NRNP6635 / NRNP 6635 Final
Exam 2025/2026 – Psychopathology
and Diagnostic Reasoning | Walden |
Latest Update with Verified Answers
Question 1: A 32-year-old male presents with a 3-month history of low mood, anhedonia, and
insomnia. He reports a recent diagnosis of diabetes mellitus. What is the most
likely diagnosis?
a) Major Depressive Disorder
b) Adjustment Disorder
c) Mood Disorder Due to a General Medical Condition
d) Persistent Depressive Disorder
Correct Answer: c) Mood Disorder Due to a General Medical Condition
Explanation: Diabetes mellitus can cause depressive symptoms due to physio-
logical changes, such as hyperglycemia or insulin resistance, affecting neurotrans-
mitter function. Ruling out medical causes is essential before diagnosing primary
psychiatric disorders like Major Depressive Disorder or Persistent Depressive Dis-
order. Adjustment Disorder requires a specific psychosocial stressor, which is not
described.
Question 2: A 15-year-old female exhibits excessive worry about academic performance, irri-
tability, and somatic complaints for 8 months. What is the most likely diagnosis?
a) Social Anxiety Disorder
b) Generalized Anxiety Disorder (GAD)
c) Obsessive-Compulsive Disorder (OCD)
d) Specific Phobia
Correct Answer: b) Generalized Anxiety Disorder (GAD)
Explanation: GAD is characterized by excessive, uncontrollable worry across mul-
tiple domains for at least 6 months, often accompanied by somatic symptoms like
irritability or muscle tension. Social Anxiety Disorder is limited to social scrutiny,
OCD involves obsessions and compulsions, and Specific Phobia is trigger-specific,
none of which are described.
Question 3: A 40-year-old male presents with auditory hallucinations and disorganized thinking
for 7 months. He denies substance use. What is the most likely diagnosis?
a) Bipolar I Disorder
b) Schizophrenia
c) Brief Psychotic Disorder
d) Delusional Disorder
Correct Answer: b) Schizophrenia
Explanation: Schizophrenia requires two or more psychotic symptoms (e.g., hallu-
cinations, disorganized thinking) for at least 6 months with functional impairment.
Brief Psychotic Disorder lasts less than 1 month, and Delusional Disorder involves
isolated delusions without other psychotic features. Bipolar I Disorder requires
manic episodes, which are absent here.
1
,Question 4: A 68-year-old male presents with memory impairment, apathy, and difficulty with
planning. Symptoms progressed gradually over 3 years. What is the most likely
diagnosis?
a) Major Depressive Disorder
b) Alzheimer’s Disease
c) Vascular Dementia
d) Normal Aging
Correct Answer: b) Alzheimer’s Disease
Explanation: Alzheimer’s Disease presents with progressive memory loss, apathy,
and executive dysfunction due to cortical atrophy. Vascular Dementia typically
shows stepwise decline with vascular risk factors. Depression may mimic cognitive
impairment (pseudodementia), but gradual progression suggests a neurodegenera-
tive process. Normal aging does not cause significant functional decline.
Question 5: A 27-year-old female reports flashbacks, avoidance behaviors, and hyperarousal 4
months after a physical assault. What is the most likely diagnosis?
a) Acute Stress Disorder
b) Post-Traumatic Stress Disorder (PTSD)
c) Generalized Anxiety Disorder
d) Adjustment Disorder
Correct Answer: b) Post-Traumatic Stress Disorder (PTSD)
Explanation: PTSD involves trauma-related symptoms persisting beyond 1 month,
including flashbacks, avoidance, and hyperarousal. Acute Stress Disorder lasts 3
days to 1 month post-trauma. GAD features diffuse worry, and Adjustment Disor-
der lacks trauma-specific symptoms.
Question 6: A 19-year-old male presents with recurrent panic attacks and fear of public spaces.
