1
NRNP MIDTERM EXAM (V1) - ACTUAL EXAM 2026/2027 |
COMPLETE COURSE REVIEW | EXPERT VERIFIED | 100
VERIFIED Q&A | COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
QUESTION 1
A 32-year-old female presents with a 4-week history of depressed mood, anhedonia, significant weight loss,
insomnia, psychomotor agitation, fatigue, feelings of worthlessness, and diminished ability to concentrate.
She reports these symptoms cause clinically significant distress and impair her social functioning. Which
DSM-5-TR diagnosis is most appropriate?
A) Major Depressive Disorder, Single Episode, Severe
B) Major Depressive Disorder, Recurrent Episode, Moderate
C) Major Depressive Disorder, Single Episode, Moderate
D) Persistent Depressive Disorder (Dysthymia)
Correct Answer: C
Rationale: The patient meets criteria for Major Depressive Disorder with at least 5 symptoms present for a
minimum of 2 weeks, including depressed mood or anhedonia. The presence of 8 symptoms indicates
moderate severity. Since the question does not specify prior episodes, "Single Episode" is most appropriate.
"Recurrent" would be used if there were prior episodes. "Persistent Depressive Disorder" requires symptoms
for at least 2 years. "Severe" would require psychotic features or significant functional impairment.
QUESTION 2
A 45-year-old male presents with a 2-year history of excessive anxiety and worry about work, health, and
family. He reports difficulty controlling the worry, restlessness, fatigue, difficulty concentrating, irritability,
muscle tension, and sleep disturbance. Which diagnosis is most appropriate?
A) Panic Disorder
B) Generalized Anxiety Disorder
C) Social Anxiety Disorder
D) Obsessive-Compulsive Disorder
Correct Answer: B
,2
Rationale: Generalized Anxiety Disorder requires excessive anxiety and worry about various topics occurring
more days than not for at least 6 months, difficulty controlling the worry, and 3 or more associated symptoms
(restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance). The patient
meets criteria with 2-year duration, excessive worry, difficulty controlling worry, and 6 associated symptoms.
QUESTION 3
A 28-year-old male presents with a 3-month history of auditory hallucinations, delusions of persecution,
disorganized speech, and negative symptoms including flat affect and avolition. Symptoms have persisted for
4 months total. Which diagnosis is most appropriate?
A) Schizophrenia
B) Schizophreniform Disorder
C) Brief Psychotic Disorder
D) Schizoaffective Disorder
Correct Answer: B
Rationale: Schizophreniform Disorder is diagnosed when the patient meets criteria for schizophrenia
including 2 or more core symptoms (delusions, hallucinations, disorganized speech, grossly
disorganized/catatonic behavior, negative symptoms) for a significant portion of time during a 1-month
period, but the total duration of illness is between 1 and 6 months. The patient has a 4-month duration,
meeting criteria for Schizophreniform Disorder. Schizophrenia requires at least 6 months. Brief Psychotic
Disorder requires 1 day to 1 month.
QUESTION 4
A 55-year-old female presents with episodes of elevated mood, decreased need for sleep, racing thoughts,
distractibility, and increased goal-directed activity lasting 6 days. She reports these episodes alternate with
periods of depression lasting 2 weeks. During the current episode, she has no psychotic features and does not
require hospitalization. Which diagnosis is most appropriate?
A) Bipolar I Disorder, Current Episode Manic
B) Bipolar II Disorder, Current Episode Hypomanic
C) Cyclothymic Disorder
D) Bipolar I Disorder, Current Episode Hypomanic
Correct Answer: B
,3
Rationale: Bipolar II Disorder requires at least one hypomanic episode and one major depressive episode.
Hypomanic episodes last at least 4 consecutive days (the patient reports 6 days) and include elevated mood
plus 3 or more associated symptoms. The absence of psychotic features and no need for hospitalization
distinguishes hypomania from mania. Cyclothymic Disorder requires 2+ years of hypomanic and depressive
symptoms not meeting full criteria.
QUESTION 5
A 62-year-old male presents with progressive memory loss, difficulty with executive functioning, and
behavioral changes over the past 3 years. Brain imaging reveals hippocampal atrophy. Which of the following
is the most likely diagnosis?
A) Vascular Neurocognitive Disorder
B) Frontotemporal Neurocognitive Disorder
C) Neurocognitive Disorder Due to Alzheimer's Disease
D) Neurocognitive Disorder with Lewy Bodies
Correct Answer: C
Rationale: Alzheimer's disease is characterized by gradual onset and progressive cognitive decline, with
prominent memory impairment and hippocampal atrophy on imaging. The patient's age (62), progressive
memory loss, executive dysfunction, behavioral changes, and hippocampal atrophy are classic findings.
Vascular NCD typically has stepwise deterioration with focal neurological signs. Frontotemporal NCD
presents with prominent behavioral/personality changes early. Lewy Body NCD features visual hallucinations
and Parkinsonism.
