NR 605 Final Exam 2026/2027 | Weeks 5–8 | Psychiatric-Mental
Health Diagnosis & Management
Question 1. Which finding is most characteristic of a manic episode?
A. Decreased energy
B. Decreased need for sleep
C. Social withdrawal
D. Psychomotor slowing
Correct Answer: B. Decreased need for sleep
Rationale: Mania commonly includes increased energy, decreased
need for sleep, pressured speech, grandiosity, and increased goal-
directed activity.
Question 2. Which neurotransmitter is primarily increased by SSRIs?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Correct Answer: B. Serotonin
Rationale: SSRIs inhibit serotonin reuptake, increasing serotonin
availability in the synaptic cleft.
Question 3. A patient taking an SSRI develops fever, agitation, tremor,
and hyperreflexia after starting another serotonergic medication.
What is the priority diagnosis?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Panic disorder
D. Lithium toxicity
Correct Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome can cause agitation, autonomic
instability, hyperthermia, tremor, hyperreflexia, and clonus.
Question 4. Which medication is commonly used as a mood stabilizer
for bipolar disorder?
A. Lithium
,B. Fluoxetine
C. Buspirone
D. Methylphenidate
Correct Answer: A. Lithium
Rationale: Lithium is an established mood stabilizer used in bipolar
disorder, particularly for mania and maintenance treatment.
Question 5. Which laboratory test is especially important during
lithium treatment?
A. Serum lithium concentration
B. Hemoglobin A1c only
C. Amylase only
D. Troponin only
Correct Answer: A. Serum lithium concentration
Rationale: Lithium has a narrow therapeutic range, making serum
concentration monitoring important for safety and effectiveness.
Question 6. Which condition increases the risk of lithium toxicity?
A. Dehydration
B. Increased hydration
C. High dietary fiber
D. Increased vitamin C intake
Correct Answer: A. Dehydration
Rationale: Dehydration and sodium depletion can increase renal
lithium reabsorption and raise lithium concentrations.
Question 7. A patient taking lithium develops coarse tremor, vomiting,
diarrhea, and confusion. What should the clinician suspect?
A. Lithium toxicity
B. Serotonin syndrome
C. Panic attack
D. Akathisia
Correct Answer: A. Lithium toxicity
,Rationale: Gastrointestinal symptoms, worsening tremor, neurologic
changes, and confusion can indicate lithium toxicity and require
prompt evaluation.
Question 8. Which symptom represents a positive symptom of
schizophrenia?
A. Avolition
B. Anhedonia
C. Hallucination
D. Flat affect
Correct Answer: C. Hallucination
Rationale: Positive symptoms include hallucinations, delusions, and
disorganized thought or behavior.
Question 9. Which is a negative symptom of schizophrenia?
A. Delusion
B. Hallucination
C. Avolition
D. Disorganized speech
Correct Answer: C. Avolition
Rationale: Avolition refers to reduced motivation and goal-directed
activity and is a negative symptom.
Question 10. A patient believes the government has implanted a
tracking device in their body despite evidence to the contrary. This is
a:
A. Hallucination
B. Delusion
C. Compulsion
D. Flashback
Correct Answer: B. Delusion
Rationale: A delusion is a fixed false belief that persists despite
contradictory evidence.
Question 11. Which assessment finding suggests auditory
hallucination?
, A. Believing neighbors are spying
B. Hearing voices when no external sound is present
C. Repeatedly checking a locked door
D. Fear of gaining weight
Correct Answer: B. Hearing voices when no external sound is present
Rationale: Auditory hallucinations involve hearing sounds or voices
without an external auditory stimulus.
Question 12. Which medication is an atypical antipsychotic?
A. Risperidone
B. Sertraline
C. Lithium
D. Lorazepam
Correct Answer: A. Risperidone
Rationale: Risperidone is a second-generation antipsychotic used for
several psychiatric conditions.
Question 13. Which adverse effect is associated with atypical
antipsychotics?
A. Metabolic syndrome
B. Severe hypoglycemia in every patient
C. Universal weight loss
D. Permanent hearing loss
Correct Answer: A. Metabolic syndrome
Rationale: Some atypical antipsychotics can cause weight gain,
dyslipidemia, insulin resistance, and hyperglycemia.
Question 14. A patient develops severe rigidity, fever, altered
consciousness, and autonomic instability after starting an
antipsychotic. What is suspected?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. OCD
Correct Answer: B. Neuroleptic malignant syndrome
Health Diagnosis & Management
Question 1. Which finding is most characteristic of a manic episode?