What is the most likely diagnosis?
a) Social Anxiety Disorder
b) Panic Disorder
c) Agoraphobia
d) Specific Phobia
Correct Answer: b) Panic Disorder
Explanation: Panic Disorder is characterized by recurrent, unexpected panic at-
tacks with persistent worry about future attacks. Agoraphobia may develop sec-
ondary to panic but requires fear of escaping situations. Social Anxiety Disorder
involves social scrutiny fears, and Specific Phobia is limited to specific triggers.
Question 7: A 55-year-old male with a history of alcohol dependence presents with confusion,
nystagmus, and gait instability. What is the most likely diagnosis?
a) Delirium Tremens
b) Wernicke’s Encephalopathy
c) Korsakoff’s Syndrome
d) Alcohol-Induced Psychotic Disorder
Correct Answer: b) Wernicke’s Encephalopathy
Explanation: Wernicke’s Encephalopathy, caused by thiamine deficiency in chronic
alcohol use, presents with confusion, nystagmus, and ataxia. Delirium Tremens in-
volves autonomic instability, Korsakoff’s Syndrome features amnesia, and Alcohol-
Induced Psychotic Disorder involves psychosis without neurological signs.
2
, Question 8: A 24-year-old female reports binge eating followed by purging three times weekly
for 4 months. She maintains normal weight. What is the most likely diagnosis?
a) Anorexia Nervosa, Binge-Eating/Purging Type
b) Bulimia Nervosa
c) Binge-Eating Disorder
d) Other Specified Feeding or Eating Disorder
Correct Answer: b) Bulimia Nervosa
Explanation: Bulimia Nervosa involves recurrent binge eating and compensatory
behaviors (e.g., purging) with normal weight. Anorexia Nervosa requires significant
weight loss, Binge-Eating Disorder lacks purging, and Other Specified Feeding or
Eating Disorder applies to atypical presentations.
Question 9: A 38-year-old male presents with elevated mood, grandiosity, and decreased sleep
for 10 days, causing job loss. He later reports depressive episodes. What is the
most likely diagnosis?
a) Schizoaffective Disorder
b) Bipolar I Disorder
c) Major Depressive Disorder with Psychotic Features
d) Cyclothymic Disorder
Correct Answer: b) Bipolar I Disorder
Explanation: Bipolar I Disorder is diagnosed with at least one manic episode
(elevated mood, grandiosity, lasting �7 days with impairment), often followed by
depression. Schizoaffective Disorder requires persistent psychosis, Major Depressive
Disorder lacks mania, and Cyclothymic Disorder involves milder, chronic symptoms.
Question 10: A 30-year-old female reports intrusive thoughts about contamination and compul-
sive cleaning rituals for 2 years. What is the most likely diagnosis?
a) Generalized Anxiety Disorder
b) Obsessive-Compulsive Disorder (OCD)
c) Body Dysmorphic Disorder
d) Illness Anxiety Disorder
Correct Answer: b) Obsessive-Compulsive Disorder (OCD)
Explanation: OCD involves obsessions (intrusive thoughts) and compulsions (repet-
itive behaviors) like cleaning to reduce distress. GAD features diffuse worry, Body
Dysmorphic Disorder focuses on physical flaws, and Illness Anxiety Disorder in-
volves health preoccupations without rituals.
Question 11: A 62-year-old female presents with disinhibition, impulsivity, and personality changes
over 18 months. Neuroimaging shows frontal lobe atrophy. What is the most likely
diagnosis?
a) Alzheimer’s Disease
b) Frontotemporal Dementia
c) Lewy Body Dementia
d) Major Depressive Disorder
Correct Answer: b) Frontotemporal Dementia
Explanation: Frontotemporal Dementia presents with behavioral changes, disin-
hibition, and frontal lobe atrophy. Alzheimer’s Disease primarily affects memory,
Lewy Body Dementia includes hallucinations and parkinsonism, and Depression
lacks neuroimaging findings or progressive personality changes.
