Answer: D
, Conceptual Explanation: Cyclothymic disorder is characterized by at least 2 years (1 year
in children) of numerous periods with hypomanic symptoms that do not meet criteria for a
hypomanic episode and numerous periods with depressive symptoms that do not meet
criteria for a major depressive episode.
4. Which of the following laboratory findings is most characteristic of Neuroleptic Malignant
Syndrome (NMS)?
A. Decreased White Blood Cell count
B. Elevated Creatine Phosphokinase (CPK)
C. Low serum potassium
D. Decreased liver enzymes
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics. A key
diagnostic marker is significantly elevated CPK due to intense muscle rigidity and
rhabdomyolysis.
5. A PMHNP is considering starting a patient on Clozapine. What is the absolute neutrophil
count (ANC) threshold required to initiate treatment?
A. Greater than or equal to 500/uL
B. Greater than or equal to 1000/uL
C. Greater than or equal to 1500/uL