QUESTION 6
A 38-year-old female with a history of trauma presents with recurrent, involuntary, distressing memories of
the event, recurrent nightmares, flashbacks, and intense psychological distress at exposure to cues resembling
the trauma. She reports avoiding thoughts, feelings, and external reminders of the event. Symptoms have been
present for 6 weeks. Which of the following is the most appropriate diagnosis?
A) Acute Stress Disorder
B) Posttraumatic Stress Disorder, Acute
C) Adjustment Disorder
D) Posttraumatic Stress Disorder, with Dissociative Symptoms
Correct Answer: B
, 4
Rationale: PTSD requires exposure to actual or threatened death, serious injury, or sexual violence, with
symptoms from all 4 clusters (intrusion, avoidance, negative alterations in cognition/mood, alterations in
arousal/reactivity) persisting for more than 1 month. The patient's symptoms have been present for 6 weeks,
meeting the acute PTSD criteria (symptoms < 3 months). Acute Stress Disorder is diagnosed when symptoms
last 3 days to 1 month. Adjustment Disorder involves emotional/behavioral symptoms in response to
identifiable stressors.
QUESTION 7
A 50-year-old male with a 25-year history of alcohol use disorder presents with memory impairment,
confabulation, ataxia, and ophthalmoplegia. Which of the following is the most likely diagnosis?
A) Alzheimer's Disease
B) Wernicke-Korsakoff Syndrome
C) Vascular Dementia
D) Frontotemporal Dementia
Correct Answer: B
Rationale: Wernicke-Korsakoff Syndrome is caused by thiamine (vitamin B1) deficiency, most commonly
associated with chronic alcohol use disorder. The classic triad includes: (1) Wernicke's encephalopathy -
confusion, ophthalmoplegia, ataxia; (2) Korsakoff's syndrome - anterograde and retrograde amnesia with
confabulation. The combination of memory impairment, confabulation, ataxia, and ophthalmoplegia in a
patient with chronic alcohol use is pathognomonic.
QUESTION 8
A 16-year-old female presents with restriction of energy intake leading to significantly low body weight (BMI
16.0), intense fear of gaining weight, and disturbance in self-perceived weight/shape. She denies binge eating
or purging behaviors. Which of the following is the most appropriate diagnosis?
A) Anorexia Nervosa, Restricting Type
B) Anorexia Nervosa, Binge-Eating/Purging Type
C) Bulimia Nervosa
D) Avoidant/Restrictive Food Intake Disorder
Correct Answer: A
Rationale: Anorexia Nervosa, Restricting Type is diagnosed when the patient meets all criteria for Anorexia
Nervosa (significantly low weight, intense fear of gaining weight, disturbance in self-perceived weight/shape)
NRNP MIDTERM EXAM (V1) - ACTUAL EXAM 2026/2027 |
COMPLETE COURSE REVIEW | EXPERT VERIFIED | 100
VERIFIED Q&A | COMPLETE RATIONALES | PASS
GUARANTEED - A+ GRADED
QUESTION 1
A 32-year-old female presents with a 4-week history of depressed mood, anhedonia, significant weight loss,
insomnia, psychomotor agitation, fatigue, feelings of worthlessness, and diminished ability to concentrate.
She reports these symptoms cause clinically significant distress and impair her social functioning. Which
DSM-5-TR diagnosis is most appropriate?
A) Major Depressive Disorder, Single Episode, Severe
B) Major Depressive Disorder, Recurrent Episode, Moderate
C) Major Depressive Disorder, Single Episode, Moderate
D) Persistent Depressive Disorder (Dysthymia)
Correct Answer: C
Rationale: The patient meets criteria for Major Depressive Disorder with at least 5 symptoms present for a
minimum of 2 weeks, including depressed mood or anhedonia. The presence of 8 symptoms indicates
moderate severity. Since the question does not specify prior episodes, "Single Episode" is most appropriate.
"Recurrent" would be used if there were prior episodes. "Persistent Depressive Disorder" requires symptoms
for at least 2 years. "Severe" would require psychotic features or significant functional impairment.
QUESTION 2
A 45-year-old male presents with a 2-year history of excessive anxiety and worry about work, health, and
family. He reports difficulty controlling the worry, restlessness, fatigue, difficulty concentrating, irritability,
muscle tension, and sleep disturbance. Which diagnosis is most appropriate?
A) Panic Disorder
B) Generalized Anxiety Disorder
C) Social Anxiety Disorder
D) Obsessive-Compulsive Disorder
Correct Answer: B
,2
Rationale: Generalized Anxiety Disorder requires excessive anxiety and worry about various topics occurring
more days than not for at least 6 months, difficulty controlling the worry, and 3 or more associated symptoms
(restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance). The patient
meets criteria with 2-year duration, excessive worry, difficulty controlling worry, and 6 associated symptoms.
QUESTION 3
A 28-year-old male presents with a 3-month history of auditory hallucinations, delusions of persecution,
disorganized speech, and negative symptoms including flat affect and avolition. Symptoms have persisted for
4 months total. Which diagnosis is most appropriate?