A. Decreased energy
B. Decreased need for sleep
C. Social withdrawal
D. Psychomotor slowing
Correct Answer: B. Decreased need for sleep
Rationale: Mania commonly includes increased energy, decreased
need for sleep, pressured speech, grandiosity, and increased goal-
directed activity.
Question 2. Which neurotransmitter is primarily increased by SSRIs?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Correct Answer: B. Serotonin
Rationale: SSRIs inhibit serotonin reuptake, increasing serotonin
availability in the synaptic cleft.
Question 3. A patient taking an SSRI develops fever, agitation, tremor,
and hyperreflexia after starting another serotonergic medication.
What is the priority diagnosis?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Panic disorder
D. Lithium toxicity
Correct Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome can cause agitation, autonomic
instability, hyperthermia, tremor, hyperreflexia, and clonus.
Question 4. Which medication is commonly used as a mood stabilizer
for bipolar disorder?
A. Lithium
,B. Fluoxetine
C. Buspirone
D. Methylphenidate
Correct Answer: A. Lithium
Rationale: Lithium is an established mood stabilizer used in bipolar
disorder, particularly for mania and maintenance treatment.
Question 5. Which laboratory test is especially important during
lithium treatment?
A. Serum lithium concentration
B. Hemoglobin A1c only
C. Amylase only
D. Troponin only
Correct Answer: A. Serum lithium concentration
Rationale: Lithium has a narrow therapeutic range, making serum
concentration monitoring important for safety and effectiveness.
Question 6. Which condition increases the risk of lithium toxicity?
A. Dehydration
B. Increased hydration
C. High dietary fiber
D. Increased vitamin C intake
Correct Answer: A. Dehydration
Rationale: Dehydration and sodium depletion can increase renal
lithium reabsorption and raise lithium concentrations.
Question 7. A patient taking lithium develops coarse tremor, vomiting,
diarrhea, and confusion. What should the clinician suspect?
A. Lithium toxicity
B. Serotonin syndrome
C. Panic attack
D. Akathisia
Correct Answer: A. Lithium toxicity
,Rationale: Gastrointestinal symptoms, worsening tremor, neurologic
changes, and confusion can indicate lithium toxicity and require
prompt evaluation.
Question 8. Which symptom represents a positive symptom of
schizophrenia?
A. Avolition
B. Anhedonia
C. Hallucination
D. Flat affect
Correct Answer: C. Hallucination
Rationale: Positive symptoms include hallucinations, delusions, and
disorganized thought or behavior.
Question 9. Which is a negative symptom of schizophrenia?
A. Delusion
B. Hallucination
C. Avolition
D. Disorganized speech
Correct Answer: C. Avolition
Rationale: Avolition refers to reduced motivation and goal-directed
activity and is a negative symptom.
Question 10. A patient believes the government has implanted a
tracking device in their body despite evidence to the contrary. This is
a:
A. Hallucination
B. Delusion
C. Compulsion
D. Flashback
Correct Answer: B. Delusion
Rationale: A delusion is a fixed false belief that persists despite
contradictory evidence.
Question 11. Which assessment finding suggests auditory
hallucination?
, A. Believing neighbors are spying
B. Hearing voices when no external sound is present
C. Repeatedly checking a locked door
D. Fear of gaining weight
Correct Answer: B. Hearing voices when no external sound is present
Rationale: Auditory hallucinations involve hearing sounds or voices
without an external auditory stimulus.
Question 12. Which medication is an atypical antipsychotic?
A. Risperidone
B. Sertraline
C. Lithium
D. Lorazepam
Correct Answer: A. Risperidone
Rationale: Risperidone is a second-generation antipsychotic used for
several psychiatric conditions.
Question 13. Which adverse effect is associated with atypical
antipsychotics?
A. Metabolic syndrome
B. Severe hypoglycemia in every patient
C. Universal weight loss
D. Permanent hearing loss
Correct Answer: A. Metabolic syndrome
Rationale: Some atypical antipsychotics can cause weight gain,
dyslipidemia, insulin resistance, and hyperglycemia.
Question 14. A patient develops severe rigidity, fever, altered
consciousness, and autonomic instability after starting an
antipsychotic. What is suspected?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. OCD
Correct Answer: B. Neuroleptic malignant syndrome
