NRNP 6635 Exam 4 V3 | NRNP 6635
Psychopathology and Diagnostic
Reasoning | Actual Q&A with Rationale
(NRNP6635 Exam 4) | Walden University
1. A 28-year-old male presents with a pervasive pattern of social and interpersonal deficits,
marked by acute discomfort with close relationships and eccentricities of behavior. He
reports having ‘special powers’ to predict the future and frequently experiences illusions.
Which diagnosis is most appropriate?
A. Schizotypal Personality Disorder
B. Schizoid Personality Disorder
C. Avoidant Personality Disorder
D. Paranoid Personality Disorder
Answer: A
Rationale: Schizotypal Personality Disorder is defined by eccentric behavior and cognitive
or perceptual distortions like magical thinking. Unlike schizophrenia, these patients do not
typically exhibit persistent, formal psychosis or hallucinations. Clinical reasoning requires
differentiating these oddities from the social withdrawal seen in schizoid or avoidant
personalities.
,2. A patient displays a long-standing pattern of unstable interpersonal relationships, an
unstable self-image, and marked impulsivity. During the intake, the patient expresses intense
fear of being left alone by the provider. What is the most likely diagnosis?
A. Antisocial Personality Disorder
B. Histrionic Personality Disorder
C. Narcissistic Personality Disorder
D. Borderline Personality Disorder
Answer: D
Rationale: Borderline Personality Disorder is characterized by a frantic effort to avoid real
or imagined abandonment. The disorder involves a pattern of instability in affects and
marked impulsivity beginning by early adulthood. Diagnostic criteria also include recurrent
suicidal behavior or self-mutilating acts.
3. Which of the following is a mandatory criterion for a diagnosis of Antisocial Personality
Disorder?
A. Evidence of Conduct Disorder with onset before age 15 years.
B. The individual is at least 21 years of age.
C. Presence of hallucinations or delusions.
D. The symptoms occur exclusively during the course of schizophrenia.
Answer: A
,Rationale: To diagnose Antisocial Personality Disorder, there must be evidence of Conduct
Disorder before age 15. The individual must also be at least 18 years of age at the time of
diagnosis. This historical component is essential to distinguish the disorder from adult-
onset criminal behavior or substance-induced irritability.
4. A patient is preoccupied with orderliness, perfectionism, and mental and interpersonal
control at the expense of flexibility and efficiency. These traits are ego-syntonic and have
persisted since early adulthood. What is the diagnosis?
A. Obsessive-Compulsive Disorder
B. Obsessive-Compulsive Personality Disorder
C. Dependent Personality Disorder
D. Avoidant Personality Disorder
Answer: B
Rationale: Obsessive-Compulsive Personality Disorder (OCPD) is characterized by a
preoccupation with perfectionism and control. Unlike OCD, OCPD is generally ego-syntonic,
meaning the individual perceives their traits as desirable or correct. Diagnosis focuses on
the rigid adherence to rules and inability to delegate tasks.
5. An 80-year-old female experiences a sudden onset of confusion, fluctuating levels of
consciousness, and an inability to focus her attention following a hip surgery. What is the
most likely clinical condition?
A. Depressive Pseudodementia
, B. Major Neurocognitive Disorder due to Alzheimer’s
C. Vascular Dementia
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute disturbance in attention and awareness
that develops over a short period. It represents a change from baseline and tends to
fluctuate in severity during the day. Medical evaluation is necessary to identify the
underlying physiological cause, such as post-operative infection or medication toxicity.
6. Which neurocognitive disorder is characterized by early-onset deficits in social cognition
and executive function, often preceding significant memory loss?
A. Alzheimer’s Disease
B. Frontotemporal Neurocognitive Disorder
C. Vascular Dementia
D. Prion Disease
Answer: B
Rationale: Frontotemporal Neurocognitive Disorder involves progressive changes in
personality, behavior, and language. Behavioral variants often present with disinhibition,
apathy, and loss of empathy. Memory and visuospatial functions are typically preserved in
the early stages compared to Alzheimer’s disease.
