NR 605: DIAGNOSIS AND
MANAGEMENT IN PSYCHIATRIC
NURSING - ADVANCED REVIEW
QUESTIONS AND ANSWERS
1. A 45-year-old patient presents with a history of recurrent depressive episodes. For the past
two years, they have also experienced periods of hypomania that do not meet the full criteria
for a manic episode. What is the most likely diagnosis?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Persistent Depressive Disorder
Answer: C
Conceptual Explanation: Cyclothymic Disorder is characterized by at least two years 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.
,2. Which clinical feature is the primary differentiator between Schizoaffective Disorder and
Mood Disorder with Psychotic Features?
A. The presence of auditory hallucinations for at least 6 months.
B. The severity of the depressive symptoms during the active phase.
C. Psychotic symptoms occurring for at least 2 weeks in the absence of a major mood
episode.
D. The patient’s response to lithium therapy.
Answer: C
Conceptual Explanation: In Schizoaffective Disorder, delusions or hallucinations must be
present for 2 or more weeks in the absence of a major mood episode (depressive or manic)
during the lifetime duration of the illness.
3. A patient is admitted with a high fever, muscle rigidity, altered mental status, and
autonomic instability after starting Haloperidol. Which laboratory finding would most
support a diagnosis of Neuroleptic Malignant Syndrome (NMS)?
A. Decreased serum creatinine
B. Hypokalemia
C. Elevated Creatine Phosphokinase (CPK)
D. Low White Blood Cell count
Answer: C
, Conceptual Explanation: Elevated Creatine Phosphokinase (CPK) due to intense muscle
rigidity and rhabdomyolysis is a hallmark laboratory finding in NMS.
4. In the diagnosis of Anorexia Nervosa, which criterion was removed in the DSM-5 to allow
for a more inclusive diagnosis?
A. Amenorrhea
B. Disturbance in self-image
C. Fear of gaining weight
D. Restriction of energy intake
Answer: A
Conceptual Explanation: Amenorrhea (the absence of menstruation) was removed as a
requirement for Anorexia Nervosa in the DSM-5 to allow males and pre-menarcheal
females to be diagnosed.
5. A 28-year-old female reports intense fear of being in open spaces, using public
transportation, and standing in line because she fears she cannot escape or get help if she
develops panic-like symptoms. She has felt this way for 7 months. What is the diagnosis?
A. Panic Disorder
B. Social Anxiety Disorder
C. Generalized Anxiety Disorder
D. Agoraphobia
MANAGEMENT IN PSYCHIATRIC
NURSING - ADVANCED REVIEW
QUESTIONS AND ANSWERS
1. A 45-year-old patient presents with a history of recurrent depressive episodes. For the past
two years, they have also experienced periods of hypomania that do not meet the full criteria
for a manic episode. What is the most likely diagnosis?
A. Bipolar I Disorder
B. Bipolar II Disorder
C. Cyclothymic Disorder
D. Persistent Depressive Disorder
Answer: C
Conceptual Explanation: Cyclothymic Disorder is characterized by at least two years 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.
,2. Which clinical feature is the primary differentiator between Schizoaffective Disorder and
Mood Disorder with Psychotic Features?
A. The presence of auditory hallucinations for at least 6 months.
B. The severity of the depressive symptoms during the active phase.
C. Psychotic symptoms occurring for at least 2 weeks in the absence of a major mood
episode.
D. The patient’s response to lithium therapy.
Answer: C
Conceptual Explanation: In Schizoaffective Disorder, delusions or hallucinations must be
present for 2 or more weeks in the absence of a major mood episode (depressive or manic)
during the lifetime duration of the illness.
3. A patient is admitted with a high fever, muscle rigidity, altered mental status, and
autonomic instability after starting Haloperidol. Which laboratory finding would most
support a diagnosis of Neuroleptic Malignant Syndrome (NMS)?
A. Decreased serum creatinine
B. Hypokalemia
C. Elevated Creatine Phosphokinase (CPK)
D. Low White Blood Cell count
Answer: C
, Conceptual Explanation: Elevated Creatine Phosphokinase (CPK) due to intense muscle
rigidity and rhabdomyolysis is a hallmark laboratory finding in NMS.
4. In the diagnosis of Anorexia Nervosa, which criterion was removed in the DSM-5 to allow
for a more inclusive diagnosis?
A. Amenorrhea
B. Disturbance in self-image
C. Fear of gaining weight
D. Restriction of energy intake
Answer: A
Conceptual Explanation: Amenorrhea (the absence of menstruation) was removed as a
requirement for Anorexia Nervosa in the DSM-5 to allow males and pre-menarcheal
females to be diagnosed.
5. A 28-year-old female reports intense fear of being in open spaces, using public
transportation, and standing in line because she fears she cannot escape or get help if she
develops panic-like symptoms. She has felt this way for 7 months. What is the diagnosis?
A. Panic Disorder
B. Social Anxiety Disorder
C. Generalized Anxiety Disorder
D. Agoraphobia
