Final Exam: NR 606 (Latest Update 2026 /
2027) Diagnosis and Management in
Psychiatric-Mental Health
**Q1: A 28-year-old combat veteran presents with PTSD symptoms
including flashbacks, persistent avoidance, and hyperarousal. Which
SSRI is FDA-approved as first-line pharmacologic treatment for
PTSD?**
**Answer:** Sertraline
**Rationale:** Sertraline and paroxetine are the two SSRIs
specifically FDA-approved for PTSD treatment. They demonstrate
efficacy in reducing all three core symptom clusters—re-
experiencing, avoidance/numbing, and hyperarousal—as well as
comorbid depressive symptoms. Fluoxetine and escitalopram may be
used off-label but lack specific FDA indication. Fluvoxamine is
primarily indicated for OCD .
---
**Q2: A patient diagnosed with Acute Stress Disorder is seen 10 days
after a traumatic industrial accident, exhibiting significant emotional
numbing and depersonalization. What is the most appropriate initial
recommendation?**
,**Answer:** Psychoeducation and monitoring for PTSD development
**Rationale:** Acute Stress Disorder is defined by symptoms
occurring between 3 days and 1 month post-trauma. The primary
acute management strategy is support, psychoeducation, and
monitoring for symptom resolution or transition to PTSD.
Benzodiazepines are discouraged as they may interfere with natural
trauma processing and increase PTSD risk. TF-CBT is indicated if
symptoms persist beyond one month .
---
**Q3: Which medication class is first-line for hyperarousal symptoms
in Fetal Alcohol Spectrum Disorders (FASD)?**
**Answer:** Adrenergic agents (clonidine, guanfacine)
**Rationale:** Adrenergic agents are first-line for hyperarousal in
FASD. Second-line options include SSRIs (fluoxetine, escitalopram,
sertraline) .
---
**Q4: Which medication class is first-line for emotional regulation
(mood swings, anxiety/depression, excitability) in FASD?**
**Answer:** Mood stabilizers (divalproex, lamotrigine)
,**Rationale:** Mood stabilizers are first-line for emotional
dysregulation in FASD. SSRIs are second-line options .
---
**Q5: Which medication class is first-line for hyperactivity and
neurocognitive symptoms (restlessness, impulsivity, executive
dysfunction) in FASD?**
**Answer:** Amphetamine-based stimulants (lisdexamfetamine,
dexedrine)
**Rationale:** Amphetamine-based stimulants are first-line for
hyperactivity and neurocognitive symptoms. Second-line includes
other stimulants (methylphenidate, atomoxetine, bupropion) .
---
**Q6: Which medication class is first-line for cognitive inflexibility
(impairments in perspective taking, frustration tolerance, social skills,
reasoning, reality testing, abstraction) in FASD?**
**Answer:** Atypical neuroleptics (risperidone, olanzapine,
aripiprazole)
, **Rationale:** Atypical antipsychotics are first-line for cognitive
inflexibility symptoms in FASD .
---
**Q7: What is the best prognosis factor for FASD?**
**Answer:** Diagnosis and treatment initiation before age six
**Rationale:** Early identification and intervention before age six
significantly improves outcomes in children with FASD .
---
**Q8: What are the facial features characteristic of Fetal Alcohol
Syndrome?**
**Answer:** Skin folds at the eye corners, small head circumference,
low nasal bridge, small eye openings, short nose, small midface,
indistinct philtrum, and thin upper lip .
---
## Lesson 6: Mood Disorders
2027) Diagnosis and Management in
Psychiatric-Mental Health
**Q1: A 28-year-old combat veteran presents with PTSD symptoms
including flashbacks, persistent avoidance, and hyperarousal. Which
SSRI is FDA-approved as first-line pharmacologic treatment for
PTSD?**
**Answer:** Sertraline
**Rationale:** Sertraline and paroxetine are the two SSRIs
specifically FDA-approved for PTSD treatment. They demonstrate
efficacy in reducing all three core symptom clusters—re-
experiencing, avoidance/numbing, and hyperarousal—as well as
comorbid depressive symptoms. Fluoxetine and escitalopram may be
used off-label but lack specific FDA indication. Fluvoxamine is
primarily indicated for OCD .
---
**Q2: A patient diagnosed with Acute Stress Disorder is seen 10 days
after a traumatic industrial accident, exhibiting significant emotional
numbing and depersonalization. What is the most appropriate initial
recommendation?**
,**Answer:** Psychoeducation and monitoring for PTSD development
**Rationale:** Acute Stress Disorder is defined by symptoms
occurring between 3 days and 1 month post-trauma. The primary
acute management strategy is support, psychoeducation, and
monitoring for symptom resolution or transition to PTSD.
Benzodiazepines are discouraged as they may interfere with natural
trauma processing and increase PTSD risk. TF-CBT is indicated if
symptoms persist beyond one month .
---
**Q3: Which medication class is first-line for hyperarousal symptoms
in Fetal Alcohol Spectrum Disorders (FASD)?**
**Answer:** Adrenergic agents (clonidine, guanfacine)
**Rationale:** Adrenergic agents are first-line for hyperarousal in
FASD. Second-line options include SSRIs (fluoxetine, escitalopram,
sertraline) .
---
**Q4: Which medication class is first-line for emotional regulation
(mood swings, anxiety/depression, excitability) in FASD?**
**Answer:** Mood stabilizers (divalproex, lamotrigine)
,**Rationale:** Mood stabilizers are first-line for emotional
dysregulation in FASD. SSRIs are second-line options .
---
**Q5: Which medication class is first-line for hyperactivity and
neurocognitive symptoms (restlessness, impulsivity, executive
dysfunction) in FASD?**
**Answer:** Amphetamine-based stimulants (lisdexamfetamine,
dexedrine)
**Rationale:** Amphetamine-based stimulants are first-line for
hyperactivity and neurocognitive symptoms. Second-line includes
other stimulants (methylphenidate, atomoxetine, bupropion) .
---
**Q6: Which medication class is first-line for cognitive inflexibility
(impairments in perspective taking, frustration tolerance, social skills,
reasoning, reality testing, abstraction) in FASD?**
**Answer:** Atypical neuroleptics (risperidone, olanzapine,
aripiprazole)
, **Rationale:** Atypical antipsychotics are first-line for cognitive
inflexibility symptoms in FASD .
---
**Q7: What is the best prognosis factor for FASD?**
**Answer:** Diagnosis and treatment initiation before age six
**Rationale:** Early identification and intervention before age six
significantly improves outcomes in children with FASD .
---
**Q8: What are the facial features characteristic of Fetal Alcohol
Syndrome?**
**Answer:** Skin folds at the eye corners, small head circumference,
low nasal bridge, small eye openings, short nose, small midface,
indistinct philtrum, and thin upper lip .
---
## Lesson 6: Mood Disorders
