PACO 687 Quiz 3: Assessment and Treatment for
Common Psychiatric Disorders | Questions and
Answers | 2026 Update | 100% Correct.
SECTION 1: Mood Disorders (Major Depression, Bipolar Disorder – DSM-5 Criteria)
Q1: A 34-year-old client presents with depressed mood, anhedonia, insomnia, fatigue, feelings
of worthlessness, and difficulty concentrating. Symptoms have persisted for 3 weeks. According
to DSM-5 criteria, how many additional symptoms must be present to meet the threshold for a
Major Depressive Episode?
A. Two symptoms, for a total of five symptoms including depressed mood or anhedonia
B. One symptom, as the duration exceeds the minimum 2-week requirement
C. Three symptoms, for a total of six symptoms including depressed mood or anhedonia
D. No additional symptoms are required if functional impairment is documented
Correct Answer: A
Rationale: DSM-5 requires at least five of nine specified symptoms present during the same 2-
week period, with at least one symptom being either depressed mood or anhedonia. The client
already presents with six symptoms, exceeding the minimum threshold.
Q2: A pastoral counselor is assessing a 28-year-old client who reports periods of elevated mood,
increased goal-directed activity, and decreased need for sleep lasting 4 days. The client denies
psychotic features. Which DSM-5 diagnosis is most appropriate?
A. Bipolar I Disorder, current episode manic
B. Bipolar II Disorder, current episode hypomanic
C. Cyclothymic Disorder
D. Major Depressive Disorder with anxious distress
Correct Answer: B
Rationale: A distinct period of abnormally elevated mood and increased activity lasting at least
4 days, without psychotic features and without causing marked impairment, meets criteria for a
hypomanic episode. The presence of at least one prior major depressive episode and absence of
a full manic episode supports Bipolar II Disorder.
, Q3: A 52-year-old client with Major Depressive Disorder reports no improvement after 8 weeks
of sertraline 50 mg daily. The client is adherent to medication and psychotherapy. Which
intervention is most consistent with evidence-based practice?
A. Augment with lithium carbonate and continue sertraline at current dose
B. Discontinue sertraline and initiate a trial of phenelzine
C. Increase sertraline to an adequate therapeutic dose of 100–200 mg daily
D. Add a benzodiazepine for adjunctive anxiolytic effect
Correct Answer: C
Rationale: SSRIs such as sertraline typically require dosing within the therapeutic range of 50–
200 mg daily for optimal antidepressant effect. Before considering augmentation or switching,
the dose should be optimized, as subtherapeutic dosing is a common cause of inadequate
response.
Q4: A client presents with depressive symptoms that have persisted for 2 years, with no
symptom-free period exceeding 2 months. The client reports low self-esteem, poor
concentration, and hopelessness but denies suicidal ideation or anhedonia. Which diagnosis
best fits this presentation?
A. Major Depressive Disorder, recurrent, moderate
B. Persistent Depressive Disorder (Dysthymia)
C. Adjustment Disorder with depressed mood
D. Depressive Disorder Due to Another Medical Condition
Correct Answer: B
Rationale: Persistent Depressive Disorder requires depressed mood for most of the day, for
more days than not, for at least 2 years in adults, with the presence of two or more additional
symptoms. The chronicity and absence of a symptom-free period exceeding 2 months
distinguish this from Major Depressive Disorder.
Q5: [Mini-Case] A 41-year-old client is brought to counseling by their spouse after a 5-day
period of markedly elevated mood, grandiose delusions of being a religious prophet, and severe
sleep deprivation. The client is agitated, has maxed out three credit cards, and requires
involuntary hospitalization. Which diagnostic consideration is most critical for immediate
treatment planning?
Common Psychiatric Disorders | Questions and
Answers | 2026 Update | 100% Correct.
SECTION 1: Mood Disorders (Major Depression, Bipolar Disorder – DSM-5 Criteria)
Q1: A 34-year-old client presents with depressed mood, anhedonia, insomnia, fatigue, feelings
of worthlessness, and difficulty concentrating. Symptoms have persisted for 3 weeks. According
to DSM-5 criteria, how many additional symptoms must be present to meet the threshold for a
Major Depressive Episode?
A. Two symptoms, for a total of five symptoms including depressed mood or anhedonia
B. One symptom, as the duration exceeds the minimum 2-week requirement
C. Three symptoms, for a total of six symptoms including depressed mood or anhedonia
D. No additional symptoms are required if functional impairment is documented
Correct Answer: A
Rationale: DSM-5 requires at least five of nine specified symptoms present during the same 2-
week period, with at least one symptom being either depressed mood or anhedonia. The client
already presents with six symptoms, exceeding the minimum threshold.
Q2: A pastoral counselor is assessing a 28-year-old client who reports periods of elevated mood,
increased goal-directed activity, and decreased need for sleep lasting 4 days. The client denies
psychotic features. Which DSM-5 diagnosis is most appropriate?
A. Bipolar I Disorder, current episode manic
B. Bipolar II Disorder, current episode hypomanic
C. Cyclothymic Disorder
D. Major Depressive Disorder with anxious distress
Correct Answer: B
Rationale: A distinct period of abnormally elevated mood and increased activity lasting at least
4 days, without psychotic features and without causing marked impairment, meets criteria for a
hypomanic episode. The presence of at least one prior major depressive episode and absence of
a full manic episode supports Bipolar II Disorder.
, Q3: A 52-year-old client with Major Depressive Disorder reports no improvement after 8 weeks
of sertraline 50 mg daily. The client is adherent to medication and psychotherapy. Which
intervention is most consistent with evidence-based practice?
A. Augment with lithium carbonate and continue sertraline at current dose
B. Discontinue sertraline and initiate a trial of phenelzine
C. Increase sertraline to an adequate therapeutic dose of 100–200 mg daily
D. Add a benzodiazepine for adjunctive anxiolytic effect
Correct Answer: C
Rationale: SSRIs such as sertraline typically require dosing within the therapeutic range of 50–
200 mg daily for optimal antidepressant effect. Before considering augmentation or switching,
the dose should be optimized, as subtherapeutic dosing is a common cause of inadequate
response.
Q4: A client presents with depressive symptoms that have persisted for 2 years, with no
symptom-free period exceeding 2 months. The client reports low self-esteem, poor
concentration, and hopelessness but denies suicidal ideation or anhedonia. Which diagnosis
best fits this presentation?
A. Major Depressive Disorder, recurrent, moderate
B. Persistent Depressive Disorder (Dysthymia)
C. Adjustment Disorder with depressed mood
D. Depressive Disorder Due to Another Medical Condition
Correct Answer: B
Rationale: Persistent Depressive Disorder requires depressed mood for most of the day, for
more days than not, for at least 2 years in adults, with the presence of two or more additional
symptoms. The chronicity and absence of a symptom-free period exceeding 2 months
distinguish this from Major Depressive Disorder.
Q5: [Mini-Case] A 41-year-old client is brought to counseling by their spouse after a 5-day
period of markedly elevated mood, grandiose delusions of being a religious prophet, and severe
sleep deprivation. The client is agitated, has maxed out three credit cards, and requires
involuntary hospitalization. Which diagnostic consideration is most critical for immediate
treatment planning?