3
Exam 2025/2026 – Psychopathology
and Diagnostic Reasoning | Walden |
Latest Update with Verified Answers
Question 1: A 32-year-old male presents with a 3-month history of low mood, anhedonia, and
insomnia. He reports a recent diagnosis of diabetes mellitus. What is the most
likely diagnosis?
a) Major Depressive Disorder
b) Adjustment Disorder
c) Mood Disorder Due to a General Medical Condition
d) Persistent Depressive Disorder
Correct Answer: c) Mood Disorder Due to a General Medical Condition
Explanation: Diabetes mellitus can cause depressive symptoms due to physio-
logical changes, such as hyperglycemia or insulin resistance, affecting neurotrans-
mitter function. Ruling out medical causes is essential before diagnosing primary
psychiatric disorders like Major Depressive Disorder or Persistent Depressive Dis-
order. Adjustment Disorder requires a specific psychosocial stressor, which is not
described.
Question 2: A 15-year-old female exhibits excessive worry about academic performance, irri-
tability, and somatic complaints for 8 months. What is the most likely diagnosis?
a) Social Anxiety Disorder
b) Generalized Anxiety Disorder (GAD)
c) Obsessive-Compulsive Disorder (OCD)
d) Specific Phobia
Correct Answer: b) Generalized Anxiety Disorder (GAD)
Explanation: GAD is characterized by excessive, uncontrollable worry across mul-
tiple domains for at least 6 months, often accompanied by somatic symptoms like
irritability or muscle tension. Social Anxiety Disorder is limited to social scrutiny,
OCD involves obsessions and compulsions, and Specific Phobia is trigger-specific,
none of which are described.
Question 3: A 40-year-old male presents with auditory hallucinations and disorganized thinking
for 7 months. He denies substance use. What is the most likely diagnosis?
a) Bipolar I Disorder
b) Schizophrenia
c) Brief Psychotic Disorder
d) Delusional Disorder
Correct Answer: b) Schizophrenia
Explanation: Schizophrenia requires two or more psychotic symptoms (e.g., hallu-
cinations, disorganized thinking) for at least 6 months with functional impairment.
Brief Psychotic Disorder lasts less than 1 month, and Delusional Disorder involves
isolated delusions without other psychotic features. Bipolar I Disorder requires
manic episodes, which are absent here.
1
,Question 4: A 68-year-old male presents with memory impairment, apathy, and difficulty with
planning. Symptoms progressed gradually over 3 years. What is the most likely
diagnosis?
a) Major Depressive Disorder
b) Alzheimer’s Disease
c) Vascular Dementia
d) Normal Aging
Correct Answer: b) Alzheimer’s Disease
Explanation: Alzheimer’s Disease presents with progressive memory loss, apathy,
and executive dysfunction due to cortical atrophy. Vascular Dementia typically
shows stepwise decline with vascular risk factors. Depression may mimic cognitive
impairment (pseudodementia), but gradual progression suggests a neurodegenera-
tive process. Normal aging does not cause significant functional decline.
Question 5: A 27-year-old female reports flashbacks, avoidance behaviors, and hyperarousal 4
months after a physical assault. What is the most likely diagnosis?
a) Acute Stress Disorder
b) Post-Traumatic Stress Disorder (PTSD)
c) Generalized Anxiety Disorder
d) Adjustment Disorder
Correct Answer: b) Post-Traumatic Stress Disorder (PTSD)
Explanation: PTSD involves trauma-related symptoms persisting beyond 1 month,
including flashbacks, avoidance, and hyperarousal. Acute Stress Disorder lasts 3
days to 1 month post-trauma. GAD features diffuse worry, and Adjustment Disor-
der lacks trauma-specific symptoms.
Question 6: A 19-year-old male presents with recurrent panic attacks and fear of public spaces.
