NR547 PMHNP ADVANCED
DIAGNOSTIC REASONING EXAM
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A 45-year-old male presents with severe muscle rigidity, fever of 103°F, tachycardia, and
altered mental status after starting Haloperidol. Which condition is most likely?
A. Serotonin Syndrome
B. Tardive Dyskinesia
C. Anticholinergic Toxicity
D. Neuroleptic Malignant Syndrome
Answer: D
Conceptual Explanation: Neuroleptic Malignant Syndrome (NMS) is characterized by
‘lead-pipe’ muscle rigidity, hyperpyrexia, autonomic instability, and altered consciousness,
often associated with high-potency antipsychotics.
2. According to DSM-5-TR, what is the minimum duration of symptoms required to diagnose
Generalized Anxiety Disorder?
A. 2 weeks
B. 1 month
,C. 1 year
D. 6 months
Answer: D
Conceptual Explanation: Generalized Anxiety Disorder requires excessive anxiety and
worry occurring more days than not for at least 6 months.
3. Which neurotransmitter pathway is primarily involved in the ‘positive’ symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: B
Conceptual Explanation: Overactivity in the mesolimbic pathway is associated with
positive symptoms, whereas the mesocortical pathway is associated with negative and
cognitive symptoms.
4. A patient is being treated with Lithium for Bipolar I Disorder. Which of the following lab
values would necessitate immediate intervention?
A. Lithium level of 0.8 mEq/L
B. Serum Sodium of 140 mEq/L
, C. White blood cell count of 8,000/mm3
D. Creatinine of 2.4 mg/dL
Answer: D
Conceptual Explanation: Lithium is cleared by the kidneys. A creatinine of 2.4 indicates
renal impairment, which increases the risk of lithium toxicity.
5. To meet the criteria for Major Depressive Disorder, at least one of the five required
symptoms must be:
A. Insomnia or hypersomnia
B. Anhedonia or depressed mood
C. Psychomotor agitation
D. Feelings of worthlessness
Answer: B
Conceptual Explanation: DSM-5 criteria for MDD require either depressed mood or loss
of interest/pleasure (anhedonia) as one of the core symptoms.
6. Which of the following is a classic physical exam finding that distinguishes Serotonin
Syndrome from Neuroleptic Malignant Syndrome?
A. Hyperthermia
B. Tachycardia
C. Hyperreflexia and myoclonus
DIAGNOSTIC REASONING EXAM
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A 45-year-old male presents with severe muscle rigidity, fever of 103°F, tachycardia, and
altered mental status after starting Haloperidol. Which condition is most likely?
A. Serotonin Syndrome
B. Tardive Dyskinesia
C. Anticholinergic Toxicity
D. Neuroleptic Malignant Syndrome
Answer: D
Conceptual Explanation: Neuroleptic Malignant Syndrome (NMS) is characterized by
‘lead-pipe’ muscle rigidity, hyperpyrexia, autonomic instability, and altered consciousness,
often associated with high-potency antipsychotics.
2. According to DSM-5-TR, what is the minimum duration of symptoms required to diagnose
Generalized Anxiety Disorder?
A. 2 weeks
B. 1 month
,C. 1 year
D. 6 months
Answer: D
Conceptual Explanation: Generalized Anxiety Disorder requires excessive anxiety and
worry occurring more days than not for at least 6 months.
3. Which neurotransmitter pathway is primarily involved in the ‘positive’ symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: B
Conceptual Explanation: Overactivity in the mesolimbic pathway is associated with
positive symptoms, whereas the mesocortical pathway is associated with negative and
cognitive symptoms.
4. A patient is being treated with Lithium for Bipolar I Disorder. Which of the following lab
values would necessitate immediate intervention?
A. Lithium level of 0.8 mEq/L
B. Serum Sodium of 140 mEq/L
, C. White blood cell count of 8,000/mm3
D. Creatinine of 2.4 mg/dL
Answer: D
Conceptual Explanation: Lithium is cleared by the kidneys. A creatinine of 2.4 indicates
renal impairment, which increases the risk of lithium toxicity.
5. To meet the criteria for Major Depressive Disorder, at least one of the five required
symptoms must be:
A. Insomnia or hypersomnia
B. Anhedonia or depressed mood
C. Psychomotor agitation
D. Feelings of worthlessness
Answer: B
Conceptual Explanation: DSM-5 criteria for MDD require either depressed mood or loss
of interest/pleasure (anhedonia) as one of the core symptoms.
6. Which of the following is a classic physical exam finding that distinguishes Serotonin
Syndrome from Neuroleptic Malignant Syndrome?
A. Hyperthermia
B. Tachycardia
C. Hyperreflexia and myoclonus
