NR 605 EXAM: DIAGNOSIS AND
MANAGEMENT IN PSYCHIATRIC-
MENTAL HEALTH NURSING
1. A patient presents with persistent symptoms of major depressive disorder. Which medical
condition should be ruled out first through laboratory testing before initiating psychotropic
therapy?
A. Hypothyroidism
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: A
Conceptual Explanation: Hypothyroidism is a common medical cause of depressive
symptoms. Testing TSH (Thyroid Stimulating Hormone) is a standard diagnostic step to
rule out physical causes of mood changes.
,2. Which antidepressant is contraindicated in a patient with a history of anorexia nervosa or
bulimia due to an increased risk of seizures?
A. Sertraline
B. Bupropion
C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion is associated with a lowered seizure threshold,
specifically in patients with active or historical eating disorders; thus, it is contraindicated
in this population.
3. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose a patient with Major Depressive Disorder?
A. 1 week
B. 1 month
C. 2 weeks
D. 6 months
Answer: C
, Conceptual Explanation: The DSM-5-TR requires at least five symptoms of depression,
including depressed mood or loss of interest, for at least a two-week period for a diagnosis
of MDD.
4. A 24-year-old male presents with a sudden onset of high fever, muscle rigidity (lead-pipe),
altered mental status, and autonomic instability. He recently started Haloperidol. What is the
most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Tardive Dyskinesia
D. Akathisia
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotic drugs,
characterized by fever, ‘lead-pipe’ rigidity, and autonomic dysfunction. It differs from
Serotonin Syndrome by the presence of rigidity rather than hyperreflexia.
5. Which laboratory value must be monitored closely for a patient taking Clozapine due to the
risk of agranulocytosis?
A. Absolute Neutrophil Count (ANC)
B. Liver Function Tests (LFTs)
C. Serum Creatinine
MANAGEMENT IN PSYCHIATRIC-
MENTAL HEALTH NURSING
1. A patient presents with persistent symptoms of major depressive disorder. Which medical
condition should be ruled out first through laboratory testing before initiating psychotropic
therapy?
A. Hypothyroidism
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: A
Conceptual Explanation: Hypothyroidism is a common medical cause of depressive
symptoms. Testing TSH (Thyroid Stimulating Hormone) is a standard diagnostic step to
rule out physical causes of mood changes.
,2. Which antidepressant is contraindicated in a patient with a history of anorexia nervosa or
bulimia due to an increased risk of seizures?
A. Sertraline
B. Bupropion
C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion is associated with a lowered seizure threshold,
specifically in patients with active or historical eating disorders; thus, it is contraindicated
in this population.
3. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose a patient with Major Depressive Disorder?
A. 1 week
B. 1 month
C. 2 weeks
D. 6 months
Answer: C
, Conceptual Explanation: The DSM-5-TR requires at least five symptoms of depression,
including depressed mood or loss of interest, for at least a two-week period for a diagnosis
of MDD.
4. A 24-year-old male presents with a sudden onset of high fever, muscle rigidity (lead-pipe),
altered mental status, and autonomic instability. He recently started Haloperidol. What is the
most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Tardive Dyskinesia
D. Akathisia
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotic drugs,
characterized by fever, ‘lead-pipe’ rigidity, and autonomic dysfunction. It differs from
Serotonin Syndrome by the presence of rigidity rather than hyperreflexia.
5. Which laboratory value must be monitored closely for a patient taking Clozapine due to the
risk of agranulocytosis?
A. Absolute Neutrophil Count (ANC)
B. Liver Function Tests (LFTs)
C. Serum Creatinine
