1
NR 606 QUIZ 2 LATEST 2026/2027 |
PSYCHIATRIC MENTAL HEALTH NP | 50
VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION I: MOOD DISORDERS – Questions 1-8
Q1: Persistent Depressive Disorder
The student is reviewing depressive disorders. A client reports feeling depressed "most of the day,
more days than not" for the past 3 years, with low energy, poor appetite, and low self-esteem.
Which diagnosis is most appropriate?
A. Major depressive disorder
B. Persistent depressive disorder (dysthymia)
C. Cyclothymic disorder
D. Bipolar II disorder
Correct Answer: B
Rationale: Persistent depressive disorder (dysthymia) is characterized by a depressed mood for most
of the day, for more days than not, for at least 2 years in adults (1 year in children/adolescents),
along with at least two of: poor appetite/overeating, insomnia/hypersomnia, low energy, low self-
esteem, poor concentration, or hopelessness. Major depressive disorder requires a 2-week period of
prominent symptoms. Cyclothymic disorder involves hypomanic and depressive symptoms. Bipolar II
requires hypomanic episodes. [100% CORRECT]
Q2: Disruptive Mood Dysregulation Disorder
The student is reviewing childhood mood disorders. A 10-year-old has severe recurrent temper
outbursts out of proportion to the situation, occurring 3+ times per week, with persistently irritable
mood between outbursts for over a year. Which diagnosis is most appropriate?
A. Bipolar I disorder
B. Disruptive mood dysregulation disorder (DMDD)
C. Oppositional defiant disorder
D. Intermittent explosive disorder
Correct Answer: B
Rationale: DMDD is diagnosed in children ages 6-18 with severe recurrent temper outbursts (verbal
or behavioral) that are grossly out of proportion to the situation, occurring 3+ times per week, with
persistently irritable or angry mood between outbursts for at least 12 months. It is not better
explained by another disorder. Bipolar I requires distinct manic episodes. ODD involves a pattern of
angry/irritable mood, argumentative/defiant behavior, or vindictiveness. Intermittent explosive
disorder involves impulsive aggression without persistent irritability. [100% CORRECT]
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Q3: Bipolar Disorder - Rapid Cycling
The student is reviewing bipolar disorder specifiers. A client with bipolar disorder has experienced 4
mood episodes (manic, hypomanic, or depressive) within the past 12 months. Which specifier
applies?
A. With mixed features
B. With rapid cycling
C. With psychotic features
D. With catatonia
Correct Answer: B
Rationale: Rapid cycling is a specifier for bipolar I and II disorders defined as at least 4 mood
episodes (manic, hypomanic, or major depressive) within a 12-month period. Mixed features refer to
simultaneous manic and depressive symptoms. Psychotic features indicate delusions or
hallucinations. Catatonia involves psychomotor disturbances. [100% CORRECT]
Q4: Antidepressant-Induced Mania
The student is reviewing medication risks. A client with previously undiagnosed bipolar disorder is
started on fluoxetine and develops pressured speech, decreased need for sleep, and grandiosity.
What is the most likely explanation?
A. Serotonin syndrome
B. Antidepressant-induced mania
C. Akathisia
D. Neuroleptic malignant syndrome
Correct Answer: B
Rationale: Antidepressants can precipitate mania or hypomania in clients with bipolar disorder,
especially if used without a mood stabilizer. Symptoms include decreased need for sleep, pressured
speech, grandiosity, and increased goal-directed activity. Serotonin syndrome involves autonomic
instability, clonus, and hyperthermia. Akathisia is restlessness. NMS involves rigidity, fever, and
autonomic instability. [100% CORRECT]
Q5: Seasonal Pattern Specifier
The student is reviewing mood disorder specifiers. A client reports recurrent depressive episodes
that begin in late fall and resolve in spring each year. Which specifier is most appropriate?
