NRNP 6665 Midterm Exam Prep Test Bank
| Questions 101-200 with Verified Answers
& Rationales (Latest 2026/2027)
,Question 1
A 7-year-old male is brought to the clinic by his mother, who reports he is
"constantly in motion," interrupts conversations, cannot wait his turn in line,
and frequently loses his schoolwork. The teacher notes these behaviors severely
impair his academic performance and social relationships at school. Symptoms
have been consistently present for 9 months. To meet the DSM-5-TR diagnostic
criteria for Attention-Deficit/Hyperactivity Disorder (ADHD), which of the
following chronological requirements must also be verified?
A) The symptoms must have been present and recognized prior to age 5.
B) Several inattentive or hyperactive-impulsive symptoms must have been
present prior to age 12.
C) The behavioral symptoms must manifest after entering structured primary
schooling.
D) Symptoms must have a documented onset before the age of 7.
Answer: B) Several inattentive or hyperactive-impulsive symptoms must have
been present prior to age 12.
Explanation: The DSM-5-TR requires that several inattentive or hyperactive-
impulsive symptoms must be present before age 12 to establish the
neurodevelopmental trajectory of ADHD. This was an update from older
DSM editions, which mandated an onset before age 7. Options A and D
reflect outdated criteria or incorrect age thresholds. Option C is clinically
incorrect, as symptoms can be present in preschool or home settings prior to
formal primary education, though they often become more impairing once
structured schooling begins.
Question 2
,A 24-year-old female patient diagnosed with schizophrenia is initiated on
haloperidol. Within 48 hours of starting the medication, she develops severe,
painful twisting contractions of her neck muscles (torticollis) and upward
deviation of her eyes. Which of the following neurotransmitter pathways is
directly implicated in the genesis of these extrapyramidal side effects (EPS)?
A) Mesolimbic pathway
B) Mesocortical pathway
C) Nigrostriatal pathway
D) Tuberoinfundibular pathway
Answer: C) Nigrostriatal pathway
Explanation: Extrapyramidal symptoms (EPS), such as the acute dystonic
reaction described here, are caused by potent dopamine D2 receptor
antagonism within the nigrostriatal pathway, which regulates voluntary motor
movements. Option A (mesolimbic) is the pathway where dopamine blockade
reduces positive symptoms like hallucinations. Option B (mesocortical) is
associated with negative and cognitive symptoms. Option D
(tuberoinfundibular) regulates prolactin secretion; blocking dopamine here
leads to hyperprolactinemia, galactorrhea, and gynecomastia.
Question 3
During a diagnostic evaluation, the parents of an 8-year-old child report that he
shows marked deficits in nonverbal communication, fails to develop peer
relationships appropriate to his developmental level, exhibits an inflexible
adherence to specific, nonfunctional routines, and demonstrates a persistent
preoccupation with parts of objects (e.g., spinning wheels). According to the
, DSM-5-TR criteria for Autism Spectrum Disorder (ASD), which of the
following is correct regarding clinical presentations?
A) Symptoms must be completely absent until early adolescence.
B) Intellectual disability must be concurrently diagnosed to satisfy the clinical
criteria.
C) Symptoms must be present in the early developmental period, though they
may not fully manifest until social demands exceed limited capacities.
D) Persistent deficits in social communication are sufficient for diagnosis
without restrictive, repetitive behaviors.
Answer: C) Symptoms must be present in the early developmental period,
though they may not fully manifest until social demands exceed limited
capacities.
Explanation: The DSM-5-TR establishes that the core behavioral features of
Autism Spectrum Disorder must be present in early childhood. However, they
may remain masked or unnoticeable until social interactions become more
complex in later childhood or adolescence. Option A is incorrect because ASD
is a neurodevelopmental disorder originating in early life. Option B is
incorrect; while intellectual disability frequently co-occurs with ASD, it is a
specifier and not a mandatory diagnostic criterion. Option D is incorrect
because a definitive diagnosis requires meeting criteria in both core domains:
social communication deficits AND restricted, repetitive patterns of behavior.