A) Schizophrenia
B) Schizophreniform Disorder
C) Brief Psychotic Disorder
D) Schizoaffective Disorder
Correct Answer: B
Rationale: Schizophreniform Disorder is diagnosed when the patient meets criteria for schizophrenia
including 2 or more core symptoms (delusions, hallucinations, disorganized speech, grossly
disorganized/catatonic behavior, negative symptoms) for a significant portion of time during a 1-month
period, but the total duration of illness is between 1 and 6 months. The patient has a 4-month duration,
meeting criteria for Schizophreniform Disorder. Schizophrenia requires at least 6 months. Brief Psychotic
Disorder requires 1 day to 1 month.
QUESTION 4
A 55-year-old female presents with episodes of elevated mood, decreased need for sleep, racing thoughts,
distractibility, and increased goal-directed activity lasting 6 days. She reports these episodes alternate with
periods of depression lasting 2 weeks. During the current episode, she has no psychotic features and does not
require hospitalization. Which diagnosis is most appropriate?
A) Bipolar I Disorder, Current Episode Manic
B) Bipolar II Disorder, Current Episode Hypomanic
C) Cyclothymic Disorder
D) Bipolar I Disorder, Current Episode Hypomanic
Correct Answer: B
,3
Rationale: Bipolar II Disorder requires at least one hypomanic episode and one major depressive episode.
Hypomanic episodes last at least 4 consecutive days (the patient reports 6 days) and include elevated mood
plus 3 or more associated symptoms. The absence of psychotic features and no need for hospitalization
distinguishes hypomania from mania. Cyclothymic Disorder requires 2+ years of hypomanic and depressive
symptoms not meeting full criteria.
QUESTION 5
A 62-year-old male presents with progressive memory loss, difficulty with executive functioning, and
behavioral changes over the past 3 years. Brain imaging reveals hippocampal atrophy. Which of the following
is the most likely diagnosis?
A) Vascular Neurocognitive Disorder
B) Frontotemporal Neurocognitive Disorder
C) Neurocognitive Disorder Due to Alzheimer's Disease
D) Neurocognitive Disorder with Lewy Bodies
Correct Answer: C
Rationale: Alzheimer's disease is characterized by gradual onset and progressive cognitive decline, with
prominent memory impairment and hippocampal atrophy on imaging. The patient's age (62), progressive
memory loss, executive dysfunction, behavioral changes, and hippocampal atrophy are classic findings.
Vascular NCD typically has stepwise deterioration with focal neurological signs. Frontotemporal NCD
presents with prominent behavioral/personality changes early. Lewy Body NCD features visual hallucinations
and Parkinsonism.
QUESTION 6
A 38-year-old female with a history of trauma presents with recurrent, involuntary, distressing memories of
the event, recurrent nightmares, flashbacks, and intense psychological distress at exposure to cues resembling
the trauma. She reports avoiding thoughts, feelings, and external reminders of the event. Symptoms have been
present for 6 weeks. Which of the following is the most appropriate diagnosis?
A) Acute Stress Disorder
B) Posttraumatic Stress Disorder, Acute
C) Adjustment Disorder
D) Posttraumatic Stress Disorder, with Dissociative Symptoms
Correct Answer: B
, 4
Rationale: PTSD requires exposure to actual or threatened death, serious injury, or sexual violence, with
symptoms from all 4 clusters (intrusion, avoidance, negative alterations in cognition/mood, alterations in
arousal/reactivity) persisting for more than 1 month. The patient's symptoms have been present for 6 weeks,
meeting the acute PTSD criteria (symptoms < 3 months). Acute Stress Disorder is diagnosed when symptoms
last 3 days to 1 month. Adjustment Disorder involves emotional/behavioral symptoms in response to
identifiable stressors.
QUESTION 7
A 50-year-old male with a 25-year history of alcohol use disorder presents with memory impairment,
confabulation, ataxia, and ophthalmoplegia. Which of the following is the most likely diagnosis?
A) Alzheimer's Disease
B) Wernicke-Korsakoff Syndrome
C) Vascular Dementia
D) Frontotemporal Dementia
Correct Answer: B
Rationale: Wernicke-Korsakoff Syndrome is caused by thiamine (vitamin B1) deficiency, most commonly
associated with chronic alcohol use disorder. The classic triad includes: (1) Wernicke's encephalopathy -
confusion, ophthalmoplegia, ataxia; (2) Korsakoff's syndrome - anterograde and retrograde amnesia with
confabulation. The combination of memory impairment, confabulation, ataxia, and ophthalmoplegia in a
patient with chronic alcohol use is pathognomonic.
QUESTION 8
A 16-year-old female presents with restriction of energy intake leading to significantly low body weight (BMI
16.0), intense fear of gaining weight, and disturbance in self-perceived weight/shape. She denies binge eating
or purging behaviors. Which of the following is the most appropriate diagnosis?
A) Anorexia Nervosa, Restricting Type
B) Anorexia Nervosa, Binge-Eating/Purging Type
C) Bulimia Nervosa
D) Avoidant/Restrictive Food Intake Disorder
Correct Answer: A
Rationale: Anorexia Nervosa, Restricting Type is diagnosed when the patient meets all criteria for Anorexia
Nervosa (significantly low weight, intense fear of gaining weight, disturbance in self-perceived weight/shape)