What is the most likely diagnosis?
a) Social Anxiety Disorder
b) Panic Disorder
c) Agoraphobia
d) Specific Phobia
Correct Answer: b) Panic Disorder
Explanation: Panic Disorder is characterized by recurrent, unexpected panic at-
tacks with persistent worry about future attacks. Agoraphobia may develop sec-
ondary to panic but requires fear of escaping situations. Social Anxiety Disorder
involves social scrutiny fears, and Specific Phobia is limited to specific triggers.
Question 7: A 55-year-old male with a history of alcohol dependence presents with confusion,
nystagmus, and gait instability. What is the most likely diagnosis?
a) Delirium Tremens
b) Wernicke’s Encephalopathy
c) Korsakoff’s Syndrome
d) Alcohol-Induced Psychotic Disorder
Correct Answer: b) Wernicke’s Encephalopathy
Explanation: Wernicke’s Encephalopathy, caused by thiamine deficiency in chronic
alcohol use, presents with confusion, nystagmus, and ataxia. Delirium Tremens in-
volves autonomic instability, Korsakoff’s Syndrome features amnesia, and Alcohol-
Induced Psychotic Disorder involves psychosis without neurological signs.
2
, Question 8: A 24-year-old female reports binge eating followed by purging three times weekly
for 4 months. She maintains normal weight. What is the most likely diagnosis?
a) Anorexia Nervosa, Binge-Eating/Purging Type
b) Bulimia Nervosa
c) Binge-Eating Disorder
d) Other Specified Feeding or Eating Disorder
Correct Answer: b) Bulimia Nervosa
Explanation: Bulimia Nervosa involves recurrent binge eating and compensatory
behaviors (e.g., purging) with normal weight. Anorexia Nervosa requires significant
weight loss, Binge-Eating Disorder lacks purging, and Other Specified Feeding or
Eating Disorder applies to atypical presentations.
Question 9: A 38-year-old male presents with elevated mood, grandiosity, and decreased sleep
for 10 days, causing job loss. He later reports depressive episodes. What is the
most likely diagnosis?
a) Schizoaffective Disorder
b) Bipolar I Disorder
c) Major Depressive Disorder with Psychotic Features
d) Cyclothymic Disorder
Correct Answer: b) Bipolar I Disorder
Explanation: Bipolar I Disorder is diagnosed with at least one manic episode
(elevated mood, grandiosity, lasting �7 days with impairment), often followed by
depression. Schizoaffective Disorder requires persistent psychosis, Major Depressive
Disorder lacks mania, and Cyclothymic Disorder involves milder, chronic symptoms.
Question 10: A 30-year-old female reports intrusive thoughts about contamination and compul-
sive cleaning rituals for 2 years. What is the most likely diagnosis?
a) Generalized Anxiety Disorder
b) Obsessive-Compulsive Disorder (OCD)
c) Body Dysmorphic Disorder
d) Illness Anxiety Disorder
Correct Answer: b) Obsessive-Compulsive Disorder (OCD)
Explanation: OCD involves obsessions (intrusive thoughts) and compulsions (repet-
itive behaviors) like cleaning to reduce distress. GAD features diffuse worry, Body
Dysmorphic Disorder focuses on physical flaws, and Illness Anxiety Disorder in-
volves health preoccupations without rituals.
Question 11: A 62-year-old female presents with disinhibition, impulsivity, and personality changes
over 18 months. Neuroimaging shows frontal lobe atrophy. What is the most likely
diagnosis?
a) Alzheimer’s Disease
b) Frontotemporal Dementia
c) Lewy Body Dementia
d) Major Depressive Disorder
Correct Answer: b) Frontotemporal Dementia
Explanation: Frontotemporal Dementia presents with behavioral changes, disin-
hibition, and frontal lobe atrophy. Alzheimer’s Disease primarily affects memory,
Lewy Body Dementia includes hallucinations and parkinsonism, and Depression
lacks neuroimaging findings or progressive personality changes.
3