Question 4
A PMHNP is reviewing relaxation therapy modalities with a 38-year-old patient
suffering from generalized anxiety disorder. The patient expresses a desire for
| Questions 101-200 with Verified Answers
& Rationales (Latest 2026/2027)
,Question 1
A 7-year-old male is brought to the clinic by his mother, who reports he is
"constantly in motion," interrupts conversations, cannot wait his turn in line,
and frequently loses his schoolwork. The teacher notes these behaviors severely
impair his academic performance and social relationships at school. Symptoms
have been consistently present for 9 months. To meet the DSM-5-TR diagnostic
criteria for Attention-Deficit/Hyperactivity Disorder (ADHD), which of the
following chronological requirements must also be verified?
A) The symptoms must have been present and recognized prior to age 5.
B) Several inattentive or hyperactive-impulsive symptoms must have been
present prior to age 12.
C) The behavioral symptoms must manifest after entering structured primary
schooling.
D) Symptoms must have a documented onset before the age of 7.
Answer: B) Several inattentive or hyperactive-impulsive symptoms must have
been present prior to age 12.
Explanation: The DSM-5-TR requires that several inattentive or hyperactive-
impulsive symptoms must be present before age 12 to establish the
neurodevelopmental trajectory of ADHD. This was an update from older
DSM editions, which mandated an onset before age 7. Options A and D
reflect outdated criteria or incorrect age thresholds. Option C is clinically
incorrect, as symptoms can be present in preschool or home settings prior to
formal primary education, though they often become more impairing once
structured schooling begins.
Question 2
,A 24-year-old female patient diagnosed with schizophrenia is initiated on
haloperidol. Within 48 hours of starting the medication, she develops severe,
painful twisting contractions of her neck muscles (torticollis) and upward
deviation of her eyes. Which of the following neurotransmitter pathways is
directly implicated in the genesis of these extrapyramidal side effects (EPS)?
A) Mesolimbic pathway
B) Mesocortical pathway
C) Nigrostriatal pathway
D) Tuberoinfundibular pathway
Answer: C) Nigrostriatal pathway
Explanation: Extrapyramidal symptoms (EPS), such as the acute dystonic
reaction described here, are caused by potent dopamine D2 receptor
antagonism within the nigrostriatal pathway, which regulates voluntary motor
movements. Option A (mesolimbic) is the pathway where dopamine blockade
reduces positive symptoms like hallucinations. Option B (mesocortical) is
associated with negative and cognitive symptoms. Option D
(tuberoinfundibular) regulates prolactin secretion; blocking dopamine here
leads to hyperprolactinemia, galactorrhea, and gynecomastia.
Question 3
During a diagnostic evaluation, the parents of an 8-year-old child report that he
shows marked deficits in nonverbal communication, fails to develop peer
relationships appropriate to his developmental level, exhibits an inflexible
adherence to specific, nonfunctional routines, and demonstrates a persistent
preoccupation with parts of objects (e.g., spinning wheels). According to the
, DSM-5-TR criteria for Autism Spectrum Disorder (ASD), which of the
following is correct regarding clinical presentations?
A) Symptoms must be completely absent until early adolescence.
B) Intellectual disability must be concurrently diagnosed to satisfy the clinical
criteria.
C) Symptoms must be present in the early developmental period, though they
may not fully manifest until social demands exceed limited capacities.
D) Persistent deficits in social communication are sufficient for diagnosis
without restrictive, repetitive behaviors.
Answer: C) Symptoms must be present in the early developmental period,
though they may not fully manifest until social demands exceed limited
capacities.
Explanation: The DSM-5-TR establishes that the core behavioral features of
Autism Spectrum Disorder must be present in early childhood. However, they
may remain masked or unnoticeable until social interactions become more
complex in later childhood or adolescence. Option A is incorrect because ASD
is a neurodevelopmental disorder originating in early life. Option B is
incorrect; while intellectual disability frequently co-occurs with ASD, it is a
specifier and not a mandatory diagnostic criterion. Option D is incorrect
because a definitive diagnosis requires meeting criteria in both core domains:
social communication deficits AND restricted, repetitive patterns of behavior.
Question 4
A PMHNP is reviewing relaxation therapy modalities with a 38-year-old patient
suffering from generalized anxiety disorder. The patient expresses a desire for