A. With seasonal pattern
B. With peripartum onset
C. With atypical features
D. With melancholic features
Correct Answer: A
Rationale: The seasonal pattern specifier applies when there is a temporal relationship between the
onset of mood episodes and a particular time of year (e.g., fall/winter). Peripartum onset occurs
, 3
during pregnancy or within 4 weeks postpartum. Atypical features include mood reactivity, weight
gain, hypersomnia, and leaden paralysis. Melancholic features include anhedonia, early morning
awakening, and psychomotor changes. [100% CORRECT]
Q6: Lithium and Pregnancy
The student is reviewing mood stabilizers in pregnancy. A client with bipolar disorder who is
pregnant asks about lithium. Which statement is accurate?
A. Lithium is absolutely safe in pregnancy
B. Lithium is associated with Ebstein's anomaly and should be used with caution
C. Lithium is contraindicated in all trimesters
D. Lithium has no fetal risks
Correct Answer: B
Rationale: Lithium use during pregnancy is associated with an increased risk of Ebstein's anomaly (a
congenital heart defect), though the absolute risk is low. It should be used with caution, and
decisions should weigh risks and benefits. It is not absolutely safe or absolutely contraindicated in all
cases. [100% CORRECT]
Q7: Depression with Psychotic Features
The student is reviewing severe depression. A client with major depressive disorder reports hearing
voices saying "you deserve to die." Which treatment is most appropriate?
A. SSRI monotherapy
B. Antidepressant plus antipsychotic, or ECT
C. Benzodiazepine monotherapy
D. Psychotherapy alone
Correct Answer: B
Rationale: Major depressive disorder with psychotic features requires either an antidepressant
combined with an antipsychotic or electroconvulsive therapy (ECT). SSRI monotherapy is insufficient.
Benzodiazepines and psychotherapy alone are not adequate for psychotic depression. [100%
CORRECT]
Q8: Atypical Depression Features
The student is reviewing depressive specifiers. Which feature is characteristic of atypical depression?
A. Early morning awakening
B. Mood reactivity (brightens in response to positive events)
C. Anhedonia
D. Psychomotor retardation
Correct Answer: B
Rationale: Atypical features include mood reactivity (mood brightens in response to positive events),
significant weight gain, hypersomnia, leaden paralysis, and a long-standing pattern of interpersonal
NR 606 QUIZ 2 LATEST 2026/2027 |
PSYCHIATRIC MENTAL HEALTH NP | 50
VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION I: MOOD DISORDERS – Questions 1-8
Q1: Persistent Depressive Disorder
The student is reviewing depressive disorders. A client reports feeling depressed "most of the day,
more days than not" for the past 3 years, with low energy, poor appetite, and low self-esteem.
Which diagnosis is most appropriate?
A. Major depressive disorder
B. Persistent depressive disorder (dysthymia)
C. Cyclothymic disorder
D. Bipolar II disorder
Correct Answer: B
Rationale: Persistent depressive disorder (dysthymia) is characterized by a depressed mood for most
of the day, for more days than not, for at least 2 years in adults (1 year in children/adolescents),
along with at least two of: poor appetite/overeating, insomnia/hypersomnia, low energy, low self-
esteem, poor concentration, or hopelessness. Major depressive disorder requires a 2-week period of
prominent symptoms. Cyclothymic disorder involves hypomanic and depressive symptoms. Bipolar II
requires hypomanic episodes. [100% CORRECT]
Q2: Disruptive Mood Dysregulation Disorder
The student is reviewing childhood mood disorders. A 10-year-old has severe recurrent temper
outbursts out of proportion to the situation, occurring 3+ times per week, with persistently irritable
mood between outbursts for over a year. Which diagnosis is most appropriate?
A. Bipolar I disorder
B. Disruptive mood dysregulation disorder (DMDD)
C. Oppositional defiant disorder
D. Intermittent explosive disorder
Correct Answer: B
Rationale: DMDD is diagnosed in children ages 6-18 with severe recurrent temper outbursts (verbal
or behavioral) that are grossly out of proportion to the situation, occurring 3+ times per week, with
persistently irritable or angry mood between outbursts for at least 12 months. It is not better
explained by another disorder. Bipolar I requires distinct manic episodes. ODD involves a pattern of
angry/irritable mood, argumentative/defiant behavior, or vindictiveness. Intermittent explosive
disorder involves impulsive aggression without persistent irritability. [100% CORRECT]
,2
Q3: Bipolar Disorder - Rapid Cycling
The student is reviewing bipolar disorder specifiers. A client with bipolar disorder has experienced 4
mood episodes (manic, hypomanic, or depressive) within the past 12 months. Which specifier
applies?
