A+ GRADED 1
NRNP 6635 Psychopathology
and Diagnostic Reasoning –
Midterm Exam – Walden
University (2025/2026)
verified exam content
Instructions
• Read each question carefully and select the most appropriate
response.
• Only one option is correct unless otherwise stated.
• The correct answer is highlighted in blue.
• Review the expert rationales to enhance your understanding of
Secti
psychopathology and diagnostic reasoning.
• Content aligns with 2025/2026 standards for psychiatric-menta
health nurse practitioner education.
, 2
Question 1
A 28-year-old female presents with excessive worry, irritability, and
difficulty concentrating for the past 8 months. She reports physical
symptoms like muscle tension and fatigue. Which DSM-5 diagnosis is
most likely?
A. Major Depressive Disorder
B. Generalized Anxiety Disorder
C. Panic Disorder
D. Social Anxiety Disorder
B. Generalized Anxiety Disorder
Rationale: Generalized Anxiety Disorder (GAD) is characterized by
excessive, persistent worry lasting at least 6 months, accompanied by
symptoms like irritability, concentration difficulties, muscle tension, and
fatigue, per DSM-5 criteria. Major Depressive Disorder focuses on
mood symptoms, Panic Disorder involves recurrent panic attacks, and
Social Anxiety Disorder centers on social performance fears.
Question 2
During a psychiatric evaluation, a client reports hearing voices
commanding them to harm others. What is the priority action for the
nurse practitioner?
A. Initiate antipsychotic therapy immediately
B. Conduct a suicide and violence risk assessment
C. Order a brain MRI to rule out organic causes
D. Refer the client for cognitive behavioral therapy
, 3
B. Conduct a suicide and violence risk assessment
Rationale: Command auditory hallucinations pose an immediate safety
risk. A violence risk assessment, using tools like the Columbia-Suicide
Severity Rating Scale (C-SSRS) adapted for homicidal ideation, is
critical to ensure safety. Antipsychotics and therapy are secondary, and
an MRI is not the priority unless neurological signs are present.
Question 3
Which neurotransmitter is most implicated in the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
B. Dopamine
Rationale: The dopamine hypothesis posits that excessive dopamine
activity in the mesolimbic pathway contributes to positive symptoms of
schizophrenia, like hallucinations and delusions. Serotonin is more
linked to mood disorders, GABA to anxiety, and norepinephrine to
arousal.
Question 4
A 35-year-old male reports a 2-week period of elevated mood, decreased
need for sleep, and grandiose plans to start a business. What is the most
likely diagnosis?
, 4
A. Major Depressive Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
B. Bipolar I Disorder
Rationale: A manic episode, defined by elevated mood, decreased sleep
need, and grandiosity lasting at least 7 days (or requiring
hospitalization), meets DSM-5 criteria for Bipolar I Disorder.
Cyclothymic Disorder involves milder symptoms, depression lacks
mania, and GAD centers on worry.
Question 5
A client with a history of trauma reports recurrent nightmares, avoidance
of reminders, and hypervigilance. Which screening tool is most
appropriate?
A. Patient Health Questionnaire-9 (PHQ-9)
B. PTSD Checklist for DSM-5 (PCL-5)
C. Generalized Anxiety Disorder-7 (GAD-7)
D. Mini-Mental State Examination (MMSE)
B. PTSD Checklist for DSM-5 (PCL-5)
Rationale: The PCL-5 is a validated tool to screen for Post-Traumatic
Stress Disorder (PTSD), assessing symptoms like nightmares,
avoidance, and hyperarousal based on DSM-5 criteria. PHQ-9 screens
for depression, GAD-7 for anxiety, and MMSE for cognition.
Question 6
NRNP 6635 Psychopathology
and Diagnostic Reasoning –
Midterm Exam – Walden
University (2025/2026)
verified exam content
Instructions
• Read each question carefully and select the most appropriate
response.
• Only one option is correct unless otherwise stated.
• The correct answer is highlighted in blue.
• Review the expert rationales to enhance your understanding of
Secti
psychopathology and diagnostic reasoning.
• Content aligns with 2025/2026 standards for psychiatric-menta
health nurse practitioner education.
, 2
Question 1
A 28-year-old female presents with excessive worry, irritability, and
difficulty concentrating for the past 8 months. She reports physical
symptoms like muscle tension and fatigue. Which DSM-5 diagnosis is
most likely?
A. Major Depressive Disorder
B. Generalized Anxiety Disorder
C. Panic Disorder
D. Social Anxiety Disorder
B. Generalized Anxiety Disorder
Rationale: Generalized Anxiety Disorder (GAD) is characterized by
excessive, persistent worry lasting at least 6 months, accompanied by
symptoms like irritability, concentration difficulties, muscle tension, and
fatigue, per DSM-5 criteria. Major Depressive Disorder focuses on
mood symptoms, Panic Disorder involves recurrent panic attacks, and
Social Anxiety Disorder centers on social performance fears.
Question 2
During a psychiatric evaluation, a client reports hearing voices
commanding them to harm others. What is the priority action for the
nurse practitioner?
A. Initiate antipsychotic therapy immediately
B. Conduct a suicide and violence risk assessment
C. Order a brain MRI to rule out organic causes
D. Refer the client for cognitive behavioral therapy
, 3
B. Conduct a suicide and violence risk assessment
Rationale: Command auditory hallucinations pose an immediate safety
risk. A violence risk assessment, using tools like the Columbia-Suicide
Severity Rating Scale (C-SSRS) adapted for homicidal ideation, is
critical to ensure safety. Antipsychotics and therapy are secondary, and
an MRI is not the priority unless neurological signs are present.
Question 3
Which neurotransmitter is most implicated in the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
B. Dopamine
Rationale: The dopamine hypothesis posits that excessive dopamine
activity in the mesolimbic pathway contributes to positive symptoms of
schizophrenia, like hallucinations and delusions. Serotonin is more
linked to mood disorders, GABA to anxiety, and norepinephrine to
arousal.
Question 4
A 35-year-old male reports a 2-week period of elevated mood, decreased
need for sleep, and grandiose plans to start a business. What is the most
likely diagnosis?
, 4
A. Major Depressive Disorder
B. Bipolar I Disorder
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
B. Bipolar I Disorder
Rationale: A manic episode, defined by elevated mood, decreased sleep
need, and grandiosity lasting at least 7 days (or requiring
hospitalization), meets DSM-5 criteria for Bipolar I Disorder.
Cyclothymic Disorder involves milder symptoms, depression lacks
mania, and GAD centers on worry.
Question 5
A client with a history of trauma reports recurrent nightmares, avoidance
of reminders, and hypervigilance. Which screening tool is most
appropriate?
A. Patient Health Questionnaire-9 (PHQ-9)
B. PTSD Checklist for DSM-5 (PCL-5)
C. Generalized Anxiety Disorder-7 (GAD-7)
D. Mini-Mental State Examination (MMSE)
B. PTSD Checklist for DSM-5 (PCL-5)
Rationale: The PCL-5 is a validated tool to screen for Post-Traumatic
Stress Disorder (PTSD), assessing symptoms like nightmares,
avoidance, and hyperarousal based on DSM-5 criteria. PHQ-9 screens
for depression, GAD-7 for anxiety, and MMSE for cognition.
Question 6
