NRNP 6635 PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING FINAL EXAM
PREP QUESTIONS AND ANSWERS
1. A 24-year-old patient presents with a 2-week history of persistently elevated mood,
decreased need for sleep (3 hours per night), pressured speech, and grandiosity. However,
the symptoms are not severe enough to cause marked impairment in social or occupational
functioning, and there are no psychotic features. What is the most likely diagnosis?
A. Bipolar I Disorder, Manic Episode
B. Major Depressive Disorder with Mixed Features
C. Cyclothymic Disorder
D. Bipolar II Disorder, Hypomanic Episode
Answer: D
Conceptual Explanation: Hypomania is defined by a distinct period of elevated mood
lasting at least 4 consecutive days, but it does not cause marked impairment in functioning
or require hospitalization, unlike mania in Bipolar I.
,2. Which dopamine pathway is primarily associated with the negative symptoms of
Schizophrenia, such as alogia and avolition?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: Hypofunction of the mesocortical dopamine pathway is
hypothesized to lead to the negative and cognitive symptoms of schizophrenia, while
hyperactivity in the mesolimbic pathway relates to positive symptoms.
3. In differentiating Delirium from Neurocognitive Disorder (Dementia), which clinical feature
is most characteristic of Delirium?
A. Fluctuating level of consciousness
B. Gradual onset over years
C. Intact attention until late stages
D. Irreversible cognitive decline
Answer: A
, Conceptual Explanation: Delirium is characterized by an acute onset and a fluctuating
course, particularly regarding levels of consciousness and attention, whereas dementia is
typically progressive and stable.
4. A patient exhibits a pervasive pattern of detachment from social relationships and a
restricted range of expression of emotions in interpersonal settings. They neither desire nor
enjoy close relationships. Which personality disorder is most likely?
A. Schizotypal Personality Disorder
B. Schizoid Personality Disorder
C. Avoidant Personality Disorder
D. Antisocial Personality Disorder
Answer: B
Conceptual Explanation: Schizoid Personality Disorder is characterized by social
detachment and restricted affect. Unlike Schizotypal, it lacks the cognitive or perceptual
distortions.
5. To meet the DSM-5-TR criteria for Major Depressive Disorder, at least one of the five
required symptoms must be either depressed mood or:
A. Significant weight loss
B. Psychomotor agitation
C. Loss of interest or pleasure (anhedonia)
DIAGNOSTIC REASONING FINAL EXAM
PREP QUESTIONS AND ANSWERS
1. A 24-year-old patient presents with a 2-week history of persistently elevated mood,
decreased need for sleep (3 hours per night), pressured speech, and grandiosity. However,
the symptoms are not severe enough to cause marked impairment in social or occupational
functioning, and there are no psychotic features. What is the most likely diagnosis?
A. Bipolar I Disorder, Manic Episode
B. Major Depressive Disorder with Mixed Features
C. Cyclothymic Disorder
D. Bipolar II Disorder, Hypomanic Episode
Answer: D
Conceptual Explanation: Hypomania is defined by a distinct period of elevated mood
lasting at least 4 consecutive days, but it does not cause marked impairment in functioning
or require hospitalization, unlike mania in Bipolar I.
,2. Which dopamine pathway is primarily associated with the negative symptoms of
Schizophrenia, such as alogia and avolition?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: Hypofunction of the mesocortical dopamine pathway is
hypothesized to lead to the negative and cognitive symptoms of schizophrenia, while
hyperactivity in the mesolimbic pathway relates to positive symptoms.
3. In differentiating Delirium from Neurocognitive Disorder (Dementia), which clinical feature
is most characteristic of Delirium?
A. Fluctuating level of consciousness
B. Gradual onset over years
C. Intact attention until late stages
D. Irreversible cognitive decline
Answer: A
, Conceptual Explanation: Delirium is characterized by an acute onset and a fluctuating
course, particularly regarding levels of consciousness and attention, whereas dementia is
typically progressive and stable.
4. A patient exhibits a pervasive pattern of detachment from social relationships and a
restricted range of expression of emotions in interpersonal settings. They neither desire nor
enjoy close relationships. Which personality disorder is most likely?
A. Schizotypal Personality Disorder
B. Schizoid Personality Disorder
C. Avoidant Personality Disorder
D. Antisocial Personality Disorder
Answer: B
Conceptual Explanation: Schizoid Personality Disorder is characterized by social
detachment and restricted affect. Unlike Schizotypal, it lacks the cognitive or perceptual
distortions.
5. To meet the DSM-5-TR criteria for Major Depressive Disorder, at least one of the five
required symptoms must be either depressed mood or:
A. Significant weight loss
B. Psychomotor agitation
C. Loss of interest or pleasure (anhedonia)
