NR 605 / NR605 Diagnosis Management
Psychiatric-Mental Health Lifespan I Final Exam Actual
2025/2026 with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
SECTION 1: Mood Disorders (MDD, Bipolar, Persistent Depressive)
(14 Questions)
Q1: A 32-year-old patient presents with depressed mood, anhedonia, significant
weight loss, insomnia, fatigue, feelings of worthlessness, and recurrent thoughts of
death for the past 3 weeks. Which diagnosis is most consistent with these
symptoms?
A. Persistent depressive disorder
B. Major depressive disorder
C. Adjustment disorder with depressed mood
D. Bipolar II disorder
Correct Answer: B
Rationale: Correct because MDD requires ≥5 symptoms present for at least 2 weeks,
including depressed mood or anhedonia.
Q2: A patient with major depressive disorder has failed two SSRI trials. What is the
most appropriate next step?
A. Add augmenting agent
B. Switch to SNRI
C. Consider MAOI
D. Refer for ECT
Correct Answer: B
Rationale: Correct because switching to a different class (SNRI) is recommended
after two SSRI failures.
Q3: The PHQ-9 score ranges from 0-27. A score of 15 indicates what level of
depression severity?
,A. Minimal
B. Moderate
C. Moderately severe
D. Severe
Correct Answer: C
Rationale: Correct because PHQ-9 scores 15-19 indicate moderately severe
depression.
Q4: A patient on fluoxetine for 8 weeks reports no improvement in depressive
symptoms. What is the most appropriate next step?
A. Increase dose of fluoxetine
B. Add a second antidepressant
C. Switch to another SSRI
D. Obtain serum drug level
Correct Answer: A
Rationale: Correct because fluoxetine may require dose titration; 8 weeks is
adequate to assess initial response.
Q5: A patient with bipolar I disorder is currently in a manic episode. Which
medication class is first-line for acute mania?
A. Antidepressants
B. Mood stabilizers
C. Antipsychotics
D. Both B and C
Correct Answer: D
Rationale: Correct because mood stabilizers and antipsychotics are first-line for
acute mania.
Q6: A 68-year-old patient with MDD is started on sertraline. What is the
recommended starting dose?
A. 12.5 mg
B. 25 mg
C. 50 mg
D. 75 mg
Correct Answer: B
, Rationale: Correct because geriatric patients should start at half the adult dose (25
mg).
Q7: A patient on lithium has a serum level of 1.4 mEq/L and reports severe tremor
and nausea. What is the priority action?
A. Increase lithium dose
B. Decrease lithium dose
C. Continue current dose
D. Discontinue immediately
Correct Answer: B
Rationale: Correct because 1.4 mEq/L is above therapeutic range (1.0-1.2 for acute);
dose reduction is needed.
Q8: A patient with depression and anxiety is started on mirtazapine. Which side
effect is associated with this medication?
A. Weight loss
B. Insomnia
C. Weight gain
D. Sexual dysfunction
Correct Answer: C
Rationale: Correct because mirtazapine's H1 antagonism causes weight gain and
sedation.
Q9: A patient with chronic pain and depression may benefit from which
antidepressant with dual indications?
A. Fluoxetine
B. Duloxetine
C. Paroxetine
D. Sertraline
Correct Answer: B
Rationale: Correct because duloxetine is indicated for MDD and neuropathic pain.
Q10: A patient with MDD and insomnia is started on trazodone. What is the starting
dose for sleep?
A. 25-50 mg
Psychiatric-Mental Health Lifespan I Final Exam Actual
2025/2026 with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
SECTION 1: Mood Disorders (MDD, Bipolar, Persistent Depressive)
(14 Questions)
Q1: A 32-year-old patient presents with depressed mood, anhedonia, significant
weight loss, insomnia, fatigue, feelings of worthlessness, and recurrent thoughts of
death for the past 3 weeks. Which diagnosis is most consistent with these
symptoms?
A. Persistent depressive disorder
B. Major depressive disorder
C. Adjustment disorder with depressed mood
D. Bipolar II disorder
Correct Answer: B
Rationale: Correct because MDD requires ≥5 symptoms present for at least 2 weeks,
including depressed mood or anhedonia.
Q2: A patient with major depressive disorder has failed two SSRI trials. What is the
most appropriate next step?
A. Add augmenting agent
B. Switch to SNRI
C. Consider MAOI
D. Refer for ECT
Correct Answer: B
Rationale: Correct because switching to a different class (SNRI) is recommended
after two SSRI failures.
Q3: The PHQ-9 score ranges from 0-27. A score of 15 indicates what level of
depression severity?
,A. Minimal
B. Moderate
C. Moderately severe
D. Severe
Correct Answer: C
Rationale: Correct because PHQ-9 scores 15-19 indicate moderately severe
depression.
Q4: A patient on fluoxetine for 8 weeks reports no improvement in depressive
symptoms. What is the most appropriate next step?
A. Increase dose of fluoxetine
B. Add a second antidepressant
C. Switch to another SSRI
D. Obtain serum drug level
Correct Answer: A
Rationale: Correct because fluoxetine may require dose titration; 8 weeks is
adequate to assess initial response.
Q5: A patient with bipolar I disorder is currently in a manic episode. Which
medication class is first-line for acute mania?
A. Antidepressants
B. Mood stabilizers
C. Antipsychotics
D. Both B and C
Correct Answer: D
Rationale: Correct because mood stabilizers and antipsychotics are first-line for
acute mania.
Q6: A 68-year-old patient with MDD is started on sertraline. What is the
recommended starting dose?
A. 12.5 mg
B. 25 mg
C. 50 mg
D. 75 mg
Correct Answer: B
, Rationale: Correct because geriatric patients should start at half the adult dose (25
mg).
Q7: A patient on lithium has a serum level of 1.4 mEq/L and reports severe tremor
and nausea. What is the priority action?
A. Increase lithium dose
B. Decrease lithium dose
C. Continue current dose
D. Discontinue immediately
Correct Answer: B
Rationale: Correct because 1.4 mEq/L is above therapeutic range (1.0-1.2 for acute);
dose reduction is needed.
Q8: A patient with depression and anxiety is started on mirtazapine. Which side
effect is associated with this medication?
A. Weight loss
B. Insomnia
C. Weight gain
D. Sexual dysfunction
Correct Answer: C
Rationale: Correct because mirtazapine's H1 antagonism causes weight gain and
sedation.
Q9: A patient with chronic pain and depression may benefit from which
antidepressant with dual indications?
A. Fluoxetine
B. Duloxetine
C. Paroxetine
D. Sertraline
Correct Answer: B
Rationale: Correct because duloxetine is indicated for MDD and neuropathic pain.
Q10: A patient with MDD and insomnia is started on trazodone. What is the starting
dose for sleep?
A. 25-50 mg
