NR 547 Week 8 Final Exam 2026
QUESTION 1
A 45-year-old male presents with a 2-week history of depressed mood, anhedonia,
significant weight loss, insomnia, fatigue, feelings of worthlessness, and difficulty
concentrating. He reports these symptoms began after losing his job. He has no history
of manic episodes. Which is the most appropriate diagnosis?
A) Major Depressive Disorder, Single Episode
B) Persistent Depressive Disorder
C) Adjustment Disorder with Depressed Mood
D) Major Depressive Disorder with Psychotic Features
CORRECT ANSWER: A) Major Depressive Disorder, Single Episode
RATIONALE: Major Depressive Disorder (MDD) requires at least 5 depressive symptoms
(depressed mood, anhedonia, weight change, sleep disturbance, fatigue, worthlessness,
concentration difficulty) present for at least 2 weeks, causing significant distress. The
symptoms began after a stressor but meet full MDD criteria. Persistent Depressive Disorder
requires 2 years of symptoms. Adjustment Disorder is subthreshold and occurs within 3
months of a stressor.
,QUESTION 2
A 28-year-old female presents with a history of extreme mood swings. She describes
periods of 5 days with elevated mood, decreased need for sleep, grandiosity, and racing
thoughts, followed by 2-week periods of deep depression with hypersomnia and
suicidal ideation. Between these episodes, she functions normally. Which is the most
likely diagnosis?
A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Major Depressive Disorder
CORRECT ANSWER: A) Bipolar I Disorder
RATIONALE: Bipolar I Disorder is diagnosed when a patient has experienced at least one
manic episode lasting at least 7 days (or requiring hospitalization). Mania is characterized
by elevated mood, grandiosity, decreased need for sleep, racing thoughts, and impaired
functioning. Depressive episodes are common but not required for diagnosis. Bipolar II
requires hypomania (not full mania) and major depressive episodes.
QUESTION 3
A 16-year-old male is brought to the clinic by his parents who report he has been
"acting out" for the past 6 months. He has been suspended from school for fighting,
,runs away from home, and has been cruel to animals. He shows no remorse for his
actions. Which is the most likely diagnosis?
A) Oppositional Defiant Disorder
B) Conduct Disorder
C) Intermittent Explosive Disorder
D) Attention-Deficit/Hyperactivity Disorder
CORRECT ANSWER: B) Conduct Disorder
RATIONALE: Conduct Disorder is characterized by a repetitive and persistent pattern of
behavior that violates the rights of others or major age-appropriate societal norms.
Behaviors include aggression to people and animals (fighting, cruelty to animals),
destruction of property, deceitfulness, and serious rule violations. Lack of remorse is a
hallmark feature. Oppositional Defiant Disorder involves angry/irritable mood and
argumentative behavior without the severe aggression seen in Conduct Disorder.
QUESTION 4
A 55-year-old male with a history of alcohol use disorder presents with confusion,
ataxia, and ophthalmoplegia. His family reports he has been drinking heavily for the past
month and has not been eating well. Which is the most likely diagnosis?
A) Wernicke's Encephalopathy
B) Korsakoff Syndrome
C) Delirium Tremens
D) Hepatic Encephalopathy
, CORRECT ANSWER: A) Wernicke's Encephalopathy
RATIONALE: Wernicke's Encephalopathy is a neurologic emergency caused by thiamine
(vitamin B1) deficiency, commonly seen in alcohol use disorder. The classic triad includes
confusion, ataxia (gait disturbance), and ophthalmoplegia (eye movement abnormalities).
Korsakoff Syndrome is a chronic complication characterized by profound memory
impairment and confabulation. Delirium Tremens is alcohol withdrawal with severe
autonomic instability.
QUESTION 5
A 38-year-old female presents with a 3-month history of recurrent, unexpected panic
attacks. She reports she is constantly worried about having another attack and has
changed her behavior by avoiding exercise and crowded places. Which is the most
appropriate diagnosis?
A) Panic Disorder
B) Agoraphobia
C) Panic Disorder with Agoraphobia
D) Specific Phobia
CORRECT ANSWER: C) Panic Disorder with Agoraphobia
RATIONALE: Panic Disorder is characterized by recurrent, unexpected panic attacks
followed by at least 1 month of persistent concern about additional attacks or maladaptive
QUESTION 1
A 45-year-old male presents with a 2-week history of depressed mood, anhedonia,
significant weight loss, insomnia, fatigue, feelings of worthlessness, and difficulty
concentrating. He reports these symptoms began after losing his job. He has no history
of manic episodes. Which is the most appropriate diagnosis?
