1. A client reports feeling sad and hopeless most of
the day for the past three weeks and has lost interest
in previously enjoyed activities. According to DSM-5
criteria, how many additional symptoms are required
(beyond depressed mood and anhedonia) for a
diagnosis of major depressive disorder?
A. 3
B. 5
C. 2
D. 4
Answer: D. 4
Rationale: DSM-5 requires ≥5 of 9 total symptoms, with at
least one being depressed mood or loss of
interest/pleasure; after the two core symptoms, 3 more are
needed to reach five total (DSM-5 Criteria for Major
Depressive Disorder - MDCalc).
2. A client on lithium therapy presents with coarse
tremors, confusion, and ataxia. Which lithium serum
level range is most consistent with moderate toxicity?
A. 0.5–1.2 mEq/L
B. 1.5–2.5 mEq/L
C. 2.5–3.5 mEq/L
D. >3.5 mEq/L
Answer: C. 2.5–3.5 mEq/L
Rationale: Moderate lithium toxicity (confusion, agitation,
, hypertonia) occurs at 2.5–3.5 mEq/L; mild is 1.5–2.5
mEq/L, and severe is >3.5 mEq/L (Lithium Toxicity -
StatPearls - NCBI Bookshelf).
3. A client exhibits auditory hallucinations and
disorganized speech for the past month, with negative
symptoms persisting over six months. According to
DSM-5, this pattern supports a diagnosis of:
A. Brief psychotic disorder
B. Schizophreniform disorder
C. Schizophrenia
D. Schizoaffective disorder
Answer: C. Schizophrenia
Rationale: Schizophrenia requires ≥2 active-phase
symptoms for ≥1 month and total disturbance ≥6 months
([PDF] DSM-5 Criteria: Schizophrenia).
4. Which side effect is most important for the nurse to
monitor in a client beginning therapy with sertraline
(an SSRI)?
A. Photosensitivity
B. Serotonin syndrome
C. Tardive dyskinesia
D. Agranulocytosis
Answer: B. Serotonin syndrome
the day for the past three weeks and has lost interest
in previously enjoyed activities. According to DSM-5
criteria, how many additional symptoms are required
(beyond depressed mood and anhedonia) for a
diagnosis of major depressive disorder?
A. 3
B. 5
C. 2
D. 4
Answer: D. 4
Rationale: DSM-5 requires ≥5 of 9 total symptoms, with at
least one being depressed mood or loss of
interest/pleasure; after the two core symptoms, 3 more are
needed to reach five total (DSM-5 Criteria for Major
Depressive Disorder - MDCalc).
2. A client on lithium therapy presents with coarse
tremors, confusion, and ataxia. Which lithium serum
level range is most consistent with moderate toxicity?
A. 0.5–1.2 mEq/L
B. 1.5–2.5 mEq/L
C. 2.5–3.5 mEq/L
D. >3.5 mEq/L
Answer: C. 2.5–3.5 mEq/L
Rationale: Moderate lithium toxicity (confusion, agitation,
, hypertonia) occurs at 2.5–3.5 mEq/L; mild is 1.5–2.5
mEq/L, and severe is >3.5 mEq/L (Lithium Toxicity -
StatPearls - NCBI Bookshelf).
3. A client exhibits auditory hallucinations and
disorganized speech for the past month, with negative
symptoms persisting over six months. According to
DSM-5, this pattern supports a diagnosis of:
A. Brief psychotic disorder
B. Schizophreniform disorder
C. Schizophrenia
D. Schizoaffective disorder
Answer: C. Schizophrenia
Rationale: Schizophrenia requires ≥2 active-phase
symptoms for ≥1 month and total disturbance ≥6 months
([PDF] DSM-5 Criteria: Schizophrenia).
4. Which side effect is most important for the nurse to
monitor in a client beginning therapy with sertraline
(an SSRI)?
A. Photosensitivity
B. Serotonin syndrome
C. Tardive dyskinesia
D. Agranulocytosis
Answer: B. Serotonin syndrome