A. With mixed features
B. With rapid cycling
C. With psychotic features
D. With catatonia
Correct Answer: B
Rationale: Rapid cycling is a specifier for bipolar I and II disorders defined as at least 4 mood
episodes (manic, hypomanic, or major depressive) within a 12-month period. Mixed features refer to
simultaneous manic and depressive symptoms. Psychotic features indicate delusions or
hallucinations. Catatonia involves psychomotor disturbances. [100% CORRECT]
Q4: Antidepressant-Induced Mania
The student is reviewing medication risks. A client with previously undiagnosed bipolar disorder is
started on fluoxetine and develops pressured speech, decreased need for sleep, and grandiosity.
What is the most likely explanation?
A. Serotonin syndrome
B. Antidepressant-induced mania
C. Akathisia
D. Neuroleptic malignant syndrome
Correct Answer: B
Rationale: Antidepressants can precipitate mania or hypomania in clients with bipolar disorder,
especially if used without a mood stabilizer. Symptoms include decreased need for sleep, pressured
speech, grandiosity, and increased goal-directed activity. Serotonin syndrome involves autonomic
instability, clonus, and hyperthermia. Akathisia is restlessness. NMS involves rigidity, fever, and
autonomic instability. [100% CORRECT]
Q5: Seasonal Pattern Specifier
The student is reviewing mood disorder specifiers. A client reports recurrent depressive episodes
that begin in late fall and resolve in spring each year. Which specifier is most appropriate?
A. With seasonal pattern
B. With peripartum onset
C. With atypical features
D. With melancholic features
Correct Answer: A
Rationale: The seasonal pattern specifier applies when there is a temporal relationship between the
onset of mood episodes and a particular time of year (e.g., fall/winter). Peripartum onset occurs
, 3
during pregnancy or within 4 weeks postpartum. Atypical features include mood reactivity, weight
gain, hypersomnia, and leaden paralysis. Melancholic features include anhedonia, early morning
awakening, and psychomotor changes. [100% CORRECT]
Q6: Lithium and Pregnancy
The student is reviewing mood stabilizers in pregnancy. A client with bipolar disorder who is
pregnant asks about lithium. Which statement is accurate?
A. Lithium is absolutely safe in pregnancy
B. Lithium is associated with Ebstein's anomaly and should be used with caution
C. Lithium is contraindicated in all trimesters
D. Lithium has no fetal risks
Correct Answer: B
Rationale: Lithium use during pregnancy is associated with an increased risk of Ebstein's anomaly (a
congenital heart defect), though the absolute risk is low. It should be used with caution, and
decisions should weigh risks and benefits. It is not absolutely safe or absolutely contraindicated in all
cases. [100% CORRECT]
Q7: Depression with Psychotic Features
The student is reviewing severe depression. A client with major depressive disorder reports hearing
voices saying "you deserve to die." Which treatment is most appropriate?
A. SSRI monotherapy
B. Antidepressant plus antipsychotic, or ECT
C. Benzodiazepine monotherapy
D. Psychotherapy alone
Correct Answer: B
Rationale: Major depressive disorder with psychotic features requires either an antidepressant
combined with an antipsychotic or electroconvulsive therapy (ECT). SSRI monotherapy is insufficient.
Benzodiazepines and psychotherapy alone are not adequate for psychotic depression. [100%
CORRECT]
Q8: Atypical Depression Features
The student is reviewing depressive specifiers. Which feature is characteristic of atypical depression?
A. Early morning awakening
B. Mood reactivity (brightens in response to positive events)
C. Anhedonia
D. Psychomotor retardation
Correct Answer: B
Rationale: Atypical features include mood reactivity (mood brightens in response to positive events),
significant weight gain, hypersomnia, leaden paralysis, and a long-standing pattern of interpersonal
