Psychiatric-Mental Health and Diagnosis
Management Practice Exam questions and
correct answers – Updated 2026 (Graded A+)
instant download pdf
Subject: NR606 Diagnosis and Management in Psychiatric-Mental Health II
Subtopic: Anxiety and Trauma Disorders (Lesson 5)
Question 1: A 28-year-old combat veteran presents with symptoms of PTSD, including
flashbacks, persistent avoidance of triggers, and hyperarousal. He has been resistant to trauma-
focused psychotherapy. Which of the following SSRIs is considered a first-line pharmacologic
treatment that addresses both the core symptoms of PTSD and potential comorbid depression?
A) Fluoxetine
B) Sertraline
C) Fluvoxamine
D) Escitalopram
Correct Answer: B - Sertraline
Rationale: Sertraline (along with paroxetine) is one of the two SSRIs specifically FDA-approved
for the treatment of PTSD. It has demonstrated efficacy in reducing the core clusters of PTSD
symptoms—re-experiencing, avoidance/numbing, and hyperarousal—as well as associated
depressive symptoms. While fluoxetine and escitalopram may be used off-label, they lack the
specific FDA indication for PTSD. Fluvoxamine is primarily indicated for OCD and is not the
first-line choice for PTSD management.
Question 2: A patient diagnosed with Acute Stress Disorder (ASD) is being seen 10 days after a
traumatic industrial accident. The patient exhibits significant emotional numbing and
depersonalization. Which of the following is the most appropriate initial clinical
recommendation?
A) Immediate initiation of benzodiazepines for anxiety relief
B) Long-term trauma-focused cognitive behavioral therapy (TF-CBT)
C) Psychoeducation and monitoring for the development of PTSD
, D) Administration of a mood stabilizer to prevent emotional dysregulation
Correct Answer: C - Psychoeducation and monitoring for the development of PTSD
Rationale: Acute Stress Disorder is defined by symptoms occurring between 3 days and 1 month
after a trauma. The primary management strategy during the acute phase (the first month) is
support, psychoeducation, and monitoring to see if symptoms resolve or transition into PTSD.
Benzodiazepines are generally discouraged in the immediate aftermath of trauma as they may
interfere with the natural processing of the event and increase the risk of developing PTSD. TF-
CBT is indicated if symptoms persist beyond one month, and mood stabilizers are not the
standard of care for acute trauma reactions.
Subtopic: Mood Disorders (Lesson 6)
Question 3: A patient with Bipolar I Disorder has been stable on Lithium 900 mg daily for two
years. During a routine check-up, the patient reports increased thirst, polyuria, and occasional
tremors. Which of the following is the priority intervention?
A) Increase the dose of Lithium to stabilize mood further
B) Order a serum Lithium level, thyroid panel, and creatinine/BUN
C) Switch the patient immediately to Valproate
D) Add a beta-blocker to address the tremors
Correct Answer: B - Order a serum Lithium level, thyroid panel, and creatinine/BUN
Rationale: The patient’s symptoms of polyuria and polydipsia are classic signs of Lithium-
induced nephrogenic diabetes insipidus or potential renal impairment. Tremor can be a sign of
toxicity or a common side effect. Before making any medication changes, it is imperative to
assess the current serum Lithium level to rule out toxicity, evaluate renal function
(creatinine/BUN), and check thyroid function, as Lithium can induce hypothyroidism. Simply
adjusting the dose or adding medications without diagnostic workup is contraindicated.
Question 4: A 34-year-old patient with Bipolar II disorder is currently experiencing a depressive
episode. The patient is currently on a therapeutic dose of a mood stabilizer. What is the most
significant clinical risk when considering the addition of an antidepressant for bipolar
depression?
A) Failure to improve depressive symptoms
B) Induction of a manic or hypomanic episode
C) Increased risk of serotonin syndrome
Management Practice Exam questions and
correct answers – Updated 2026 (Graded A+)
instant download pdf
Subject: NR606 Diagnosis and Management in Psychiatric-Mental Health II
Subtopic: Anxiety and Trauma Disorders (Lesson 5)
Question 1: A 28-year-old combat veteran presents with symptoms of PTSD, including
flashbacks, persistent avoidance of triggers, and hyperarousal. He has been resistant to trauma-
focused psychotherapy. Which of the following SSRIs is considered a first-line pharmacologic
treatment that addresses both the core symptoms of PTSD and potential comorbid depression?
A) Fluoxetine
B) Sertraline
C) Fluvoxamine
D) Escitalopram
Correct Answer: B - Sertraline
Rationale: Sertraline (along with paroxetine) is one of the two SSRIs specifically FDA-approved
for the treatment of PTSD. It has demonstrated efficacy in reducing the core clusters of PTSD
symptoms—re-experiencing, avoidance/numbing, and hyperarousal—as well as associated
depressive symptoms. While fluoxetine and escitalopram may be used off-label, they lack the
specific FDA indication for PTSD. Fluvoxamine is primarily indicated for OCD and is not the
first-line choice for PTSD management.
Question 2: A patient diagnosed with Acute Stress Disorder (ASD) is being seen 10 days after a
traumatic industrial accident. The patient exhibits significant emotional numbing and
depersonalization. Which of the following is the most appropriate initial clinical
recommendation?
A) Immediate initiation of benzodiazepines for anxiety relief
B) Long-term trauma-focused cognitive behavioral therapy (TF-CBT)
C) Psychoeducation and monitoring for the development of PTSD
, D) Administration of a mood stabilizer to prevent emotional dysregulation
Correct Answer: C - Psychoeducation and monitoring for the development of PTSD
Rationale: Acute Stress Disorder is defined by symptoms occurring between 3 days and 1 month
after a trauma. The primary management strategy during the acute phase (the first month) is
support, psychoeducation, and monitoring to see if symptoms resolve or transition into PTSD.
Benzodiazepines are generally discouraged in the immediate aftermath of trauma as they may
interfere with the natural processing of the event and increase the risk of developing PTSD. TF-
CBT is indicated if symptoms persist beyond one month, and mood stabilizers are not the
standard of care for acute trauma reactions.
Subtopic: Mood Disorders (Lesson 6)
Question 3: A patient with Bipolar I Disorder has been stable on Lithium 900 mg daily for two
years. During a routine check-up, the patient reports increased thirst, polyuria, and occasional
tremors. Which of the following is the priority intervention?
A) Increase the dose of Lithium to stabilize mood further
B) Order a serum Lithium level, thyroid panel, and creatinine/BUN
C) Switch the patient immediately to Valproate
D) Add a beta-blocker to address the tremors
Correct Answer: B - Order a serum Lithium level, thyroid panel, and creatinine/BUN
Rationale: The patient’s symptoms of polyuria and polydipsia are classic signs of Lithium-
induced nephrogenic diabetes insipidus or potential renal impairment. Tremor can be a sign of
toxicity or a common side effect. Before making any medication changes, it is imperative to
assess the current serum Lithium level to rule out toxicity, evaluate renal function
(creatinine/BUN), and check thyroid function, as Lithium can induce hypothyroidism. Simply
adjusting the dose or adding medications without diagnostic workup is contraindicated.
Question 4: A 34-year-old patient with Bipolar II disorder is currently experiencing a depressive
episode. The patient is currently on a therapeutic dose of a mood stabilizer. What is the most
significant clinical risk when considering the addition of an antidepressant for bipolar
depression?
A) Failure to improve depressive symptoms
B) Induction of a manic or hypomanic episode
C) Increased risk of serotonin syndrome