A) Major Depressive Disorder, Single Episode
B) Persistent Depressive Disorder
C) Adjustment Disorder with Depressed Mood
D) Major Depressive Disorder with Psychotic Features
CORRECT ANSWER: A) Major Depressive Disorder, Single Episode
RATIONALE: Major Depressive Disorder (MDD) requires at least 5 depressive symptoms
(depressed mood, anhedonia, weight change, sleep disturbance, fatigue, worthlessness,
concentration difficulty) present for at least 2 weeks, causing significant distress. The
symptoms began after a stressor but meet full MDD criteria. Persistent Depressive Disorder
requires 2 years of symptoms. Adjustment Disorder is subthreshold and occurs within 3
months of a stressor.
,QUESTION 2
A 28-year-old female presents with a history of extreme mood swings. She describes
periods of 5 days with elevated mood, decreased need for sleep, grandiosity, and racing
thoughts, followed by 2-week periods of deep depression with hypersomnia and
suicidal ideation. Between these episodes, she functions normally. Which is the most
likely diagnosis?
A) Bipolar I Disorder
B) Bipolar II Disorder
C) Cyclothymic Disorder
D) Major Depressive Disorder
CORRECT ANSWER: A) Bipolar I Disorder
RATIONALE: Bipolar I Disorder is diagnosed when a patient has experienced at least one
manic episode lasting at least 7 days (or requiring hospitalization). Mania is characterized
by elevated mood, grandiosity, decreased need for sleep, racing thoughts, and impaired
functioning. Depressive episodes are common but not required for diagnosis. Bipolar II
requires hypomania (not full mania) and major depressive episodes.
QUESTION 3
A 16-year-old male is brought to the clinic by his parents who report he has been
"acting out" for the past 6 months. He has been suspended from school for fighting,
,runs away from home, and has been cruel to animals. He shows no remorse for his
actions. Which is the most likely diagnosis?
A) Oppositional Defiant Disorder
B) Conduct Disorder
C) Intermittent Explosive Disorder
D) Attention-Deficit/Hyperactivity Disorder
CORRECT ANSWER: B) Conduct Disorder
RATIONALE: Conduct Disorder is characterized by a repetitive and persistent pattern of
behavior that violates the rights of others or major age-appropriate societal norms.
Behaviors include aggression to people and animals (fighting, cruelty to animals),
destruction of property, deceitfulness, and serious rule violations. Lack of remorse is a
hallmark feature. Oppositional Defiant Disorder involves angry/irritable mood and
argumentative behavior without the severe aggression seen in Conduct Disorder.
QUESTION 4
A 55-year-old male with a history of alcohol use disorder presents with confusion,
ataxia, and ophthalmoplegia. His family reports he has been drinking heavily for the past
month and has not been eating well. Which is the most likely diagnosis?
A) Wernicke's Encephalopathy
B) Korsakoff Syndrome
C) Delirium Tremens
D) Hepatic Encephalopathy
, CORRECT ANSWER: A) Wernicke's Encephalopathy
RATIONALE: Wernicke's Encephalopathy is a neurologic emergency caused by thiamine
(vitamin B1) deficiency, commonly seen in alcohol use disorder. The classic triad includes
confusion, ataxia (gait disturbance), and ophthalmoplegia (eye movement abnormalities).
Korsakoff Syndrome is a chronic complication characterized by profound memory
impairment and confabulation. Delirium Tremens is alcohol withdrawal with severe
autonomic instability.
QUESTION 5
A 38-year-old female presents with a 3-month history of recurrent, unexpected panic
attacks. She reports she is constantly worried about having another attack and has
changed her behavior by avoiding exercise and crowded places. Which is the most
appropriate diagnosis?
A) Panic Disorder
B) Agoraphobia
C) Panic Disorder with Agoraphobia
D) Specific Phobia
CORRECT ANSWER: C) Panic Disorder with Agoraphobia
RATIONALE: Panic Disorder is characterized by recurrent, unexpected panic attacks
followed by at least 1 month of persistent concern about additional attacks or maladaptive
