NR 605: DIAGNOSIS AND
MANAGEMENT IN PSYCHIATRIC
NURSING - ADVANCED PRACTICE
EXAM QUESTIONS AND CORRECT
ANSWERS A+ GRADE
1. A 32-year-old female presents with a 3-week history of low mood, anhedonia, and
significant weight loss. She reports hearing a voice telling her she is ‘worthless’ only when she
feels most depressed. What is the most likely diagnosis?
A. Schizophrenia
B. Major Depressive Disorder with Psychotic Features
C. Schizoaffective Disorder
D. Delusional Disorder
Answer: B
Conceptual Explanation: In MDD with psychotic features, psychosis occurs exclusively
during the mood episode. In Schizoaffective disorder, psychosis must persist for at least 2
weeks in the absence of a major mood episode.
2. Which neuroanatomical pathway is primarily responsible for the development of
extrapyramidal symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
,B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The nigrostriatal pathway controls motor function. D2 blockade
here leads to EPS, including dystonia, akathisia, and parkinsonism.
3. A patient taking Clozapine presents for a routine follow-up. Which Absolute Neutrophil
Count (ANC) result would require immediate discontinuation of the medication?
A. 1800/mm³
B. 1600/mm³
C. 800/mm³
D. 1200/mm³
Answer: C
Conceptual Explanation: According to Clozapine REMS, an ANC below 1000/mm³ (Severe
Neutropenia) requires treatment interruption and specialized management.
4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Bupropion
B. Fluoxetine
, C. Venlafaxine
D. Mirtazapine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances common in Bulimia or Anorexia Nervosa.
5. A 45-year-old male with Bipolar I Disorder is started on Lithium. Which lab value is the
most critical to monitor due to the risk of toxicity?
A. Serum Creatinine and GFR
B. Liver function tests (LFTs)
C. Complete Blood Count (CBC)
D. Amylase and Lipase
Answer: A
Conceptual Explanation: Lithium is renally excreted. Changes in renal function
(Creatinine/GFR) can lead to toxic accumulation of Lithium.
6. Which medication is considered the first-line treatment for a patient diagnosed with
Nightmare Disorder associated with PTSD?
A. Lorazepam
B. Prazosin
C. Quetiapine
MANAGEMENT IN PSYCHIATRIC
NURSING - ADVANCED PRACTICE
EXAM QUESTIONS AND CORRECT
ANSWERS A+ GRADE
1. A 32-year-old female presents with a 3-week history of low mood, anhedonia, and
significant weight loss. She reports hearing a voice telling her she is ‘worthless’ only when she
feels most depressed. What is the most likely diagnosis?
A. Schizophrenia
B. Major Depressive Disorder with Psychotic Features
C. Schizoaffective Disorder
D. Delusional Disorder
Answer: B
Conceptual Explanation: In MDD with psychotic features, psychosis occurs exclusively
during the mood episode. In Schizoaffective disorder, psychosis must persist for at least 2
weeks in the absence of a major mood episode.
2. Which neuroanatomical pathway is primarily responsible for the development of
extrapyramidal symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
,B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The nigrostriatal pathway controls motor function. D2 blockade
here leads to EPS, including dystonia, akathisia, and parkinsonism.
3. A patient taking Clozapine presents for a routine follow-up. Which Absolute Neutrophil
Count (ANC) result would require immediate discontinuation of the medication?
A. 1800/mm³
B. 1600/mm³
C. 800/mm³
D. 1200/mm³
Answer: C
Conceptual Explanation: According to Clozapine REMS, an ANC below 1000/mm³ (Severe
Neutropenia) requires treatment interruption and specialized management.
4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Bupropion
B. Fluoxetine
, C. Venlafaxine
D. Mirtazapine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances common in Bulimia or Anorexia Nervosa.
5. A 45-year-old male with Bipolar I Disorder is started on Lithium. Which lab value is the
most critical to monitor due to the risk of toxicity?
A. Serum Creatinine and GFR
B. Liver function tests (LFTs)
C. Complete Blood Count (CBC)
D. Amylase and Lipase
Answer: A
Conceptual Explanation: Lithium is renally excreted. Changes in renal function
(Creatinine/GFR) can lead to toxic accumulation of Lithium.
6. Which medication is considered the first-line treatment for a patient diagnosed with
Nightmare Disorder associated with PTSD?
A. Lorazepam
B. Prazosin
C. Quetiapine