Psychopathology and Diagnostic
Reasoning | Actual Q&A with Rationale
(NRNP6635 Exam 4) | Walden University
1. A 28-year-old male presents with a pervasive pattern of social and interpersonal deficits,
marked by acute discomfort with close relationships and eccentricities of behavior. He
reports having ‘special powers’ to predict the future and frequently experiences illusions.
Which diagnosis is most appropriate?
A. Schizotypal Personality Disorder
B. Schizoid Personality Disorder
C. Avoidant Personality Disorder
D. Paranoid Personality Disorder
Answer: A
Rationale: Schizotypal Personality Disorder is defined by eccentric behavior and cognitive
or perceptual distortions like magical thinking. Unlike schizophrenia, these patients do not
typically exhibit persistent, formal psychosis or hallucinations. Clinical reasoning requires
differentiating these oddities from the social withdrawal seen in schizoid or avoidant
personalities.
,2. A patient displays a long-standing pattern of unstable interpersonal relationships, an
unstable self-image, and marked impulsivity. During the intake, the patient expresses intense
fear of being left alone by the provider. What is the most likely diagnosis?
A. Antisocial Personality Disorder
B. Histrionic Personality Disorder
C. Narcissistic Personality Disorder
D. Borderline Personality Disorder
Answer: D
Rationale: Borderline Personality Disorder is characterized by a frantic effort to avoid real
or imagined abandonment. The disorder involves a pattern of instability in affects and
marked impulsivity beginning by early adulthood. Diagnostic criteria also include recurrent
suicidal behavior or self-mutilating acts.
3. Which of the following is a mandatory criterion for a diagnosis of Antisocial Personality
Disorder?
A. Evidence of Conduct Disorder with onset before age 15 years.
B. The individual is at least 21 years of age.
C. Presence of hallucinations or delusions.
D. The symptoms occur exclusively during the course of schizophrenia.
Answer: A
,Rationale: To diagnose Antisocial Personality Disorder, there must be evidence of Conduct
Disorder before age 15. The individual must also be at least 18 years of age at the time of
diagnosis. This historical component is essential to distinguish the disorder from adult-
onset criminal behavior or substance-induced irritability.
4. A patient is preoccupied with orderliness, perfectionism, and mental and interpersonal
control at the expense of flexibility and efficiency. These traits are ego-syntonic and have
persisted since early adulthood. What is the diagnosis?
A. Obsessive-Compulsive Disorder
B. Obsessive-Compulsive Personality Disorder
C. Dependent Personality Disorder
D. Avoidant Personality Disorder
Answer: B
Rationale: Obsessive-Compulsive Personality Disorder (OCPD) is characterized by a
preoccupation with perfectionism and control. Unlike OCD, OCPD is generally ego-syntonic,
meaning the individual perceives their traits as desirable or correct. Diagnosis focuses on
the rigid adherence to rules and inability to delegate tasks.
5. An 80-year-old female experiences a sudden onset of confusion, fluctuating levels of
consciousness, and an inability to focus her attention following a hip surgery. What is the
most likely clinical condition?
A. Depressive Pseudodementia
, B. Major Neurocognitive Disorder due to Alzheimer’s
C. Vascular Dementia
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute disturbance in attention and awareness
that develops over a short period. It represents a change from baseline and tends to
fluctuate in severity during the day. Medical evaluation is necessary to identify the
underlying physiological cause, such as post-operative infection or medication toxicity.
6. Which neurocognitive disorder is characterized by early-onset deficits in social cognition
and executive function, often preceding significant memory loss?
A. Alzheimer’s Disease
B. Frontotemporal Neurocognitive Disorder
C. Vascular Dementia
D. Prion Disease
Answer: B
Rationale: Frontotemporal Neurocognitive Disorder involves progressive changes in
personality, behavior, and language. Behavioral variants often present with disinhibition,
apathy, and loss of empathy. Memory and visuospatial functions are typically preserved in
the early stages compared to Alzheimer’s disease.
